75 Years of Vision The Lasting Gift of Southwestern Medical Foundation Part I: 1939 to 1979 Turn of the century postcard of Main Street, downtown Dallas.

1890 Eighteen-year-old Edward Cary comes to Dallas to work at his brother’s medical supply business. 75 YEARS OF VISION: THE LASTING GIFT A MEDICAL WILDERNESS 1890 TO 1939

I n 1890, Dallas was a growing center of commerce for North Texas. The population had gone from roughly 400 people in 1850 to nearly 38,000. The city was thriving, but its potential as a leading American city was far from understood. The medical care offered in Dallas was primitive. Science-based medicine was in its infancy. Dallas doctors had not yet accepted the germ theory of disease. Surgical hygiene and the sterilization of medical instruments were virtually nonexistent. The average life expectancy was just 47 years. Infections such as pneumonia, diarrhea, influenza and tuberculosis were leading causes of death. Yellow fever, scarlet fever and dengue fever were common. Patients with contagious diseases were isolated, often along with their families, in “pest houses” where they remained quarantined without care until they died or it could be shown they no longer had the illness. While qualified and notable doctors were practicing medicine in Dallas at the time, many more were poorly trained. Most received only basic training from small medical schools, which required only one to two years of study following three years of high school. While no photos of Dallas’ first Fake medical licenses were common. An MD degree could be conferred “pest houses” exist, this early 1900s building also served to quarantine by return postage in exchange for a letter of intent and a fee of fifteen dollars. patients with contagious diseases. In fact, a stranger could come to town, say he was a doctor, register with a health officer and be allowed to practice medicine. The majority of births and medical care – even surgeries – took place in the patient’s home. Surgeries were performed without the benefit of anesthesia. There were a few private, for-profit hospitals operated by doctors and one small, public City Hospital, which by most accounts was unsanitary, poorly equipped and “in every way unqualified for use as a hospital.”

SOUTHWESTERN MEDICAL PERSPECTIVES . SPRING 20 14 5 Against this background in 1890, a young man named Edward Cary came to Dallas at the age of eighteen. He quickly fell in love with the city — its busy streets, imposing houses and warm friendly people. Cary had come to work at his older brother’s dental, medical and hospi- Bellevue Hospital Medical College tal supply business, where he soon gained confidence as a salesman. was then considered the finest medical school in the United States. But Edward Cary had dreams of becoming a doctor. During business trips, he saw medical schools in Oklahoma, Texas and Louisiana, but he was determined to attend Bellevue Hospital Medical College

in New York (now the NYU School of Medicine), at the time considered the finest medical school in the country. In May 1894, a new 100-bed hospital opened on a 17-acre, wooded site, which lay just outside the Dallas city limits at Oak Lawn and Maple avenues. It became the new “City Hospital,” and immediately and dramatically improved the quality of public hospital care in Dallas. It was named Parkland because it was built on land originally purchased for a city park. Cary left for New York in 1895. Bellevue’s In 1898, the St. Paul Sanitarium opened on Bryan Street. It was department of ophthalmology had an outstanding state-of-the-art for its time reputation, and the medical specialty immediately attracted with elevators, electric and gas lights, electric call bells, radiators, him. After graduating in 1898, he interned at the Eye fireplaces and bathrooms with hot and cold running water. Infirmary at Bellevue (famous at the time) where he was The original Parkland Hospital (top ) properly fitted with glasses that corrected a troubling eye opened on May 19, 1894. The city of Dallas bought the hospital an condition, something he had suffered from all his life. ambulance for $500 that same year. In Dallas, the Daughters of Charity of St. Vincent de However, the horse to pull it was not purchased until June 2, 1896 — Paul, a Society of Apostolic Life for women within the at a cost of $100. Catholic Church, honored an urgent request of area businessmen and physicians who determined that the rapidly growing city was in need of additional hospital facilities. On June 15, 1898, the Daughters of Charity opened a 110-bed hospital, called the St. Paul Sanitarium (later renamed St. Paul Hospital in 1927). It was staffed by nine sisters and featured spacious wards, large private rooms and well-lit operating rooms equipped with fine surgical instruments. Like Parkland, its facilities were open to the public and Dallas physicians. Dallas’ first general medical school resulted from a call issued by In 1900, St. Paul Sanitarium opened Mayor Ben E. Cabell to bring the city’s “reputable” physicians together. Dallas’ first “Training School for Nurses.” This graduation photo from The meeting quickly turned into one of harsh disagreements. Only 1903 shows black ribbons on the 15 of the 55 physicians in attendance were in favor of forming a new graduates’ hats indicating they have received their degree. The name was medical school. later changed to “St. Paul School of Nursing” and operated until 1971. The doctors who opposed it argued that there were already too many medical colleges in the country, that Dallas was not large 6 75 YEARS OF VISION: THE LASTING GIFT

1898 Dr. Edward Cary ( standing with legs crossed at left ) watches a surgery performed in front of medical students at Bellevue Hospital in New York.

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MID 1901 Dr. Charles Rosser, dean of the new school, 1902 -1903 persuades Dr. Cary to serve The “Annual Announcement” on the volunteer faculty. from the Medical Department of the University of Dallas, which lists a total of 34 alumni.

SEPTEMBER 15, 1900 1903 A new medical school was formed While attending an American called The University of Dallas 1902 Medical Association convention, Medical Department (even though Dr. Cary is appointed Dr. Cary hears AMA president there was no such thing as a dean of The University of Dallas predict that proprietary schools of University of Dallas at the time ). Medical Department. medicine are not sustainable.

1901 1903 Dr. Cary makes an The school becomes Baylor unexpected return to Dallas College of Medicine, to care for his mother Dr. Cary remains dean. Hospital after his older brother dies. affiliation is with Texas Baptist He sets up what he Memorial Sanitarium. believes is a temporary ophthalmology practice.

1902 After fire destroyed the orignal building, the medical school was moved into this one, purchased by Dr. Cary, located on Ervay Street.

8 75 YEARS OF VISION: THE LASTING GIFT enough to support such a college and that Dallas physicians were not capable of instructing medical students. Dr. Charles Rosser, who led the effort for the new school, answered, “May the Lord have mercy upon a sick man who must have at his bedside a doctor who cannot teach a student how to study.” On September 15, 1900, the new school filed for a charter with the Texas secretary of state as The University of Dallas Medical Department (even though there was not a University of Dallas at the time). On November 19, it opened in an abandoned synagogue across the street from what is now the Adolphus Hotel. The medical school was open only two months when infighting occurred — an echo of earlier disagreements — and Dr. Rosser emerged as dean. In 1900, the principal method of medical school education was by lecture. Dissection was rare. The only cadavers available were unclaimed bodies “snatched on the sly” before (or sometimes immediately after) burial in a pauper’s grave. But perhaps the largest obstacle in producing qualified physicians was the lack of a teaching hospital in which medical students could receive training. After considering the school’s request, Dallas municipal authorities agreed to allow the new medical school students to attend to patients at Parkland Hospital. Three times a week, they would travel by wagon across town for clinical practice and observation. The medical school’s first year was a modest success, primarily attracting transfer students from a medical school in Fort Worth and a few “doctors” who had previously been practicing in Dallas without a diploma. At graduation, 19 students received their diplomas. In 1901, Dr. Cary was making plans to settle in New York, considering an offer of profes- sorship from the Polyclinic, a prestigious postgraduate medical school, when his life took an unexpected turn. His brother, Albert, had died, leaving their mother without someone to care for her in Dallas. So Cary returned to comfort her and settle his older brother’s affairs. Uncertain of how long he would need to stay, Cary established what he believed would be a temporary ophthalmology and otolaryngology practice. In no Edward H. Cary, MD, was the first dean time, the ophthalmology side of his practice flourished — as the city of both The University of Dallas Medical had almost no qualified specialists. Department (1902 ) Dr. Rosser soon learned of Cary’s skill and successful practice, and Baylor College of Medicine (1903). and asked him to teach at the new medical college. Dr. Cary was made professor of ophthalmology and otolaryngology. Six months after serving in the volunteer faculty, he was named dean. Dr. Cary proved himself to be a dynamic, energetic and tough leader. He divided the 120 students into four classes and quickly pruned less qualified students by imposing strict academic standards. At the end of his first year, The University of Dallas Medical Department awarded diplomas to 15 men. But by 1903, just four graduates received diplomas as Dr. Cary was determined to hold the school to the highest standards of medical education.

