Chapter 19: Leadership, Leaders, and Concerns For MD Anderson
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Description
Dr. Kleinerman begins this chapter by talking about how her view of her self as a leader has evolved through lessons learned. She talks about how she identifies and develops potential leaders. She also cites wisdom she has learned: “You have to be ready to bask in reflected glory,” and offers the view that president of the institution, Ronald DePinho, MD, is a “negative example” of that kind of leadership. Next Dr. Kleinerman talks about changes in MD Anderson culture under Dr. DePinho’s leadership and expresses concerns that “we are losing a lot of our soul.” Dr. Kleinerman then offers perspectives on Dr. Charles A. LeMaistre [Oral History Interview] and Dr. John Mendelsohn [Oral History Interview].
Identifier
KleinermanES_04_20140618_C19
Publication Date
6-18-2014
City
Houston, Texas
Interview Session
Eugenie Kleinerman, MD, Oral History Interview, June 18, 2014
Topics Covered
The University of Texas MD Anderson Cancer Center - Critical EvaluationGrowth and/or Change Critical Perspectives on MD Anderson Institutional Mission and Values MD Anderson Culture Portraits Controversy
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.
Disciplines
History of Science, Technology, and Medicine | Oncology | Oral History
Transcript
Tacey Ann Rosolowski, PhD:
Yeah. Tell me a little bit about your own development as a leader, you know, how you want to do that. I mean, I know you’ve mentioned along the way some kind of key moments, but did you set out and say, “This is the kind of leader I want to be?” or was it an intentional process in any way?
Eugenie Kleinerman, MD:
So, yeah, of course I wanted to be a leader that was liked, and I rapidly learned that success and liked, you know, wanting to be liked is a recipe for failure. So I wanted to be a leader that was liked, I wanted to be a leader that accomplished, I wanted to be a leader that was known for changing the Division of Pediatrics, the perception, the way things are done. I wanted to be a leader that brought the best cancer care to children. But I never viewed it as I want to be a leader so I will get famous. That wasn’t my motivation. I really had my success with MEPACT, and I said, “Okay.” Just like my dad told me, “You will see something. You’ll know you can do a better job of something you love with one hand tied behind your back, and you will do that.” But he also told me when you’re a leader, you have to be ready to bask in reflected glory, because it’s not longer about you, and you will never be given the credit, and you have to be okay with that. And he has been absolutely right.
Tacey Ann Rosolowski, PhD:
Interesting.
Eugenie Kleinerman, MD:
Absolutely right. I also learned you can’t make a decision based on what’s popular. You have to really—it’s important to get input, but in the end, you’ve got to make the decision. Just like the rounding, I mean, I was not popular for saying this [unclear] the way we’re going to go. As a leader, you’ve got to be ready to make a decision and implement a change, knowing that you’re going to be probably not liked intensely. But as long as you’re respected—so that’s what—I wanted to be respected.
Tacey Ann Rosolowski, PhD:
And how do you go about identifying individuals within the division or in the institution at large that you feel could be leaders? What do you see in them? And then what do you do to cultivate that to kind of create a pipeline?
Eugenie Kleinerman, MD:
Well, in terms of the institution, I’ve probably been very bad at that. I’ve tried to do it with my own faculty, recognize where their strengths are, and I’m pretty good. I have a pretty good sixth sense of where somebody’s strengths are and trying to guide them towards that. But at the same time, you have to balance what’s the institution value. And so even if they’re strong in education, you’ve got to be the one that says, “Look, I know you love education, and you and I think it’s real important, but if you’re going to be successful, you’ve got to cut back on this education and focus on this, because that’s how you’re going to be judged.” So I have tried to recommend some of the men and women junior faculty for positions. One of my male junior faculty, when I couldn’t—I was on an NIH study section. When I couldn’t go, I recommended that he go. Now he has been asked to be a permanent member of that study section. So I try to figure out what the strengths of that individual, and then see where I can have influence in putting them into a situation where they have the opportunity to shine. So I don’t think—it just sort of happens.
Tacey Ann Rosolowski, PhD:
Yeah, comes up on a case-by-case basis as opportunities arise.
