Early manhood

My Pathway into Medicine

I am a fourth-generation physician (Doctor of Medicine) in my family.  It was expected of me to become a doctor.  My older brother had gone to Baylor Medical School.  My father and his father were doctors.  My great grandfather on my mother’s side of the family was a doctor.  He was president of the Texas Medical Association in its early days.  He practiced in Grimes county.

I remember a time when I was a senior in high school at Sunset High in Dallas that there were colleges that came to the school during my senior year and I had spoken to several.  I was impressed by the presentation by Princeton University in New Jersey.  I had a conversation with my dad and he said I could go to any college I wanted to, but the only place he would pay for was Baylor University.  Both my dad and mother were Baylor graduates as were other members of both families.  I went to Baylor.

 

When I was at Baylor University, my brother was in the Navy.  I applied for a program that would make me an Ensign in the Navy and pay me while I was in medical school.  As I had decided to get married, this seemed to be a good thing to do.  I failed to pass the physical due to a flat foot.  The Navy was correct, as I later had to have surgery to correct a very painful ankle, which by the way is still bothering me when I walk.

 

I did not have much fun in college.  My girlfriend was still in school in Dallas at Sunset.  I was taking a pre-med track that would have me go to medical school in three years.  After I finished my first year at medical school I was eligible to get a Bachelor of Science degree.  My academic work was primary.  I was determined to make good grades, as the competition for places in medical schools was fierce in the late 1950’s.  Most of my classes were in the morning and I spent every afternoon studying.  I had three roommates who were never there in the afternoons.  I also spent some time studying in the library when I needed reference books.  This was way before the Internet.  Now, most schools have their textbooks in a place in the library and everyone uses electronic books.  Baylor was on the quarter system and it went fast.  I was taking four subjects and sometimes five.  This was necessary on the three-year program.  I had very little time to play.  I remember playing golf very few times during those years.

 

The spring of my last year (1957) at Baylor my mother became ill.  She was diagnosed with adenocarcinoma of the stomach.  The biopsy was done by Dr. Cecil Patterson.  Dr. Patterson was a pioneer gastroenterologist in Dallas who worked with my dad’s longtime friend Dr. Milford Rouse.  Dad elected to take mother to the Mayo Clinic for treatment.  She had surgery performed by Dr. O. T. Claggett.  She had a rather extended stay, as she spent about a week for a diagnostic work up prior to surgery.  After her surgery, dad called me and wanted me to come to Rochester to stay with mother while she recovered.  It would allow him to get back to work.

 

I decided with all my professors to leave school before the end of the spring quarter.  The major course I had hanging was comparative anatomy.  I was to finish the courses that summer.  I went to Rochester. I left all my “stuff” in my dorm room.  My future father-in-law went to Waco and helped to have it packed and brought to Dallas.  It included a very large antique oak roll top desk.

 

Mother’s recovery from surgery was uneventful, but the surgery was not curative.  We all knew she would not live long.  Her approaching death influenced my decision to get married.  I married my high school sweetheart.  She was, and still is, a nice person.  We were just mismatched.  She needed more attention than I was able to give her when I was in medical school and post graduate training.  Unfortunately, it took thirteen years for us to realize it.  I married in June of 1957.  Mother died in September.

I had a good job working that summer in the Mobil Oil Company’s research lab that was then located in Duncanville, Texas.  The newly-weds rented a small duplex in Oak Cliff and settled in with a dead cat in the refrigerator (the major comparative anatomy object).  I had applied and was accepted to attend Baylor Medical School in Houston.  When we knew mother’s situation, I decided to try to switch to Southwestern Medical School in Dallas, so I could be closer to dad.  I knew he would not take mother’s passing well and I did not want to leave him alone.

 

I went through an interview process and was accepted to attend.  It did not hurt that the dean at Southwestern Medical School was a former medical school classmate of dads at Baylor.  I started school in September of 1957.  It was four years of very hard work and little time for anything else.  I was graduated in 1961 and elected to spend the next year in an internship at Dallas Methodist Hospital.

Stories

I did not work during the school years of my freshman and most of the sophomore year.  I was too busy trying to pass my course work and the school required asking for permission before freshmen and sophomores could have jobs.  I was very fortunate to have a father who was supportive of my efforts and who was able to help us financially.  He supported me in medical school and paid for my wife’s education at S.M.U.  My wife worked part time while she was going to school.  I began my part time work in the late spring of my second year.

