A Tragedy of Epic Proportions

A Tragedy of Epic
Proportions, But Who’s the Most Guilty?


Leonard Zwelling

         At 11:17 AM CDT on Friday, September 26, 2014, Dr. Ana Maria
Gonzalez-Angulo was found guilty of aggravated assault in a dating relationship
in the 248th District Criminal Court of Judge Katherine Cabaniss. This
is a first-degree felony and carries a lifetime maximum sentence. She stands
convicted of poisoning Dr. George Blumenschein her friend, research partner and

penalty phase of the trial began 10 minutes later with the video recorded deposition
of a medical breast oncologist who was formerly a member of the MD Anderson
faculty, but had since left. This deposition was taken on September 20, 2014
after this witness came forward to “do the right thing” in response to
conversations she had had with other members of her former MD Anderson
department. The trial had already begun. This was 14 months AFTER Dr. Gonzalez had been arrested!

         A very disturbing pattern emerged in this trial and the
latest depositions from two female medical breast oncologists only
reaffirmed what I had already commented upon on this blog. It appears that a
group of some 5 female medical breast oncologists were close enough with each
other at work to know that one of their group, the defendant, was in trouble.
She was more agitated. She was losing weight. Topic one in her conversations
was Dr. George Blumenschein, a medical oncologist in a different department at
Anderson who she referred to on her speakerphone as “Babe,” despite his being in a long-term relationship with someone other than the defendant. Several of these
women docs questioned their troubled soul sister about having an intimate relationship
with the man who had become her close scientific collaborator. All took her “No”
at face value but knew it was not true as Drs. Gonzalez and Blumenschein
frequently shared sleeping arrangements on business trips around the world.

         Thus, the slow moving, but accelerating car crash that began
right after Thanksgiving of 2012 with anonymous threatening notes to Dr.
Blumenschein’s live-in girlfriend Evette Toney, followed by the attack on the
defendant on December 17, 2012 that probably never occurred, culminating in the
ethylene glycol poisoning that has left Dr. Blumenschein with less than half
his renal function, was a virtual biochemical pathway to kidney cell death in
which no one was willing to intervene. For a group of women interested in
interventional cancer therapy to alleviate human suffering, they were sadly
silent when their healing was needed most, by one of their colleagues, the

         One can always say the demeanor and mood of Dr. Gonzalez was
a personal matter and not the business of others in the workplace. Really?
These are a group of patient care physicians, healers by definition. Are they
going to say that when someone is in emotional turmoil it does not affect that person’s clinical skills? These women had a responsibility to step up and help their
hobbled sister and if not, when the poisoning occurred, they should have been
far more forthcoming with the authorities about what they knew and when they
knew it. Are they their sister’s keeper? Yes they are! Instead, most stayed in
the shadows until just before the trial or even after it began. There was over
a year between the arrest and the trial. Where were these physicians during
that time?

         But I don’t only fault the witnesses who were finally
coerced to testify and whose testimony was critical to the verdict. The defense
was absent.  They relied on reasonable
doubt and fortunately the 12 reasonable people in the jury box took less than
four hours to tell them they might have rethought that strategy. Then again,
the two physician witnesses whose
testimony made up the prosecution side of the penalty phase and who attested to
hearing the defendant claim to have people killed in her native Colombia would
have been pretty hard for the defense to refute had their testimony come in at trial.

         I do not know why these physician colleagues of the
convicted stood by and watched their colleague’s life crumble and say and do
nothing. I do not know why even after the arrest of their colleague they did
not come forward. When asked directly, one of the witnesses, a very senior
faculty member, had no answer to that question.

         Well, I do.

         When I first came to Anderson, I was shocked at how much
support I had to get my laboratory running and integrate into the ebb and flow
of MD Anderson and Houston. Everyone around me made it clear that I had joined
a family that was there to support me in our collective fight against cancer.
In fact, that’s what Dr. LeMaistre, our President then, had on his tee shirt:

Cancer, Now That’s a Job!”.

the years, I became part of that support team for others and am proud of it. I
loved the MD Anderson I came to and I still do. I just can’t seem to find it
any more. What happened?

         Since I never believed that MD Anderson was the buildings,
but rather the people, and that the only two assets MD Anderson ever had were
its name and the faculty, then something really bad happened somewhere to the
people. I believe it is the same thing that has happened in almost all aspects
of American life. There is a singular lack of leadership and at MD Anderson
this has been taken to a new level. And that level is low and dropping.

         Rather than rehash what I have said many, many times before
about when this began and why, I think attention needs to be turned to repair
and this is not beyond repair.

comes next, the repair, is not beyond our control either.  So here are some suggestions:

1.  Create a Blue Ribbon panel of faculty and staff to
investigate how the institution responded to this crisis. It should be led by
an expert in crisis management unaffiliated with MD Anderson or the UT System.
(I have names.)

2.  Interview all faculty and staff associated with this
case focusing on those who testified and even those who did not but should have
as to whether or not they perceived a problem in not having had a safe outlet to
get help with dealing with the signs of trouble for the defendant.

3.  Create a clear understanding that it is a violation of
federal and institutional policy to view a medical record of anyone in whose
care you are not involved.

4.  Determine if a crisis management team needs to be
assembled to guide leadership at the departmental and divisional levels when
faced with issues like this one.

5.  Get outside help in assessing the root causes of this
tragedy and the role of the leadership and culture in the mishap which I
believe was considerable. The major factor was fear which is propagated from the top.

6.  Get a publicly available report out in 90 days with a
plan of action to increase the likelihood that this never happens again.

        I don’t
think these steps are rocket surgery, but perhaps they can be a way back to an
MD Anderson where the welfare of each is the duty of all.

        In the
penalty phase of this trial, the defense team brought forward many witnesses
that testified to Dr. Gonzalez’s excellence as a caring physician, exactly the
kind that lives and breaths the core values of MD Anderson. What happened?

        I have a
friend who is a great spiritual teacher who says: “of course you have multiple
personalities. You’d be crazy if you didn’t.”

        That has
got to be the case here.

        The woman
we heard about during the trial committed an unforgivable crime. I was
convinced of her guilt as was the jury. The person being described in the
penalty phase bears no resemblance to the convicted physician obsessed with a
colleague to the point of doing him serious harm. She was dedicated, brilliant,
hard-working and compassionate, a great physician, investigator and care giver.
This has got to be a tragedy of Shakespearean proportions. I just wish I could
understand what happened within the mind of this doctor that led to these
events. And more importantly, how her colleagues, who clearly were all of sound
mind and great compassion as well, decided to stand on the shore while several careers
desperately needed a lighthouse and a life line.

        It is
essential that MD Anderson really look into the mirror of self-scrutiny and
figure out what occurred to make sure there are systems in place to help those
in the kind of conflict in which Dr. Gonzalez found herself. There can be
nothing more important for the leadership to address. Now! And if they decide
not to, it may be time (ok, it’s well past that time) for  new leadership.

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