Boston is Not America and it Definitely Isn’t Texas            June
5, 2013

By Leonard Zwelling

            In
the hit Broadway musical The Book of Mormon, the Mormon missionaries in Uganda
sing a song called “I Am Africa’ describing how they have come to appreciate
the place they were sent to spread the message of Jesus Christ of the Latter
Day Saints. This song is mocking “We Are the World” and all other songs where
Americans seem to be celebrating their understanding of a culture that is not
their own without having spent the time needed to absorb that culture. Both
songs scream, “we get it”, when in fact singing the song at all shows that the
singers do not.

            In
my life, I have been fortunate to be imbued by the culture of four places: New
York City, Durham, North Carolina, Washington, DC and Houston, TX. There are
things about each that I adore, but of all of these places it is Houston that
is most my home, my city, my culture. It took me a long time to get there.

            Within
Houston, the culture of MD Anderson is also very unique. There is no place in
the world like it. It is a university and a hospital making it complex in the
extreme. It is blessed to have the finest clinical cancer care faculty ever
assembled plus a closely aligned group of basic scientists intrinsically
interested in addressing the cancer problem as one of translational biomedicine
requiring clinical insight and molecular analysis to work together. And on top
of that, MD Anderson has a whole building dedicated to preventing cancer. Have
you ever heard of a place investing so much to put itself out of business?

            As
I took my trip through life, I have spent the last 40 of my 65 years in
academic medicine. In every one of those years I had to watch out for a group
of people who had peculiar cultural characteristics—even stranger than those of
New Yorkers. They are arrogant, smart, aggressive, brilliant, difficult to deal
with and often in charge. These folks have one thing in common. They have all
spent time in that famous upper middle class boys’ school in Cambridge, MA or
its medical affiliate across the river or one of its many hospitals.

            Among
these people are some of my closest friends. Dan Karp did attend undergraduate
school there but he cleansed himself among the Blue Devils at Duke in medical
school (we were housemates) and that Blue Devil saved his soul. To the rest of my friends from Harvard, I
apologize for the generalization but since I have told you all this before and
we have managed to still talk civilly, this will come as no news. Forgive me for trying to make a point.

            I
can say it no better than George Will did when commenting on basketball star
Jeremy Lin: “it’s nice to see Harvard produce someone who is not a net
subtraction from the public good.”

            Once
again, in the email from an IACS leader, we learn about the arrogance of the
Harvard mindset that has plagued MD Anderson through two presidents now.  At least the last guy tried to figure
out Houston and MD Anderson before he set about “improving” it. That all ended
with ImClone and Enron. The new guy doesn’t even pretend to think there is
anything we can teach him about the clinical care of patients with cancer. He’s
hopped on a rocket ship headed for the moon funding it with clinical revenue
(if 82% of our money comes from the clinic surely some has gone to IACS, the
platforms and the moon shots).

            When
I first got to Durham, some of my classmates from the South took me to AB’s
cafeteria for lunch. AB’s was near the tobacco factories and was a segregated
facility in 1966. I had never seen such a thing, being a naïve Long Islander in
the deep South for the first time ever. It was culture shock. However, I am
glad to say that by the time I left Durham 9 years later, AB’s and the public
hospital wards of Duke Medical Center were both integrated. That did not
prevent me from being denied housing in Durham because one of my fraternity
brother roommates was black.

            Perhaps
it would have been wiser for those coming to Houston from Boston to have given
us a chance to show them around MD Anderson before they extolled the
superiority of Boston.

            Of
course, Boston is still there…..

            One
night in suburban Maryland near Washington, DC during my oncology fellowship,
friends took Genie and me to our first encounter with Maryland crab eating. The tables were covered in brown paper and the crabs were dumped hot and steaming in front of you to be
chiseled and hammered into an edible commodity. It is a Maryland ritual that I
have since learned to love. Then, however, I was an arrogant New Yorker (yes,
moi! Can you believe it?). I asked the waitress to bring me some shrimp to eat
instead, because I was from New York and wouldn’t work for my dinner.

            Without
batting an eyelash she said, “well you can’t use that as a crutch for the rest of your life”.

            I
left her a large tip.  Cheaper than
psychotherapy!