In a recent newsletter, Frank Bruni of The New York Times tells about former Speaker of the House John Boehner. The Speaker has a new book out that is climbing the best seller lists mostly because he dishes all kinds of political dirt, mostly on fellow Republicans like Ted Cruz and Mitch McConnell. You would think such a book and such a literary event as its publication would be a cause of joy among the opinion writers of The Times, but Bruni is a harsh critic of Boehner’s latest play for redemption. If he saw all of this misbehavior when he was Speaker, why didn’t he speak up then?
I know the answer to this one.
If you are fortunate enough to have a job that comes with some power to affect events or move institutions in what you believe to be the right direction, you give up such jobs, which are usually well-paying, with great reluctance.
I once had such a job as a vice president at MD Anderson. Despite the egregious misbehavior I witnessed on the part of some of Anderson’s leadership and not a small number of faculty members, for the most part, I went along. Every time I tried to buck the zeitgeist in a meaningful way, the zeitgeist pushed back and I was cowed into silence. Eventually, I gave up the responsibility that was making me miserable (overseeing clinical research) and three years later was fired completely because I had become extraneous. Firing me was a good decision. I was contributing very little at that point.
In my next job, I pushed back a lot harder and a lot faster. I saw outright corruption and poor medical care being tolerated because the entity for which I was working was making a ton of money, much of it from federal largesse, and no one there wanted the boat rocked. I was rocking. Hard. Once again, I was gone. Once again, it was a good decision.
But when I look back at my two experiences in medical leadership, while the one at Anderson was both heady and rewarding, I really did not speak up as I should have and a lot of people got away with a lot of misdeeds in my opinion. During the second job, I spoke up but was immediately dealt with as any disrupter would be.
Mr. Bruni’s criticism of Speaker Boehner is probably deserved, but cut him a little slack. It’s very easy to think you know what someone else in a position of power ought to do. It’s quite another once you realize that doing the right thing is incompatible with career longevity. I am sure that Mr. Boehner evened some scores in his book. I am also sure that he might have been a greater hero had he tried to even those scores while he was still in power. But, as I said, it’s easy to second guess.
My take away from my two firings was that at least I got in the arena and tried to figure out a way to fight for what I believed while still keeping my job. I managed for twelve years at Anderson. That’s far longer than Mr. Boehner was Speaker so I guess I did okay.
What makes this so difficult, is very often, in medical leadership positions, the well being of patients is at stake. Does this mean that there are often conflicts of interest in the lives of medical leaders? It does. There is no easy solution. Walking the tightrope between doing the right thing and keeping your job can be a real challenge. Speaking up can be risky—even for the Speaker of the House.