I worked in the summers.  The summer between my freshman and sophomore years, I work in the pharmacology department for Dr. Andres Goth doing clinical research.  It was an interesting experience, and I learned that I did not want to be a full-time researcher.  We did experiments on the effects of Dextran on the blood clotting mechanism.  Dextran was one of the first IV fluids used to replace the acute loss of blood in accident victims.  It was fraught with problems, as some patients developed severe bleeding problems after receiving Dextran.  Dr. Goth was trying to find out what was the cause.  We used white rats.  It turned out to be a blood platelet phenomenon.  I also learned to play bridge that summer.  Dr. Goth took the month of August off on vacation.  His secretary, Patsy, was an avid bridge player.  We played bridge a lot while Dr. Goth was out of the office.  Bridge was more fun than killing rats!

 

The first two years of medical school are spent in the “basic sciences.”  The first exposure to patients and clinical medicine was called “Physical Diagnosis” and was taught by some very fine professors.  Two of them were Dr. John Chapman, a very senior internist who ran the Woodlawn pulmonary disease hospital, and Dr. Charles “Mickey” Lematre, a very young internist who later became the chancellor of the University of Texas system.  We were taught how to perform a physical exam.  After completion of the course, I became eligible for a job working for the City of Dallas.

Working at the Dallas City jail

My friend Trevor Mabery, who was a year ahead of me in school, told me of a job that was available at the Dallas city jail.  Trevor and I had become friends when we were both at Baylor.  He lived down the hall in the dorm where we lived.  He started working at the jail in the summer after his sophomore year.  I also began the same work at the end of my second year.

 

Dr. Paul Bass was the city of Dallas health officer.  Their office was just down the street from Parkland, and each night before work, we were required to stop by the office and pick up the medical bag that contained all we would need to perform the job.  Dr. Bass had been a medical school classmate of my dad’s and was probably one of the main reasons I got the job.  It was one of the best part time jobs a medical student could have.

 

One of the evenings when I went to work that summer, when I arrived, the room was full of young men sitting around the periphery of the large room.  They were applicants for policemen and firemen positions.  When Dr. Bass saw me come in the door, he called out to me “hey Billy”.  He said he wanted me to stay and help do the pre-employment physicals on potential firemen and policemen.  He said my role would be to draw blood from each man for routine testing.  I told him in a very soft voice that I did not know how to draw blood, as that has not yet been a part of my training.  In a very loud voice, Dr. Bass said that was no problem, as he would teach me.  There were immediate groans from all the men, as all had heard the entire conversation.  I learned that drawing blood on young healthy men was not much of a challenge, and everything went well that evening.

 

I worked at the Dallas city jail every fourth night for the remainder of my time in medical school.  The call room/office was just across from the basement entrance to the jail.  The front door of my room was about 20 feet from where Jack Ruby shot Lee Harvey Oswald.  We had an exam room and a bed where we slept.  It was usually quiet and there was time for study and sleep.  Our role was to triage patients to see who needed to be taken to Parkland for treatment.  I remember one of the first nights I worked, I was called to see a female inmate who was having seizures.  I watched her have thirteen grand mal seizures before she finally stopped.  It was a wonder she did not die.  We were successful in getting her transferred to Parkland.  My most frequent treatment was to give paraldehyde for delirium tremens, symptoms of sudden withdrawal from alcohol.  The stuff must have tasted terrible, but it did relieve the symptoms.  I remember one guy who had stuck pieces of toilet paper to the walls of his cell and set them on fire.  He said they were the skins of animals he had killed.  We were offered food and drink as part of our payment for the work.  I remember the meals were filling but not of much quality.  The coffee was terrible!  It was a great job and it provided much needed income.  I don’t remember the names of the other three guys that worked there other than my friend Trevor.

 

I also had a job working at Parkland on the weekends.  Another of my college friends, David Fletcher, and I ran the lab connected with the Parkland emergency room.  I had learned lab techniques while working the summer between my junior and senior years in the lab at the V. A. Hospital in McKinney.  I spent a rotation there the spring of my junior year on the medical service.

