July 13, 2008
Dr. Michael DeBakey, R.I.P.
Dr. Michael DeBakey (previous posts here) died late Friday at the age of 99. One of the most influential men in Houston's history, Dr. DeBakey was the world-famous cardiovascular surgeon who researched, developed and initially implemented not only a variety of devices that help heart patients, but also such now-common surgical procedures as heart-bypass surgery. Two of the Chronicle's finest reporters -- Science reporter Eric Berger and Texas Medical Center reporter Todd Ackerman -- provide this outstanding article on Dr. DeBakey's remarkable life, and Eric provides an audio file of his 2005 interview of Dr. DeBakey here. The New York Times' article on Dr. DeBakey's death is here.
As with my late father, Dr. DeBakey was one of the leaders of a talented generation of post-World War II doctors who embraced the optimistic view of therapeutic intervention in the practice of medicine, which was a fundamental change from the sense of therapeutic powerlessness that was widely taught to doctors by their pre-WWII professors. As noted earlier here and here, that seismic shift in medicine has changed the course of human history.
But the tremendous impact that Dr. DeBakey had on medicine is exceeded by the massive effect that he had on Houston. When Dr. DeBakey accepted the president's position at Baylor College of Medicine a few years after the end of World War II, the Texas Medical Center was a sleepy regional medical center. Over the next two decades, Dr. DeBakey was one of the key leaders who transformed the Medical Center into one of the largest and best medical centers in the world. Dr. DeBakey was the catalyst who established the culture within the Texas Medical Center of cutting-edge research, productive competition but also widespread collaboration, quality care for patients and good, old-fashioned hard work that attracted the best and brightest physicians, teachers and students from around the world to the Medical Center.
This massive importation of intellectual capital over the last 60 years of Dr. DeBakey's life generated enormous wealth and benefits for Houston. Today, the medical facilities of the Texas Medical Center are the largest aggregate provider of jobs in the Houston area, even greater than the local jobs provided by the energy industry.
That's quite a legacy in my book.
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December 19, 2007
The remarkable story of Kevin Everett
Three months ago, Kevin Everett, a tight end for the Buffalo Bills who was born and raised in Port Arthur just east of Houston, suffered a serious spinal cord injury during an NFL game. At the time of the injury, there was grave doubt whether Everett would ever walk again.
As this Sports Illustrated article recounts, Everett's recovery from his serious injury has been nothing short of amazing. One of the interesting aspects of Everett's recovery is that it may have been fueled by the gutsy call of a 45 year-old orthopedic surgeon on the scene in Buffalo, but it was certainly facilitated by the remarkable rehabilitation services of the Texas Medical Center's Institute for Rehabilitation and Research (known as "TIRR") and the inspiring resolve of the 25 year old patient. TIRR is regularly ranked as one of the finest rehabilitation institutions in the U.S. and is one of the many reasons that Houston is among the world's finest medical centers.
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November 28, 2007
The NY Times on the DeBakey-Cooley rapprochement
Following on this earlier post about Todd Ackerman's fine piece on the rapprochement between longtime Texas Medical Center rivals, Dr. Michael DeBakey and Dr. Denton Cooley, this New York Times article examines the history of the feud and the recent reconciliation.
The article passes along the following famous anecdote from the investigation into Dr. Cooley's use of an artificial heart back in the early 1960's without proper authorization:
Dr. Cooley recalled that a lawyer had once asked him during a trial if he considered himself the best heart surgeon in the world.“Yes,” he replied.
“Don’t you think that’s being rather immodest?” the lawyer asked.
“Perhaps,” Dr. Cooley responded. “But remember I’m under oath.”
Read the entire article.
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November 26, 2007
A Texas Medical Center giant
This Alexis Grant/Chronicle Q&A column interviews one of the truly outstanding physicians who has made the Texas Medical Center one of the most extraordinary medical centers in the world -- Dr. Ralph Feigin of Texas Children's Hospital. Take a moment to review Dr. Feigin's remarkable biography and the interview, and then take a moment to appreciate this man's tremendous contribution to pediatric medicine in Houston over the past 30 years. It's a legacy that will not soon be matched.
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November 8, 2007
The DeBakey-Cooley rapprochement
The longtime feud and resulting intense competition between Houston cardiovascular surgeons Michael DeBakey and Denton Cooley was a part of what catapulted Houston's Texas Medical Center into the upper tier of the world's great medical centers over the past 40 years.
Now, the Chronicle's fine Texas Medical Center reporter, Todd Ackerman, reports in this article that the DeBakey-Cooley rift is no more:
It's considered one of medicine's best-known feuds: two brilliant and egotistical doctors on the frontiers of cardiovascular surgery, whose falling-out divided a community and became the stuff of legend.Immortalized in a Life magazine cover story, the rift persisted for decades. Although the competition spurred them to achievements that transformed the Texas Medical Center into the world's heart treatment center, the former collaborators avoided each other and barely spoke.
But recently, Michael DeBakey and Denton Cooley buried the hatchet.
"I'm glad the rivalry may have passed by," Cooley said on Oct. 27, presenting DeBakey with a lifetime achievement award at a meeting of Cooley's Cardiovascular Surgical Society. "I hope this is not just a temporary truce or cease-fire (but) ... a permanent treaty between us."
DeBakey, 99, responded that he was glad to be there for two reasons: "One is, I'm alive. And the other, of course, is to get this award. Denton, I am really touched by it."
Read the entire article.
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August 18, 2007
A job well done
University of Houston student-athlete and football player Jerrod Butler was stricken by sudden cardiac arrest on Monday during a weightlifting session at the University of Houston. Butler passed out and stopped breathing.
Members of the UH athletic training staff, led by Mike O'Shea and John Houston, immediately revived Butler, performing CPR and using an automatic external defibrillator. Butler was then rushed the short drive to the Methodist Hospital emergency room at the Texas Medical Center, where he was put on a ventilator and placed in the intensive care unit.
On Thursday, Butler was moved out of the ICU and into a regular room.
It's easy in our busy lives to take professionals such as O'Shea and Houston for granted, but they are the type of dedicated people who make Houston such a special place to live. A tip of the hat to these two fine professionals on a job well done.
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June 5, 2007
Texas' medical licensing logjam
The number of insurance companies offering medical malpractice insurance policies has dramatically increased and malpractice insurance premiums have substantially decreased since the 2003 legislation enacting medical malpractice caps in Texas, but the med mal caps have contributed to at least one unanticipated problem:
. . . about 2,250 license applications await processing at the Texas Medical Board in Austin. The wait could be as long as a year for some of the more experienced doctors because it takes longer to review their records.The fear is that some doctors will give up on Texas and go elsewhere instead of waiting. A $1.22 million emergency funding request was approved during the last days of Texas legislative session for the Texas Medical Board, which licenses physicians. That is on top of the $18.3 million regular biennial appropriation, said Jane McFarland, the board's chief of staff.
The board plans to add nine new employees to its 139-member staff, seven of which will help chop away at the backlog of license applications.
