Integrity: Where Does It Come From; Where Does It Get Lost?
By
Leonard Zwelling
On the bus back from the dinner party that was my initiation to Duke Medical School Board of Visitors (BoV) membership, I happened to be sitting next to a youngish woman with whom I struck up a conversation. She too was a new BoV member. As seems to be inevitable, the subject of AI arose. I related the story of how I used Claude to format my book and cover for Amazon KDP. Obviously, I am sold on AI as a valuable tool.
She wanted to know what the book was about. I related the story in brief of my various jobs, the challenges when I faced some sort of corruption, and my inevitable firing from three jobs in a row—my vice presidency at MD Anderson, my service as ad interim Chief Medical Officer at Legacy Community Health, and as a board member of the San Jose Clinic. This is not a sterling track record.
In each instance, I either ran up against management wanting to go in a direction that did not include me or I faced outright corruption. I’m writing a novel about all of this now.
Her interest was different than I would have imagined.
“How did you maintain your integrity?” she wanted to know.
I actually had not thought about it, but blurted out, “what you see all around you,” meaning the stalwart and ardent Duke supporters on the bus. “This is what got me through.”
My training as a Duke medical student and as a Duke medical house officer demanded the utmost of integrity. There were no shortcuts. There was no way to fudge a lab result or not do a complete history and physical exam on every patient. If a spinal tap was needed in the middle of the night, you had to do it. It was always the same two questions I asked myself—what needed to be done, who needed to do it? If the answer came back “me”, it was I who did it.
You supported your fellow students and residents, too. You got through it together and in the joint effort came the confidence, competence, and integrity that is the essence of “Dukeiness.”
What I did not mention on the bus ride was my childhood upbringing which was extremely strict in the integrity department. Lying was not tolerated. Treating others as I wished to be treated was paramount. And excellence in all things was expected. And yes, corporal punishment was occasionally used. My father was a first lieutenant in the Second World War and brought a military flavor to his parenting.
Now, did this make me an addict to Gold Stars? It did. In effect, I was primed from birth to be an academic physician even though I didn’t know it.
Whenever I asked my father a question, he said, “look it up.” Remember, there was neither the internet nor Claude in 1955. We did have a World Book Encyclopedia, though.
When I came home from school after a test, my mother asked how I did? If I said I got 100, she would say, “the test was too easy.” If I got a 97, she would say, “where are the other three points.”
I am not suggesting that my childhood was not fun. It was, but it was also strict, guided by rules, and always, always laden with the drive for integrity.
Thus, it was impossible for me to be otherwise and on the occasions when I was, it didn’t serve me well.
When it was reported in The Washington Post that the MD Anderson President, my boss at the time, presided over testing of the drug he discovered, developed, and commercialized for the company ImClone using MD Anderson patients unaware of his involvement in and potential profit from the experimental studies in which they were enrolled, a flagrant conflict of interest, I had to deal with the local press reporting the scandal. Instead of saying, yes, he was wrong, I obfuscated as I was expected to do to protect the president.
The next day we were both excoriated in the Houston Chronicle. Meanwhile, he made $6 million in one day selling his stock to another drug company. I made nothing. Although I kept my job, I compromised my integrity. The right move would have been to tell the truth and get fired if need be.
Claude says integrity is “the quality of being honest and having strong moral principles that you consistently follow.” I like to think that I have integrity and it sounds like I did pretty well given my conversation with this young woman. Anyway, she bought two of my books on the trip back from the party.
Currently, the President of the United States prides himself in having no integrity. He’s not even honest with himself let alone with the American people.
The current president of MD Anderson may or may not have integrity. No one knows because his values are undecipherable thus his adherence to them is opaque. Good leaders cannot have opaque values. Good leaders should exude integrity and inspire others to do have it, too.
Several people with whom I have worked exuded that integrity—Margaret Kripke, David Hohn, Kurt Kohn, Nick Kredich, Charles Scoggin, Bruce Dixon, Irv Krakoff, Mickey LeMaistre. These people inspired me to be better. Each is thanked in my new memoir, An Unfinished Product.
I know what integrity looks like even on days I don’t see what I hoped for in the mirror. Neither Donald Trump nor Peter Pisters is my idea of examples integrity. In that, is the problem the country and MD Anderson face.
