Chapter 26:  Reflections on Leadership Style, Intellectual Freedom, and MD Anderson

Title

Chapter 26: Reflections on Leadership Style, Intellectual Freedom, and MD Anderson

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Description

In this chapter, Dr. Freireich reflects on leadership style, intellectual freedom, the legacy of Dr. Charles LeMaistre, Dr. John Mendelsohn, and MD Anderson in general.

Identifier

FreireicEJ_04_20010813_C26

Publication Date

8-13-2001

Publisher

The University of Texas MD Anderson Cancer Center

City

Houston, Texas

Topics Covered

Overview; Character, Values, Beliefs, Talents; Professional Values, Ethics, Purpose; Critical Perspectives; Personal Background; Leadership; Portraits; The Professional at Work; Obstacles, Challenges; Institutional Politics; Controversy; Understanding the Institution; MD Anderson Culture; Working Environment; Institutional Mission and Values; The Researcher; Critical Perspectives on MD Anderson; MD Anderson History; On Texas and Texans

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 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

Emil J Freireich, MD

I love MD Anderson. Dr. LeMaistre loved LeMaistre. That's not to be critical. People have different goals in life. Dr. Clark would have died for MD Anderson. This was his creation. It's what he cared about. Dr. Mendelsohn cares about science. He's got LeMaistre's qualities. He's a LeMaistre figure all the way.

Lesley Brunet, MA

There is that resemblance. Is it just they're tall and white-haired?

Emil J Freireich, MD

The regents like people who look presidential. Mendelsohn has that air, and his wife is just absolutely charming. But he cares about cancer. He cares about science. He cares about research; he really does. LeMaistre didn't care a hoot about medicine or science or anything.

Lesley Brunet, MA

One thing we haven't talked about is LeMaistre's departure. Was it his choice?

Emil J Freireich, MD

Fortunately, I wasn't involved in that. He told the public that it was because of his wife's illness. She had allergies, and he was recommended to take her to the drier climates of Colorado. That's what he says. I don't believe that for a minute.

Lesley Brunet, MA

He had been in office a long time. Some would say it was time.

Emil J Freireich, MD

He was here 18 years, and he was old. When was he born? Do you know?

Lesley Brunet, MA

No, I don't know offhand.

Emil J Freireich, MD

I'd say '24.

Lesley Brunet, MA

By '95 he'd be about 75.

Emil J Freireich, MD

Yes. He was 74, for sure, maybe 75. The regents don't like presidents over the age of 70. They didn't like Dr. Clark at that age. They like young, vigorous leadership. He was still doing very well, but I think he was asked to leave. There was a change in the university administration, and Roger Bulger had left. They had a new president over here, and I just think he was asked to leave. But he had accumulated an enormous fortune as president of this institution. He's really bled the citizens of this state. He continues on some of these advisory boards. I think he's been fired from most of them and replaced by Mendelsohn. But I'm sure he was asked to leave. I was involved in the search for the new president, because I was chairman of the faculty senate at one point, and we had a subcommittee in the senate that advised the regents on his replacement. We interviewed Mendelsohn, and we interviewed other candidates. We had some input, but I don't think it was significant. It was trivial. It was already decided, I'm sure.

Lesley Brunet, MA

You were also head of the executive committee for a while.

Emil J Freireich, MD

Oh, I've been head of everything. I was chairman of the Research Committee and chairman of the Safety Committee.

Lesley Brunet, MA

It's sort of surprising, because you sometimes seem to be in conflict with people, but you have to be elected, right?

Emil J Freireich, MD

Yes. I did an interview for this journal, Lancet Oncology.

Lesley Brunet, MA

Oh, it just came out.

Emil J Freireich, MD

Yes, while I was on vacation. I always start with my background, as I did with you. If you have to fight your way out of a pile of crap, you learn to be energetic and goal oriented. I've always been that. I've always wanted to get done what needed to be done, politics aside, and that's costly.

When Dr. Clark was here, everybody knew that Clark liked what I was doing. We were building. We were making money. We were adding buildings. We were doing research. We were getting famous. Before DT, we were not a scientific, clinical institution. We put MD Anderson on the map, our little gang of warriors. But once we were on the map and accomplished, we outlived our usefulness, and we got cast aside, so that's appropriate. The renewal of the species keeps youth and vigor.

Lesley Brunet, MA

How does that explain why you were elected?

