We Were Once Pirates
By
Leonard Zwelling
This op-ed by Peggy Noonan in The Wall Street Journal of May 9 is a paean to CNN inventor and jack of all trades Ted Turner. In the piece Noonan says this of Turner:
“we need renegades, brigands and pirates, we want their visions and breakthroughs, we want their spirit—go for broke, trust your brain, be wild, insist, announce you are here.”
Noonan’s description of Ted Turner is my description of MD Anderson and its faculty circa 1984–visions, breakthroughs, spirit, brains, wild men (and women), and most of all, pirates. The most important reason that Dr. Kleinerman and I came to MD Anderson, despite its rather checkered reputation in academic oncology at the time, was the promise that that we could do anything that we could imagine. We may have appeared to be joining the pirates to our friends at the NIH who thought us crazy for leaving tenured positions for the uncertainty of working for new chairmen in Cell Biology and Medicine at a place known for breaking the rules of clinical research on a regular basis. Yes, there were MD Anderson faculty members who broke the rules, but others wrote new and better ones. And Genie had a drug to try in patients that those running the NCI would not allow her to test and I needed a lab of my own to pursue my sometimes off the mainstream ideas in molecular pharmacology.
It was also the people for whom we worked who had Ted Turner’s bold vision and daring that allowed Genie to be the first woman to head a clinical division and me to go to business school and rise to a vice presidency. None of this was planned, but none of it would have happened had we stayed safely in Bethesda.
Now my question is are there any more pirates at Anderson or are they all being walked off the plank so that those in charge can retain their large salaries and exhibit little imagination? I detect a distinct inhibition of young talent to the point of driving some of them out of the institution. This is not the MD Anderson that so attracted us over 40 years ago.
Now it may be that I am so out of it that I am missing the Jolly Rogers of the current faculty flying right before me. Perhaps I read too few journals. But I ask, can the current leadership of MD Anderson really set sail for the future given its lack of academic accomplishment and obvious suppression of young faculty progress?
Steve Jobs is quoted in Walter Isaacson’s biography as saying:
“A players hire A players, but B players hire C players — and C players hire D players. It doesn’t take long to get to Z players. This trickle-down effect causes bozo explosions in companies.”
Has the MD Anderson leadership succeeded in continuing down the alphabet? It seems so to me.
I do know of some cutting-edge work at Anderson on the effects of the microbiome on the effectiveness of treatment with immunotherapy agents and the novel, targeted treatment of lung cancer based on the molecular characterization of biopsied material. But when we got here and for years thereafter, every single department on the clinical side and in the basic labs had amazing ideas about cancer biology and novel approaches to cancer treatment. Is this still true? Furthermore, I was quite certain that the experimental care being rendered 30 years ago was care that could only be obtained at Anderson. I wonder about that now.
I want to believe it is still true, but when my MRI scheduled for 10:15 on June 18 required cardiology clearance because of my new pacemaker (which is MRI compatible), why did the people running the scheduling system make the cardiology consult for three hours AFTER my MRI? Can no one apply AI to scheduling at MD Anderson? It seems a trivial thing to do nowadays. Is Anderson being run by the gang that can’t shoot straight?
As an Anderson patient, it is still a seemingly impervious wall between me and my care team that is supposed to be bridged by My Chart. I am not impressed yet. I get messages to my concierge doctor using the Methodist My Chart system easily. The MD Anderson system works less well. Personally, I use email or the telephone to contact my Anderson care teams.
When we got to MD Anderson, it was alive with ingenuity, invention, and chutzpah. That was Ted Turner and that used to be us. We were the pirates of academic oncology and even as Irv Krakoff and Ki Hong brought order to the clinical trial chaos that we discovered when we got here, they also were pirates in their own right. In fact, as a vice president overseeing the infrastructure for clinical research, I had to face Dr. Hong’s table of department chairmen more than once. They were imposing. They were the world leaders in their fields. And they too were pirates. I dare say the current clinical leadership could use a few pirates. So could the greater institution at-large.
We were once pirates and loved it. It’s hard for me to believe that those who occupy the places on the deck of the ship that we once held are having nearly as much fun as we did.
