Frank Underwood’s Moon Shot

Frank Underwood’s Moon


Leonard Zwelling

         America Works.

         That’s the name of the program proposed by the President of the US to
fix what has ailed the country since the days of FDR and the Great Depression.
President Underwood believes that the root of the country’s undoing has been
massive dependency on government hand-outs and entitlement payments. He wants
to substitute the money currently used to pay for Social Security, Medicare,
food stamps and other examples of federal safety net largesse with a program
that gives every American who wants one a job.

         This new program has gone wanting for congressional support.
No Congressman or Senator would dare support the elimination of all of these
tax-payer-supported programs in lieu of a jobs program. President Underwood
cannot even get in the batter’s box, let alone to first base, to even try his
program anywhere.

         He has an idea. He talks the mayor of Washington, D.C. into
declaring the joblessness in the nation’s capital a disaster and thus eligible
for FEMA funds. President Underwood depletes FEMA’s appropriated budget
allocation to pay for this giveaway in support of 50,000 jobs in DC. Congress
is apoplectic but can do little to stop the experiment. A threatening hurricane
approaches President Underwood’s native South Carolina and FEMA does not have
the money to support the populace should the storm come ashore.

is always a cost to a bold experiment, especially one that no one else sees as
essential and everyone agrees is very risky.

         By now, most of you have discerned that the above scenario
is all fiction. It is one of the many plot lines of the third season of House
of Cards on Netflix and if you aren’t watching, you are missing the best
fictional depiction ever devised of the DC I knew. In the series, America Works
is to President Underwood what the Moon Shots are to President DePinho—expensive,
costly to others, and not really based on any good theory as the Space Age analogy used
by the MD Anderson President is neither historically nor scientifically sound.
The Apollo Program was neither a science experiment nor an experiment at all.
The physics of success to get a man to the moon and back were known. It was
just the willingness of President Kennedy to use the Moon Shot as a metaphor to
best the Soviet Union that begat Neil Armstrong and his “small step.” It was essentially a Cold War ploy of great expense.   

         There are a lot of people in the social safety net who
cannot work, especially those over 65 that would be and are very threatened by
President Underwood’s proposed jobs program.

         There are many valuable faculty members whose work does not
integrate into a Moon Shot and who may well make a seminal discovery all by
themselves. Big science definitely works in the physics of rocketry and is a
good way to use brute force to apply already proven technology (e.g., human
genome sequencing) to a specific, defined problem. Whether or not large teams
of very independent people can be coerced into joint ventures of discovery in cancer biology remains
to be seen.

         Of course, the problem of individualism is averted if all
the decisions are made by one person. Just like the fictional President
Underwood, Dr. DePinho keeps tight control over the strategy of Anderson’s
science through the use of lackluster surrogates in positions of great responsibility
who he keeps on tight leashes. The lap dog executives are apologists and
cheerleaders for an idea whose success goes unmeasured and unrealized. We are still
waiting for the first MD Anderson cure under DePinho’s watch, but it could
happen. If it does, it is likely to be the product of the work going on
throughout the world being brought into Anderson and placed into the insightful
hands and minds of the best cancer clinicians in the world as has always been
the case. Would there really be all of those success stories with Gleevec if
not for the Leukemia Service at Anderson despite the discovery of the drug
having been made elsewhere? Doubtful.

         The MD Anderson model of wide scale clinical application of
the best new cancer treatment ideas in the world under the guidance of
world-class clinicians and clinical investigators is one the world has embraced
for 75 years. For what reason is that strategy changing into one characterized
by a heavy investment in basic science, big science and the marginalization of
clinical excellence as a parameter for promotion and tenure? And why is MD Anderson going at this alone?

         Dr. DePinho’s Moon Shots are as likely to produce
breakthroughs as President Underwood’s jobs program is to fix the welfare
state. It’s possible, I guess, but is that the best path to a cure?

         I guess we will see how America Works fares if there is
another season of House of Cards. The success of the Moon Shot programs will be
more immediately known because Dr. DePinho told us we would see a few cures in
5 years.


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