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Later that year, during an American Medical Association (AMA) convention in New Orleans, Dr. Cary listened as the AMA president predicted that within five years, no medical school without university affiliation could survive. Dr. Cary contacted Baylor University in Waco, and three weeks later the medical school had an affiliation contract with the university. In return, the medical school donated its property to Baylor. The school was reorganized, and Dr. Cary became dean of what was now Baylor College of Medicine. In 1905, the AMA Council on Medical Education was founded and began inspecting and grading U.S. medical schools. It quickly discovered most schools were so bad that it was reluctant to publish results. This prompted the Carnegie Foundation to conduct an independent investigation, which was led by Abraham Flexner. The “Flexner Report” was released in 1910. Flexner praised quality medical schools but reported “scandalous conditions” in inferior ones. Four medical schools were evaluated in Texas — two in Dallas, one in Fort Worth and one in Galveston. Only The University of Texas Medical Abraham Flexner released his infamous Branch at Galveston was given high marks. “Flexner Report” in 1910. Over 150 medical schools across the United States and Canada The report emphasized that those schools “...whose total annual were critically, often brutally, reviewed. resources are below $10,000...[have ] so small a sum that the endeavor to do anything substantial...is futile.” At the time, Baylor College of Medicine’s annual income was $7,735 — all of it from tuition. Inadequate financing and a lack of philanthropic support would continue to plague the school. The faculty was often in turmoil, and medical research, because of the expense, was rare. That same year, the AMA Council lowered the school’s ranking to “B” — meaning it was no longer fully accredited. (It regained its “A” rating in 1916.) On March 18, 1913, the cornerstone for a new Parkland Hospital was laid on the same grounds as the original Parkland, and a gleaming brick building opened on February 1, 1914. It was the first brick hospital building to be built in the state and immediately became the most modern medical facility in the region. The renewed Parkland had an overwhelmingly positive effect on the quality and availability of medical care, and the hospital became a symbol of pride and hope for the future. In 1916, Cary organized the Greater Medical Center campaign of Dallas, which raised $500,000. He announced his goal was to make Dallas one of the seven great medical centers of the United States. On April 16, 1917, President Wilson declared war on Germany. As a result, doctors across the country were rapidly mobilized. At Baylor, a military hospital unit was quickly assembled and sent overseas. Dr. Cary, who was also President of the Texas Medical Association (TMA) at the time, wanted to volunteer, but President Samuel Palmer Brooks at Baylor University in Waco convinced him he was needed more at home. Dr. Cary took over responsibility for the organizing and training of the Baylor Medical Surgical Unit. 10 75 YEARS OF VISION: THE LASTING GIFT

1913 A group of nurses, led by May Forster Smith, organized the Dallas Baby Camp, an open-air clinic on the lawn of Parkland Hospital. The nurses recognized that children received better care when it was focused only on them. Nurse Smith wasn’t satisfied with just a camp; she wrote her vision on a chalkboard: “Someday, the Dallas Baby Camp will be 1918 1910 a great hospital. Watch us grow !” Baylor College of Medicine The “Flexner Report” The camp was the precursor of what is now the sole surviving is published. would become Children’s Medical Center. medical school in North Texas.

1910 Dr. Cary becomes President of the Dallas County Medical Society.

FEBRUARY 1, 1914 The second Parkland Hospital opened its doors. Doctors and nurses are shown on opening day. The hospital was hailed as “one of the best equipped institutions of its kind in the Southwest.”

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MARCH 20, 1923 The 18-story Medical Arts Building opened in downtown Dallas. Conceived and built by Dr. Edward H. Cary, it was the tallest reinforced concrete structure in Texas and one of the first skyscrapers in the world devoted to medical offices. It had office space for over 300 physicians and dentists. It instantly became one of the centerpieces of the Dallas skyline.

12 75 YEARS OF VISION: THE LASTING GIFT

After WWI, the school’s clinical facilities were reorganized and the Texas Baptist Memorial Sanitarium became designated as its official teaching hospital. (The name was changed to Baylor Hospital in 1920 and to Baylor University Hospital in 1936.) Only medical school faculty and members of the sanitarium staff were permitted to practice there. While it continued to struggle, Baylor College of Medicine still fared better than other schools in the area. By 1918, it was the sole surviving medical school in North Texas. But the money needed to improve and expand the school remained a critical and unsolved issue. After years of struggle, personal investment and hard work, Dr. Cary stepped down as dean in 1920 to devote more time to his medical practice and pursue a bold, new business idea. By 1923, Dr. Cary had completed the first skyscraper in Dallas, the 18-story Medical Arts Building. The building was a revolutionary concept, containing over 300 physician’s offices, complete with a small hospital and operating rooms. The building received national publicity. As a result, Dr. Cary became a man of substantial financial means and acclaim. In 1932, Dr. Cary’s charisma, reputation and national visibility led him to election as President of the American Medical Association (AMA). While president, Dr. Cary traveled 100,000 miles across the U.S. gaining critical insights into the state of medical education in America, as well as seeing the financial challenges facing other medical institutions firsthand. By 1938, Baylor College of Medicine was in dire financial straits. There was little research conducted, instruction was primarily in the form of lectures and the school was again in danger of losing its Class “A” academic rating. Over the course of nearly 40 Dr. Cary, however, was now more than ever dreaming about “a truly great years, Dr. Cary had become Southwestern Medical Center,” which he knew could only develop through an elder stateman of American medicine. sustained philanthropic support. One last, bold attempt to raise $5 million to support medical research was launched, but the endowment failed to materialize, in large part because the country’s attention was being drawn to the escalating war in Europe. Elsewhere, Dr. Cary watched the continued growth of medical centers with strong philanthropic support, such as Johns Hopkins, the Cornell Center, Northwestern and the Mayo Foundation, that set new standards of excellence. The thought “Why not a great medical center in Dallas?” became firmly planted in his mind. After years of experience in nearly every facet of medical education and stepping onto the national stage to lead the discussion in key issues facing the growing healthcare industry, Dr. Cary was fully aware of the many challenges that such an effort would entail. At the turn of the century, a young doctor made an unexpected return to Dallas from New York, to set up a temporary medical practice. Nearly 40 years later, that same man, now an elder statesman of American medicine, would find the philanthropic and business leaders of the city he’d fallen in love with so many years before eager to help him turn his dream into a reality.

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January 21, 1939 The Texas Secretary of State authorizes the incorporation of Southwestern Medical Foundation.

“It is formed for the establishment of facilities and clinics in the study of the causes, the prevention and the cure of diseases of the minds and bodies of needy persons... .”

excerpt from the Charter

14 75 YEARS OF VISION: THE LASTING GIFT

A GRAND VISION 1939 TO 1943

A s the idea for Southwestern Medical Foundation was incubating in Dr. Cary’s mind, Karl and Esther Hoblitzelle had become the city’s leading philanthropists – having established an agricultural research center, supported numerous educational initiatives and donated a sizable art collection to the Dallas Museum of Fine Arts. The Hoblitzelles’ financial success had arisen from the entertainment industry. In 1905, Karl Hoblitzelle, with his brother and others, founded the Interstate Amusement Company and opened vaudeville theaters in Dallas, Fort Worth, Waco and San Antonio as well as in Mississippi, Louisiana and Arkansas. When he was named president of the company the following year, Hoblitzelle insisted on booking acts suitable for the whole family to enjoy. Until then, the mention of vaudeville summoned images of smoke-filled saloons and chorus girls Karl Hoblitzelle, dancing the length of the bar. circa 1910 In 1920, he married Esther Thomas, a musical comedy star, who had performed on Broadway under the name Esther Walker. The couple quickly became a part of Dallas’ social, civic and cultural circles. Hoblitzelle hired famous architects to design magnificent theatres that seated thousands. When interest in vaudeville dwindled in the 1930s, Hoblitzelle built “motion picture” theaters with air-conditioning and the latest technical advances in sound. The Hoblitzelles brought excitement to Dallas. The Majestic The Majestic Theatre opened its doors on April 21, 1921 as a vaudeville Theatre hosted film premieres attended by Hollywood stars like theatre. It was built by Hoblitzelle and designed by John Eberson, one of Jimmy Stewart, Gregory Peck and John Wayne. (The Hoblitzelle the foremost designers of early 20th Foundation gifted the Majestic Theatre to the City of Dallas in Century theatres. January 1976.)

