Is One MD Anderson An Algorithm For Mediocrity?

Is One MD Anderson An Algorithm For Mediocrity?


Leonard Zwelling

In The New York Times Sunday Opinion on July 31, Ross Douthat notes how algorithms are reducing innovation and creativity by homogenizing the clothing, streaming video, and even the music that directs our tastes and our judgments. That which the computer deems successful is repeated over and over until new ideas and genre bending insight go unrecognized in a sea of sameness.

That’s what I fear will happen if One MD Anderson takes hold and homogenizes the thinking, behavior, and scientific research that has served MD Anderson so well over the many years. The greatest contributions to cancer medicine and basic science that have emerged from MD Anderson have come from those who think differently, see in new ways, and create novel treatments and diagnostics when no one else can see the way forward. If everyone is the same, acts the same, thinks the same, and works by the same rules, the likelihood of new ways to detect and eliminate cancer will decrease significantly.

In our kitchen is a three-dimensional sculpture by David Kracov called “Thinking Outside the Box.” We bought it in Jerusalem and I even had to put it together when it arrived. Here’s a picture:

In the box are the many uninspired humans toiling away at their labors—the ones inside the box. Outside the box are the exceptional folks with light bulbs going off above their heads. They have the new ideas. They are the fountains of innovation. They are what drove MD Anderson to greatness and are the very people that make America great and always have. (America doesn’t need to be made great again. It already is.)

No one exemplified this spirit at MD Anderson more than the late, great Emil J Freireich who never saw or heard a new idea he wouldn’t embrace and test. J was a rebel. He drove most people crazy with his radical ideas about clinical research and the lack of need for randomized trials. He knew a breakthrough when he saw it. If he needed a statistician to tell him a treatment worked, it hadn’t.

I am not advocating that we go back to the days when randomized clinical trials were judged by some to be unnecessary. But I do worry that those who think differently, behave differently, and do science differently may no longer find a welcome home at MD Anderson. That would be a tragedy for that is exactly what MD Anderson is for and why patients keep coming to MD Anderson. MD Anderson has what no place else does—hope and innovation embodied in its faculty. These qualities cannot be duplicated easily even in the various MD Andersons around Houston and around the country. The “mother ship” is still where the new treatments originate.

We cannot allow the current drive to homogenize the faculty with the rest of the staff to quash what the world counts on MD Anderson for. One MD Anderson as I understand it is a bad idea for the faculty and more importantly for patients.

Beware of the behavior algorithm of conformity when it is the outlier who should be celebrated.

4 thoughts on “Is One MD Anderson An Algorithm For Mediocrity?”

  1. David Farquhar, Emeritus Professor

    Perceptive, provocative, and enlightening commentary on current MD Anderson administration and some of its serious shortcomings, particularly from a faculty perspective. The institution would enjoy far greater employee harmony if only President Pisters would learn from your hard-earned field experience. From everything I’ve heard from faculty, Dr. Pisters operates in a substantially autocratic mode and has become increasingly unpopular. He clearly lacks the wisdom and administrative skills of all of his predecessors – each of whom I’ve personally known and admired – bar the penultimate. Saw this movie before and it does not end well.

    1. Leonard Zwelling

      Exactly, but this is movie-worthy. Shakespearean tragedy with no winners. Lots of losers. Pisters was a poor choice on basis of cv alone. No research experience to speak of. He was the anti-Ron, but then turned into a worse tyrant. Who knew?

Leave a Comment

Your email address will not be published. Required fields are marked *