How Many Psychiatrists Does It Take To Change A Light Bulb? What About Changing A President?

How Many Psychiatrists Does
It Take To Change A Light Bulb? What About Changing A President?

By

Leonard Zwelling

         Light bulb changing jokes are great.

         How many Jewish mothers? Don’t worry. I’m fine in the dark.

         Administrators? Five. One to hold the bulb and one to turn
the four-legged stool he’s standing on.

         Psychiatrists? One, but the light bulb has really got to
want to change.

         Now the joke is on Donald Trump. Can he change from a
mud-slinging, fast-talking, insulter-in-chief to a true Presidential candidate
who actually acts like one?

         The answer to this one is: we’ll see.

         In my limited experience in dealing with powerful men
(senators, congressmen, Nobel laureates, deans, CEOs, department chairs and
presidents of all kinds), I have found that they change very reluctantly. They
believe that their very existence in the corner office (or virtual throne) must
mean they have done everything right and they have nothing more to learn. The
truly wise ones know better, but I have met so few of them.

         Two come to mind and interestingly, they were both GOP
senators.

         My boss on Capitol Hill was Mike Enzi, the senior senator
from Wyoming. He was a voracious reader. He took notes on the books he read and
wrote book reports on the good ones, sometimes passing them out to the staff.
He always was looking to take in new information that would alter his approach
to what he considered a sacred task, finding the 80% of any issue on which
Democrats and Republicans could agree and to make that the basis of new legislation.
He worked hard to do that, especially with Senator Kennedy, but when the senior
senator from Massachusetts became ill, and his very partisan staff took over
the negotiations surrounding the ACA, it should have come as no surprise that
the Dems would have to ram through the bill and the GOP would be grousing about
it ever since.

         Another changeable man I met on the Hill was former Senator
Tom Coburn, a primary care doc from Oklahoma and probably the sharpest knife in
the congressional drawer. He was a thinker and a doer and like Senator Enzi
desperately looking for a compromise when health care reform legislation was
being discussed. It never happened. Only two meaningful Republican amendments
were ever passed through the Health, Education, Labor and Pensions Committee on
which both men sat. There was very little compromise and although there was a
lot of talking, there was little real discussion. Negotiation was also in short
supply among the staffers who were more partisan than their bosses and on the
Democratic side pretty much in the “tough darts, we won” mode in 2009. This did
not endear them to their colleagues on the GOP side of the great staff divide.

         I bring all this up because if MD Anderson is ever going to
reclaim the high ground in ethics and morals, let alone make any progress against
cancer, the President is going to have to change, either in behavior or in fact.

         He needs to install true shared governance and stay out of
tenure decisions. He has people to do that for him. They are called faculty.

         He needs to install a real oncologist as the Chief Medical
Officer, This is simply not a job for a radiotherapist, a sort of oncologist
with only one drug.

         He needs to have someone who can explain the budget and the
finances so that a third grader can understand them, because that’s the
intelligence level in economics of many fiduciaries who need to understand
these numbers.

         He needs to make his research strategy clear and shed some
light on IACS and the entire drug development program as well as on its budget.
What’s been spent? What’s been gained? What’s the plan? What’s the metric of
success?

         Stop firing everyone you don’t like. It might be beneficial
if you learned to get along with those with whom you disagree. They may have
something to teach you.

         I don’t know if Dr. DePinho can change. I don’t know if the
Chancellor cares if he changes. I do know that for either of them to be
successful they both need to do better jobs than they have done to date so
change would be of benefit.

         I do know how many people it takes to change a Chancellor or
a President. The majority of the number on the Board of Regents.

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