The Excellence of MD Anderson Care Comes From Its People

The Excellence of MD Anderson Care Comes From Its People

By

Leonard Zwelling

I have been writing this blog for over 15 years now. I started it to raise awareness of the disaster the immediate past president of MD Anderson was. That proved to be prescient. He had the shortest tenure in the history of MD Anderson presidents.

Since then, I have written countless pieces about the leadership of MD Anderson. Readers know I think it has been less than admirable for the entire 21^st century. Too much self-dealing, too many big salaries, too much of an adversarial relationship with the faculty. And what happened to innovation? It died on the rocks of Enron and ImClone in 2001.

So given that background, how about some really good news about MD Anderson?

If you have followed some of my recent pieces, you know that I had to fight the scheduling system at Anderson to arrange the prostate MRI ordered by my doctor who has been following my borderline PSA for years. For the most part, he does this with careful serial determinations of my PSA and physical exams. About 3 or 4 years ago, I had my first prostate MRI, MD Anderson style. This may be TMI, but that exam at Anderson includes the use of a rectal probe to get perfect images, with and without contrast. The first time I had this exam, I was unaware of what was coming. This time I got smarter. I requested propofol.

In the interim, between that 2022 exam and this new one, I acquired a pacemaker which is a bit of a complication when doing an MRI. Even though my pacemaker is “MRI compatible,” cardiology had to clear me for the imaging exam. So, I had to coordinate between imaging, cardiology and anesthesia to get agreement on a date and time for the test. I also learned that the rectal probe is no longer needed if the 3 Tesla MRI is used, but that has not been cleared for use with a pacemaker, so I had to undergo the probe again on the 1.5 T machine. I hope I got that right.

After much wrangling and a separate visit to the Cardiology clinic, I was given a slot—June 15, 9:45 AM.

The directions to Diagnostic Imaging in My Chart were excellent despite being circuitous due to construction and I arrived right on time. Registration was brisk and simple because I had filled out several questionnaires on-line prior to the day of the test.

I was taken back rather quickly, had my vital signs taken, an IV placed, stepped into a gown, and sat. Cardiology came by and cleared my pacemaker yet again. Anesthesia came, too. Finally, after two hours it was my turn. The MRI room had opened up.

I was walked down the hall and positioned on a gurney, when one of the many people around me (it must have been at least ten by then) asked whether I wanted the rectal probe placed before the propofol was started. I laughed.

“That’s why we are doing it this way. Put me to sleep first and go slowly so I can enjoy it. Then do what you have to.”

The team rolled me into the MRI room and the gurney fit right into the machine. I did not have to transfer to a new gurney as one usually has to do. I was inserted into the coil and the anesthesiology nurse did her magic. She was absolutely the most skilled administrator of propofol I have ever encountered. She slid me right into a dream state over what seemed like 30 seconds of bliss. I was conscious right up until I wasn’t. She was masterful.

When I awoke I was in recovery and wide awake. I do love propofol. As a graduate of Demarol, Fentanyl, and Versed from years of colonoscopy exams, this stuff is way better.

Yes, it was a lot of work on my part to schedule this exam, but once the team assembled, they were utter professionals, caring and skilled in every way. This is an example of why MD Anderson care is so good. My Chart and Epic may be pains, but the people caring for the patients are every bit as good as anyone on Earth. I felt seen, heard, and cared for.

If every patient that comes through the clinics and hospital are treated the way I was on June 15, MD Anderson ought to be the number one place for cancer care in the country. Now, if only someone could explain to me how such lousy leadership deserves such excellence at the front lines. My guess is that the people who cared for me have never met Dr. Pisters or any of his vice presidents. They are too busy doing their jobs and doing them extremely well.