We Need More Choices–And Better Ones


We Need More Choices—And Better Ones


Leonard Zwelling


In his opinion piece in The New York Times on March 19, the traditional conservative David Brooks notes that there have arisen two strains in the Republican Party.

The first is the Trump-DeSantis strain of populism and culture war politics centered on resentment, anti-wokeism, and the remaking of the history of the country through altering textbooks and pronouns.

The second is being led by successful GOP governors like Brian Kemp (Georgia), Glenn Youngkin (Virginia), and Chris Sununu (New Hampshire). These leaders are focused on economic growth, adding more jobs, and attracting new industry to their states. None is angry.

The Trumpers and the followers of DeSantis tend to be dour ogres with few interpersonal skills and a generally combative nature.

The second group consists of upbeat visionaries who actually like other people and want to grow their states’ prosperity to the benefit of all.

Brooks goes on to note that all of the upbeat crowd is, thus far, staying on the sidelines of the 2024 presidential race. In 2016 many were all in, but today only Nikki Haley is competing and she’s an ex-governor and served in the Trump Administration. Just say for me she is unlikely to gain any traction in this race.

As Brooks says:

“So right now the Republican Party has two leading candidates with similar views and the same anti-woke combativeness. The race is between populist Tweedledum and populist Tweedledee.”

I’ve been looking for a way to think about the leadership of academic medicine that could explain my recollection of past leaders (brilliant visionaries) and my horror at the current crop (push button technocrats), particularly at MD Anderson.

Clark and LeMaistre were visionaries and Mendelsohn genuinely liked other people and had a real plan to launch MD Anderson into being a national brand (“Making Cancer History”), and the credentials to actually do it. These three pioneers have been followed by one leader who saw the world revolve around him and his ideas of drug development as an academic mission until it no longer did and his successor who is trying to convince the world of his excellence fooling only his bosses in Austin.

I don’t know what is happening at other academic cancer centers or, in general, any academic medical centers. What I do know is that medicine, academic or otherwise, has become a bureaucratic nightmare for doctors and investigators alike. No one went to medical school to become a clerk, yet between the electronic medical record, pre-authorization of every order, and the drive to see more and more patients (one every 15 minutes, please) being a doctor is bordering on an assembly line job and less a profession. Physician extenders don’t extend. They replicate.

Voters in the GOP primary may yet have a choice of a visionary to run against President Biden who certainly is not now nor ever has been visionary. But if a pleasant alternative to Trump and DeSantis is going to rise, that person ought to make himself, herself, or their self known soon. Time is running out and if the choice is between Biden-Harris and Trump-Greene, I do believe we are in a heap of trouble either way.

“Where have you gone Joe DiMaggio, our nation turns its lonely eyes to you.” (Paul Simon)

Len Zwelling’s new novel, “Conflict of Interest” is now available at barnesandnoble.com

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