Making HERO History: How Could This Happen Here?

Making HERO History: How
Could This Happen Here?

By

Leonard Zwelling

         There may be no city in the world more diverse and more
tolerant than Houston, TX. There is no minority that is not represented here.
We have people of all colors and beliefs. We have food of all degrees of
intensity. It was said that there were 70 languages spoken at MD Anderson alone
when I worked there. How then is it possible that the Houston Equal Rights
Ordinance, or HERO, went down to such an overwhelming defeat on Election Day?

         Like so many other questions the answers to which seem
repellant and incredible (think Donald Trump, Ben Carson and Jeb Bush), this
can all be explained rationally, even if not by rational behavior.

         As
I understand HERO, it was to prevent the discrimination against a host of the
traditionally picked upon. Two things seemed to undermine what one would have
thought would have been a slam dunk in a city like our own.

First,
the opponents picked one small group, the transgender community, to home in on
as posing a unique threat, the assaulting of women in public restrooms by
disguised men. This is, of course, not even close to being the point of HERO
which is really aimed at discrimination in housing, jobs, the workplace and
other venues of public access. HERO’s opponents ran a clever scare campaign
suggesting that male sexual predators would dress up like women and assault the
unsuspecting females in public toilets. This is pure horse hockey, but
obviously scared enough people to doom the ordinance.

Second,
Mayor Parker managed to use an uncharacteristically heavy hand to threaten some
of leaders of the black churches in the city who opposed this ordinance and
only managed to rev up opposition to HERO even more. How is it possible that
predominantly black areas of the city voted against an anti-discrimination law?
The threat of censorship, eavesdropping and sexual predators running wild
managed to sink the proposal. Whether or not the NFL (2017 Super Bowl) or NCAA
(2016 Final Four) chooses to penalize Houston for this vote remains to be seen.
The next mayor may try again with a more narrowly written ordinance to align
Houston with cities in the rest of the state and the country with regard to an
anti-discrimination stance. That the most tolerant of American cities and the
only major city with a lesbian mayor voted this down is a tribute to clever
advertisement and transparent dishonesty. 

This,
of course, brings us to Making Cancer
History an equally clever and dishonest ad campaign that has come on like gangbusters
to a television near you. There have been a series of grimacing and smiling
faces, some of my friends in white coats, against a pale background extolling
the virtues of MD Anderson and its people to make cancer history. This is
really unlikely and certainly is if any one out there becomes convinced that they
have to come to MD Anderson or the cancer will make them history.  Unfortunately, it is still true that many
cancers are fatal, even with the best of cancer care, which I believe actually
is given by the faculty of MD Anderson. That does not mean the faculty consists
of wizards capable of eradicating cancer on sight. It means that the faculty
bring compassion, experience, clinical judgment and technical expertise to
every patient, but more than the faculty, the cancer determines the outcome.
The faculty of MD Anderson may or may not be more likely to make anyone’s
cancer history. It would be nice to know that though given:

·     The cancer death rate is pretty steady.

·     Older people get most cancers such that a cure of all
patients with cancer might extend the life span of the average American 3.5
years.

·     The greatest weapon against cancer death is prevention
and the greatest weapon in cancer prevention is a healthy lifestyle including physical
fitness, sufficient sleep, a good diet, normal weight, no smoking, no drugs, no
hepatitis, safe sex, and regular screening as recommended by which ever
advisory panel is your favorite.

·     The nature of cancer is still not understood but it
certainly is extremely heterogeneous from patient to patient and even within a
single patient. Genetic instability is the hallmark of cancer making targeting therapy
very challenging despite claims to the contrary.

·     The individualization of cancer care so highly touted
by almost all major cancer care providers is both true if the physicians are
allowed sufficient time to assess each patient and untrue if one thinks one lab
test will allow a perfectly tailored curative regimen to be devised.

I
have written about this before. It is not likely that cancer will ever be
eliminated. It is unlikely that disseminated solid tumors will be easily cured
if at all. While the genomics revolution is of great interest and has great
potential, the manner in which to employ the technology is not yet entirely
clear and the benefit of doing so is still not calculated in survival advantage
or dollars although both of these calculations will be essential to determine
when and how to use modern lab-based technology.

The
HERO proposal fell victim to modern advertising and fear. MD Anderson seems to have
taken a page from the same playbook in attempting to drive business to its
front door with fancy commercials and catchy slogans. All that’s fine, but
let’s call each effort what it is—false advertising. And far, far too
simplistic.

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