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May 8, 2007
Dr. Don W. Chapman, R.I.P.
Longtime Houstonian Dr. Don W. Chapman died last Thursday at the age of 90 (a Chronicle article is here). With Don's passing, Houston has lost one of the extraordinary group of doctors who catapulted Houston's Texas Medical Center into one of the premier medical centers in the world. I had the privilege of getting to know Dr. Chapman and his loving wife of 60 years (!), Mary Lou, through my father and mother, who were lifelong friends of the Chapmans.
As with my father, Don was a member of the groundbreaking generation of post-World War II doctors who embraced the optimistic view of therapeutic intervention in the practice of medicine, which was a fundamental change from the sense of therapeutic powerlessness that was widely taught to doctors prior to the post-WWII medical professors such as Don Chapman and Walter Kirkendall. We all take therapeutic intervention in medicine so much for granted these days that it is easy to overlook just how revolutionary this change was in the way medicine had been dispensed for decades and even centuries before Don and Walter's special generation of teachers and researchers.
Don and my father completed their medical residencies together at the University of Iowa Medical School just in time for WWII. Don served in the war with great distinction as a Major in the Medical Corps of the U. S. Army and as the primary Cardiac Consultant for the European Theater while stationed at the 5th General Hospital and later the 98th General Hospital. Upon returning from the war, Don went on the faculty of Baylor College of Medicine and was one of the original ten Baylor faculty members who moved to Houston when Baylor moved to the Texas Medical Center location in 1944. Don and and the other Baylor faculty members at the time began operating in a fledging medical center that consisted of the new medical school and one 234-bed hospital.
Within two years of arriving in Houston, Don introduced cardiac catheterization to the Medical Center, which allowed Baylor faculty members and Methodist Hospital physicians to offer precise cardiovascular diagnosis and groundbreaking heart disease intervention for the first time. Under Don's leadership, the Medical Center quickly became a pioneer in cardiovascular diagnostics and surgery as Don pioneered the use of a mechanical pump to circulate blood during open heart surgery, participated in one of the first coronary bypass operations in a Houston hospital and was a member of the team that researched and developed the initial mechanical heart implants. For good measure, Don in 1955 was one of the founding partners in Houston Cardiovascular Associates, which grew into one of the best cadiology private practices in Houston.
As director of Baylor's Section of International Medicine, Don also became a leader in promoting cardiology education around the world by starting a program at Baylor that sends students to teaching centers around the world. Don served as a visiting professor and conducted seminars in numerous countries, including China, Columbia, Germany, South Africa, Guatemala, Switzerland, and Turkey. Not coincidentally, Texas Medical Center institutions now serve over 10,000 international patients annually.
Don was also a prolific researcher, authoring and contributing to more than 100 publications of medical literature. He received many professional honors, but the ones that he treasured the most were the ones he received for teaching, such as the Baylor Distinguished Faculty Award in 1978, 1981 and 1993 and the Outstanding Teacher Awards that he received from Baylor students in 1958 and 1962. In 1992, the Cain Foundation honored Don with the endowment of the Don W. Chapman, M.D. Chair of Cardiology at Baylor and, in 1993, the University of Iowa honored Don with that institution's Distinguished Alumni Award.
Don's contributions to Houston and the Medical Center were enormous. Today, 63 years after Don's arrival in Houston, the Texas Medical Center is comprised of over 45 institutions (including 11 educational institutions and 15 hospitals and specialized patient care centers) that contain 6,500 patient beds and employ 75,000 people. Not only is the Medical Center now the largest employment center in Houston, Baylor College of Medicine is now widely acknowledged to be one of the best medical schools in the country.
How's that for a professional legacy?
But Don's remarkable professional accomplishments don't provide the full measure of this man, who was a genuinely kind and warm human being. When my father at the age of 55 decided with my mother to move our large family (10 children!) to Houston from Iowa City at the beginning of 1972, Don and Mary Lou Chapman graciously welcomed us to Houston and took an active interest in the unwieldly Kirkendall clan. Don took a particular interest in me while I was a wayward undergraduate student in the early 1970's and kept up with me as I worked my way through law school and became a part of the Houston legal community. I will never forget the wonderful impression that this successful man made on me in taking the time to express his genuine interest in what I was doing in my career. I was particularly touched by his phone call to me after my father's sudden death in 1992 in which he told me how the eulogy that I delivered at the funeral had moved him to tears and how much he was going to miss his lifelong friend and colleague.
The memorial service for Don will be at 2:00 p.m. today in the sanctuary of the First Presbyterian Church, 5300 Main Street, in Houston's Museum District just north of the Texas Medical Center. Immediately following the service, the family will receive friends during a reception in the church's Fellowship Hall. In lieu of usual remembrances, contributions in memory of Don may be directed to the Memorial Garden, First Presbyterian Church, 5300 Main St., Houston, TX, 77004 or to Methodist Hospital Foundation Cardiology Department Research, 6565 Fannin St., Houston, TX, 77030.
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May 3, 2007
Changing history
The NY Times' medical reporter, Lawrence Altman, M.D., tells the story of how Houston's famed heart surgeon Michael E. DeBakey changed the course of history by persuading the late Boris Yeltsin that he could survive heart bypass surgery after the Russian president had suffered a heart attack in the fall of 1996. The surgery saved Yeltsin's life and allowed him to live for another decade.
Of course, there are some who would argue that Dr. DeBakey efforts did not change history for the better.
Posted by Tom at 4:10 AM | Comments (0) | TrackBack (0)
January 25, 2007
Thinking beyond the UH Medical School
BlogHouston.net's Kevin Whited notes this Chronicle/Todd Ackerman article about the University of Houston floating a proposed new Texas Medical Center-based medical school in a collaborative project with The Methodist Hospital and Cornell University's Weill Medical School.
Unfortunately for UH, the proposal has zilch chance of floating for much more than a few minutes amidst the shark-infested waters of Texas educational politics. Heck, the political forces in Texas cannot even agree to provide adequate funding of UH's uncriticizable goal of becoming the state's third tier I research university. The University of Texas, Texas A&M University, and Baylor College of Medicine -- Methodist's former longtime partner -- are just a few of the powerful political forces that would almost certainly line up against the UH-Methodist proposal.
Yet, the UH-Methodist proposal has merit, so here's a proposed modification. Rather than start another medical school from scratch, let's merge the University of Houston system with the Texas A&M system and have A&M expand its fledgling medical school into the Texas Medical Center from its current central Texas outpost. From a broader standpoint, the merger makes sense because it gives the A&M system something that it desperately needs -- a major urban presence -- while also giving UH something that it has always lacked -- that is, access to adequate endowed capital. Such a merger would also provide A&M with the law school that it has always coveted and would greatly facilitate UH's elevation into a tier I research institution, which is something that would substantially benefit the Houston area.
