The only thing more attractive to a
president of a major academic institution than a new building is a new building
that is attached to the money to pay for its erection before ground is broken. Without
the cash, bonds may need to be floated or reserves may need to be tapped or
capital campaigns initiated. Thus, the latest indulgence for the university
leader may require some accountability in the future if the plan to raise the
dough falls short. If he or she has a donor on the hook for the full price, he
or she is home free. Let the building begin!

There are usually two ways to get your name
on one of these buildings. The first is an honorific for unusual service to the
organization the new building will support. The Clark and LeMaistre Clinics and
Mendelsohn Faculty Center are examples of this at MD Anderson. Note that unless
you happen to have been the president of an institution, it is unlikely that
you will get your name on the side or top of a building.

     The other way to get your name on a
building is to buy your way on. This is called a “naming opportunity” by
development offices throughout the world. Now this is a sure fire way to attain
immortality in stone (unless the naming precedes the check clearing as happened
on the south campus a few years ago and the posted name had to be removed). MD Anderson has the Mays Clinic, the
Alkek Pavilion, and the Smith Research Building among others.

     But building naming opportunities are not equal
opportunity opportunities. You have got to be filthy rich (usually the ante is
at least $25 million to get into this game) or somehow have risen to the
highest office in the place. Please remember that MD Anderson has had four
presidents in the time that the United States has had 12 to my count. What
about the rest of us?

     Let’s examine what is up for grabs among
the lesser lights of MD Anderson who never made it to the corner office, for example. Fred Becker has a cabinet of his
awards somewhere. Irv Krakoff a conference room. Margaret Kripke also a
conference room. Even Bob Hickey only has an auditorium. There are countless
others who at least used to have their portraits hung after their service to
Anderson concluded. I am not sure where the portraits are now, but I didn’t get
one when I retired (although a picture of me painted by some of the leadership
would look more Picasso or Dali than Rembrandt, I fear). This is the final entry
on the list of the “things I missed” including the lack of a retirement prom, a
retirement party or the portrait all of which were the norm for retirees when I
arrived in 1984. This is most unfortunate, but a sign of the times, I fear.

     Honorific naming, regardless of the means
by which the naming occurs, are all about the past. The building may be for
future use, but the name is to commemorate something about someone who is
either old or dead. What is so interesting is that while the naming looks
backwards, the building is for looking forward.

     Now the same can be said about the attitude
brought by the leadership of an organization. Ronald Reagan was great at both.
He loved to refer to the American past (especially the American West in which
he had been a major player—on film) while assuring us all that our best days
were ahead of us. That’s a good trick to pull off for every great leader. But
to do that it helps to have a clear-eyed view of the past (even if fictional as Reagan’s was) and an equally
grounded vision of the future.

     At MD Anderson, the past two presidents
have made a big deal out of what new they were bringing to Houston. (And how
grateful we should be for their coming). Many of us resented their very
northeastern approach to us “ignorant Texans” (bless our hearts) when it came
to modern cancer care and fundamental cancer research. They viewed themselves
as our saviors (a notion they probably got from the Regents who hired them).
The Anderson establishment, especially the clinical establishment, viewed them
as outsiders and carpetbaggers. The Mendelsohns got over this for a good long
run by doing the hard work of getting integrated into Houston. The DePinhos,
not so much, which is unfortunate for Anderson which is looking even more like
an afterthought in Houston health care delivery and more like a destination for
foreign sheikhs with money (especially for those buildings).

     The continued success of any on-going established
entity will be best served by leadership that respects its past and uses that
as a foundation for a future in a very rapidly changing world. While being
proactive is certainly a positive attribute, getting out ahead is not always a
virtue, particularly when the future is shrouded in mystery as it is with

     Perhaps converting Anderson from the
primary place for cancer care to a clinical delivery system that funds a drug
company will turn out to be a good idea. But to do that well will necessitate
acknowledging the excellence of the past while also acknowledging that no one
knows the future. Given the latter, surrounding oneself with the most
knowledgeable people of all talents from all over the country and world would
make the most sense. Do you think that is what has happened in the past three

     Me neither.

some extra links for you. The first is to a set of letters in Monday’s NY Times
in response to an article about the small effect of doctors’ salaries on
overall health care costs. The second is a video of Onyx the putting dog who
happens to belong to my son Andrew. The first link will make you think. The
second will make you laugh. Or do I have that backwards?

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