Leonard Zwelling

In The New York Times on Sunday July 10, the Sunday Review section’s back page was devoted to a discussion among 10 voters of diverse party affiliations on the subject of political courage.

The group debated the merits of Joe Manchin, Liz Cheney, AOC and others as contributing their courage and bravery to the present political situation in the United States. I don’t want to discuss their opinions of each of these people, but they did agree that going against what your constituency favors was risky and required some courage as is opposing the mainstream of your party (e.g., Liz Cheney). I would like to focus on a much smaller scale. That scale would be leadership in academic medicine and particularly at MD Anderson.

I think that the past presidents of MD Anderson were all brave in one way or another. R. Lee Clark had a vision for a free-standing cancer center in association with the state’s major university. That was quite a vision and it surely worked out well under his leadership for many years as MD Anderson became one of the foremost places for cancer care in the country under his guidance.

I was more than closely associated with the courage of Mickey LeMaistre. The idea of creating a fourth mission area for the established cancer center—cancer prevention—was way ahead of its time. Once again, Like Clark before him, Dr. LeMaistre, a non-oncologist, saw the handwriting on the wall and the importance of preventing cancer and finding ways to do it. This went against an entrenched group of faculty who disagreed. I saw Dr. LeMaistre assert himself under pressure and I saw him keep his powder dry when he couldn’t win. He was one of the wisest men I have ever known. He also always put MD Anderson and its faculty and patients first in all his decision making—even concerning the type of windows in the new hospital. Mickey was both a brave and a cautious leader. That’s why his tenure was so long.

John Mendelsohn, for whom I worked throughout my administrative career, also had a singular vision for MD Anderson and it was different from that of Dr. LeMaistre. John wanted to truly turn MD Anderson into the greatest academic cancer center on the planet, with provosts, and great basic science, and research-driven patient care. He also had the best credentials of any president of MD Anderson ever as a true oncologist, hematologist, internist and bench investigator. John knew good science for he did it himself, even developing a unique targeted drug against cancer. John set the MD Anderson on a new direction at the cusp of the new millennium. That took courage.

Finally, although I thought Ron DePinho was too self-serving and egocentric to run the MD Anderson, plus he was not remotely a clinical oncologist, he did have a vision and it was the right vision for its time—the use of MD Anderson discoveries to both drive clinical care and commercialize the findings for a novel revenue stream. That too took courage to sell to a doubting group of academics. Unfortunately, Dr. DePinho’s integrity lagged behind his vision and he eventually had to resign after bouts of self-dealing, nepotism, and conflict of interest. This brings us to now.

Dr. Pisters is a real oncologic surgeon and, from what I can tell, a pretty good one, too. But, he lacks the Clark gravitas, the LeMaistre vision, the Mendelsohn scientific curiosity, and the DePinho daring and chutzpah to be effective. At some point in time, now that he has successfully wrestled the Covid challenge to the ground for the institution, Dr. Pisters is going to have to exhibit the bravery of his predecessors and articulate a vision for MD Anderson that pushes it forward.

It seems to me that science is more important than ever, but the DePinho view of working with industry is equally critical. What’s the Pisters plan?

I’m waiting.

Oh yes, and “One MD Anderson” won’t cut it.

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