“No”: The Magic Word

“No”: The Magic Word


Leonard Zwelling


Kurt Streeter’s opinion piece in The New York Times on July 29 describes the power asserted by gymnast Simone Biles when she said “no.” Ms. Biles had had enough of the pressure to perform, the abuse by team doctors and the abusive coaching by the Karolyis. We don’t know precisely why Ms. Biles decided at this moment that she had reached her tipping point. But she had. Other articles have equated her sense of “being lost in the air” with the yips in golf—the inability to make a short putt. No matter. It’s a moment of panic that precludes optimal performance. It happens to humans.

But Biles’ exertion of her on self-interest is just the latest example of athletes taking control of their sports and their lives. It appears that the amateur barrier has been broken and NCAA athletes will be able to be compensated for the use of their images (e.g., in video games). This is long overdue as universities have made a mint on the performances of these unpaid student-athletes and their coaches garner multi-million dollar endorsement deals and shoe contracts. The time has finally come for the very people upon whose performances the whole system depends reap some of the benefits of their efforts and acquire a bit of self-determination in the process.

What I found so interesting is that I have been advocating for exactly the same thing in academic medicine for years. I called it turning Wednesday into Sunday.

Let’s take MD Anderson Cancer Center as an example.

During the darkest days of the DePinho years when the clinical faculty were looked upon as “ATM machines” as one astute faculty member put it at a large meeting, I was proposing that the clinical faculty regain control of the institution in a simple fashion. Allow the entire clinical enterprise to operate as it does on the weekend during a week day. Turn Wednesday into Sunday. All out-patient clinic visits would be cancelled. Any needed chemotherapy administration or emergency visits could take place in the emergency room. In patients would be cared for as usual—on-call. If the leaders of the institution at that time (Drs. DePinho, Buchholz and Dmitrovsky) didn’t like it, they could see some patients themselves. And if they made one move to punish the clinical faculty, Thursday would look like Sunday, too. A few days of the loss of that clinical revenue and I was certain the faculty would have been in a great position to negotiate some changes in the conduct of the busines of the cancer center which was both losing money and denigrating the importance of clinical care and clinical faculty well being.

Simone Biles has struck a critical blow for the freedom of athletes to control their own destiny. They are not trained seals who can be expected to perform on cue at a date and time determined years in advance. Simone Biles, as Mr. Streeter notes, used the magic word. It’s not the end of the oppression of world class athletes, but it’s a start.

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