Penn State: There But by the Grace of God…

I used to work in the oncology field. Whenever we learned of a treatment error occurring at another hospital or cancer center, we recited a little prayer made popular by our chief nursing officer: “There but by the grace of God go I.”

It was a gentle reminder that our patients and we, as an organization, faced treatment-related risks daily. An unwelcome happenstance given the life-and-death firefight patients and staff acknowledged and embraced.

I recalled this prayer a few weeks ago as news broke of the Penn State allegations.

No organization is immune to crises. Such events are serious when they involve the health of a patient. And equally serious when they involve the safety of children.

If the Penn State allegations turn out true and, at the risk of the obvious, one wonders: How did this happen?

First thoughts: Administrators were protecting one of their own. Perhaps, they thought they were protecting the institution.

MANY YEARS AGO, a crisis was looming at our cancer center. Everyone knew it was going to be big (as in “international”). Much, much bigger than a single treatment error. A lot was riding on the outcomes of four studies — one of which was led by our CEO. The studies involved thousands of patients throughout the world. Many hundreds at our own center.

As things began heating up, faculty members warned me that I was getting too close to the issue. Meaning, if the axe fell, my neck might be near the block. Yet, as the chief communications person, there was no distancing myself.

I consulted a colleague at another center, the most-reputable person in our field, for advice. Her response? “Protect the institution at all costs. Even if it means resigning.”

Her words suggested that something nefarious might be going on. Yet, I didn’t believe this to be the case. Nonetheless, her point was made.

Now, let me say that I could do a whole piece here on how the media (specifically the venerable New York Times and NBC) did major, one-sided stories before data on the study of concern was evaluated — let alone published. (Even our CEO, principal investigator on the study, had not seen the data.)

It’s not about protecting the ‘institution.’ It’s about protecting your constituents — your mission. Then, the institution will be fine.

They had made up their minds. Or, perhaps, were especially deferential to other cancer administrators especially opposed to the concept.

Ultimately, I reconciled myself to whatever would happen. But I wouldn’t wash my hands of it. Our patients deserved the truth — whatever the “truth” would be. So we focused on them. Not on the media (though we provided all the information we could), not the lawyers, not on our donors or any of our many “special” constituents with their own interests and biases.

Just the patients. And we hid nothing.

And though the news was, in general, not good, there were nuggets of insights the research engendered. And here is where it gets a little weird…

Somehow — despite attempts by the media and icons in the oncology field to paint the treatment as inordinately costly and dangerous, and its proponents greedy, self-serving and power-hungry – the patients gleaned unbiased, objective information. Despite the many dimensions of the data, confounding even the most-skilled biostatisticians.

The organization?

The organization was fine. My boss was fine. I was fine. In fact, I think we even earned credibility points by not trying to spin the facts. (And more folks understood the reasons behind, and difficulty underlying, medical research.)

In this, I learned two things:

One, truth rises to the top. Despite powerful forces to the contrary and convoluted, difficult data. Patients were given every bit of information we had. We offered them perspective. They sought it on their own. They were also extremely pissed off at the media* for the contrived attempts at impugning the characters of organizations and individuals.

And, two, it’s not about “protecting the institution.” It’s about protecting your constituents…your mission. If you’re sincere about those two reasons for your existence, the institution, ultimately, will be fine. And you will have served those whose trust you seek.

I hope the Penn State allegations aren’t true. But, if they are, let us all learn one or two important lessons so that this never happens again.

*With one exception: Detroit Free Press medical writer Patricia Anstett refused to follow the herd mentality and published extremely balanced information.
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