I HAPPENED TO BE VISITING a friend at the University of Texas M.D. Anderson Cancer Center in Houston this past June when good and bad news collided. The good news was that one of the center's patients, 73-year-old Josephine Fleming, of Denton, had become the first lung cancer patient in the world to survive for five years after being treated with gene therapy. This was considered a huge vindication for a controversial form of treatment that the center's scientists had long championed, as well as for Anderson's philosophy of "translational research"—making cutting-edge, even experimental, treatments available to patients through clinical trials as soon as is safely possible. The bad news was that the long arm of scandal had reached out and touched the nation's largest cancer center: Questions were being raised about Anderson president John Mendelsohn's longtime relationship with the biotech company ImClone, which had become the subject of inquiries concerning its business practices as well as insider trading by its executives, their families, and their friends (including interior-decorating and entertaining guru Martha Stewart). Even Houston's most incorruptible institution, it appeared, wasn't immune to infection by Enronitis.
The most interesting thing about this convergence was how little it seemed to affect "the Anderson," as its loyal employees and patients prefer to call it. Indeed, when I first encountered the hulking twelve-story pink-granite edifice known as Albert B. and Margaret M. Alkek Hospital—the main structure of M.D. Anderson's three-building campus at the Texas Medical Center—I had the immediate sensation that this was a mood-swing-free zone, like the Supreme Court. The business of eradicating cancer, like the business of maintaining justice, is such an all-consuming and righteous mission that those who pursue it can't afford to be distracted by such temporal matters as scandals. In other words, business went on as usual, which is to say, with a certain persistent cheerfulness and aplomb that I have not found in any other hospital I have ever been in, either as a patient or a journalist.
When you visit M.D. Anderson, it's hard not to be encouraged about the decades-old war on cancer. Here are four million or so square feet of labs and operating rooms, where nearly a thousand of the world's finest doctors spend most of the institution's annual $1.4 billion operating budget studying, diagnosing, and treating a single disease. With its emphasis on clinical trials, there has never been anything quite like the Anderson in the history of medicine.
But then, there has never been a hospital like the Anderson; in many ways, it does not seem like a hospital at all. The main lobby, with its vaulted ceilings and designer colors, is more mindful of a chic hotel than a medical facility that treats a disease that will kill nearly 40 percent of the people it afflicts. It doesn't reek of that familiar hospital odor either, and its employees—from janitors to world-class researchers—don't have the familiar hospital attitude that the place exists for the staff, not the patients. There seems to be an acute awareness that since more than a third of us will be diagnosed with cancer before we die—and the rest of us will suffer along with a loved one who has it or live in fear of acquiring it until we die of something else—we're all in this cancer thing together, and there's really no reason to be anything but nice to each other about it. This is why the Anderson, among many other things, is one of the sweetest and most serene places you'll find, no small accomplishment for an institution that treats 65,000 people from all over the world each year.
Almost everything here seems designed to take your mind off the Big C. There are aquariums everywhere you turn; a food court with a pianist; a 322-room hotel run by Marriott International, where outpatients and spouses and loved ones can enjoy a fully loaded cable system and excellent room service. From the moment you enter the hospital's registry, you have patient advocates and troubleshooters who can handle all of your appointments or, if necessary, bully your managed-care company into paying for your treatment. Josephine Fleming, the lung cancer survivor, told me, "I have never been treated better anywhere, at any time in my life."
The Anderson's institutional optimism is genuine and rooted in its history. It has been in the business of fighting cancer for a long time—since 1941, when it was created, in a rare moment of foresight, by the Texas Legislature as both a public hospital to treat the disease and a part of the University of Texas system to study it. The blend of research and treatment enables M. D. Anderson to embrace the cultural myth, so dear to Texas and Houston, that you can do whatever you dare to do. While most cancer centers are a part of a medical school or a wing of a large hospital, the Anderson is among just a handful of freestanding centers in the nation that study and treat the disease exclusively. (Memorial Sloan-Kettering Cancer Center in New York is the most notable other example.) Most important, because the Anderson is chartered and partly funded by the state, it has always had to be egalitarian. Sitting in a waiting room, I saw a cab driver from Houston's Fourth Ward sitting next to a sheik who had just jetted in from Saudi Arabia for chemo. And while its rich and famous patients have always been noted prominently in articles about the Anderson—in recent years it has treated rocker Eddie Van Halen and Southwest Airlines chairman Herb Kelleher—it still spends about $120 million a year on cancer care for the indigent. All of this has created a unique ambience that is remarkably optimistic. Rather than treating cancer as something that one dies from, the Anderson treats it as something that can be lived with.
The amenities and the culture are just the sizzle; the main reason most cancer patients think of M.D. Anderson first is that