SOUTHWESTERN MEDICAL PERSPECTIVES . SPRING 20 14 15 75 YEARS OF VISION: THE LASTING GIFT

When Dr. Cary approached Karl Hoblitzelle with his vision of advancing medical education and scientific research in the Southwest, Hoblitzelle embraced the idea at once. On January 21, 1939, Dr. Cary — joined by Hoblitzelle, E. R. Brown and Dr. Hall Shannon — obtained a charter for the operation of Southwestern Medical Foundation. The charter was far-sighted, giving the Foundation the flexibility to own and operate a medical school. At a Foundation dinner held two days later at the Adolphus Hotel, it was agreed that the new medical center should belong to the entire Southwest. Further, that the center should “perpetuate medical education and scientific research in an assured nonsectarian environment.” Notable charitable foundations such as the Carnegie and Rockefeller Foundations had made it their policy not to contribute to religiously affiliated organizations, and the men estimated that as much as $25 million would need to be raised. Both Dr. Cary and Karl Hoblitzelle had a tremendous gift for inspiring others and used their influence to call the Dallas philanthropic community to action. Each man wrote eloquently and produced dozens of letters and articles, and “...this is but the seed spoke with great passion regarding the Foundation’s noble of a visionary ideal. From it, in time, mission and the role that “a great medical center” would play will spring the steel, concrete in the care of all Dallas citizens. and stone of a great city of mercy where While both men contributed financially to the Foundation, haven may be found by all.” the early records of the organization reflect that Hoblitzelle Karl Hoblitzelle (and later, the Hoblitzelle Foundation) made repeated gifts Upon signing the charter of $5,000 and $10,000 in order to help keep the Foundation on its feet. During this period, Dr. Cary commanded the national healthcare stage. In 1939, he helped found the National Physicians Committee, which opposed the idea of a national health insurance. Dr. Cary strongly supported group hospitalization (a precursor to what eventually became health insurance like Blue Cross Blue Shield) as the smarter alternative — believing that federal or state bureaucracy was a means of political control that ultimately would not be in the best interest of the people, the quality of medical care or the medical profession itself. He testified before Congress as one of the country’s leading experts on the subject. It was said at the time that no man fought harder to see that the ethics of the medical profession were maintained. By June 1940, half a world away, Hitler had taken over France. In Washington, Congress approved the first peacetime draft in American history. In Dallas, in August 1940, a telegram was sent to Baylor College of Medicine by U.S. Surgeon General James C. Magee requesting that the college organize a medical unit for the army to be composed of hospital staff, medical school faculty and alumni. A month later, London was bombed for 57 consecutive nights. On a Sunday morning, December 7, 1941, the Japanese attacked Pearl Harbor. The next day President Roosevelt called for a declaration of war. Three days later, Japan, Germany and Italy declared war on the United States. 16 75 YEARS OF VISION: THE LASTING GIFT

Understanding the financial challenge before him, Dr. Cary invites the Director of Medical Service for the Rockefeller Foundation to speak before a large group of Dallas doctors and businessmen.

“It is time for people to realize that medical research is not adequately supported. The function of a foundation is to work in the modern time in the expanding field of research.”

Alan Gregg, MD Rockefeller Foundation

December 7, 1941 As the country is suddenly drawn into the second World War, the energies and resources of a nation are turned elsewhere.

SOUTHWESTERN MEDICAL PERSPECTIVES . SPRING 20 14 17 75 YEARS OF VISION: THE LASTING GIFT

Rendering by then prominent Dallas architectural firm LaRoche & Dahl.

M A R C H 11, 194 2 “Plans for a great medical center on a 35-acre tract along Harry Hines Boulevard and including Parkland Hospital grounds were announced by Southwestern Medical Foundation through its president, Dr. E. H. Cary. The proposed medical center would rank with the finest in the nation. Buildings planned for the center and necessary equipment will cost from $1,000,000 for the start and run up to $25,000,000 when completed. Baylor University College of Medicine has been offered the opportunity of sponsoring the medical school. Negotiations have been underway for six months with the Baylor Trustees for participation in the project.”

Excerpt from The Dallas Morning News

18 75 YEARS OF VISION: THE LASTING GIFT

“It is especially remarkable that so much of what was imagined 72 years ago has come to pass: A sprawling medical campus designed for research, education and clinical care. It all started with a vision. Vision matters.”

Daniel K. Podolsky, M D President, UT Southwestern

B ut decades of dreams — dreams that Dr. Cary knew would benefit humanity — weren’t about to be put on hold. For months he’d been working closely with leading Dallas architects to render a master plan for a medical center on land adjacent to Parkland Hospital. At the same time, the Foundation had begun to push toward an agreement with Baylor University for the joint operation of Baylor College of Medicine. On March 8, 1942, Dr. Cary revealed his vision to the public for a sprawling medical center that would be spread across a 35-acre tract of land on Harry Hines Boulevard. The centerpiece of the vision, a new medical school, would be named Southwestern Medical College. Baylor College of Medicine was offered a detailed proposal to become an integral part of the new center, which was approved by the Board of Trustees at Baylor in Waco on June 23, 1942. But Dr. Walter H. Moursund, Dean of Baylor College of Medicine in Dallas, had growing concerns. Under the proposed plan, Baylor and the Foundation would share operational roles — Baylor would direct education and academics while the Foundation would handle physical operations — ownership of the buildings constructed by the Foundation would remain with the Foundation. In exchange for financial support and the land to expand, Baylor College of Medicine would be asked to drop its affiliation with Baylor University Hospital and realign with Parkland. As these issues and others were considered, the agreement was canceled on April 27, 1943. It was immediately announced that the medical school would relocate to Houston, having accepted a proposal offered by the MD Anderson Foundation and other Houston benefactors. In May, the last Dallas class of Baylor College of Medicine received their diplomas. As the graduation ceremony ended, the challenge to assemble an exemplary medical school landed squarely at Dr. Cary and the Foundation’s feet. Dr. Davis Spangler, President of the Dallas County Medical Society (DCMS), stepped forward to pledge his organization’s full support of Dr. Cary’s bold vision — an important early endorsement that rallied hundreds of physicians and dentists to the cause. Still, it would have been an enormous undertaking to pull together in a year, or even two. To do so in a few short months would take a miracle.

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The official seal of the new medical school.

May 5, 1943 Southwestern Medical College is officially established by Southwestern Medical Foundation.

20 75 YEARS OF VISION: THE LASTING GIFT

SETTING THE STANDARDS 1943 TO 1949

I n the midst of World War II — a war that placed incredible demands upon the individual courage and resourcefulness of nearly every American — Southwestern Medical Foundation announced on May 5, 1943, the founding of a new medical school. The immediate and overwhelming demands of the task before them swept aside discussions of Baylor’s departure. The to-do list of the Foundation was daunting. A sizable endowment campaign needed to be organized and launched. Land needed to be purchased. A formal agreement with Parkland Hospital needed to be In 1943, Dallas began war made. Existing faculty needed to be paid. Somewhere in Dallas, a building had to rationing. Over 350,000 ration books were distributed. be found to house the school. Returning and new student applications needed to be processed. Scarce scientific and medical equipment needed to be found and purchased. A medical library needed to be stocked. Construction of new facilities needed to begin. A means of recognition to help inspire young doctors to excellence was needed. The new school needed accreditation. And in the time that remained, additional faculty of the highest caliber would need to be recruited. What followed was nothing short of extraordinary. On June 3, 1943, a drive for a $1.5 million endowment began — $1 million for buildings and $500,000 for operating expenses. Three members of the Foundation’s Board of Trustees, accepted the challenge of the fundraising effort: Fred F. Florence of Republic National Bank, Ernest R. Tennant of Dallas National Bank and Robert L. Thornton of Mercantile National Bank. Mayor Woodall Rogers stepped up to advance the cause at a Founder’s Day dinner. “We are standing on the threshold of the greatest period of endeavor Dallas has ever seen,” he said. “This is the greatest investment in human welfare that a forward-looking city could make.”

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Many, including some of the city’s most notable civic and business leaders, pledged their financial support. The Chamber of Commerce and the Citizens Council announced their commitment to raise $100,000 annually for ten years to help defray operating expenses until the school had acquired sufficient endowment income. The community pulled together, and the $1.5 million goal was exceeded by $200,000. With the benefit of such support, the Foundation acquired 26 acres of land on Oak Lawn Avenue adjacent to Parkland Hospital. Proximity was critical as Parkland had established itself as Dallas’ most prestigious hospital. Additionally, a 25-year contract was negotiated with the city and county of Dallas to provide medical services for Parkland Hospital patients in return for using its clinical facilities for teaching. There was a full-time faculty of 18, including the dean, who needed to be paid. These and other immediate operational needs couldn’t wait for ”Faculty and staff members were sent endowment income to materialize, so Hoblitzelle and all over the country to try to find necessary scientific equipment. Funds, Dr. Cary each put up $100,000 to fund the Foundation. supplies, books and equipment were A building suitable for laboratories and lectures was donated by individuals, business firms, clubs, desperately needed until a permanent building could be industrial concerns and hospitals.” built. The Foundation was given permission to use Alex Catherine Schultz W. Spence Junior High School, a building the Dallas School Office of the Dean District had recently shut down as unsuitable for use. Nearly $100,000 worth of scarce scientific equipment would be hunted down and purchased from across the country. The 277 student applications submitted for admission to the college’s first semester were processed, and classes were organized. In July, Dallas’ alumni of Baylor College of Medicine donated thousands of medical volumes to begin to fill the school’s medical library. Local physicians and the library of the Dallas County Medical Office gave as well. Later during the school year, $15,000 would be spent to expand the necessary reading and teaching materials. To communicate the highest expectations the Foundation had for its students, an annual award was initiated to recognize those young doctors who best exemplified the special qualities found in the greatest physicians — knowledge, understanding and compassion. It was called the Ho Din award — Ho Din being a Greek acronym representing “the spirit of medical wisdom.” Over the years, many prominent physicians went on to receive the prestigious award, including Drs. Charles Sprague, future Nobel Laureate Joseph Goldstein and Charles James Carrico to name only a few. On July 1, 1943, Southwestern Medical College began in earnest to make doctors The Ho Din Award was out of bright young men and women. started by the Foundation in 1943 and has been That day Dr. Cary addressed the 277 students telling them, ”This is an historic awarded every year since occasion, the beginning of something truly worthwhile for Dallas and the Southwest. its inception. It is the fruition of 40 years of effort by the best and highest- minded medical men in Dallas. Medicine belongs to all the people. That is the goal of this Foundation.” 22 “Gentlemen, we have succeeded. Southwestern Medical College is now a reality. All that remains is to make the school the finest in the country, and that job is up to all of us.”

