Explaining My Pride, Explaining My Disappointment
By
Leonard Zwelling
https://www.wsj.com/opinion/gatekeepers-and-national-traumas-5b1fef30
As I age, I find that I have mulled certain ideas around in my head for a very long time.
One of these ideas is why my loyalty and pride in Duke seems so unbreakable and the same loyalty and pride does not apply to MD Anderson. I spent nine years at Duke and 29 at Anderson. My resulting disinterest in supporting Anderson financially seems odd. Even through the lacrosse scandal and a less than adequate university president in the recent past, my support for Duke never wavered.
It’s way more than the basketball team at Duke, although the Coach K era was a lot of fun. It is also not about gratitude for my undergraduate education. It was far too brief (three years) and, while I did acquire some important knowledge about the New Testament and Freudian psychology, what I learned as a Duke undergrad did not affect my career all that much. Of course, my medical education and residency training were the basis for my professional career, but it’s even more than that.
On September 20, in The Wall Street Journal, Peggy Noonan’s column explained a lot.
Essentially her piece is about how certain parts of the American character used to make life better for everyone and how these functions seem to be failing us now. There used to be communal values that were engrailed in the genes of the government. Now they seem to have been ceded to individual parents as the government, the media, and higher education crumble as ethical bulwarks against the mob.
She listed three:
You are the gatekeeper-Great leadership determines what gets through to those they lead. The important stuff is touted. The vile and superfluous, suppressed. This is over now that we have the Internet. Everything gets through in an unfiltered fashion unless a parent can stop it.
Both Noonan and I wrote about the difference between what the public including young people saw after the JFK assassination in 1963 and what they saw when Charlie Kirk was killed. In the case of the former, the images of the assassination were highly edited still photographs in Life Magazine that were not gratuitously graphic. In the case of the latter it was all there on the Internet, but was not good for anyone to see. I suspect way too many teenagers have now seen their first piece of real death.
In medicine today, doctors have no power as healers by being the gatekeepers of professional wisdom. Don’t you want your doctor to have healing powers that you do not have? I do. But if your first move as a patient is to Google or Co-Pilot with every new symptom, your doctor has to undo the nonsense you may have read before he or she can actually do the doctoring. This is sad. Imagine the job for any parent when their child opens a vein to their mind through the Internet on his or her cellphone and that vein is filled with garbage.
Hold the line-Great leaders inspire those they lead to stand for values in times of trouble. Great military leaders are skillful at instilling not only the values for which their troops fight, but the power vested in these young warriors by being the special keepers of those values.
How does a parent do that today? How can a parent teach the importance of civil discourse to their child when there is so much crass discord in the system? How does anyone know what’s true when the professional opinion of scientists and medical experts is undermined by the most powerful health official in the country? We doctors are not holding the line here either. We all should be donning white coats and heading for the headquarters of HHS demanding the ouster of RFK from his job. He is a menace and so are those he appoints even as one he appointed at CDC and then fired, fights him for us.
I was so lucky to be surrounded by doctors at Duke that made sure that I knew that I was to be the line of defense against ignorance and disease when I cared for a patient. I was to bring all my skills, all my intelligence, all my knowledge, and all my energy (and the last of these is what I had the most of when I was in training), to bear on every medical challenge, even in the middle of the night. This is gone in medicine. It has been supplanted by limited doctors’ working hours, physician extenders, and hospitalists. We have all become employees not professional craftsmen.
Many patients, especially those in a hospital, don’t even know who their doctor is. How is that holding the line? How can we ask patients to hold us in any regard if we don’t hold our own profession and our own place in it in any regard?
Class isn’t everything, but it makes everything better-This is not about socioeconomic class. This is about Fred Astaire class. Jackie Kennedy class. A parent must exude this. A parent must set a model for his or her children especially in the manner in which they deal with others in business and social settings.
If there was anything that was modeled for me at Duke and for which I will be forever grateful, it was how to be both a bedside doctor and a physician-scientist. Without that bedrock demonstration, I would never have been ready to learn how to be a clinical oncologist or a biochemist.
So, what does any of this have to do with my very different relationships with Duke vs. MD Anderson?
In the case of Duke, especially Duke Medical School, the leaders there have made sure we graduates were kept informed of the progress in education and research at Duke. The current leader, Dr. Mary Klotman, has gone out of her way to meet with us and share her goals and aspirations for the faculty and for the students. She is the gatekeeper of Duke excellence. She holds the line against attacks from the likes of the leadership at HHS and the NIH. And, with absolute certainty, she exudes class each and every time we meet with her. We know that the future of the medical school and the stewardship of our contributions are in good hands.
At MD Anderson in this century, the leadership has not been the gatekeepers of the two greatest assets of the institution—its name and its faculty. John Mendelsohn got too busy trying to enrich himself. He wound up on the front pages of the Washington Post and Houston Chronicle after he took leadership positions in two failed and criminal companies Enron and ImClone. That’s not gatekeeping, holding the line, or class. Ron DePinho was even worse. He had no respect for the faculty and surely none for the institution he was mistakenly chosen to lead. Peter Pisters has no idea where the gate, the line, or class even start. As ill-fitted as DePinho was for the Anderson job, Pisters is even more so.
Why would we support such an organization that chooses its leaders so poorly and doesn’t want our help anyway? The last time anyone from the Development Office at MD Anderson met with us was 25 years ago. We have made significant donations to Anderson in the past, but not this century.
Let me end by pointing to an MD Anderson leader I knew very well and who embodied everything Peggy Noonan was addressing in her piece. Our donations to Anderson occurred when he was president.
That was Charles LeMaistre who had been the Chancellor of the UT System before he was tapped to lead Anderson. Beyond being a visionary when it came to cancer prevention, he understood that he was the gatekeeper of those two Anderson assets—its name and its faculty. In all my years working for him (1984-1996), I never saw him stumble in this regard. He also held the line of that excellence against any attempts by those in Austin to undermine Anderson’s progress. I saw that with my own eyes. And as for class, there may have been no one I ever met in academic medicine who exuded more class than Dr. LeMaistre. He was exactly what you want in a president. He profoundly understood his job.
Peggy Noonan’s column made me understand a lot of things I have been mulling over for quite some time. You might think about them too as they apply to your life and your career and certainly your parenting.