Emil J Freireich, MD

Because everybody knew that I would do a good job, and I was aggressive about seeking it. I wanted to be head of the executive committee. There were only 7 or 8 department chairmen, and you can only do it for 2 years, so you eventually came up. I've been chair of everything—Research Committee, Executive Committee, Promotions/Tenures. I've done everything here, just because I was energetic and people knew they could rely on me.

Lesley Brunet, MA

You say you were never insubordinate. How do they define "insubordinate"?

Emil J Freireich, MD

I have never been insubordinate. Insubordinate is that you don't do what you're told and you don't follow proper procedures. I have always followed the rules. I have always been a team player. I always did what I thought was good for MD Anderson, personalities aside, and that's my goal in life. You see, I'm very taken with Texas. I've always worked for the government. I worked for the federal government, and I worked for state government, but I hate bureaucracy. I'm a very right-wing conservative. I believe in freedom. I believe in freedom of thought. I believe in freedom of action. I believe in decentralization. I think anyone who thinks as DeVita did, that he can control cancer research for 250 million people, is crazy. Those people have to be executed. No matter how brilliant you are, there are more brilliant people around. You have to give people opportunity and motivation. So I believe in freedom. I'm a very strong believer in that. Whenever one imposes on my freedom to think—intellectual freedom, academic freedom, social freedom—I'll get violent. All the things I told you about that appear to be insubordinate were all done by the rules. I didn't go around Dr. LeMaistre, and I didn't go around Dr. Krakoff. Dr. Krakoff thought I did, but I did it perfectly properly. It was a multidisciplinary clinic, and I went to LeMaistre. LeMaistre initiated the program in thoracic oncology. The prescription thing we did absolutely perfectly. We defended ourselves perfectly. There was no need to kill hostages. That's not honorable. So everything that I've told you, in my opinion, was done by the book. I went to LeMaistre when I said I wanted to go to the regents. That was recommended to me. I went to Mr. Trotter in good faith. He agreed to try to help me improve MD Anderson, not me. When I talked to the regents, when I talked to the chancellor, and when I talked to Trotter, I said, "Look, don't worry about Freireich. I'm trivial." This is the greatest cancer center in the world. You've got to care about MD Anderson. If you care about MD Anderson, if you want to cure cancer, this place has to be a leader. MD Anderson is a symbol of intellectual freedom. That's the trouble with Washington. That's the trouble with liberals. They're megalomaniacs. Liberals know more than any conservative. You're a liberal. You know how that goes. We know how to do healthcare. Hillary Clinton knows how to deliver healthcare better than 50,000 people who've worked in healthcare their entire lives. Some idiot lawyer comes out of law school, and she knows how to do healthcare. She doesn't know anything about healthcare, and she doesn't care. She's just got this arrogance of the liberal. The liberal arrogance believes that once you figure out what makes reason, then everybody else should follow your reason. I believe in intellectual freedom. What comes out of a productive society depends on taking advantage of the resources you have, the people. So the national cancer program consists of 30 to 50 cancer centers, each independent, following their own train of thought, not organized into some atom bomb project, but doing what they think they ought to do. MD Anderson has a unique opportunity in Texas. Roswell Park has an opportunity. University of California has an opportunity. They're all different. They all have different leaders. They all have Freireichs. They all have Hershes. They all have Bodeys. They all have Gradys. They all have Keatings. They all have people who want to cure cancer. Give them a chance. Give them freedom. Get the FDA off their back. Get the NCI off their back. Provide plenty of resources. The federal government wants to stimulate research. They don't know how to do it, so they give it to NCI. That's the only way they know how to do it. What NCI should do is what Bush did. They should send the money to Texas and let them decide what to do with it. Texas should just give it to the university, and they decide what to do with it. The university should give it to the institute, so they decide. The people making decisions have to be the people closest to the problem because they're the ones who know what's going on. People who know how to do healthcare are doctors and nurses and patients, not bureaucrats.

I've always been a team player. I've always been proper. I never cheat, I never steal, and I don't lie. I always do what's good for MD Anderson, which is what I believe is good for the cancer effort in the United States and what I believe is good for the cancer effort in the world. But I work hard at it.

Lesley Brunet, MA

Yes, I know you do.

Emil J Freireich, MD

When I was tense, I used to keep these elaborate calendars, so everything is documented with memos and notes.

