Normalizing the Abnormal: How DePinho Altered MD Anderson

Normalizing the Abnormal: How DePinho Altered MD Anderson

By

Leonard Zwelling

         In an insightful piece in the NY Times Magazine of November 6, Charles Homans describes how the Trump candidacy (and now looming presidency) altered what is considered “normal” in American politics. I think this is a good observation because things like misogyny, racism, xenophobic anti-immigrant rhetoric, and general rude conduct have all become part of the landscape in our politics in the past 18 months as never before. It’s the new normal. And, after all, Trump won.

http://www.nytimes.com/2016/11/06/magazine/the-normalization-of-trump-and-what-comes-after.html?action=click&contentCollection=magazine&region=rank&module=package&version=highlights&contentPlacement=9&pgtype=sectionfront&_r=0

         Now I want to argue that the same has happened at MD Anderson over the past five years. What was once an academic patient care institution of the highest quality with core values of integrity, caring and discovery has been supplanted by a huge factory characterized by self-dealing, callousness, and commercialization. And I believe this change can be placed firmly at the feet of Dr. DePinho, Dr. Shine, and the UT Board of Regents.

         In 1996, the Board of Regents selected a true physician-scientist to be president of MD Anderson. John Mendelsohn was and is a real doctor, board-certified in medical oncology and in hematology, I believe, and was deeply knowledgeable about both patient care and biomedical translational research. He had developed a real cancer drug prior to coming to Houston and that drug is now an FDA-approved therapy. No one can doubt the bona fides of the man selected to lead the nation’s number one cancer center in 1996.

         In 2011, not so much.

         Instead of hiring a medical or surgical oncologist, the Board of Regents under what appears to be the spell of Dr. Shine, hired Ron DePinho, a great basic scientist with virtually no clinical credentials and none in cancer medicine. Why?

         The first obvious reason is that the candidates for the job were somewhat lackluster. Of the three known finalists for the job, one was a woman and had no chance and the other was the incumbent Provost who really had not made a ripple on the institution in the four years he was there. I assume he was staying low key in order not to annoy President Mendelsohn by actually objecting to one of his less than sterling decisions (e.g., salaries on grants which predated Dr. DuBois) and to position himself as the favorite son once Dr. Mendelsohn announced his retirement. That announcement came, but I doubt it was voluntary by Dr. Mendelsohn and then I suspect the Executive Vice Chancellor for Health Affairs and the Board of Regents fell in love with Dr. DePinho’s pledge of success in what Mel Brooks called “the search for more money.” I also surmise that the consensus in the country was that Dr. Dubois had the inside track for the presidency so why bother wasting all that energy competing. Such doubts never entered the DePinho mind and thus…

         Since 2011, the firing of many senior faculty from leadership roles has become common place. The press to see more and more patients has become a constant din that has encountered a major speed bump with the operationalization of EPIC and a real question as to whether those additional patients are really there to be seen. Maybe they have been scarfed up by competitors or MD Anderson’s self-competition in New Jersey, Arizona, Florida, California and the sites in Houston that “have you surrounded.”

         And worst of all, every time someone suggests a new idea to detect, prevent or treat cancer, the first words out of somebody’s mouth is, “can we patent that?”

         This is not the MD Anderson I knew when I arrived in 1984, but it is the new normal.

         Just as Donald Trump has normalized a vulgar form of American politics, Ron DePinho has transformed a place that was unique in all the world to the common cast of a typical money seeking American academic medical center in 2016.

         And now the budget has exploded as well. When it comes to the comportment of the faculty and staff, rude is the new normal. When it comes to the budget, red is the new black.

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