While the University of Texas would almost certainly oppose such a merger, perhaps a deal could be struck at the same time to merge the Texas Tech University system into the UT system while organizing the remainder of Texas' non-affiliated public universities into a third university system for funding and administrative purposes. Such a structure would give Texas a similar structure to that of the reasonably successful California model, which has generated far more first rate, tier I research universities (10) than the current dysfunctional Texas system (2). Indeed, almost anything would be a huge improvement over the current Texas system, which allocates a disproportionate amount of endowed capital to the UT and A&M systems while starving the remainder of Texas' public universities.
Make sense? You bet. Chances of happening? Probably not much. But just as UCLA and Cal-Berkeley co-exist productively in the same university system in California, UH and A&M could do the same in Texas. And just as two major university systems work side-by-side together to educate Californians, a similar structure would be a substantial improvement in the educational system of Texas.
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December 30, 2006
Reacting to the DeBakey surgery story
The reactions to last weekend's fascinating story about the surgery to repair a dissecting aortic aneurysm in 97-year old Medical Center icon, Dr. Michael DeBakey, are as interesting as the story itself. The following are a few comments selected from letters to the NY Times regarding the story:
"Dr. Michael E. DeBakey’s surgery may have been a technical advance of heroic and dramatic proportions, but it was a setback for patients’ rights. Dr. DeBakey is the epitome of the informed patient, and a document evidently existed that said he did not want surgery for his disease.Progressing into a coma as one dies is a normal part of the terminal stages of many illnesses. Directives exist to prevent such an incapacitated patient from becoming a victim of the grieving spouse or the frightened caregiver.
Because of Dr. DeBakey’s stature and publicity about his case, this surgery may decrease patients’ right to die in a manner they desire, an unfortunate result of a remarkable feat."
"Your article about Dr. Michael E. DeBakey’s aortic aneurysm operation was described as emblematic of the difficulties of end-of-life care, but it is as much or more emblematic of the difficulty patients encounter in having their wishes to forgo treatment respected. No one in the world had better capacity to refuse this operation than Dr. DeBakey, and he did.
. . .After the world’s best medical care, months in the hospital and a million dollars, Dr. DeBakey and his family had a happy outcome.
But for those thousands of ordinary patients who must struggle against family, church and state to refuse invasive, risky, experimental or simply unwanted care, it is not necessarily a happy ending."
"I wonder if Katrin DeBakey would have been so eager for her husband’s surgery if she had had to provide all the postoperative care herself as the rest of us have to do.
Almost any elderly patient with good insurance and an educated and younger spouse making decisions can get good high-tech surgery, but the system fails when the hospital dumps the patient back home on the spouse after only two days of postoperative hospital care.
In Mrs. DeBakey’s case, her husband received months of in-hospital intensive care, emergency care, more surgery, physical therapy and psychological support.
The rest of us caregivers would have long since passed the breaking point from dealing on our own with medical emergencies, unavailable doctors, no home nurses, no respite time and the psychiatric problems of many elderly male patients — rage and depression."
"The article about Dr. Michael E. DeBakey illustrates many central issues that arise in determining types of care for gravely ill patients and whether to perform a risky but potentially lifesaving procedure.
The case exposes the standards of patient autonomy and informed consent — foundational principles of ethical medicine — to be impossible ideals. Even Dr. DeBakey, likely the person most thoroughly informed about the procedure, regretted his prior decision to forgo the surgery.
Another problem exposed by this case is the persistent misuse of the do-not-resuscitate order, interpreting it to signify more general wishes about less aggressive care instead of its actual, more restricted meaning: not resuscitating in the event of cardiac arrest."
As one of the other letter-writers pointed out, the story also reflects that Dr. DeBakey is the consummate educator, using his experience to prompt consideration and discussion of important medical and ethical issues in caring for patients who are close to death. He is truly one of Houston's treasures.
Posted by Tom at 7:09 AM | Comments (0) | TrackBack (0)
December 26, 2006
A patient of the surgery he created
This NY Sunday Times story by Lawrence K. Altman, MD reports that one of Houston's greatest surgeons continues to be on the cutting edge of surgical and related medical issues even as he approaches 100 years of age:
In late afternoon last Dec. 31, Dr. Michael E. DeBakey, then 97, was alone at home in Houston in his study preparing a lecture when a sharp pain ripped through his upper chest and between his shoulder blades, then moved into his neck.Dr. DeBakey, one of the most influential heart surgeons in history, assumed his heart would stop in a few seconds. [. . .]
But when his heart kept beating, Dr. DeBakey suspected that he was not having a heart attack. As he sat alone, he decided that a ballooning had probably weakened the aorta, the main artery leading from the heart, and that the inner lining of the artery had torn, known as a dissecting aortic aneurysm.
No one in the world was more qualified to make that diagnosis than Dr. DeBakey because, as a younger man, he devised the operation to repair such torn aortas, a condition virtually always fatal. The operation has been performed at least 10,000 times around the world and is among the most demanding for surgeons and patients.
Over the past 60 years, Dr. DeBakey has changed the way heart surgery is performed. He was one of the first to perform coronary bypass operations. He trained generations of surgeons at the Baylor College of Medicine; operated on more than 60,000 patients; and in 1996 was summoned to Moscow by Boris Yeltsin, then the president of Russia, to aid in his quintuple heart bypass operation.
Now Dr. DeBakey is making history in a different way — as a patient. He was released from Methodist Hospital in Houston in September and is back at work. At 98, he is the oldest survivor of his own operation, proving that a healthy man of his age could endure it. [. . .]
But beyond the medical advances, Dr. DeBakey’s story is emblematic of the difficulties that often accompany care at the end of life. It is a story of debates over how far to go in treating someone so old, late-night disputes among specialists about what the patient would want, and risky decisions that, while still being argued over, clearly saved Dr. DeBakey’s life.
It is also a story of Dr. DeBakey himself, a strong-willed pioneer who at one point was willing to die, concedes he was at times in denial about how sick he was and is now plowing into life with as much zest and verve as ever.
But Dr. DeBakey’s rescue almost never happened.
Read the entire fascinating story, which includes Dr. DeBakey's frank admissions that death seemed like a reasonable alternative to the pain he was enduring, that he initially declined the surgery because he would rather die than risk becoming an invalid and that he went into denial as his condition deteriorated. It is a fascinating story about facing death by a man whose legacy is saving lives.
Posted by Tom at 4:20 AM | Comments (1) | TrackBack (0)
October 20, 2006
Texas Children's huge expansion
Texas Children's Hospital -- already the largest pediatric hospital in the country -- announced a massive $1.5 billion expansion earlier this week that calls for 2 million square foot expansion, including construction of a maternity center, a neurological research institute and a satellite hospital in west Houston. Texas Children's is one of the largest employers in the Medical Center and expects to create an additional 2,500-3,000 jobs in connection with the expansion. The Chronicle's Todd Ackerman has story here.
Juxaposed between earlier posts here and here on the struggles of Baylor College of Medicine and the University of Texas Medical Branch to define their future in the troubled waters of America's health care system, Texas Children's bold expansion is a reminder of the strong influence that Houston's Texas Medical Center and vibrant medical community will have on this key domestic policy and economic issues facing American society.
