What Is The Pisters Era At MD Anderson?

What Is The Pisters Era At MD Anderson?

By

Leonard Zwelling

https://www.nytimes.com/2025/09/09/opinion/trump-era.html

On the website of The New York Times on September 9, Carlos Lozada mulls over what the term Trump Era really means. It seems to mean different things to different people, but surely the figure of Donald Trump has dominated the last ten years of American politics and changed the state of the world. Whether you perceive that change as better or worse will depend on your point of view as well as the performance of your 401(k), but I am sure you have a point of view about Donald Trump and how he has changed the world.

Until recently, the same could be said about the presidents of MD Anderson. Each of the four men who preceded the current president put an indelible stamp on the place. Some of this was very good, indeed. Lately, not so much. I have been fortunate enough to have been an observer of three of those four past presidents and served two of them directly. Here’s what I saw.

I was not here when R. Lee Clark started MD Anderson (obviously), nor was I here when he concluded his tenure. It is, however, easy to see what the Clark Era meant for the institution. It was Clark’s vision to build a free-standing cancer center at the edge of Houston. He created the Pink Palace and stocked it with the likes of Frei, Freiriech, and Fletcher. The Clark Era of MD Anderson established excellence in patient care more than anything else.

The LeMaistre Era had two great visions. The first was really that of Vice President of Research Fred Becker to boost the quality of the basic science at the institution to make MD Anderson a greater force in academia and to attract the likes of Fidler, Kripke, and Lennarz. The second LeMaistre stroke of genius was to make cancer prevention a major mission area for MD Anderson and then installing Bernard Levin to do just that. And, it was done. Cancer Prevention was its own division with both research and clinical branches. LeMaistre was way ahead of the rest of the world in his realization that prevention was the way to reduce the incidence of cancer.

The Mendelsohn Era also had two primary foci. The first was “research-driven patient care.” More than anything, John Mendelsohn wanted the bench research at MD Anderson to be world-class. Even though he himself was never able to attract a member of the National Academy of Sciences to work at Anderson, he created the soil in which the science of MD Anderson grew. This was also true of clinical science where the Division of Cancer Medicine under Ki Hong had nothing but world-class clinical investigators as department chairs with better and better basic science driving the clinical protocols that gave MD Anderson patients first crack at the newest cancer therapies.

Here the story turns darker.

Mendelsohn also brought the beginnings of the drug company dominance of clinical research to Anderson and with it the drive for turning academic inquiry into personal profit. He was the poster child for this when he allied himself with Sam Waksal and ImClone to commercialize Erbitux even before he got to Houston. Erbitux was the drug Mendelsohn discovered. But Mendelsohn ran into major issues of conflict of interest. Then, Mendelsohn also chose to involve himself as a board member for a corporation that had donated money to Anderson and his reputation sunk with the collapse of that corporation, Enron. Actually, two MD Anderson presidents were on the Enron board, LeMaistre and Mendelsohn. Enron’s collapse led Mendelsohn to wrap himself in lawyers and cede major institutional decisions to one of them, Dan Fontaine. All of a sudden, MD Anderson was open for profit. MD Anderson also became the province of the attorneys. For all intents and purposes, it still is.

It was logical then for the Board of Regents to by-pass Ray Dubois, a true academic, as the next president, and instead pick Ron DePinho whose contribution was nepotism and money for himself and his wife’s office furniture. The trajectory of greed initiated by John Mendelsohn had been taken to the next level by Ron DePinho. Nonetheless, DePinho did have a vision to cure cancer. It was distorted, but he could articulate it. There was a plan to the DePinho Era. It was just a bad one and surely was poorly executed.

That brings us to today and the Pisters Era. No one is quite sure what the Pisters Era has contributed to MD Anderson beyond the drive to get lay evaluators of health care competence and magazine boards to rate MD Anderson highly and to expand the MD Anderson work force to levels R. Lee Clark could never have imagined. I assume that as long as Pisters can keep MD Anderson in the black, he can keep his $4 million pay package and pay his yes men and yes women a million dollars each. However, when Pisters is done, no one will know that he was here unless the Board of Regents elects to name a veterinary facility for him. Pisters will have left no footprints on Holcombe at all.

Every leader can have an era named after him or her. It can be good or bad. In fact, it can be both depending on the eye of the beholder. As Lozada writes, this may be true of Trump. It has certainly been true of the leadership of MD Anderson. The problem is that the MD Anderson leadership has been on a downward trajectory for the past 25 years.

The next leader of MD Anderson must have a vision for the future of cancer care and research that incorporates the realization of the power of big pharma, the shrinking of grant dollars for bench research, and the need to gain greater access for all people to the latest in cancer prevention. The next president will also have to mobilize the faculty to fulfill his or her vision because the current faculty is pretty burned out. Finally, the next president of MD Anderson has to grow a big pair of ears to listen to those he or she hires and to develop a real liaison with the rank-and-file faculty by reconstituting something like the Faculty Senate to the extent state law allows. Of course, Pisters could do all that now. He could, but he hasn’t.