Edward H. Cary, MD

JUNE 1943 Southwestern Medical Foundation Officers and Board of Trustees the year Southwestern Medical College opened. 75 YEARS OF VISION: THE LASTING GIFT

OCTOBER 1944 The last of the plywood barracks were completed.

1943 vs Today

Total Full-time Annual Total Nobel NAS* Students Faculty Budget Sq Ft Laureates Members

4,600 2 ,1 0 0 $1.86 B 7.7 M 6 21

200 17 $200,000 25,000 0 0

1943 numbers are shown relative to 2014 end-of-year projections. *National Academy of Sciences

24 75 YEARS OF VISION: THE LASTING GIFT

At first blush, the possibilities for new construction seemed nonexistent. The country was at war. Building materials were impossible to come by — nearly everything was rationed. Skilled labor was scarce. Without receiving priority certificates to secure building materials, moving forward could not occur. But the reality of wartime meant the armed forces needed doctors. As the war continued, the need increased. There was also an acknowledgment that new doctors would not only care for the sick and wounded on battlefronts halfway around the world, but maintain and protect the health of the home front’s growing population. It proved serendipitous that Dallas was the base of operations for the military’s Eighth Service Command. The Foundation realized it had a simple case to make. The military needed doctors, and the new medical school was in a position to turn out some of the best. General Walton H. Walters found the arguments persuasive. Col. Bradley Colley, chief of surgery for the Eighth Service Command, agreed to build prefabricated plywood barracks to house the school. On July 16, 1943, authorization and top priority were given to buy required materials and begin construction of nearly 30,000 square feet of buildings. On September 27, 1943, the first classes were held in the first of the newly completed barracks. Every surface was made of ¾-inch plywood — floors, ceilings, walls and roofs. The buildings were not air-conditioned. Windows would stick. Heating was inadequate. And the roof would leak. But while the architecture was best described as “henhouse classic,” it was home. They were quickly dubbed “The Shacks.” As the barracks neared completion, the medical school needed accreditation, a task Dr. Cary was uniquely suited for, having served as President of the AMA. Accreditation was given on December 15, 1943. The speed of the acceptance was unprecedented. Southwestern Medical College became the nation’s 68th medical school and likely the first to begin operations with an “A” rating — putting it on par with the oldest and best medical institutions in North America. To preserve the quality of education, the Foundation deter- mined that a maximum of 64 new students would be admitted each year, ensuring time for individual instruction in clinical subjects. “They will learn from the outstanding physicians and surgeons of Dallas, who serve on the clinical faculty…that a sick The reality of wartime meant the armed forces needed person presents not merely a scientific question, but a problem skilled doctors. As the war continued the need had increased. For the first few years of the new medical of human values that involves the aspirations and frustrations school’s operation, all male students were required to be in the military. of an individual,” Dr. Cary said. Incredibly, within a matter of months, the semblance of a quality medical school was in place, and in spite of its facilities Southwestern Medical College began to flourish. The final challenge lay in the recruitment of additional full-time faculty.

SOUTHWESTERN MEDICAL PERSPECTIVES . SPRING 20 14 25 75 YEARS OF VISION: THE LASTING GIFT

Dr. Cary’s vision was to find men and women who excelled in medical education as well as medical research. What is remarkable is that within the next 12 months, the Foundation successfully recruited a prestigious faculty, enviable of more established medical campuses. The long list included Dr. Tinsley R. Harrison, a pre-eminent physician in Internal Medicine, who was also made dean of faculty, Dr. William L. Mengert, Dr. Gladys Fashena, Dr. Arthur Grollman and Dr. Morton F. Mason. Throughout the first year of operation, research done by these and many other physicians, supported by grants from the Foundation, began producing outstanding results — many of which were published in the foremost scientific journals in the country. Notably, Dr. Harrison’s work in the field of hypertension had already won him worldwide acclaim and Dr. Fashena had made great strides in combating Dr. Tinsley R. Harrison was the original editor-in-chief of the medical rheumatic fever, a devastating disease that at the time ranked as one of the chief textbook “Harrison’s Principles causes of death in school-age children in Texas. of Internal Medicine.” It was first published in 1950 – and is currently Dr. Fashena, in later years, would comment that she had never been associated in its 18th edition. with a medical school in which morale was so high. On March 20, 1944, just nine months after opening, Southwestern Medical College graduated 61 seniors — 38 young men were commissioned first lieutenants in the medical corps of the Army, and 15 took their oath of office as medical officers in the Navy. In a review of its first year of operations, the Foundation’s annual report ended with this: “Contributions to the science of medicine through research have been recorded in the work completed by patient investigators, fired by a humanitarian zeal that is represented by the idealistic vision of the Foundation. For knowledge, for science, for the people – surely, this is worthwhile.” In 1945, when it was determined that the financial needs of the day-to-day operations of the school were exceeding the Foundation’s projections, Fred Lange, the Foundation’s Managing Director, was asked to lead a fundraising drive. “Outstanding scientists and medical educators must be assured of a permanent, growing institution,” Dr. Cary said. Lange was aided by Karl Hoblitzelle who sent letters to Dallas business organizations asking that the medical center be designated as the top civic activity of the year. “This beginning is but the seed of a tremendous idea and a visionary ideal,” he wrote. “From it, in time, will spring the steel, concrete and stone of a great city of mercy, where haven may be found by all, the rich and the poor alike.” Lange’s efforts were so successful that by September 1945, the Foundation had pledges for $1.3 million and other income totaling $260,000 per year. To their credit, many practicing Dallas physicians participated generously in the drive and, overall, nearly 2,000 individuals were inspired to contribute to the fund. During the remainder of 1945, the Foundation saw gifts of $100,000 come from

26 An early X-ray machine.

Cadavers? Yep, cadavers. 75 YEARS OF VISION: THE LASTING GIFT

“The Hoblitzelle donation ensured a world of possibilities. Without its happening when it did, I seriously doubt that UT Southwestern would be the institution that is today.”

William T. Solomon Chairman, Southwestern Medical Foundation, for six years

1945 The Hoblitzelle Foundation donates the money to purchase 62 acres – effectively doubling the size of the proposed medical center campus.

28 75 YEARS OF VISION: THE LASTING GIFT

T. E. Braniff for use in the construction of clinical laboratories (which was added to the $1 million building fund raised in 1943), and the Hoblitzelle Foundation donated $125,000 to purchase 62 acres on Harry Hines Boulevard, adjacent to the proposed site of a new Parkland Hospital. The land was given as a memorial tribute to Hoblitzelle’s late wife, Esther, who had died of cancer in 1943 at the age of 48. For the Foundation, it was a farsighted acquisition in that it connected with a tract of land where the new Parkland Hospital was proposed and assured that the new medical center would have room to grow into its future. By 1946, physicians returning from war could not return to their same postions since Baylor had relocated. The major reason these rearrangments did not produce more antagonism was because Millard Heath, Dallas County Medical Society Director, “effectively neutralized with tact and courtesy the divisions within the medical community.” Fortunately the need for doctors was growing, as the population of Dallas was now approaching 400,000. As more veterans returned, the need for a new Veteran’s Administration Hospital to provide care for injured soldiers and veterans became clear. In 1947, a new VA hospital seemed on the verge of breaking ground near the medical center campus. Bonds for the nearly $7 million hospital had been launched. That same year, the Foundation provided $306,000 for medical school operations and an additional $75,000 for research. Rae Skillern had donated $100,000 for a student center. It was announced that construction would soon start on a $2 million building for the medical school, the basic sciences building, its first permanent structure. As the vision of the new medical center began to materialize, interest in the school took off. Student applications exceeded 600 for the 64 spaces available. The faculty had grown to 35 full-time members and more than 350 part-time members of the clinical faculty – physi- cians who had their own medical practices but volunteered to teach part time without pay. An article in the Dallas Times Herald in May 1948 praised Southwestern Medical College’s faculty as some of the “best reserves of teachers in medical science in the nation.” The medical school had become a shining example of a community coming together for the betterment of everyone. But suddenly, in the midst of such success, progress slowed to a crawl. Architectural plans for the new Parkland Hospital entered a cycle of revisions. Plans for moving forward with the new Veteran’s Hospital were delayed by budget concerns. A long period of waiting began. The Foundation Board decided that construction for its medical school should wait until these issues were resolved, which meant that visible progress came to a halt. At the same time, the cost per student was rising logarithmically as new technologies were applied to medical instrumentation. It was becoming apparent that the Foundation would be hard pressed to acquire the endowment required for the kind of medical center that Dr. Cary had imagined. As the Flexner Report had suggested almost 40 years earlier and as Dr. Cary well knew from decades of experience, in order to secure its future, the medical school would need to be absorbed by a well-funded university.

