Leonard Zwelling


One of the true marvels of the American system of government is the ease with which the people can replace their leader. Oh, it looks hard, but recent history shows that it really isn’t.

Mr. Trump was gone in four years as was Jimmy Carter and George H. W. Bush and their major flaws were not being able to live up to the challenges of the office in the perception of most American voters. The challenges were different among these leaders. Mr. Trump was actually sitting on a very good economy when Covid struck a blow against him and that economy from which neither was able to recover. The economy was the undoing of Mr. Carter and Mr. Bush despite Carter’s making progress in the Middle East (until the ayatollah undid that) and Bush actually winning a war there. In the end, Bill Clinton is still right. “It’s the economy, stupid.”

This bodes ill for Mr. Biden in the midterms and maybe beyond given our current level of inflation and its effect on the usual American optimism. Despite the Republicans nominating a host of awful pro-Trump candidates when there really were some excellent GOP choices in the many primaries, my guess is that the Republicans will take over the House and the Senate will stay pretty close, although with better candidates in Georgia, Ohio, and Pennsylvania, the GOP could have dominated the upper chamber as well and may yet.

The point here is despite the doom and gloom surrounding the American psyche in 2022, there is always hope that we are one election away from better times. My guess is that it will take a few more than one election today, but I am still hopeful.

Now, when it comes to leadership turnover in non-political aspects of our lives, I am a good deal more pessimistic. I am afraid that in both corporate America and academic medicine, it’s a lot tougher to make changes at the top, even when they are obviously necessary.

The above editorial describing Putin’s Russia gave me some insight into why this is. Unlike the President of the United States who is surrounded by adversaries in Congress, governorships, and state legislatures, the leaders of corporate America and academic medicine surround themselves with their hand-picked underlings whose well-being is dependent on the continued rule of the CEO or president. It’s in the best interest of the potential pretenders to the throne to keep the current king in place. Thus, Mr. Putin has few challengers as the system that made him president gave any potential rival villas and yachts and billions of dollars. (Why rock the boat as it were)?

And if the yachts and money don’t keep Putin in power, the terror insures it as he eliminates (kills or jails) all potential rivals (e.g., Aleksei Navalny).

It is my contention that for some time now, the same has been true at MD Anderson and it has reached its zenith in the current administration where unearned vice presidencies serve as yachts and professionalism substitutes for terror.

My only question as was the one voiced in the editorial by Oleg Kashin is why there is no collective action to end the nonsense that is guaranteed to yield mediocrity and fear?

The current leadership of MD Anderson is, as the prior administration was, unworthy of the great tradition of clinical and research excellence, but it will be up to the faculty to decide when enough is enough and the risk of not doing something is finally exceeded.

I’m waiting. I’m watching.

Unfortunately, the mechanisms for turnover at the top of Pickens are less clear cut than those used to make changes in the occupant of the White House. MD Anderson is far more removed from those to whom it reports than the White House is from the American people. It is more removed, but not unremoved. At some point the misbehavior of the last Anderson president reached the point where the powers that be in Austin had had enough. It’s going to be harder this time.

Harder, but not impossible.

My theory of longevity at MD Anderson is that everyone there is a beaker. That beaker is filled with brightly colored liquid. Everyone’s beaker is filling. No one knows how big his or her beaker is, the rate with which it is being filled, or how full of liquid it is, but once the beaker overflows, you’re gone. I was a beaker once and mine overflowed. Everyone’s does. As a close friend has said, “it always ends badly.” It’s just a matter of when and why.

2 thoughts on “Turnover”

  1. I am impressed how you continue to endear yourself to the current MD Anderson senior leadership. Your blogs must reach some of them. Do you ever get feedback from “head shed” at MDA?

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