All my life I assumed that fixing was
about repairing something that is broken. The chain on my bike came off; my Dad
fixed it. I drove my electric train too fast around a bend in the track and it
fell off the table my Dad had built for the layout. Painstakingly, over many
weeks, he fixed it.  When I was two and
many times thereafter, serious illness affected my father. He almost died more
than once, but he always came back from the hospital. Fixed.

       I knew early on that I could never be the
engineer he was, nor have the skill with tools both big and small he could
wield. I could never fix ‘things’ like my Dad. So I set out to fix people. I
became a doctor and I truly believe that is why. The doctors had the magic that
fixed my father. I wanted the magic.

       Of course, I learned early in medical
school that there was no magic involved at all and if there was, it resided
with the patient not the doctor. Gradually, over 7 years of school, internship,
residency and fellowship, I became a medical man of science. There was no room
for magic in my world. If anything got fixed, it was because a doctor made the
correct diagnosis and implemented the proper treatment. It was fixing all
right, but it didn’t seem all that magical when I had attained the secret and
learned that there was no secret. It was hard learning, hard application of the
knowledge and hard work that was the only secret to medicine. Or so I thought.

       Once I learned as an oncologist, that it
was the rare patient that I could actually fix (cure), I turned my attention to
the laboratory where it was no longer about fixing but about discovering. I was
OK at that, but it never really grabbed me the way it did so many of my
colleagues at both the NCI and at Anderson. I think deep inside, I wanted to go
back to fixing.

       Let’s fix organizations, I thought. I was
struggling to keep my grants afloat and I was tired of the lab rut of a lab
rat. I went to business school to learn how to fix companies. After all, as
friend Marty Raber always says of me, “when the going gets tough, Len goes to

       I actually was able to fix some of the
broken processes serving the Anderson research faculty, but that gig, like so
many others in my life, ran out. I pissed off too many people and was way too
heavy handed with the club of the federal rulebook than I needed to be.

       Now what to fix?

       Here I am at Legacy Community Health
having fallen in to being the ad interim Chief Medical Officer. My major goal
in the 3 to 6 months I will have at this job is to heal the fairly common rift plaguing
American medicine. This is the divide between the clinicians delivering patient
care and the operations staffs with their hands on all the infrastructure to
allow the care to be delivered. It can be done here at Legacy, a far, far
smaller operation than MD Anderson where the same problem has been haunting the
cancer center for years. It will require some addressing as Legacy grows to
serve the needs of the less fortunate in Houston and beyond. Ditto MD Anderson.

       I might be able to help fix this at
Legacy. I was effectively locked out of helping at Anderson, which was probably just as well for me.

       I write about fixin’ today because all my
life, as I have reviewed, I thought it was an activity to repair things. Only
after I got to Texas did I realize it is a word that describes what you are
about to do or intend to do.

       “I’m fixin’ to rope that bull” or in my
case, “I’m fixin’ to drink that beer”.

       After a life of trying to surpass my
father at fixing things, I think right now I will be fixin’ to do less fixing
for soon enough it is I who will be fixed (as in formalin) and I don’t want to
spend the entirety of what life I have left, only trying to fix anything.
Except perhaps my golf swing.

       Some things are simply beyond repair. Is
MD Anderson one of them? Only you can decide if it is broken and if it is, can
it be fixed and if it can, do you want to do it. I no longer did and I no
longer could any way. I didn’t have the required skills nor was I among the
chosen (and I do mean CHOSEN) leaders, for there is no democracy at 1515.

       So all you faculty cowboys: What are you
fixin’ to do? 

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