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October 7, 2006
M.D. Andersen patients get a nice Friday surprise
The University of Texas M.D. Andersen Cancer Center in Houston's Texas Medical Center is one of the nation's leading cancer hospitals and research centers. It is a place where difficult issues relating to life and death are confronted on a daily basis, yet the M.D. Andersen professionals work hard to encourage a culture of hope and optimism. It is truly one of Houston's most remarkable places.
Consistent with that remarkable nature, look at who M.D. Andersen patients and workers were able to stumble across yesterday over the lunch hour:
On her way to Friday night's concert in The Woodlands, Sheryl Crow made a detour for a smaller, kindred audience: women with breast cancer.Six months after her own breast cancer made headlines, the Grammy-winning rocker stopped by the University of Texas M.D. Anderson Cancer Center to mingle with and play for patients and survivors of the disease.
"After I was diagnosed Feb. 22, everything screeched to a halt," Crow told about 200 women who gathered at the hospital's Nellie B. Connally Breast Center for the intimate mini-concert. "I'm on a new path now: I don't want to spend any time doing anything I don't want to do."Crow, 44, who had surgery and then reconstruction, joked that "breasts are everything" in her business. She said she's been given a clean bill of health, and called her bout with cancer as "life-changing" for her mostly male crew as for her.
Introduced as a "self-described schoolteacher from Missouri who's built a second career as a singer-songwriter," Crow didn't grant media interviews.
An M.D. Anderson spokesperson said her staff had contacted the center to say that Crow wanted to visit and play a few songs for patients.
Wearing jeans, a white vest and heels, Crow sang Soak Up the Sun and Every Day Is A Winding Road to an appreciative audience that packed the center's lobby even though M.D. Anderson gave no official notice of the event. Cell phone cameras clicked away as she played. [. . .]
Crow made the M.D. Anderson appearance as she winds down a national tour with John Mayer.
The tour had been postponed after surgery she's described as "minimally invasive" and follow-up radiation treatment. . .
She made no in-depth references to the ordeal Friday, sticking to music and intimate conversations with patients.
"This brightened everyone's spirits," said Cory Hanson, a Richmond woman with Stage 3 breast cancer. "I'd been a little upset because I'd wanted to get tickets to The Woodlands show, but decided not to because I wouldn't have the energy after today's treatment. But this was a pretty good substitute. At The Woodlands, I wouldn't have sat up front or gotten a hug."
By the way, my teenage daughter reports that the Crow-Mayer concert at The Woodlands Cynthia Mitchell Pavilion was a "10."
Posted by Tom at 7:58 AM | Comments (0) | TrackBack (0)
September 30, 2006
Baylor Med decides to go it alone
The Houston professional community and the Medical Center was abuzz yesterday with Baylor College of Medicine's announcement late this week that the school will construct a new teaching hospital in the Texas Medical Center and end its recent affiliation with St. Luke's Episcopal Hospital as its primary teaching hospital. This move comes only a couple of years after Baylor (which has no affiliation with Baylor University in Waco) terminated its longstanding with the Methodist Hospital as its primary teaching facility (previous posts here), a relationship that was as storied as the Medical Center itself. As usual, the Chronicle's Todd Ackerman -- who has done a superlative job in covering the Baylor-Methodist split and the changing nature of Baylor within the Medical Center -- has this excellent report on the development.
Baylor's new hospital will resolve Baylor's increasing concern over being the nation's only top-20 medical school that does not own a hospital or whose department chairs do not head the key medical departments at an affiliated teaching hospital. The announcement is really not a surprise as there have been rumors for the past six months or so that Baylor-St. Luke's partnership was on the rocks. Although the two institutions entered into merger negotiations shortly after they entered into the teaching hospital affiliation, those negotiations didn't go anywhere as St. Luke's staked a vision of providing medical services in new hospitals throughout the far-flung Houston metropolitan area. The straw that broke the camel's back was St. Luke's dragging its feet in making Baylor department chairs the head of the hospital's parallel medical departments.
The demise of Baylor's relationships with both Methodist and St. Luke's is a reflection of the difficulties involved in sustaining long-term business and professional relationships in the face of the fast-changing world of American health care finance. When those pressures overwhelm a productive relationship such as the one that Baylor and Methodist long-enjoyed, the risk increases that a decline in the quality of medical care will be the ultimate result, which is a risk that should concern all of us. On the other hand, Baylor is presenting an ambitious plan for maintaining its position as one of the top medical schools in the country, and more competition between outstanding hospital facilities in one of the nation's top medical centers could well generate even better medical care and research. How it turns out will reflect much in regard to the direction of the American health-care finance system and the challenges of training physicians within that changing system.
Posted by Tom at 8:00 AM | Comments (0) | TrackBack (0)
June 26, 2006
Houston's gift to Botswana
Major W. Bradshaw has long been one of the talented physician-teachers that makes Houston Texas Medical Center such a fascinating place. Dr. Bradshaw came to Houston and the Baylor College of Medicine as an Assistant Professor of Medicine in 1972 to ramrod Baylor's development of expertise in microbiology and immunology. An outstanding teacher, Dr. Bradshaw was promoted to Dean of Education in 1996 and to Senior Vice-President and Dean of Medical Education in 2004. Now, while most contemporaries are planning their retirement, the Chronicle's Leigh Hopper reports that Dr. Bradshaw has other things in mind:
[After 30 years at Baylor], Bradshaw is making an unusual career move. He's heading to Botswana, a country in sub-Saharan Africa that is roughly the size of Texas.Baylor is expected to announce this week that Bradshaw has accepted a job as interim founding dean at University of Botswana's medical school, the first such school in a country with one of the world's worst HIV rates. Next month, he and his wife move to Gaborone, Botswana's capital, leaving their home, their children and grandchildren for at least a year.
"It's pretty remarkable for (the University of Botswana) to have the sitting dean of education for the No. 10 medical school in the United States to all the sudden be their new founding dean," said Baylor College of Medicine President Peter Traber. "That's quite a recruitment."
Dr. Bradshaw's appointment is part of Baylor's affiliation agreement with the University of Botswana, which is starting the country's first medical school to address Botswana's critical health needs, including a high percentage of the population that is infected with the HIV virus. Under the leadership of Baylor pediatric professor Mark Kline, Baylor has already opened a treatment center for HIV-infected children in Botswana in 2003 as a part of Baylor's International Pediatric AIDS Initiative. What better legacy for a teacher such as Bradshaw -- who has had a major influence on one of America's finest medical schools -- than to contribute his talents to the creation of a medical teaching institution in a part of the world that needs it the most. Just another example of the magnificent influence that the professionals of Houston's remarkable Texas Medical Center are having throughout the world.
Posted by Tom at 5:37 AM | Comments (0) | TrackBack (0)
April 10, 2006
The Medical Center philanthropist
Todd Ackerman does a fine job covering the Texas Medical Center for the Chronicle and, in this Sunday Chronicle article, profiles Dan Duncan (previous posts here), chairman of Houston-based Enterprise Products Partners, LP and the leading philanthropist to Houston's famed Texas Medical Center.
