Fired Again

Fired Again

By

Leonard Zwelling

For a supposedly hard working, intelligent person, I have been fired from a significant number of jobs over my years. The firings were always more likely to be due to insubordination than incompetence.

I think the earliest job from which I was fired was as a stock boy at Fortunoff’s Department Store in Garden City, Long Island. It was a job I got once I obtained a driver’s license (you had to be 17 in New York) and had some time to work after class during my senior year of high school. I was pretty good at it, too, finding the right color dish rack in the huge warehouse for demanding customers.

However, I was also heavily involved with my high school choir and the schedules of the two—the job and choir rehearsals and performances—began to clash. I always chose the choir. Then one day, my boss at work had had enough of my absences and fired me. He should have. I bounced back and had a summer job within weeks.

The next time I was removed from a job, sort of, was when my mentor at the NIH asked me to leave his lab when we were constantly fighting about what experiments to do and who would get credit for the findings. I had been working in his lab for seven years by then. I had even designed a whole series of new experiments using a technique I learned on my own from another mentor, the late Nate Berger in St. Louis. I wrote up the work, and got it published in the Journal of Biological Chemistry all by myself without revisions. I was ready for my own lab.

My mentor thought the entire lab ran on his money. Actually, it was yours. It was federal tax dollars, but he thought it was his to dole out and to control all aspects of the lab. I disagreed. Again, he was right. I was wrong. Again, I bounced back. I moved to MD Anderson and started a 29-year career in research and, after business school, research administration.

Unfortunately, toward the end of those years, my usefulness to the Anderson mission, the institution’s president, and his newly designated Provost was no more. Fired again. Bounced back again.

I spent the next year on Capitol Hill doing staff work in the U.S. Senate while on sabbatical from Anderson. It was 2009–the first year of the debate on health care reform. There was no better time to be there. That was a pretty good bit of resilience on my part and a great time to be in D.C. I actually wrote a book about the year called Congressional Malpractice, but never had the time to finish it once I got back to Anderson where I was handed some tasks like being the ad interim chair of Carcinogenesis in Smithville (I moved all my D.C. pots and pans to Bastrop) and overseeing the Pharmaceutical Development Center, something I never understood at all.

After retiring from Anderson in 2013, a year before I had to, I went to work at Legacy Community Health, the largest federally-qualified health clinic in Houston. I was to assist the Chief Medical Officer (CMO) on a number of projects including education and community outreach. After only ten weeks on the job for me, he quit and they made me the acting CMO, something I had not bargained for or sought. I quickly ran up against the philosophy of the CEO, the CFO and the Chief Strategic Officer. Their philosophy was: make as much money as possible regardless of the quality of the delivered clinical care. My philosophy was a good bit different. I had been taught since medical school to put patients first, not money. I should have known better. The latter two execs at Legacy were felons formerly imprisoned following the Enron scandal prior to their putative rehabilitation at Legacy. They didn’t seem rehabilitated to me.

I tried to appeal to the Legacy Board of Directors, on which I had served before being hired. That went down poorly. Fired again. That’s when I finished that first book which had been a work in progress for five years by then.

Today (NOV 14), my service on the Board of Directors of the San Jose Clinic, a Catholic charity care delivery system in downtown Houston and Ft. Bend County, was terminated by the archbishop of the Catholic archdiocese in a letter emailed to me by the archbishop’s secretary. Fired at a distance this time! No explanation was given. Once again, however, I had had a major falling out with the archdiocese leadership over a lack of clarity in the quality of care being delivered and the fiduciary role the board had to the Catholic Church, to donors, to grant funders, and to the patients. This time I was not alone in being fired. Colleagues who shared my concerns were also removed.

Having brought these concerns to the attention of the archdiocese through its representation on the San Jose board, I was ostracized as being insubordinate and then dismissed.

As in many of my other occasions of being relieved of responsibility, I have butted heads with authority when I felt that authority was hurting the organization. Of course, the authority in neither of these two clinics was a physician. Perhaps it should have come as no surprise that my worry about patient care was not always shared by the leadership of either clinic.

The list of my firings is far less remarkable than the fact that I was able to have a productive career in large academic institutions for many years without being fired. But remember, I have recently written about how certain such institutions foster an atmosphere of excellence and “something greater than yourself.” I thrived in such places. Most other institutions are really mediocre in their leadership. I have done poorly in such environments.

Once I have found myself in an atmosphere that is unresponsive, distant, and not devoted to excellence, I do poorly in such situations. This traces back to my rigid parental upbringing stressing honesty and integrity, my need for excellence, and the values drummed into me by my parents and my teachers at Duke Medical School.

So, an observation for those of you who still hold on to core values like integrity, the sanctity of the individual’s worth, and working toward something greater than yourself. When you take a new job, if you can, try to figure out what it’s going to be like to work at this new place and what its corporate values are. It’s hard to do, but well worth the effort. And don’t read the corporate values. Ask the workers if they are real. You’ll be happier. You’ll be more successful. You’ll probably not get fired.

It seems I have learned nothing over 77 years except that I don’t quit fast enough. What I have definitely learned is that I know who I am and I know what I believe. That many institutions do not share my beliefs is not really of note. I just need to do a better job of staying away from such places. Fortunately, I’m retired and don’t need to bounce back this time.

But, I still do worry about the patients in the hands of people who do not share my values. The well-being of these patients is in the hands of people who do not understand medicine or healthcare. As a friend has said to me, “this never ends well.”

In academic medicine, in many places, it already hasn’t ended well at all.