Leonard Zwelling


In foreign policy, there is an order to things. You have to decide what the future should look like and then how to get there.

During a training session on internal communications, the specialist training the president of MD Anderson, his wife and me that Saturday many years ago conveyed a valuable lesson. When you address the collected faculty and staff, especially for the first time, start with this:

I have a vision of the future.

I have a plan to get us there.

It won’t be easy.

It will be worth it when we get there.

Peggy Noonan in her piece in The Wall Street Journal on May 11 discusses two things.

The first is the inherent split in the country’s politics that is severe at the moment. There are those who back President Trump, no matter what. They have taken a chance with their votes in 2016 that a non-politician will keep more of his promises than did the line of past politicians who have brought the country to a place that is unrecognizable to many Trump voters. In fact the country was brought there by a rise in diversity through immigration, globalization and the effects of the Internet, but Trump voters blame the changes in America on external factors other than these. They believe that tomorrow can look more like yesterday. They are wrong, but they have as many votes as do those who oppose their point of view. Perhaps, more importantly, their votes were more strategically and electorally placed, so Trump won. The next 18 months will be all about how that split runs on November 3, 2020. The last 24 months have been prelude for this with the climax of that prelude being the Mueller Report that we are still arguing about.

How you view the Mueller Report depends a great deal on how you voted last time and how you might next time. The Trump supporters think the report exonerates the president of any wrongdoing. The loyal opposition wants to beat the drum loudly that the report does no such thing and that the president is guilty of obstruction of justice. Of course there are many people who wish the whole damned thing would go away and that Congress would do something to guarantee access to affordable health care, improve the infrastructure and stop the gun violence in our streets and our schools.

The Democrats are inching up on impeachment and the Trump White House wishes that they would get on with it. Trump is ready for another fight because he thinks he can win. He may be right. The country may be tired of collusion and obstruction and just wishes the Congress would be more accommodating and let the president do his job. Mr. Trump is happy to play the victim. He thinks it’s a winning strategy for him.

This is the first thing the Noonan piece is about–our intrinsic differences despite our yoked dependence on each other. America has become like conjoined twins. But each twin is fighting with the other despite the fact they are mutually co-dependent.

The second thing she discusses is intrinsic to the four pieces of advice I was given about addressing groups that one is to lead. How are you going to execute your vision?

Obvious, you first have to be able to articulate your vision. Trump has done this well. He wants to take America back to the good old days of post-WWII white, male dominated politics. MAGA. This cannot happen and thus we have heard no real how from Trump. He has no idea how. He cannot be bothered with how. He has no plan. Maybe, the voters will hold him accountable for having no how. Maybe. Low unemployment, good economic numbers and illusion of prosperity might be enough to get him re-elected. But if those tariffs on Chinese goods take hold and everyone’s Target and WalMart bills start to rise, watch out.

Finally, there is also an order to how academic medical centers evolve. The leader needs to have a vision and a plan and then has to execute. Right now, MD Anderson is a divided place. Most faculty are fat and happy. The coffers seem full. The place is expanding. There will be a new proton center and MD Anderson care is available all over town and in some other states. What could be wrong?

Ask a Chinese faculty member. See how he or she is feeling today.

When the government comes calling, there’s an order to the appropriate response. What happened recently at Anderson is not it. The leadership has to work to bring everyone on the faculty and indeed the whole place back under one umbrella. It has to articulate what a vision of the future will look like and then it has to execute. Where is MD Anderson going? More Moon Shots? At least the last guy had a vision. Of course, he didn’t know how to make it real either without going broke.

In its first test of execution, this new leadership team did poorly. They will have other chances. Let’s hope they grow, learn, evolve and do better. They knew what. They didn’t know how. Yet.

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