Duncan's life is a quintessential Houston success story, a hard-working, self-made man who started his first company with $10,000 and a trailer-truck and, after working for a small independent oil and gas company, started Enterprise in 1968 and built it into a $15 billion company that is one of the two largest companies in the nation that transports natural gas between exploration and end-use. As Ackerman's profile points out, that task has not always been easy -- such as during the mid-1980's when the bottom fell out of the natural gas market -- but Duncan perservered and was ultimately rewarded for his vision and hard work. Couldn't happen to a nicer fellow.
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January 31, 2006
Baylor's cancer research and care initiative
The Chronicle's Todd Ackerman -- who does a fine job of reporting on matters relating to Houston's Texas Medical Center -- reports today that Dan Duncan, chairman of Houston-based Enterprise Products Partners, LP, has donated $100 million to Baylor College of Medicine to trigger funding of Baylor's effort to become the second comprehensive cancer center in Houston's Texas Medical Center (the other is the University of Texas M.D. Anderson Cancer Center). The gift follows Duncan's earlier $35 million gift to Baylor last year.
This is a major development for the Medical Center, which -- through M.D. Anderson -- is already one of the primary cancer care and research venues in the United States. The collaborative effort of M.D. Anderson and Baylor's new facility may propel the Texas Medical Center to the forefront of cancer research and care in the entire world.
Posted by Tom at 6:47 AM | Comments (0) | TrackBack (0)
December 6, 2005
M.D. Anderson research center continues to grow
The Chronicle's Todd Ackerman reports that the University of Texas M.D. Anderson Cancer Center has received a $20 million donation from Lowry and Peggy Mays as the cancer center continues raising funds for its 116 acre research park under development about a mile and a half south from the main M.D. Anderson hospital complex in Houston's Texas Medical Center. The Mays gift to M.D. Anderson comes on the heels of an earlier $30 million gift from the Red McCombs family. Mr. Mays built San Antonio-based Clear Channel Communications into the largest radio station company in the U.S.
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November 29, 2005
A great Houstonian
Samuel Ward Casscells, III is a 53 year old M.D. and professor of biotechnology at the University of Texas Health Science Center at Houston in Houston's amazing Texas Medical Center. He is also an Army medical corps reservist, and recently was awarded both the General Maxwell Thurman Award and the Army Meritorious Service Medal for his service during Operation Iraqi Freedom. In this Houston Chronicle op-ed, Dr. Casscells writes about the reason that he joined the military and the surprising experience that followed:
I had joined the Army Reserve for what seemed good reasons at the time: to help a hard-working medical corps, to live up to the examples of some of my heroes (Drs. Denton Cooley, James "Red" Duke, Michael DeBakey, and my father, surgical giants who wore Army green), and to set an example for my children.It proved to be more than that: gripping, inspiring and filled with surprises. As only one in 200 Americans is in uniform today, most do not know any soldiers; hence this report.
One month after being commissioned, I received a phone call from Army Surgeon General Kevin Kiley: "Col. Casscells, welcome aboard. I want to be ready in case of a flu pandemic. You have some experience. We may even have some fun. Stand by for orders."
In a few months, I felt like a member of a big family. I would not say a team because there was so little rah-rah, and — to my surprise — no bragging, no macho, no arguing and very little politics. Even in the sand, with all the surgeons from Operation Iraqi Freedom, the focus was the mission: how to prevent and treat injuries and illness.
All suggestions were welcome. All are addressed by rank, but the general speaks as respectfully to the sergeant as to a colonel. And there is lots of laughing and gentle teasing (a perennial: the Air Force, always ready, will go anywhere — as long as there is a dry golf course, and cocktails).
[snip]
Equally wondrous to me: There was not a shred of racial awareness, much less tension. I finally had to ask. The answer is that, since President Truman integrated the Army Officer Corps in 1948, there have been several generations of advancement based on merit (which means hard work, smart work, but especially teamwork). Thus there are thousands of black officers who command with quiet confidence.
Read the entire piece. Hat tip to Clear Thinkers reader Byron Hood for the link to Dr. Casscells' inspiring op-ed.
Posted by Tom at 7:40 AM | Comments (0) | TrackBack (0)
October 1, 2005
Texas Medical Center players make nice
The Chronicle's Todd Ackerman, who has done a fine job over the past couple of years of covering the divisive split between former Texas Medical Center partners, Baylor College of Medicine and the Methodist Hospital -- reports today that Baylor and Methodist have entered into a settlement brokered by Texas Attorney General Greg Abbott and that Baylor and its new teaching hospital -- St. Luke's Episcopal Hospital -- have decided to shelve their ongoing merger negotiations for the time being.
Whew! Never a dull moment in the Medical Center, eh?
Mr. Ackerman reports that the Baylor-Methodist truce is centered around a new collaborative $16 million program between the institutions to improve immunization and emergency room programs for Houston's underprivileged:
"I have great respect for these institutions and am grateful we were all able to sit at the table to transform some serious differences into a cooperative environment of good will," said Abbott. "The ultimate goal is to ensure the highest level of care to the community, as well as to the neediest among us, especially the children of Houston."The agreement also calls for Baylor and Methodist to renew a spirit of collaboration by agreeing to share teaching, research and clinical programs and to limit the recruitment of staff from one institution to another.
During the negotiations, chaired by former Harris County Commissioner and current Texas Medical Center board member Elizabeth Ghrist and attended by three members from both insitutions' boards, Abbott barred negative communication and recruiting of staff by either institution. He extended the negotiations, originally scheduled to finish at the end of August, through September, when he promised to make a pronouncement.
Friday, Abbott made that pronouncement. Joined by top officials of Baylor, Methodist and the Texas Medical Center, he said the new agreement ends the protracted dispute and marks "a new era."
The agreement between the institutions calls for 90 to 130 Baylor residents to rotate through Methodist for at least the next five years; for the two to share urology; ear, nose and throat; cardiovascular disease prevention; and cell and gene therapy programs; and for scientists at Baylor and at Methodist's new research institute to collaborate.
It calls for both institutions to attract new doctors and scientists to the Texas Medical Center rather than recruit from each other.
Given the raid on Baylor's faculty that Methodist engineered over the past year, it remains to be seen whether that last provision of the settlement holds up. However, Mr. Abbott's involvement in brokering the settlement certainly adds an element of governmental action that did not exist before in the various dust-ups that have taken place between the two institutions in their messy divorce.
Meanwhile, Mr. Ackerman reports that the Baylor-St. Luke's merger negotiations have been shelved on a friendly basis as the new partners assess their new medical school-teaching hospital relationship. That such negotiations have been put on hold is not particularly surprising given that such a merger would be highly unusual in the world of academic medicine between even longtime partners, much less ones that have been together for a less than a year. My sense is that the negotiations may revive as the parties get more comfortable with their relationship and evaluate how a merger could facilitate both parties' goals in the ever-shifting sands of financing and providing health care in the U.S.