SOUTHWESTERN MEDICAL PERSPECTIVES . SPRING 20 14 29 75 YEARS OF VISION: THE LASTING GIFT

September 18, 1949 Dr. Cary signs over ownership of land, buildings, equipment, library and grants valued at $1.43 million to The University of Texas System.

30 75 YEARS OF VISION: THE LASTING GIFT ASSURING THE FUTURE 1949 TO 1954

I n 1949, the two most established nearby universities that could have been considered for the medical school’s university affiliation were Texas Christian University and Southern Methodist University. But both were struggling to meet their budgets. There remained a single, but remote possibility – The University of Texas in Austin. Remote because before any such affiliation could be considered, the UT System Board of Regents would first have to submit a request to the state legislature to create a bill authorizing support of a second medical school — the first being The University of Texas Medical Branch at Galveston, which was established in 1891. In May 1949, however, such a bill was passed. It was announced that the location of the new medical school would follow a review and the recommendation of the House of Delegates of the Texas Medical Association (TMA). Southwestern Medical Foundation was well-prepared for the opportunity. The University of Texas in Austin campus in the early 1950s. After the initial review, El Paso, Dallas, San Antonio and Temple remained. The Foundation’s final presentation was brief and to the point. It detailed a faculty already in place, a student body at work, laboratories in use, ground-breaking research underway and the transfer of nearly $1.5 million in assets held by the Foundation, including an impressive tract of land on Harry Hines Boulevard, giving the school room to expand. Some say that behind-the-scenes maneuvering combined with skillful lobbying of the Texas Legislature helped the Foundation’s cause, but in any event, the delegate vote was 79 to 54 in favor of Dallas, which the UT System Board of Regents unanimously accepted. The Foundation completed the donation of land and facilities, certain restricted funds and equipment to the UT System on September 18, 1949, and the newly named Southwestern Medical School of The University of Texas began operations. The Foundation retained monetary assets, wills and similar contributions, to continue operations and fulfill its original mission.

SOUTHWESTERN MEDICAL PERSPECTIVES . SPRING 20 14 31 75 YEARS OF VISION: THE LASTING GIFT

Dallas medical students rejoiced as their tuition was reduced by 80 percent. But beyond that, the benefits of joining the UT System would take several years to materialize. Technically, the medical school was a statutory branch of the UT System, not a consti- tutional branch, which meant the school faced the hazard of approaching the legislature for all appropriations. Through 1950, medical school and Foundation efforts to convince the legislature to appropriate money for new construction were denied. To make matters worse, the UT System limited state support to the salary scale of its main university, which set $9,600 as the ceiling for a full professor. In order to attract a quality faculty, there was no doubt that medical school salaries would need to be supplemented. Fortunately, whenever the Foundation was presented with the need for such supplemental funds on no occasion did they fail to provide The new sign reads: Southwestern assistance. Without their support, the task of filling major faculty vacancies — Medical School of The University of Texas. More tangible physical difficult enough on its own — would have been impossible. benefits of joining the UT System Near the end of 1950, a single phone call made to a young doctor at Yale would take years to materialize. would soon bring the school’s Department of Internal Medicine great acclaim. In January 1951, Donald Seldin came to Dallas at the urging of Charles Burnett, himself a Harvard-trained endocrinologist and the medical school’s new Chairman of the Department of Internal Medicine. Seldin was a promising researcher in kidney disease at Yale. Burnett told him that he could start his own nephrology program in Dallas. Dr. Seldin was 31, and nowhere in the traditional medical schools in the East could he have been given such an opportunity. “At Yale, there were so many first-rate faculty members crowded into one section of the department that the chances of my setting up a program of my own or advancing along academic lines were very slim.” Seldin agreed to take the position even though he had never been to Dallas. Though cautioned by his peers, he was highly intrigued with the possibilities. Yale School of Medicine at about the time Dr. Seldin left for Dallas. He drove his wife and infant daughter to Texas from Connecticut. When he Not a shack in sight. got to the corner of Maple and Oak Lawn, he pulled into a filling station and asked the attendant how to get to the medical school. The attendant gestured in the direction of a railroad overpass. Seldin followed the man’s instructions but found nothing but ramshackle military barracks and a lone, dilapidated brick building. He returned to the filling station and told the attendant what he’d seen. “That’s it,” the attendant said. “That’s the medical school.” “It was a hell of a place,” Dr. Seldin would tell people later. Seen from a fresh perspective, the shacks more than deserved their moniker. Since their completion, water leaks had softened the bond that held the layers of plywood laminate together. The buildings leaned, pushed by the wind. There were holes in the floors that exposed the bare dirt foundation. When it got too cold, experiments had to be canceled or rescheduled because the lab equipment would freeze. Every now and then, a laboratory

32 JANUARY 1951 Dr. Don Seldin arrives in Dallas. Former students would later call him “magical” and “incredible” and “the only truly great man I know.” 75 YEARS OF VISION: THE LASTING GIFT

“To take a historical perspective...Seldin is one of the two most impactful figures in the history of modern medicine.”

Eugene Braunwald, MD Faculty Dean, Harvard Medical School

“An exceptionalist in academic medicine like Babe Ruth was an exceptionalist in baseball, Leonard Bernstein in music and Steve Jobs in computer technology.”

Joseph Goldstein, PhD Former Seldin student, awarded Nobel Prize in 1985

“The people that Don Seldin attracted and persuaded to stay became the heart and soul of the institution.”

Kern Wildenthal, PhD President Emeritus, UT Southwestern

“He’s the most remarkable man I’ve ever met.” L. David Hillis, MD UT Health Science Center at San Antonio

plywood barracks

railroad tracks

“Our lecture room at the end of one wing was about 20 feet from the railroad track. When a slow-moving freight train went by, as it did regularly, the speaker had to pause for several minutes.”

James Hoffman, MD Class of 1945

34 75 YEARS OF VISION: THE LASTING GIFT instrument or a chair leg would punch its way through the floor. There was, in fact, little to sustain Seldin’s initial enthusiasm. Construction of the new medical school showed no signs of materializing, and plans for a new Parkland Hospital languished. To make matters worse, in April 1951, Burnett told Seldin that he was considering an offer in North Carolina. A few months later, he left, leaving Dr. Seldin as the only remaining member of the Department of Internal Medicine. As 1951 continued, momentum slowed further. Movement on a new Parkland Hospital remained in limbo. And planning and budget issues continued to confound further development of the VA hospital. Toward the end of 1951, Texas Governor Allan Shivers led a delegation from Austin to Dallas to see for himself whether the legislature should appropriate funds for the construction of permanent buildings for the medical school. A former member of the Department of Pathology recalls: “Students, fellows and faculty were lined up in the shacks to welcome the governor and his entourage. The governor walked in through the back of one the long shacks and as he got halfway down the edifice, a window simply dropped out of the wall. The governor continued walking and another hundred feet later, one of his feet went through the floor. We knew from the look on his face that he was going to help us.” Over the next few months, the Chairman of Pediatrics left for Rochester, the Chairman of Surgery (and Dean) left for Washington University in St. Louis and the Chairman of Obstetrics and Gynecology left for the University of Illinois. By the end of 1951, not a single full-time chairman remained in any clinical department. The shacks did not age gracefully. In fact, years after they were torn Despite his ambition and initial engagement, the situation gave Seldin pause. down, many believed that the He considered his options: he’d received an offer to return to Yale, another shacks were recycled army barracks left over from World War I. to join Burnett in North Carolina and yet another was in the works from Harvard. Or he could stay. Dr. Seldin was offered the chairmanship of Internal Medicine, but declined. Construction of new Parkland Hospital was barely being discussed. The medical school was housed in deteriorating shacks. The school had no dean, since Carl Moyer, who was also Chairman of Surgery, had left for St. Louis. To Seldin’s surprise, these issues suddenly resolved themselves. Dr. George Aagaard, a man whom he much admired, was appointed the new dean. Governor Shivers, at a special session of the legislature, released funding for the medical school’s first building. And the county appropriated money through a bond issue to begin construction on a new Parkland Hospital. Encouraged, Seldin chose to stay. He was made the acting Chairman of the Department of Internal Medicine. A year later the appointment became permanent. Seldin saw the medical school as an unspoiled opportunity, a place not yet molded by East Coast tradition and convention. In his time at the school, he had also witnessed that

SOUTHWESTERN MEDICAL PERSPECTIVES . SPRING 20 14 35 75 YEARS OF VISION: THE LASTING GIFT

Dallas had no shortage of bright and motivated medical students. Just as Dr. Cary provided the original vision for a great medical center in Dallas, Dr. Seldin came to embody its enthusiasm, style and philosophy. He would go on to become recognized as “one of the dominant intellectual forces in American medicine.”

