High-Agency People
By
Leonard Zwelling
https://www.nytimes.com/2026/04/01/opinion/high-agency-silicon-valley.html
My son Andrew is teaching me about AI agents. As far as I can understand, these are AI-generated bots that do your work for you while you are asleep or doing other things. I don’t want one, but, of course, I don’t really have a job any more. If I did still work, I could see the utility of an entity that could pay the bills, do the laundry, and cook dinner, if that’s what an agent can do. That seems farfetched, but maybe not. I do know that AI agents can keep your calendar, set up meetings, and schedule Zoom calls. My executive assistant used to do those tasks for me when I was a vice president. Maybe I needed an agent although my assistant was very good.
In the attached article from The New York Times on April 5, Sophie Haigney taught me about being “high agency.” This is a little different.
“High agency is now being branded as a personality trait. It implies decisiveness, self-assurance and a willingness to take risks, a predilection for thinking ‘outside the box’ and questioning systems.” In business school in 1991 we called those kinds of people re-engineers, but every generation needs its own language for this, I guess.
“A low-agency person is a cog in the machine, working a regular job, spending too much time answering emails.”
The implications here is that it is good to be a high-agency person.
None of this seemed all that new to me beyond the use of the new terminology. People who take control of their lives and make contributions to society through their work seem to be high agency and always have been. I think what Ms. Haigney adds that is new to me is that high agency people cannot be “constant hamster wheels of action, unmoored from any values.” To me high-agency people without values are caught in Brownian motion or are photons—all energy and no mass. They are likely to do harm.
So, who is the number one high-agency person in the world today? I think we have to go with President Trump. And what about his values? Not all that great.
If there is one thing that best characterizes Trump’s behavior it is that he just does things from firing loyal cabinet members to starting wars and, unfortunately, seems to do these things without thinking and without an overall ethic. High-agency people have no doubt about their capabilities whether or not they have had the experience or have the credentials to do what they have decided to do. They just do. That’s Mr. Trump. I am reminded of Tevye’s plea in Fiddler on the Roof. “If you’re rich they think you really know.” It is pretty evident at this point that Mr. Trump, despite having been president before, and, putatively being rich, doesn’t quite understand how the system is supposed to work. He thinks he can show up at the Supreme Court and intimidate the justices with his presence. I don’t think so. You are supposed to go to Congress before waging war. You are supposed to explain the war to those who elected you and whose money you are using to fight the war. This just seems courteous if nothing else, but perhaps not high agency as Trump sees it. He may be rich, but he doesn’t really know–anything.
High agency can, however, be put to good use when tempered by discipline, experience, and mentorship. MD Anderson, when I got there in 1984, was filled with people of high agency. Everyone I met knew they could cure cancer and acted like they could. This led to some remarkable breakthroughs in treatments and the development of the next generation of leaders in the world of clinical oncology. However, one of the problems with this group of high-agency investigators at Anderson in the 1980s was that the rest of the world was reluctant to believe what they published because their agency was not constrained by the federal rules of clinical research, the Code of Federal Regulations. Their high agency lacked a key value. That was what I discovered when I was assigned the oversight of the infrastructure for clinical research in 1995 and tried to preserve the high agency I had discovered 11 years before, but add a little compliance to the mix at the request of the FDA. I think we did that pretty well.
Today at Anderson, as is the case in the Trump Administration, all of the high agency is at the top of the organization while most of the rest of the faculty are expected to be low-agency cogs seeing a patient every 15 minutes and doing the research bidding of the drug companies while maximizing billing at every turn. Those immediately surrounding the president don’t dare disagree with him. If they are high agency they hide it well. They dare not exhibit high agency. This maldistribution of agency is not a formula for curing cancer especially when the high agency assumed by the MD Anderson president is not accompanied by a research background, meaningful academic credentials, or a nurturing management style.
So, I am all for high-agency people. My medical school education was based on this principle. “At Duke we do not make cookies. We make cookie cutters,” we were told early on. However, patient well-being trumped everything else and the leaders at Duke, then and now, were real physician-investigators, not just high agency, but credentialed and of high integrity.
I spent several hours yesterday going through back issues of The New England Journal of Medicine that have been piling up on a rocking chair in my bedroom. In almost every issue was the result of a novel cancer trial with remarkable agents I could only have dreamed of during my oncology fellowship. I must have gone through eight or nine issues, each containing four or five original articles. None of the ten or so oncology articles I reviewed was from MD Anderson. How can that possibly be?
If the only high-agency person in an organization is the CEO and he is without qualifications for his job, it is likely that the rest of the place will be filled with cogs in the machine and progress by the organization is not likely. And, unlike AI agents, the cogs in such a machine are producing very little.
High-agency people can be very creative. They can also be very destructive when their energy is unfocused because of a lack of education, experience, or judgment. That is Donald Trump. That is Peter Pisters. Board of Regents? Can you hear me?