Posted by Tom at 8:47 AM | Comments (0) | TrackBack (1)
August 31, 2005
AG intervenes in Baylor-Methodist squabble
The Chronicle's Todd Ackerman continues his fine reporting on the saga of the Medical Center divorce between The Methodist Hospital and Baylor College of Medicine with this report that Texas Attorney General Greg Abbott has engaged the feuding ex-partners in a series of meetings over the past two weeks for the purpose of ending the bickering between the institutions, which has been going on for the better part of two years now.
In the meantime, Mr. Ackerman reports that, even as the talks took place, eleven Baylor cardiologists left for Methodist, bringing to 80 the total number of physician and faculty defections that Baylor has suffered since the split in April, 2004. Previously, Baylor departments of pathology, neurology/neurosurgery, plastic surgery, anesthesiology and orthopedics suffered physician or faculty losses to Methodist.
A former Houstonian, Mr. Abbott clearly is taking a special interest in resolving the Baylor-Methodist feud that has shaken Houston's Texas Medical Center. Mr. Abbott was a young attorney in private practice in Houston during the early 1980's when he was paralyzed from the waist down after being seriously injured by a falling tree branch while jogging at Houston's Memorial Park. Mr. Abbott was treated at Medical Center hospitals, and he has often publicly expressed his appreciation for the extraordinary treatment that he received there, particularly his rehabilitation stint at The Institute for Rehabilitation and Research (known as "TIRR"). As such, he is a powerful voice for the public interest in mediating the Baylor-Methodist dispute.
Posted by Tom at 6:25 AM | Comments (0) | TrackBack (0)
August 9, 2005
The politics of charity in the world of health care
Wealthy Houston plaintiff's lawyer John O'Quinn (earlier posts here and here) recently proposed to donate $25 million to St. Luke's Episcopal Hospital -- the largest gift in the hospital's 50 year history -- in return for renaming the hospital's highly-recognizable medical tower the "O'Quinn Medical Tower at St. Luke's."
Well, the Chronicle's Todd Ackerman, who does a fine job of staying on top of Medical Center stories, reports in this article that the St. Luke's board's decision to accept the donation from Mr. O'Quinn is not going over well with a number of St. Luke's doctors:
The plan to rename the edifice after John O'Quinn in recognition of a $25 million donation by his foundation has infuriated many St. Luke's doctors, who last week began circulating a petition against it and Monday night convened an emergency meeting of the medical executive committee.
"Perhaps you are unaware of the intensity of feelings held by many physicians about Mr. John O'Quinn," says the petition, which is addressed to the Rev. Don Wimberly, bishop of the Episcopal Diocese of Texas and chairman of the St. Luke's Episcopal Health System board of directors. "The primary source of his financial success has been representing plaintiffs in medical liability and products liability cases, many of them groundless."
Dr. Priscilla Ray, a psychiatrist who wrote the petition, said that even though doctors were let out of the breast-implant litigation, it was onerous because they had to hire lawyers, prepare for trial and be deposed."The bottom line is, Mr. O'Quinn has contributed toward the litigious environment in which doctors work, toward the changed relationship between doctors and patients," said Ray. "Now, doctors have to fight not to see each patient as potential plaintiff, and patients might have impaired confidence in their doctor."
"It offends us to have money we earned and which he took by suing us going to name after him a medical building in which we work each day," says the petition. "The naming of buildings at the law school or perhaps at a medical liability carrier seems much more appropriate."
Well, the University of Houston is way ahead of the docs on that idea, as the law school has already named its library after Mr. O'Quinn. But now that idea on the medical liability carrier building . . .
Despite the current hub-bub, my sense is that this will die down soon and the board's decision to accept the donation will not be changed. Raising funds is too important in the dog-eat-dog worlds of academic medicine and health care finance to let little things such as principle stand in the way of a big donation.
Posted by Tom at 6:21 AM | Comments (2) | TrackBack (2)
July 17, 2005
The Robertsons of Houston
The late Corbin Robertson, Sr. was a bright business mind when he came to Texas as a young man from Minnesota in the 1940's. After marrying Wilhelmina Cullen -- the daughter of famous Houston wildcatter Hugh Roy Cullen -- Mr. Robertson ultimately became the brains behind the investment of the Cullen Family oil and gas fortune, a role that Richard Rainwater successfully emulated decades later for Ft. Worth's Bass Family. Houston benefitted greatly from Mr. Robertson's business acumen as both the Cullen and Robertson families became among Houston's greatest philanthropists, contributing huge amounts to institutions such as the University of Houston and the Texas Medical Center.
Mr. Robertson's son -- longtime Houston businessman Corby Robertson, Jr. -- has continued his legacy of astute business acumen and philanthropy. After starring as an outside linebacker for the University of Texas football teams of the late 1960's, Mr. Robertson returned to Houston and worked his way into assuming leadership from his father of the Robertson Family's closely-owned oil and gas business, Quintana Petroleum Corporation. However, over the years, Mr. Robertson has branched his family's fortune into the ownership of a non-sexy but more plentiful (and potentially more lucrative) alternative energy resource -- coal.
As this Chronicle article reports (here is an earlier Forbes article), Mr. Robertson's Natural Resource Partners, a Houston-based master limited partnership -- has a market capitalization of $1.6 billion and, since going public on the New York Stock Exchange in 2002, the value of the partnership's units have more than tripled to a recent price of $63. Quarterly distributions have also increased 62 percent since the partnership went public.
By the way, one item the Chronicle article missed is that, among his many civic duties, Mr. Robertson is currently the chairman of the board of Baylor College of Medicine, where he has led Baylor's board during its historic split last year with its longtime primary teaching hospital in the Texas Medical Center, Methodist Hospital. Nevertheless, the Chronicle article is a good overview of the business background of Houston's First Family of energy and highlights the business talent that has helped make Houston the energy capitol of the United States.
Posted by Tom at 5:00 AM | Comments (0) | TrackBack (1)
July 9, 2005
Medical Center institutions rank highly again
U.S. News & World Report's annual "America's Best Hospitals" survey is out again and, as usual, Houston's Texas Medical Center is well-represented in the lists of the top hospitals in a number of different categories. Here is a previous post on the 2004 survey.
The U.S. News and World Report survey ranks the country's top 50 hospitals in 17 specialties. Less than a third of the 6,000 U.S. hospitals meet the eligibility criteria and only 176 of those institutions qualified for a ranking. The rankings are based on a survey of board-certified physicians around the country, patient survival data and various other indicators, such as the ratio of nurses to patients, technologies and services available to patients, the number of discharges over a three-year period, and whether the institution has Magnet status as determined by the American Nurses Credentialing Center.
M.D. Anderson was again ranked as one of the top two hospitals in cancer care, a position that it has held since U.S. News and World Report began its annual survey in 1990. M.D. Anderson held the No. 1 position in 1992, 2000, and 2002 through 2004. M.D. Anderson also ranked fifth in gynecology, and 11th in both otolaryngology (i.e., ear, nose and throat diseases) and in urology.