“I believe that every member of the faculty in the clinical department is responsible for investigative activity, because this is the key point of the educational process. This is the method of ascertaining truth. If the individual teacher is not a scholar, what entitles him to operate within the university framework? Is it his charm? Is it his vividness? The necessary qualification of the scholar is that he in some sense exhibit the imaginative type of activity that is inherent in the research process.”

Donald Seldin, MD

By February 1952, Dallas-based architects were preparing plans for a 90,000-square- foot building to house the school’s basic sciences departments. The legislature had speci- fied that the total cost could not exceed the $2.75 million that had been appropriated. When the lowest construction bid came in $100,000 over budget, Dean Aagaard faced a dilemma. Unless he could raise the difference before the contractor’s deadline for accep- tance ended, it would be another six months before the matter could be discussed again. He called Dr. Cary at six in the morning to ask if the Foundation could provide the additional funds. By 7 a.m., phones all over Dallas had pulled men out of bed to vote “yes.” In April 1952, Parkland broke ground on the new medical center campus. Seldin would go on to create a department of clinical scholars second to none. Because money was tight and there was little possibility for bringing in outside talent, he got there by adopting a unique strategy. He selected his best students and residents, sent them off for additional training, and then brought them back to Dallas as faculty members. He immersed himself in their lives. Students would see him doing rounds at 3 a.m., and when he finished, he would give lectures about what he’d seen. His personal involvement gave him an opportunity to uncover his most exceptional students. Some he knew held tremendous potential, like Jean Wilson and Joe Goldstein, among many others. He took them aside and explained his vision. Like Cary, Seldin wanted to create an institution dedicated to research, clinical work and teaching. And importantly, he wanted every member of the faculty to do all three. He believed conducting research should make you a better doctor, which in turn would help you to frame better questions that could be answered in the lab. At the time, it was a highly innovative approach to medicine that, interestingly, paralleled Dr. Cary’s views on collaborative medicine.

26 36SOUTHWESTERN MEDICAL PERSPECTIVES 75 YEARS OF VISION: THE LASTING GIFT

APRIL 1952 Parkland Hospital breaks ground on the new APRIL 1954 medical center campus. New Parkland Hospital opens to high praise.

1952 Legislature approves September 1, 1953 $2.75 million for new basic Dr. Donald Seldin promoted to sciences building. Chairman of Internal Medicine.

December 5, 1952 1954 September 18, 1954 Building contract awarded Texas legislature The medical school is for basic sciences building appropriates $3.5 million renamed The University after the Foundation for clinical of Texas Southwestern contributes $100,000. sciences facilities. Medical School.

D E C E M B E R 11, 19 5 3 Dr. Edward Cary dies at age 81 in Dallas. Karl Hoblitzelle becomes the second president of the Foundation.

“...without his leadership, his day-by-day devotion to an ideal, there would have been no rallying point, and perhaps no cause at all.”

Karl Hoblitzelle Excerpt from his writing honoring Dr. Cary

SOUTHWESTERN MEDICAL PERSPECTIVES . SPRING 20 14 37 75 YEARS OF VISION: THE LASTING GIFT

1954 Parkland Hospital opened to high praise and became the exclusive teaching hospital for the medical school.

1959 vs Today

Total Full-time Annual Total Nobel NAS* Students Faculty Budget Sq Ft Laureates Members

4,600 2 ,10 0 $1.86 B 7.7 M 6 21

500 100 $4 M 250 K 0 0

1959 numbers are shown relative to 2014 end-of-year projections. *National Academy of Sciences

38 75 YEARS OF VISION: THE LASTING GIFT

Dr. Seldin had fortuitously brought his academic vision to Dallas at the beginning of one of the greatest revolutions in biology – a revolution that yielded the structure of the gene, the unraveling of the genetic code and a period that welcomed a new scientific discipline called molecular biology. Molecular biology promised untold dividends in comprehending cellular function and promised countless extensions into molecular medicine and more effective treatment options. In 1953, the Veteran’s Administration sold land along Harry Hines (which had been intended as the site for its new hospital ) to the Foundation. Plans had changed and it was determined that it was more cost effective to remodel VA hospitals at their current locations. As 1953 came to a close, Dr. Cary passed away, just a year short of learning that the UT System had approved $3.5 million for a permanent building to hold the school’s clinical sciences departments. Along with the approved funding, the medical center’s name was changed to The University of Texas Southwestern Medical School. With Dr. Cary’s passing, tributes from the AMA, Blue Cross, Republic Bank and dozens of other institutions poured in praising the counsel and leadership that Cary had brought to the national healthcare stage. He was hailed as both a local hero and national visionary.

“When we get our new buildings up on that fine site Karl Hoblitzelle gave us – as we keep adding the best men to be had – as we continue hunting for the fundamental facts about sickness and as we inaugurate new research projects – with all this going on, everybody in Dallas will come to know something great has happened in their city.”

Dr. Cary, on the occasion of his 75th birthday

“Cary has built his own enduring monument and lived to see that it’s good. A man could hardly ask for more.”

The ending of the book, More Than Armies, The Story of Edward H. Cary, MD, by Booth Mooney

While Dr. Seldin ingeniously and ably steered the direction of the medical school, The University of Texas System and its Board of Regents had stepped solidly into the role of primary financial supporter. The Foundation stayed the course, growing endowment income for future construction and supplementing the salaries of some of the best and brightest researchers in the country. A new Parkland Hospital opened in 1954 to high praise, became the exclusive teaching hospital for the medical school and played a key role in attracting top medical talent. 1955 was summed up best by the late John S. Chapman, MD, Professor Emeritus of Internal Medicine and author of the definitive history of medical education in Dallas: “…if one looked at Southwestern as it had staggered along six years earlier, it had thrived mightily.” However, more — much more — was about to be accomplished.

SOUTHWESTERN MEDICAL PERSPECTIVES . SPRING 20 14 39 75 YEARS OF VISION: THE LASTING GIFT

January 29, 1955 The Basic Science Hall is dedicated.

40 75 YEARS OF VISION: THE LASTING GIFT buildING MOMENTUM 1955 TO 1979

O n January 29, 1955, the Basic Science Hall was dedicated, becoming the first medical school building on the new campus. ( It was later renamed Edward H. Cary Basic Science Hall in 1960.) The building was located near Parkland Hospital and allowed the basic science departments to move out of the shacks. Members of the clinical science departments, including Dr. Seldin, would have to wait until 1958, the year the Hoblitzelle Clinical Science Building was com- pleted, before they could move. At which point the shacks were mercifully abandoned — having dutifully served for some 15 years through wind and rain and rot, freezing cold and the occasional fire. That same year, Southwestern Medical Foundation launched a $4 million campaign for the “…building of a new $10 million St. Paul Hospital…which will give great impetus toward bringing to life one of Dallas’ dreams of many years,” said Karl Hoblitzelle, Foundation President. In late 1959, groundbreaking for the The Hoblitzelle Clinical Science Building was built directly behind the Basic Science Hall. new St. Paul Hospital took place. Parkland Hospital is seen in the upper left. The new campus was coming to life. In many ways, the tremendous success of the medical center over the next two decades (and beyond) owes much to the fact that the school had put itself in a position to leverage an unprecedented period of rapidly expanding medical knowledge — much of it ignited by a single event. Groundbreaking for In 1953, James D. Watson and Francis Crick (Cambridge University) St. Paul Hospital. Hoblitzelle is fifth from the left. with Maurice Wilkins (King’s College, London) famously announced the basic structure of DNA. The three men were jointly awarded the 1962 Nobel

SOUTHWESTERN MEDICAL PERSPECTIVES . SPRING 20 14 41 75 YEARS OF VISION: THE LASTING GIFT

Prize for Physiology or Medicine “for their discoveries concerning the molecular structure of nucleic acids and its significance for information transfer in living material.” This led to a new understanding of biology, that human cells contain chromosomes made up of genes. The ramifications of the discovery would prove endless. For the first time, it allowed for the study of diseases caused by defective genes and the search to isolate inherited genes responsible for specific diseases. Furthermore, the understanding of how proteins are designed and can cause disease provided windows of opportunity for drug development that had never before been possible. Pharmaceutical science would be transformed by a new understanding of the way cells within the human body worked. Add to this the fact that medical technology was rapidly advancing. The use of

The discovery of ultrasound and magnetic resonance imaging would make it easier to diagnose disease. the DNA molecule Incredible advances in surgical instruments and techniques would lead to organ transplants, forever changed the course of from kidneys to hearts. Major developments were occurring in replacement surgery for medical research. hips, knees and elbows. Advances in the area of reproductive science were being made as well. New understanding and treatment of cancer and the increasingly effective use of a combination of drugs, radiotherapy and surgery was underway. This time of tremendous excitement and innovation served as a catalyst for significant increases in both state and federal funding. It also served to inspire generous private gifts from the Dallas philanthropic community. Increased state funding was initiated by Governor John Connally. He used his political skills to increase taxes in order to raise teacher salaries, improve libraries, support education, and fund scientific and medical research. While his efforts 1963 were wide-ranging, the medical school directly benefited. $930 million Not coincidentally, the National Institutes of Health (NIH) had significantly raised its funding budget. By 1960, it had 1960 $400 million in annual grant monies — the majority of which $400 million would be awarded to thoughtfully crafted proposals for 1957 biomedical research and training. $98 million Seldin and his teams of clinical scholars made extensive From 1957 to 1963, the NIH budget grew almost ten-fold. use of the opportunities afforded by NIH grants. It would soon become evident that the medical school’s quality of medical investigation could compete with the best medical schools in the country. The conception and development of the Dan Danciger Research Building was a perfect example of the synergies in place at the time. It was completed in 1965 and connected the Hoblitzelle Clinical Sciences Building with Parkland Hospital. It began in 1960, when the Danciger Foundation pledged $750,000 for a new research building. The Foundation added an additional $250,000. The medical school filed matching grants with the NIH and received additional funds. And in 1961, the school was given an additional $1 million grant from the National Advisory Council on Health Research.