Eugenie Kleinerman, MD:
Right.
Tacey Ann Rosolowski, PhD:
Yeah, yeah. Thanks for your thoughts on that. Leadership is always an issue that comes up, you know. I mean, either I ask the question directly, but it’s always sort of a theme in this because I’m interviewing people who’ve really been active in developing the institution, and there’s no training in how to be a leader. (laughs)
Eugenie Kleinerman, MD:
No, there isn’t. And my father also said you learn more from negative examples. And I think our president, unfortunately, is a real negative example. He came in and it wasn’t about—it was about him. He wasn’t ready to bask in reflected glory. He didn’t get to know the institution and what was critical to the people. He just assumed that he knew. And, you know, when people don’t perceive that you have their interest, their passion, you don’t understand them, you know, it’s tough to be a general leading your troops into battle.
Tacey Ann Rosolowski, PhD:
Mm-hmm. Now, I know you’ve already spoken some about changes in the institutional culture. I’m wondering if you have anything else you’d like to add about that, or your concerns for the institution.
Eugenie Kleinerman, MD:
Yeah. I’m very concerned about some of the decisions that are being made. When I first came, we really didn’t—I don’t want to say didn’t care, but it wasn’t such a premium that we get a stamp of approval from the NIH. Clinical trials were based on what we knew about patients, the novel things, the good ideas that we have, vetting it here. We set the tone. We said what was important. We didn’t let somebody else tell us the way we’re going to do something, how to do it. And I think it swung—you know, you have to get a paper in Cell or Nature. You need to have two or three RO1s, you know. You need—why? When I came, we were not like a medical school. We were not the same. You know, having a Department of Biochemistry that was filled with National Academy members was not our goal. Our goal was to do basic science so that we could understand cancer, so that we could come up with new therapies, so we could cure the patients. And whether the biochemist was defining the mechanism of action and what pathways were targeted by the chemotherapy so that we could figure out or, you know, identifying a new enzyme that would get a paper in Nature, no. And many people came and left because they didn’t like that, which is fine. But I think now we’re moving. We have to have somebody with structural biology, we have to have—and it’s like we’ve lost our way. We’ve lost our focus. And when I first came, individually you were judged on your contributions to the whole. Now it’s much more focused. In order to get a merit and you’re a research person, you have to have 40 percent of your salary on grants. If you have 39 percent but you’re a great teacher or you’ve served on numerous institutional boards and you really helped us define and—sorry, 40 percent, that’s the rule. I think when you’re a leader, you have to make some decisions that are a little gray, and you have to be willing to make those decisions and stand up to the criticism and say, “I made this decision because I’m your leader and I think this is important,” and not just say, “Well, everybody has to be a cookie cutter.” I’m sorry, cookie. Okay. At Duke they used to tell us—Duke Medical School—“We don’t make cookies; we make cookie cutters.” And that’s where I think MD Anderson was when I first came. We were turning out cookie cutters, and now we’re turning out cookies.
Tacey Ann Rosolowski, PhD:
Those perfect things that are all the same. (laughs) Just to push your metaphor.
Eugenie Kleinerman, MD:
Yes, and if you’re not the perfect cookie, then you’re going to get, you know, squirted and put into the dough again.
Tacey Ann Rosolowski, PhD:
Right. Well, I’m reminded of—I think it was our first interview session, where you said you discovered at a certain point that you didn’t want to be cooking with other people’s recipes; you wanted to be making up the recipes. (laughs)
Eugenie Kleinerman, MD:
And that’s what we did. We made up the recipes, whether in the laboratory or in the clinical research arena or taking care of patients or developing new—I mean, you know, we were the first to really have a big integrative medicine with the yoga and the—you know. I have a faculty who’s done a great job in designing a nutrition program, but she can’t get funded because it’s not sexy. But I think it’s important. And she can be the leader, but she’s not going to be a cookie, a perfect cookie. And there was always a place for that here, and I’m concerned that there won’t be. It still—but I’m concerned.
Tacey Ann Rosolowski, PhD:
Mm-hmm. Right.
