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. SOUTHWESTERN MEDICAL PERSPECTIVES . SPRING 20 14 7 75 YEARS OF VISION: THE LASTING GIFT 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.