Lesley Brunet, MA

Of events that occurred?

Emil J Freireich, MD

Every event.

Lesley Brunet, MA

And you've saved all those.

Emil J Freireich, MD

On a day-to-day basis. See, "March 16, new Advisory Committee." "March 17, first discussion."

Lesley Brunet, MA

You created these at the time. This isn't something you went back and did?

Emil J Freireich, MD

No. This is not retrospective. This is live.

Lesley Brunet, MA

That's good.

Emil J Freireich, MD

Yes, I keep everything. When an event occurs that I think is signal, I write it down. That's what you do if you're a scientist. You record everything, because you can't think about everything while it's going on. I have these elaborate notes, day to day, and I wrote them down every day.

Lesley Brunet, MA

That is a great historical record.

Emil J Freireich, MD

They are, but not really important.

Lesley Brunet, MA

But they are important.

Emil J Freireich, MD

I'm a compulsive record keeper. Here's the letter Dr. Loo wrote that's very important. When he retired, he got a job at the Cancer Institute, believe it or not.

Lesley Brunet, MA

Yes, I know. I was surprised.

Emil J Freireich, MD

He was blackballed. I wrote a very strong letter to Bruce Chabner. Here's the whole document about the methyltetrahydrofolate.

Lesley Brunet, MA

He was fired from the head of Pharmacology, but he continued to work here?

Emil J Freireich, MD

No, he left. After he got fired, he resigned. This is a good letter. It documents the whole thing I've been telling you about. This was written to Bruce Chabner, who was then deputy head of the Cancer Center, director of the Division of Cancer Treatment. "Worst price to pay is the fact that monies collected and allocated by Congress are being used for review. No potential for contributing to the discovery of anything."

Lesley Brunet, MA

Did you ever get discouraged about the bureaucracy?

Emil J Freireich, MD

No. You can't be discouraged about bureaucracy. The world is made up of people, and people are distributed normally on the curve of brilliance and stupidity, motivation and no motivation, lethargy and energy and indolence. We've got 30,000 genes. There are all kinds of people. There is a great majority of people who you can make humor out of it, but they rise to their level of incompetence. You can't tell how a person's going to behave with responsibility until he gets it. You can't tell how you're going to be as a mother until you have a child. You can't tell how you're going to behave as a president until you get the job. Once you get it, then you're in a situation where evaluating your performance creates difficulties for everybody above. My wife is a great philosopher. She's kept me going all these years. I would've died of a heart attack at the age of 40 if it weren't for her. She always said, "You know, Dr. LeMaistre doesn't care about you. He's trying to do the best job he can do at what he thinks his job is." And that's true of everybody in a bureaucracy. They're all doing what they think their job is. If you're hired to be a regulator by the FDA, you're going to regulate, and regulation requires that if something is done that is bad, you're at fault. If something is done that is good, you had nothing to do with it. So you immediately become a regulator; you do nothing. That's bureaucracy. A bureaucrat is a person whose main concern is to keep his own job, and that's true of all of us. I want to keep my job right now. Dr. Mendelsohn can fire me tomorrow, and probably will, because I'm not much use anymore.

Lesley Brunet, MA

Something we haven't talked about?

Emil J Freireich, MD

But I did get the LeMaistre award, so I have Mickey with me forever.

Lesley Brunet, MA

That's ironic.

Emil J Freireich, MD

He didn't hand it to me. The first 6 or 7, he came personally to hand them out. But when I got mine, he didn't hand it to me. Dr. Mendelsohn did.

Lesley Brunet, MA

You had a 15-year anniversary of DT.

Emil J Freireich, MD

Yes.

Lesley Brunet, MA

It was a big deal.

Emil J Freireich, MD

It was a big deal. We did that deliberately.

Lesley Brunet, MA

LeMaistre didn't come.

Emil J Freireich, MD

No, he didn't come. We did that to demonstrate to the institution how we benefited everybody. In other words, rather than worry about what we were doing, they should benefit from it. So we tried to show how the programs we had initiated benefited the hospital—the pumps, the vessels, nurses, the IV team, the Pheresis Center, and the platelet transfusion. All the things we were doing were good for everybody at MD Anderson. That was the purpose of our 15-year anniversary.

Chapter 26:  Reflections on Leadership Style, Intellectual Freedom, and MD Anderson

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