BORED AND A VISITOR

Bored and A Visitor

By

Leonard Zwelling

         October 29 was the annual Board of Visitors (BoV) dinner at
the Four Seasons downtown. As most of you know, the BoV is essentially a club
with honorific membership that putatively oversees and advises the leadership
of MD Anderson, but is, in reality, the boosters club. You gain access by
having a prominent position in the world or giving MD Anderson a lot of money,
or preferably, both.

The
BoV should never be confused with having an oversight function of the strategy,
performance, or productivity of MD Anderson or its leadership. Most of the BoV
know nothing about cancer or cancer research. In the main, they are business
people or patients. The true fiduciary oversight of MD Anderson rests with the
Board of Regents as it does for all UT components. The BoV has no more
authority than the American Vice President.

         I have attended this dinner many times before, usually as a
Vice President, later as a spouse. Today, I was the latter. I was arm candy for
the Head of Pediatrics, but remember when it comes to candy it’s close to
Halloween and I may have been her trick rather than her treat.

         But there was something really different this year and I
don’t think it was anyone in the room but me for I no longer shared any concerns
with most of the people there other than the Head of Pediatrics and was surely
an outsider as never before. I truly was bored and a visitor at the Board of
Visitors dinner.

         “Why?” I wondered.

         Obviously I no longer work at Anderson and haven’t for over
a year. I haven’t had a meaningful role there since 2007, but still I had
attended the dinner in the recent past and did not feel as estranged as I did
last night.

         Why?

         As is usually the case for the selected faculty who get to
attend, there is business to conduct and BW (Beautiful Wife) had some, but it
was with a person who had really treated me quite badly over the years after
having professed to be my friend. Usually, I would walk over with her and be
pleasant. This time, I sent her on her own and had a beer in the corner alone.
It felt safer, but it was a Miller Lite which is not very good beer, and I
couldn’t really drink it.

I
simply could not think of any place I would less want to be than this dinner
with the folks in the room. People I care about and who I served as a VP and
whose missions I believe in are suffering. Most were not present as they are not
prominent enough in the MD Anderson hierarchy to gain an invitation. In the
name of money and the glory of a very few, the well being of the many is ignored
or worse. The faculty is disenfranchised from the operations and direction of
the institution when in the past the faculty WAS the institution and the people
on the BoV knew that. This crowd seemed oblivious to the roiling turmoil into
which they stepped. When the out-going Chair of the BoV took the stage and referred
to Anderson as the number one place for cancer care, there was a split second
hiccup of silence for one thing the crowd was quite aware of was the
institution’s position as number 2 in the USNWR poll last time.

It
is not productive to lobby Congress once a year in a mad charge up Capitol Hill
as many medical and science societies do expecting results and getting none.
The NIH budget is flat and is unlikely to grow with the in-coming Congress of
2015 no matter what the AACR or ASCO membership does.

Likewise,
the BoV cannot really oversee or even understand anything with a once a year
invasion of the MD Anderson campus, a series of reports from its leadership and
a glittering dinner.

Perhaps
it was my business suit instead of the black tie I used to wear to BoV events.
Perhaps it was the Executive VP for Business Affairs giving the invocation
after having used the institution’s time and money to acquire a PhD in
management and a masters degree in Religion. Perhaps it was seeing so many
women without their prominent husbands this year. I am not sure what that was
about.

Medicine
and especially academic medicine is in a time of transition in the United
States and unlike the threatened Clinton cataclysm that wasn’t in 1994, this
time the tsunami of health care reform is upon us all. Even MD Anderson. If I
hear one more story from the faculty about the subjugation of academic
activities to the quest for more money through ever more Draconian demands for
grant dollars and ever more rapacious pursuit of clinical reimbursement
dollars, I am going to scream.

This
year when I went home to Anderson, I didn’t recognize the place even though I
had been there many times before. But it was not MD Anderson’s change that made
me feel this way. It was my own. I was done. I couldn’t fake the smile or the
good will. I couldn’t pretend that things were going to be all right. I had
walked into the room of a very sick patient and was out of ideas to make things
better. It was time for palliative care and I was the patient needing the
morphine.

This
was no longer even a nice place to visit.

Toto,
we’re not in MD Anderson any more.

I
asked the BW if I could skip the post-dinner remarks. I went to the bar
downstairs and had a beer, a real one, St. Arnold’s, and watched the World
Series until it was time to get the car and go home.

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