42 75 YEARS OF VISION: THE LASTING GIFT

1964 Dr. Kern Wildenthal (who would later become president ) graduates from UT Southwestern. July 1960 He would travel to England Danciger Foundation pledges $750,000 to earn his PhD at Cambridge. for a research building at Southwestern and Southwestern Medical Foundation adds $250,000. UT System authorizes the school to file an application with the National Institutes of Health for matching funds. 1965 Dan Danciger Research Building completed.

1960 The UT System prepares a master development plan in an effort to 1963 July 1, 1967 help transform its Dallas-based medical Construction of the Dr. Charles C. Sprague of school into one of the Dan Danciger Research Tulane University takes office as top medical schools in the country. Building began. Dean of the Medical School.

Fall 1962 Joseph L. Goldstein enters medical school at Southwestern.

“We always wore white shirts and ties. When we were doing gross anatomy, then we’d remove the ties.”

James Atkins, MD, Class of ‘67 Professor of Internal Medicine

SOUTHWESTERN MEDICAL PERSPECTIVES . SPRING 20 14 43 75 YEARS OF VISION: THE LASTING GIFT

Parkland proved to be an invaluable teaching hospital as well as a place where UT Southwestern physicians and investigators could advance quality patient care.

1971 Parkland opens the 1962 first high-risk maternity Parkland’s ER becomes a unit in the nation. model system for the nation when it reorganizes into six treatment areas and begins the country’s first nurse-directed triage system. 1973 UT Southwestern created the first and largest clinically oriented skin bank in the country to provide 1961 1966 grafts for burn patients. Parkland opens one of The surgery and Later that year, an eight-year-old the largest civilian burn units anesthesiology staffs at Parkland patient at the Parkland Burn in the United States and UT Southwestern publish Center became the first person to with four designated wards. the first medical text on trauma. survive such major burn wounds.

1963 The floral wreath Governor Connally’s placed on the door wounds were much more of Parkland’s severe than many realized Trauma Room 1, since he recovered so well. where President The UT Southwestern Kennedy was physicians that saved his pronounced dead life did so while caring for at 1:00 p.m., 30 other patients that November 22. came to the ER that day.

“Few hospitals in our land have ever faced the intense pressure Parkland was subjected to on November 22 and in subsequent days. Yet its staff and personnel never let the situation get out of hand, never let the excitement of the moment overcome reason and responsibility, and never permitted anything to disrupt the hospital’s normal day-to-day service to the people of Dallas.”

Governor John Connally May 20, 1964

44 75 YEARS OF VISION: THE LASTING GIFT

The medical school continued to expand. A key reason for its growth was inextricably linked to Parkland as its teaching hospital. The bulk of all clinical teaching, internships, residencies and rounds provided the vast majority of the training requirements for medical students in an exceptional environment. In January 1961, the Dallas County Hospital District Board endorsed the idea of building a medical center for children as part of the growing center. The proposal called for a 200-bed facility on seven and a half acres that the hospital district would deed for construction. “The decision to include the Children’s Medical Center...represents a major step forward in our medical care program for the needy children of Dallas,“ said Hoblitzelle. “It also creates the opportunity for the highest order of medical coordination.” That same year, the Foundation extended its influence beyond the medical school campus by announcing its support for the construction of a new hospital on a 71-acre site in what was considered “the northern section of Dallas.” The 350-bed facility would be called Presbyterian Hospital of Dallas and cost $7.5 million. The Foundation contributed funding, planning and development expertise. A cooperative agreement between the hospital and the medical school would provide a teaching program at both undergraduate and graduate levels. At the close of 1962, the medical school was awarded its first general research support grant from the NIH. At the time, some 250 research projects involving 135 faculty members and more than 200 technical assistants were underway. In the mid-60s, the Foundation saw increased levels of charitable giving for both unrestricted gifts and those earmarked for specific purposes. This was aided in part by a fundraising campaign, “The Responsive Instrument of Your Wishes,” which highlighted the results of generous support of community leaders and philanthropists in the past. In 1966, the Dan Danciger Research Building, the Pauline and Adolf Weinberger Laboratories for Cardiopulmonary Research and the Skillern Student Union Building were dedicated. That same year, the Board of Regents changed the school’s name to The University of Texas Southwestern Medical School at Dallas. In 1967, UT Southwestern medical students performed better on Part II of the National Boards than students at any other medical school in the country. It was a milestone academic achievement that proved the intellectual acumen of both UT Southwestern’s students and faculty. With continued community support, the Foundation announced that another building, the Fred F. Florence Bioinformation Center, had been funded through a $1 million gift. In March, Karl Hoblitzelle, a man of uncommon generosity who had For nearly 30 years, passionately helped to steer the Foundation for nearly 30 years, died. It was Karl Hoblitzelle played an essential role in difficult to imagine how Hoblitzelle’s vision and generosity would be guiding, funding and ensuring the success of replaced, and to honor his service, the title of chairman would not the Foundation. be held for another ten years. George MacGregor, as president, led the Foundation until he was later named chairman.

SOUTHWESTERN MEDICAL PERSPECTIVES . SPRING 20 14 45 75 YEARS OF VISION: THE LASTING GIFT

On July 1, 1967, Dr. Charles Sprague came to UT Southwestern as dean of the medical school from Tulane University School of Medicine. He’d grown up in Dallas (in fact, his father had served as mayor from 1937 to 1939). Dr. Sprague had earned his medical degree from The University of Texas Medical Branch in Galveston, served in the Navy and trained in internal medicine and hematology at Tulane University, Washington University and Oxford. Both Sprague and Seldin shared a strong belief that the basic science departments should be raised to the level of the clinical sciences departments by providing much-needed physical space and recruiting additional outstanding faculty. This kind of mutual respect between diverse depart- ments was (and continues to be) unusual compared to that found in many universities. It came from a philosophy originally outlined by Dr. Cary and put into practice by Dr. Seldin, which led to a high level of collegiality that would come to typify the culture of UT Southwestern. Dr. Sprague developed a proposal to expand South-

Gregarious, with a booming baritone voice and an engaging western Medical School into a “Life Sciences Center,” smile, Dr. Sprague joined UT Southwestern as dean of the medical that would offer education, research and patient care in school. Five years later, it would become an academic medical center with medical, graduate biomedical sciences and allied health medicine, allied health and related fields. The bold plan sciences schools. Dr. Sprague would become the new institution’s first president. would more than double the size of the existing campus, adding close to a million square feet of new space. Huge applications (quite literally a single application might weigh as much as ten pounds) for large grants were submitted to Washington — work that required months of preparation. The effort paid off, and federal and state monies were approved totaling $32.5 million. Still, the visionary project was $7.5 million short. To make up the difference, Southwestern Medical Foundation immediately launched a major fundraising drive called the “Life Sciences Center for the Southwest.” It proved so successful that when medical school faculty members arrived at the “kick-off breakfast” to officially begin the campaign, they were told that commitments made by the Dallas philanthropic community had already surpassed the target goal by nearly $1 million. “It was the largest sum ever raised here by a private foundation for capital improve- ments,” declared John M. Stemmons, Vice President of the Foundation. The first of the new buildings began to be occupied in 1972. In November, the name and scope of the medical school were changed with its reorganization into The University of Texas Health Science Center at Dallas, which now included Southwestern Medical School, the Graduate School of Biomedical Sciences and the School of Allied Health Professions. Dr. Sprague was named as the institution’s first president.

46 75 YEARS OF VISION: THE LASTING GIFT

“…[ it will ] bring together on one campus all of the sciences concerned with the life of man to interact together productively to permit the evolvement of answers to all of man’s health problems. In this view, The University of Texas Southwestern Medical School is seen as the focus of a regional medical center second to none in the world.”

Charles Sprague, MD

April 18, 1968 May 16, 1971 Dean Sprague presents his The Foundation anounces proposal to the Board of Regents for June 1969 it raised over $8.3 million in its developing a “Life Sciences Funding for the $40 million support of the Life Sciences Center” that would offer education, expansion project is to come from campaign and donates the funds research and patient care in UT System funds, federal and to UT Southwestern. The medicine, allied health professions private funds already pledged to the combined gifts of four families – and related fields. The plan the development program, Jones ( Jesse), Richardson, calls for building a million square but funding would eventually fall Stemmons and Zale – feet of new space. short by $7.5 million. topped over a million dollars.

