I am not at all sure that either Dr. Kleinerman (the Beautiful Wife, BW) or I really found our life purpose completely until we got to Houston and to MD Anderson in 1984.

Genie had been a tenured faculty member at the NCI’s Biologic Response Modifier Program in Frederick, Maryland. That’s where she started her collaboration with the late, great Josh Fidler. They both knew that the immune-stimulant therapy he developed in mice and which she examined in human systems, liposome encapsulated muramyl tripeptide, was ready for clinical testing, but the leaders at the NCI would not allow her to do the trials there. No problem at MD Anderson. Come on down! And to make a thirty-year story short, she, Dr. Fidler and Norman Jaffe did exactly that and proved that this new adjuvant in combination with conventional chemotherapy could prolong the lives of adolescents with osteosarcoma, actually curing some. One of the “kids” Genie cured is an oncologic orthopedic surgeon in Pittsburgh with kids of his own. Genie had accomplished the measure of clinical excellence determined to be the gold standard by none other than J Freireich. She had developed a cancer treatment.

One of my favorite descriptions of anyone in academic medicine whose reputation exceeded his abilities and accomplishments was that he or she was a photon—all energy and no mass. Photons have no gravitas and leaders need to have gravitas. This is well elucidated in the attached op-ed from The Wall Street Journal on February 14 by Joseph Epstein. Epstein was talking about President Biden. And, I agree. I am never impressed with Biden and he’s gotten worse with age. At least when he was bullying Anita Hill he seemed to have some political weight. Now, he seems like a bumbling, dressed up elderly gentleman who mumbles platitudes and tells stories about his childhood, that illustrate nothing. In the end, Biden is a product of a life in the Senate—making deals, pumping hands, slapping backs and inappropriately smelling the hair of the nearest female. He’s no chief executive as the past year has demonstrated.

David Axelrod wrote an informed op-ed on the website of The New York Times on February 14. In it he begged Mr. Biden to use the platform of the State of the Union Address to express his empathy for what Americans have gone through in the past two years. Rather than do what most of his predecessors have done with this time before the Congress and the American people, laud his administration’s accomplishments and paint a rosy picture of the future, he should acknowledge that the state of the union is not great although better than when he took office. Then he needs to spend a little time convincing us all that he gets the problems—the virus, inflation, immigration, crime—and has concrete ideas for how to make progress on these issues in real time.

In The New York Times on February 7, Ezra Klein writes about the key missing ingredient in America’s response to the coronavirus pandemic—trust. We don’t trust the government and we don’t trust each other. Countries with greater trust ratings did better in the pandemic, particularly in Asia (Japan, South Korea, and Singapore).

Trust was undermined almost immediately in the US. First, we didn’t need masks, then we did. Then schools were closed down for unclear reasons and people had to work from home. We were disinfecting our groceries when it turned out this virus was transmitted through the respiratory route, not on surfaces. Then there’s the whole question of vaccine mandates which probably would have been better handled by not needing them because the case for vaccines was effectively made by the CDC and NIH which obviously did not happen. Oh, they tried, but it didn’t work. Many did not trust the government.

This blog has been a strong supporter of any person affirming his or her or their gender identity. That’s not the issue for today. The issue is athletic competition and most specifically the case of Lia Thomas, the swimmer from the University of Pennsylvania who used to be on the men’s swimming team there and now competes as a woman after her gender transition. When Thomas competed as a male, she was ranked 462. Now, competing as a woman, she is number 1 with a bullet, setting records in meets regularly. Is this right?

It is now common knowledge that American-born freestyle skier Eileen Gu (aka Gu Ailing) won a gold medal in the big air event in the Beijing Winter Olympic Games. The problem is that they she won the medal competing for the host country because her mother is a native of China and she says:

“Because they (meaning China) understand my mission is to use sport as a force for unity, to use it as a form to foster interconnection between countries.”

Hmmm. I guess that is in the Olympic spirit, but scratch a little deeper and some troubling things emerge.

In The New York Times on February 4, the podcaster and author Roxane Gay goes to great lengths explaining why she has removed her popular podcast from Spotify in solidarity with Neil Young and Joni Mitchell. The great Canadian musicians removed their music from the world’s most popular streaming service in protest over Spotify’s continued support for “The Joe Rogan Experience,” another podcast that has promoted Covid misinformation through its giving a forum to vaccine deniers and others whose harmful ideas can lead to preventable illness and death. Spotify and Rogan have countered with pledges to make sure accurate information is posted prior to the airing of misinformed views and to include more varied opinions. The question is: is that enough? Young and Mitchell think not. Neither does Gay.

I think it was about 2003 when it began. Members of my staff housed in the oldest part of the Pink Palace (the original MD Anderson building) began having upper respiratory symptoms–coughs, mucous discharges and breathing problems. My Associate Vice President at the time was among those affected. She called in Environmental Health and Safety and after at least two if not three tries, the environmentalists determined that the duct work in our part of the building was disintegrating and the particulate matter being extruded from the ducts was making people ill.

I adore The Wall Street Journal and often agree with its politics, but the editorial that led the Journal’s editorial page, Review & Outlook, on Monday January 24 misses the mark completely.

The Journal calls the Centers for Medicare and Medicaid Services (CMS) a “death panel” for being unwilling to pay for a new class of Alzheimer’s drug that was given accelerated approval by the FDA recently despite the advisory board’s recommendation not to do so. While it may be true that these new agents like Aduhelm decrease the amyloid in the brains of people with Alzheimer’s, they have not been conclusively shown to alter the course of the disease or the decline in cognitive function of its victims. Thus, CMS will pay for the drug IF the recipient is on a clinical trial—one that is randomized between drug and placebo. This is exactly as should be the case with a drug given accelerated approval. That approval basically says we need more data to know if this really works, but since it might and the target disease is one desperately needing treatment, a randomized, placebo-controlled trial is the best way to do it.