Other Medical Center institutions also ranked highly in various categories. Texas Children's Hospital ranked fourth in pediatrics, while The Menninger Clinic ranked tenth in psychiatry and The Institute for Rehabilitation and Research (known as "TIRR") ranked fifth in rehabilitation. The Texas Heart Institute at St. Luke's Hospital ranked eighth in heart and heart surgery, while St. Luke's also ranked 40th in urology and 42nd in kidney disease. Memorial Hermann Hospital -- the teaching hospital for the University of Texas Health Science Center -- was ranked 41st in kidney disease and 49th in urology.
Finally, the The Methodist Hospital ranked in more specialties than any other Texas hospital -- tenth in neurology and neurosurgery, 13th in urology, 14th in opthamology, 16th in heart and heart surgery, 17th otolaryngology, 19th in psychiatry and 42nd in gynecology.
As I have noted many times, not only is the Texas Medical Center one of Houston's largest centers of employment, it is an amazing collection of medical services talent.
Posted by Tom at 7:12 AM | Comments (1) | TrackBack (0)
McCombs makes huge gift for M.D. Anderson research
San Antonio-based businessman Red McCombs has given the University of Texas M.D. Anderson Cancer Center $30 million for its huge $500 million research park that will eventually consist of six centers focusing on cutting edge areas of cancer research.
The gift -- which is one of the two largest that M.D. Anderson has ever received -- will go to help fund the developing Red and Charline McCombs Institute for the Early Detection and Treatment of Cancer on M.D. Anderson's 116-acre south campus. That campus is about a mile and a half from the main M.D. Anderson hospital complex in the Texas Medical Center.
Posted by Tom at 6:16 AM | Comments (1) | TrackBack (0)
June 19, 2005
Remembering a special father
Inasmuch as I am one of ten children of the marriage of Walter M. and Margaret Kirkendall, I have a large number of family members (over 30 nieces and nephews at last count), many of whom are regular readers of this blog. This particular blog post is primarily for those family members and our family friends, but even if you are not a member of those groups, feel free to read on and learn about a special father and a remarkable Houstonian.
The memory of where I was when my father died remains indelibly etched on my mind.
Shortly after 8:00 a.m. on Saturday morning, July 13, 1991, I was preparing to play golf in Iowa City, Iowa during my 20th high school reunion. Unexpectedly, the pro shop summoned me from the first tee that I had a telephone call. When I reached the phone, my brother Matt was on the line with terrible news. Our father, Dr. Walter M. Kirkendall, had suffered a serious heart attack moments earlier in a Chicago-area hotel room while preparing to attend his niece Sarah's wedding with our mother. At the time of the call, Matt did not know whether our father had survived the attack. Minutes later, after I had quickly returned to my hotel room to gather my things for a hurried trip to Chicago, Matt called again. Our father had died that morning in Chicago at the age of 74, probably before I had left the golf course in Iowa City.
Consequently, my memories of Walter Kirkendall's death are inextricably intertwined with golf. To a large degree, that is utterly appropriate because, over the final 15 years of his life, Walter and I spent countless hours together golfing.
These regular golf games began in 1976 when I entered law school at the University of Houston. Back then, we would rise early most weekend and holiday mornings to play the venerable back nine at Memorial Park Golf Course in Houston. In 1982, we transferred those weekly games at Memorial to several Houston-area clubs, concluding at Lochinvar Golf Club. The final time I saw Walter alive was the Sunday morning before his death when we played golf together at Lochinvar. Inasmuch as he played quite well that day, one of my enduring memories of Walter is his chortling in the clubhouse as he collected his golf bets from me.
Thus, my golfing memories of Walter are surrounded by an aura of good fortune and warm appreciation. Good fortune because golf allowed me to enjoy many hours of Walter's wisdom, insight, and humor. Warm appreciation because golf allowed me to give something back to this man who premised his life on giving to others.
You see, despite his love of golf, Walter never became an active member of a private golf club. Walter gladly sacrificed something that would have been primarily for his enjoyment -- that is, golf on a private course -- for what he considered the more important needs of his large (ten children!) family. Accordingly, as I joined several golf clubs over the final decade of Walter's life, I made a point to give Walter an opportunity to play golf at those clubs as much as he wanted. His pure enjoyment of our golf outings is one of my life's greatest satisfactions.
In addition to being a special father, Walter Kirkendall was a remarkable doctor and teacher. Born in 1917 and raised in Louisville, Kentucky, Walter graduated from the University of Louisville Medical School in 1941 and then went to the University of Iowa in Iowa City for an internship the following year. As with many men of his generation, Walter finished his internship and residency at Iowa just in time to serve three years as an Army medical officer in North Africa and Italy during World War II, after which he returned to Iowa City to complete his training in medicine.
In 1949, Walter joined the University of Iowa Medical School Faculty and -- along with esteemed colleagues such as Jack Eckstein, William Bean, Lew January, Frank Abboud and many others -- proceeded to play a major role in the development of the University of Iowa's fine medical school over the next 23 years. Walter and his colleagues were at the forefront of the post-WWII doctors who embraced the optimistic view of therapeutic intervention in the practice of medicine, which was a fundamental change from the sense of therapeutic powerlessness that was widely taught to these men by their pre-WWII professors. Several of Walter's colleagues have told me that Walter's attitude of therapeutic optimism was his greatest contribution to the education of his students.
Over his 40+ year academic career, Walter developed a program of teaching and research in hypertension and renal disease for which he received national and international recognition. His first professional publications were on renal disease, but by the mid-1950's, he was publishing papers on hypertension and the effects of drugs in patients. After 1960, almost all of his 85 abstracts and 72 papers involved research on the clinical pharmacology of hypertension. In addition to his teaching, research, and service on multiple professional committees, Walter also directed the Cardiovascular Research Laboratories at the University of Iowa from 1958-70 and the Renal-Hypertension Division from 1970-72. Iowa honored Walter for his contributions to the University by awarding him the Distinguished Achievement Award in 1986.
Perhaps most remarkably, however, is that Walter in 1972 -- at the age of 55 when most other academics are settling in to comfortable surroundings -- decided to uproot his large family and move to Houston where he became the first Chairman of the Department of Medicine at the then-new University of Texas Medical School in Houston's famed Texas Medical Center. In Houston, Walter continued his professional passions -- teaching, research and clinical medicine -- for the remainder of his life at UT-Houston. In addition to being the first Chairman of the Department of Medicine, Walter was director of UT-Houston's Hypertension Unit from 1976 and director of the General Medicine Division from 1982 until his death. During his 20 years at UT-Houston, Walter became the patriarch of UT-Houston's faculty and student body, reflected by the UT-Houston alumni awarding him the first Benjy F. Brooks Medal in 1991 as the outstanding clinical faculty member, the school's naming of it's internal medicine library and suite in Walter's honor, and the Walter M. Kirkendall Endowed Lecture Series that UT-Houston sponsors each year.