Eugenie Kleinerman, MD:
And I’m concerned that there’s no voice on what we want to be. Do we want to be cookies or do we want to be cookie cutters? And I think there’s too much of a focus on—I understand you have to worry about money, but I think we’re losing a lot of our soul. Maybe older people say that all the time about the institution that they’ve grown up in, so, you know, it’s maybe just a Q.E.D.
Tacey Ann Rosolowski, PhD:
Yeah. Change is really tough. (laughs) Yeah.
Eugenie Kleinerman, MD:
Yeah, but if you have change in a thoughtful manner, slowly. I mean, Dr. LeMaistre told me once, he said, “Genie, MD Anderson is like a 747.” Remember that was way back when. “You cannot make a quick right turn in a 747. You’ve got to gently turn the path.” It’s not like a little plane where you could go [demonstrates], although in Pediatrics we do have that nimbleness. We can make quick changes because we’re much smaller, and we have. That was when we decided to do family-centered care. We just did it.
Tacey Ann Rosolowski, PhD:
Interesting. Yeah. Yeah. Just—I mean, you’ve spoken some about Dr. DePinho, obviously, but I wonder what’s your view of Dr. LeMaistre and also Dr. Mendelsohn? How were they to work with?
Eugenie Kleinerman, MD:
Dr. LeMaistre was an amazing man. I’m sure I told you this. He made you feel like you were the only person in the room. He talked to you. I was a little assistant professor. He’d stop and talk to me, never felt he was looking over his shoulder for somebody better to talk. I really felt he was focused on me. In fact, I’m sure I—I believe I mentioned this. My son, we went to an event, and I took my son, who was maybe in middle school, and there was a party, and so Dr. LeMaistre was talking to him and walked away, and he came to me, he says, “I really want to go talk more with Dr. LeMaistre.”
Tacey Ann Rosolowski, PhD:
Wow.
Eugenie Kleinerman, MD:
So, you know, even a kid. I’d travel with him on Southwest Airlines when we would go for philanthropic events, and I’d see him take out the cocktail party list and memorize who’s the person, the wife, the children. He really had just a very personal touch, and you always got the feeling—whether it was true or not, this was the perception—that he really wanted the best for you. He was thinking about what was good for everybody. He was struggling with the decisions that he had to make in terms of the institution. And so you always felt when he made a decision that you didn’t like, you were confident that he considered all aspects.
Tacey Ann Rosolowski, PhD:
Interesting.
Eugenie Kleinerman, MD:
And so that made it a lot easier. “Okay, you know—.” And I can’t even remember some, but there was decisions he made, and you’d say, “Okay, well, he’s the leader. He must have good reasons, and I trust. I trust him.” So I learned a lot on how to deal with people as a leader from him. Dr. Mendelsohn, when he initially came, he went around with a yellow pad, talking to everybody, listening. Not talking, listening, did a great deal of listening. I always felt it was very easy to talk to him and let him know what my concerns were. As I think I told you, he opened up his house. I said this is what he said, “Okay, we’ll have a party in my house.” So I did feel like there was a partnership. I didn’t agree with a lot of the decisions that he made, and I think towards the end of his term, he became distanced and not attached and was sort of making decisions that I didn’t feel that he was like he was in the first years, so I think he lost some perspective. But I think some of the decisions at the end that he made, he really felt were the right decisions.
Tacey Ann Rosolowski, PhD:
Are you thinking of something in particular? I’m just curious. Yeah, yeah. I’ve heard from others—
Eugenie Kleinerman, MD:
Well, I think, all this outreach, MD Anderson Spain and Orlando and all this and international stuff, I don’t understand the rationale, and the superficial explanations that have been given, I’m not confident of. So that’s one of the things. I felt like there were so many things that we need to fix here and yet now we’re diversifying and diluting. I don’t know that that’s the right decision. It may be. But I feel that he made the decision because he felt it was the best thing for MD Anderson, not for John Mendelsohn, but for MD Anderson.
Recommended Citation
Kleinerman, Eugenie S. MD and Rosolowski, Tacey A. PhD, "Chapter 19: Leadership, Leaders, and Concerns For MD Anderson" (2014). Interview Chapters. 1415.
https://openworks.mdanderson.org/mchv_interviewchapters/1415
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