The Futility Of Trying To Understand Why Leaders Do What They Do

The Futility Of Trying To Understand Why Leaders Do What They Do

By

Leonard Zwelling

https://www.nytimes.com/2025/12/18/us/politics/trump-insults-second-term.html?searchResultPosition=1

In this thoughtful analysis piece from The New York Times on December 20, Peter Baker tries to understand why Donald Trump makes the decisions he does. Of course, this includes Trump’s need to name buildings after himself, something no other president has ever done.

A lot of this speculation about Mr. Trump’s motivations stem from the recent Vanity Fair article that has gained so much attention for supposedly shining a light on Trump’s Chief of Staff Susie Wiles, who has never given interviews before, but sat for a series of 11 for this article. There have been multiple attempts since this article hit the Internet to use Trump’s unusual behavior to understand why he does what he does. This includes Wiles’ characterization of Trump as having an “alcoholic’s personality” despite the president not being a drinker. People are assuming she is comparing Trump to her famous alcoholic father Pat Summerall, but she may have been referring to Trump’s “unpredictable, attention-seeking, unrestrained behavior.” Either way, there must be some deep pathology at the bottom of Trump’s behavior to explain all that we have witnessed in the past ten years.

In the end, President Trump will not be judged as a success or failure based on what a therapist might infer about his motivations from his public deeds and utterances. Rather, it will be the substance of his accomplishments in office that will determine his place in the history books no matter how many buildings he slaps his name on. The next guy can always take the name down.

Trump’s comments about Rob Reiner were just crude, but so many other comments by Trump are equally insensitive. He just seems to say what is on his mind when his mouth is open with absolutely no filter whatsoever. He is grandiose, narcissistic, and self-centered. Whether or not he is unhinged, will have to be assessed by those better equipped to do so than I. The issue here is that an awful lot of ink and air time is being spent on analyses of Trump’s personality. Frankly, this is not my concern. Shooting at boats and killing people who MAY be drug dealers without knowing for sure, rounding up American citizens and throwing them in jail using ICE storm troopers to do so, and pardoning thousands of convicted criminals are far more important to me than Trump’s psyche.

At MD Anderson, there is much gossip about what appears to be a war on older faculty, an emphasis on making money by working the clinical faculty harder, and a truly lackluster crew of leaders around the president, Peter Pisters, all of whom are making in excess of $1M. As with Mr. Trump, there is much speculation as to why Dr. Pisters has surrounded himself with largely incompetent people (although he seems to be trading up with Jeff Lee and Albert Koong), why he has used “professionalism” to fire some truly excellent faculty, and why he insists on Saturday clinics as a way to balance his budget rather than right-sizing his 28,000- member working force. Pisters also needs to be lauded and applauded at all committee meetings he attends—like Donald Trump.

My personal probing of the Pisters psyche was wholly unsuccessful. He was a blank slate, showing no emotion, and even less passion for anything but business school-speak. Nothing really seemed to move him over our many discussions, including cancer research or, for that matter, the difficulties facing cancer clinicians trying to deliver excellent care in 2025.

However, like Trump, I do not judge Pisters by his motivations or his personality, which I find basically inscrutable. Rather, as with Trump, I want to know what Pisters has done. I really don’t see that MD Anderson is the better for Pisters having led it. He says he has raised $1.9B on the way to $2.5B. What exactly can be spent on research? Everyone in cancer research at Anderson wants to know. If 40% of salaries must be on soft money and the NIH pay line is dropping to the fourth percentile, how can the faculty be expected to meet the 40% requirement? Will Pisters use some of the money he has raised to offset that likely gap? Can he, or is that money spoken for or, more likely, not currently on hand, but only IOUs expected in future years?

Analyzing the motivations of a leader may be of interest as a parlor game, but it is little more than that. Clearly, President Trump needs attention and to feel rewarded and, for that matter, adored by the American people. The people just want him to help them pay their bills and keep their kids safe. Has he done that? Not yet.

As for Dr. Pisters, I am sure he wanted to be President of MD Anderson for a reason. I just can’t figure out what it was beyond the money for him personally and the power vested in the office. All the previous presidents of MD Anderson had an idea what they wanted:

Lee Clark wanted a great center, dedicated only to cancer, and he was successful.

Mickey LeMaistre wanted a patient-friendly place and wanted the center to expand into the area of cancer prevention. He was successful.

John Mendelsohn wanted to improve the science at Anderson. He too was successful, however he mistook MD Anderson for a university when he introduced ideas like salaries on grants. This was an error for which the faculty is paying every day. Having been caught up in business woes, he left the presidency for unknown reasons to the faculty. I am quite sure it was not voluntary.

Ron DePinho had grand plans for the Center including drug development at an industrial scale and total control of research. He failed. While I have no idea what his motivations were, he alienated most of the faculty.

And that brings us to Dr. Pisters. I have no idea what Dr. Pisters wants or wishes to contribute to the MD Anderson mission. He has yet to articulate any new ideas that he wishes to introduce beyond Saturday clinics and excelling in the metrics devised by various business school graduates to measure the center’s excellence. The faculty could not care less.

In the end, it’s not why an individual succeeds in a leadership role, but exactly what he or she accomplishes. So far, I’d say the ledger on Mr. Trump and Dr. Pisters is on the negative side. Tell that to their shrinks!