Harry Ransom, Chancellor of the UT System, was dedicated to academic excellence. Dr. Seldin described their first meeting:

“We had a long discussion...I told him I thought the Department of Internal Medicine was doing well, but I didn’t think the medical school in Dallas would advance...[if ] just one department achieved academic success. I also mentioned the weaknesses in the basic sciences. Ransom listend attentively. He essentially told me that he wouldn’t put the financial resources into the school by way of a blank check. But if the school took the initiative to request well thought out programs, appointments and activities, he would support them to the full.”

Donald Seldin, MD

SOUTHWESTERN MEDICAL PERSPECTIVES . SPRING 20 14 47 “These buildings, these towers of hope for the future will in a not-too-distant day stand in the midst of a medical center second to none.”

Karl Hoblitzelle

30 48SOUTHWESTERN MEDICAL PERSPECTIVES 75 YEARS OF VISION: THE LASTING GIFT

Sprague and Seldin successfully recruited outstanding leaders to head the basic sciences departments. Among them: Drs. Samuel McCann (Physiology), Ronald Estabrook (Biochemistry), Jonathan Uhr (Microbiology) and Rupert E. Billingham (Cell Biology).

Dr. Jonathan Uhr Dr. Rupert E. Billingham

SOUTHWESTERN MEDICAL PERSPECTIVES . SPRING 20 14 49 75 YEARS OF VISION: THE LASTING GIFT

Under Dr. Sprague’s leadership, the medical center would receive national recognition for its many research accomplishments and award-winning faculty.

FASHENA PRITCHARD ESTABROOK

Gladys J. Fashena, MD, taught at Jack A. Pritchard, MD, pioneered Ronald Estabrook, PhD, was Baylor College of Medicine but translational research in the areas recruited by Dr. Sprague in 1968. elected to accept an appointment of preeclampsia-eclampsia ( tox- He made UT Southwestern a as one of two female faculty at emia of pregnancy), hematology, world-renowned center for bio- Southwestern Medical College placental abruption and obstet- chemistry research and education, when it opened in 1943, instead rical hemorrhage. His research attracting some of the nation’s of relocating to Houston. Fashena changed the way obstetrics is best and brightest scientists and had a master’s degree in philoso- practiced worldwide. In 1955, students. At the time, Dr. Esta- phy from Columbia and a medical Pritchard built a model system for brook was among the most cited degree from Cornell Medical handling high-risk and complex researchers in the country for his College. During her career of pregnancies, including innova- breakthrough work on the hemo- practicing and teaching, she es- tions in prenatal care that set a protein molecule, cytochrome tablished the pediatric cardiology standard for the nation. P450. His work on its biological department at Children’s Medical Dr. Pritchard wrote and edited functions significantly furthered Center Dallas and became a the definitive medical textbook, scientific understanding of how pioneer in the fields of pediatric “Williams Obstetrics,” and trained the body metabolizes drugs, cardiology and pediatric research the physicians who later took pollutants and environmental for nearly 40 years. over as its authors and editors. chemicals, including carcinogens.

50 75 YEARS OF VISION: THE LASTING GIFT

GOLDSTEIN AND BROWN

Many research projects were happening can occur in children as young as five at the medical school, but among the years of age. most remarkable at the time was the work of Their studies led to the discovery of a cell Drs. Joseph Goldstein and Michael Brown. surface receptor for a category of cholesterol In 1972, Goldstein and Brown were newly called LDL as well as an understanding of appointed Assistant Professors in Medicine. how this receptor carries LDL particles into Goldstein had been a former student of cells. Once inside the cell, among other Seldin’s and was “sent off” to gain further functions, LDL inhibits cholesterol synthesis. experience. Goldstein and Brown met as Brown and Goldstein elegantly proved fresh-faced interns at Massachusetts General that FH is caused by genetic defects in the Hospital in Boston. Goldstein convinced LDL receptor, which as a result disrupts the Brown to go to Dallas, which he did in 1971. normal regulation of cholesterol metabolism. Goldstein followed a year later. Their early work explained a genetic Together, they set out to unravel a human cause of heart attacks and led to new ways genetic disease called familial hypercholes- of thinking about cholesterol metabolism. terolemia (FH). In patients with FH, the con- This discovery would ultimately lead to a new centration of cholesterol in blood is elevated class of drug treatments to lower cholesterol many times above normal, and heart attacks called statins.

“In 1977, Joe Goldstein and I had gotten a lucrative offer that we knew Southwestern couldn’t match. Erik Jonsson, a co-founder of Texas Instruments, had become Mayor of Dallas. He heard about the offer and asked to speak with us. During the meeting, he shared a passionate vision of the city’s future. He gave us his home phone number and said if we ever needed anything for our research we should call that number and the check would be on our desk the next morning. We left the meeting with tremendous confidence that the leaders of Dallas were behind us. We never called. We never had to. But the knowledge that the support was there if we needed it, gave us the courage to tackle difficult and challenging problems.”

Michael Brown, MD Director of the Jonsson Center for Molecular Genetics at UT Southwestern

SOUTHWESTERN MEDICAL PERSPECTIVES . SPRING 20 14 51 75 YEARS OF VISION: THE LASTING GIFT

The heart of the UT Southwestern campus now included the Philip R. Jonsson Basic Science Research Building, the Eugene McDermott Academic Administration Building, the Tom and Lula Gooch Auditorium, the Eugene McDermott Plaza and lecture rooms, the Cecil and Ida Green Science Building, the Fred F. Florence Bioinformation Center and the Harry S. Moss Clinical Science Building. Along with those donors, came significant gifts from the Jones, Stemmons and Zale families; and the Hoblitzelle and Sid Richardson Foundations. It was the addition of these buildings, which finally gave the faculty the room to grow. This transformed the regional medical school into an impressive national medical center.

HARRY HINES BOULEVARD By 1978, the primary buildings of the UT Southwestern campus included:

1 ) Eugene McDermott Academic Administration Building 3 2 ) Eugene McDermott Plaza and lecture rooms 1 3 ) Tom and Lula Gooch Auditorium 4 ) Fred F. Florence Bioinformation Center 5 ) Harry S. Moss Clinical Science Building 6 ) Philip R. Jonsson Basic Science 2 12 4 8 10 Research Building 9 7 ) Cecil and Ida Green Science Building 7 8 ) Edward H. Cary Basic Science Building 9 ) Karl Hoblitzelle Clinical Science Building 13 10 ) Dan Danciger Research Building 6 11 ) Skillern Student Union Building 5 11 12 ) Parkland Hospital 13 ) Southwestern Institute of Forensic Science

It should be noted that the philanthropy directed to both the medical school and the Foundation by the three founders of Texas Instruments was remarkable, not only for its generosity but for its inspired philosophy. Each man — Erik Jonsson, Eugene McDermott and Cecil Green — firmly believed that basic research, in and of itself, could lead to the discovery of scientific principles that could change the world. In 1979, the school’s research excellence was recognized when Ronald W. Estabrook, PhD, became the first biomedical researcher from Texas elected to the National Academy of Sciences (NAS). Many UT Southwestern researchers would later receive national and international acclaim for their work. Throughout the 70s, the Foundation’s endowments continued to grow as new advances in medicine inspired donors to contribute to medical research, education and patient care. This outpouring of support from the community would lead the Foundation down a permanent path. When a promising research idea needed an endowment, when a new building needed funding, when the medical school needed monies to attract the best medical minds in the country, the Foundation was there. To enhance achievement. Fill financial gaps. And accelerate innovation. Dr. Cary had said it best years ago: “Surely, it is worthwhile.”

52 75 YEARS OF VISION: THE LASTING GIFT

“Charlie Sprague was the catalyst that enabled UT Southwestern Medical School to grow from a small, relatively unknown institution into one of the most highly respected medical schools in the nation.”

The late Paul M. Bass Chairman Emeritus, Southwestern Medical Foundation

LATE 1970s At Dr. Sprague’s urging, Ralph B. Rogers, a prominent Dallas civic leader, joined the Dallas County Hospital District. Under his leadership, the Board of Managers would later orchestrate an $80 million bond issue to reinvigorate Parkland Hospital. Funding that would not only improve the quality of patient care but continue to attract some of the best medical minds in the country to UT Southwestern.

IN Our Fall issue State and national funding would begin to decline, challenging the Foundation, the medical school and the philanthropic community to make up the difference. The work of Drs. Brown and Goldstein, and many others, bring the medical school international acclaim.

1979 vs Today

Total Full-time Annual Total Nobel NAS* Students Faculty Budget Sq Ft Laureates Members

4,600 2,100 $1.86 B 7.7 M 6 21

1,200 500 $90 M 1.5 M 0 1

1979 numbers shown relative to 2014 end-of-year projections. *National Academy of Sciences

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