Consequently, the foregoing outlines Walter's remarkable professional legacy -- two institutions served for over 20 years each while teaching and pursuing cutting edge research in a key area of medicine throughout his career. James T. Willerson, M.D., the current President of the University of Texas Health Science Center, observed in his eulogy of Walter at UT-Houston's memorial service for him after his death:
Dr. Frank Abboud called me two days ago, wanted to come join me yesterday, early in the morning to visit and talk about Dr. Kirkendall, and then go to his funeral with me. . . Dr. Abboud told me that people in Iowa at the Medical School had never felt that Dr. Kirkendall had left. He was still there. What he had given, what he represented, what he continued to give was part of Iowa.Can you imagine having that impact on an institution, and people years after you've left? Dr. Kirkendall did. How many of us could claim the same thing, ever?
But the foregoing summary cannot adequately convey Walter's truly endearing qualities. He was a devoted teacher to his medical students and residents, and was constantly interested in the development of their careers. Patients appreciated his thoroughness, fairness and profound concern for them and their families. Many conversations with Walter invariably turned to stories about his aversion to wastefulness, the clutter in his office, his sense of humor, his competitiveness, and his suspicion that the sodium ion is bad for one's health. The following eulogies that were given at Walter's funeral and memorial service elaborate on these qualities: the eulogy of my brother Bud, who is a district judge in Seguin, TX; my eulogy; the eulogy of my brother Matt, who is an internist in Dubuque, Iowa; the memorial service closing of my sister Mary, who is a pediatric emergency room physician in San Antonio; the eulogy of Dr. Willerson; the eulogy of Dr. Chevis M. Smythe, and the eulogy of Dr. Philip Johnson.
I close with two of my favorite stories about Walter. One is recounted by Tom S. McHorse, M.D., former president of the Travis County, Texas (Austin) Medical Association. Dr. McHorse recalls vividly his experience with Walter in examining a patient while in medical school:
The setting is the University of Iowa Hospital staff service ward one February morning. For physicians who graduated after 1980, ward is defined as a large room with eight to ten patient beds separated by curtains, as many emergency rooms currently have. As medicine was practiced in 1968, acute MIs, bacterial endocarditis, and other illnesses were treated in hospital for six weeks or more. The patient in bed four was such an extended stay patient.Dr. Kirkendall was rounding with his entourage of residents and nurses. As we approached this frequently examined patient, a distinct change was obvious from the day before. The patient truly had the worst "soup bowl" haircut you can imagine. At bedside, Dr. Kirkendall addressed his first question to the patient:
"Who cut your hair?""The hospital barber," replied the patient, somewhat taken aback.
Dr. Kirkendall was clearly not pleased as he turned to his residents and declared:"Incompetence at any level should not be tolerated."I have no memory of the patient's diagnosis or anything else Dr. Kirkendall taught us that week, but I have long remembered that statement of Dr. Kirkendall.
The second story was passed along by Dr. Smythe in his eulogy during UT-Houston's memorial service for Walter, in which he recounted a particularly personal experience with Walter:
Now, at this time, I want to skip ahead to something very personal. 1975-76 was also not a bed of roses at this institution. And, when I was bounced out of the Dean's Office, I was profoundly hurt, very profoundly hurt, and, I was also puzzled. Since those who were relatively active in my demise had been the people to whom I was closest, I was also alone and considerably puzzled as to whom to turn.Now, Dr. Kirkendall himself was under no mean pressure at that same time. And indeed, the forces that were playing on us were pretty much identical. But, Walter is the person who said "Cheves, come to my office every Thursday at 11:00 o'clock." And, he was a person who said "I will help you retrain yourself as a physician." And, he did.
And, that episode illustrated this man's extraordinary generosity of spirit more than anything that I've ever seen.
I will be grateful to him for the rest of my life.
Walter's understanding of the importance of service to others is the thread that binds the fabric of families, friendships, schools, professions, communities, and, ultimately, societies. In his quiet and confident manner, Walter understood the importance of his life's work, and this understanding formed the cornerstone of his unbendable sense of fulfillment and contentment in his personal and professional life. In my book, that's quite a fine legacy, and I am taking this Father's Day to appreciate my blessing to have been touched by it.
Posted by Tom at 4:00 PM | Comments (6) | TrackBack (0)
June 16, 2005
TMC rejects Baylor complaint on Methodist
As predicted here and here, this Todd Ackerman/Chronicle article reports that the Texas Medical Center managers' board of directors rejected Baylor College of Medicine complaint's Wednesday that the Medical Center's historic charter and deed restrictions prohibit Methodist Hospital's creation and operation of its own education and research programs and its partnership with the New York-based Cornell University Weill Medical School.
As an aside, Mr. Ackerman notes that the TMC board and the Texas Attorney General are tiring of the Baylor-Methodist spat:
In a letter to the presidents of Baylor and Methodist, the board also delivered a rebuke of sorts, reminding the battling institutions of their historic obligation to cooperate "to better serve the interests of the people of Texas" and calling for them to resolve their dispute. It marked the first time since the longtime partners split in April 2004 that the TMC made such a formal appeal.A similar appeal was made after the meeting by Texas Attorney General Greg Abbott's office, which previously had stayed out of the dispute. Saying it has concerns about the future of the Medical Center, it released a statement expressing hope the two institutions "exhaust every avenue in trying to work out their differences."
My sense is that a lawsuit between the two former Medical Center partners is still a distinct possibility. Stay tuned.
Posted by Tom at 6:14 AM | Comments (0) | TrackBack (0)
June 13, 2005
Baylor Medical School lays the wood to Methodist
Following up on a story noted in this earlier post, the Chronicle's Todd Ackerman continues his outstanding reporting over the past year on the historic split between Baylor Medical School and Methodist Hospital with this article in which he reports that Baylor has formally accused Methodist of attempting to put the medical school out of busienss in connection with an administrative proceeding before the entity that manages the Texas Medical Center.
The context of the current phase of the dispute between the two longtime Medical Center partners is a proceeding before the Texas Medical Center's covenant compliance committee in which the committee will determine whether Methodist is violating the Medical Center's deed restrictions by starting competitive education and research programs with New York's Cornell University Weill Medical School. Baylor contends that the programs and affiliation between Methodist and Cornell is an attempt by Methodist to harm Baylor.
Although a legal longshot (Texas law does not favor covenants that restrict competition), Baylor's latest salvo is another public relations nightmare for Methodist, which is attempting to carve out a post-Baylor plan to remain a primary research institution. Methodist has a big advantage in that its $2.3 billion endowment is over twice the size of Baylor's endowment, but Baylor is aggressively pursuing new affiliations with other Medical Center institutions. Consequently, there is no assurance that Methodist's current financial advantage will result in a dominant position in the Medical Center five to ten years down the road, particularly if Methodist's research affiliations do not compete effectively with those of Baylor and other Medical Center institutions.
Posted by Tom at 5:57 AM | Comments (1) | TrackBack (0)
May 18, 2005
Merger rumblings in the Medical Center
The Texas Medical Center has already been rocked over the past year by