 

The month or so before I started my internship was spent working for Dr. Pete Mattson, a busy orthopedic surgeon.  He wanted me to become an orthopod, but after following him around, I decided that was not what I wanted to do.  They worked very hard and made a handsome living,  But I did not like dealing with the major trauma cases that almost always kept you up all night.

Training after medical school

I was graduated from the University of Texas Southwestern Medical School in June 1961 at the age of 24.  I consulted many people about where to do my internship.  At that time, it was typical to have a “rotating” internship.  You were on many different medical and surgical services, internal medicine, pediatrics, OB-Gyn, surgery, urology, orthopedics, anesthesia, and experience in general practice working in the charity out-patient clinic.

My mother’s brother Benjamin Wells, who had the most varied experience of any doctor I knew, said I should consider Dartmouth-Hitchcock Medical Center in Hanover, New Hampshire.  It was affiliated with Dartmouth Medical School.  My dad had remarried by this time, and again was not supportive of me being so far away from home.   My friend Milton Cardwell and I visited Denver General Hospital.  I ultimately decided on Dallas Methodist Hospital.  I decided to stay in Dallas but wanted to get away from Parkland.  Of the private hospitals in Dallas, Methodist had the “best” internship

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During this time, all doctors were subject to the military draft.  I applied for what was called the Berry Program.  It allowed you to decide when you wanted to complete your two-year military obligation to avoid an interruption of training.  I elected to enter the Air Force after my internship, as I had not decided what area of medicine I wanted to practice.  I received my orders and would enter the Air Force in July 1962.  In the late spring of 1962 I became interested in anesthesia.  I had some very good role models of several anesthesiologists at Methodist, Dr. Charles Sloan, and Dr. Charles Tandy.  I applied for and was accepted in the program at Parkland where Dr. Pepper Jenkins was chief.  I wrote the Air Force to see if I could get a deferment to take anesthesia training, but they did not agree to defer my entry into the Air Force.

U.S.A.F.

The Air Force physical failed to find anything wrong with me.  At that time, if you were a doctor and physically able to practice medicine, you were able to be a doctor in the Air Force.  I spend two very nice years at Brooks Air Force Base in San Antonio, Texas.  During my internship, I assisted a prominent proctologist, Dr. Tom Smith, in many surgeries.  When he found out I was due to enter the Air Force, he contacted a longtime friend of his, Dr. Ted Bedwell, who turned out to be a general officer and the commander of the School of Aviation Medicine at Brooks AFB.  General Bedwell arranged for me to be assigned to the base dispensary.  My first year was spent as a general medical officer working in the clinic all day.  At the end of my first year, the base flight surgeon spot was to open.  I applied for the position and was accepted.  I spent the second year as a flight medical officer. 

One of my favorite Air Force stories related to my relationship with the base commander, Colonel McIntire.  I made friends with a sergeant who ran the base pistol team.  His wife was one of my patients.  We had one afternoon off each week for R&R.  He invited me to try out for the base pistol team.  I made the team and did well.  I progressed in my skills and went to a tournament held at Kirtland Air Force Base in Albuquerque.  I won a place for a spot to go to the national pistol tournament held at Camp Perry, Ohio.  One of the duties of the base flight surgeon was to perform annual physical exams on everyone on the base who was on flying status.  One of those people was the base commander, Colonel McIntire.  During his examination I found him to have high blood pressure.  He admitted he had been troubled with it the year or so before, but the previous flight surgeon had fudged on his numbers.  If you take blood pressure medicine, you can’t be on flying status.  Being a straight arrow kind of doctor, I refused to pass him on his physical, as I thought he was making a big health mistake by not taking medicine for his hypertension.  He lost his flying status and monthly flight pay.  Needless to say, he was not happy with me or my decision.  To be able to go to the pistol tournament at Camp Perry, orders had to be approved by the base commander.  When Colonel McIntire found my name on the list, my pistol shooting career ended abruptly.

War Threat

There was a very exciting event that occurred soon after I entered the Air Force.  It became popularized by the movie "Thirteen Days."  During the Cuban missile crisis in October of 1962 all the military was put on alert.  Fortunately our President John F. Kennedy and his brother made a deal with the Russians and the threat was relieved by them removing the missiles from Cuba.  If you did not see this movie when it came out in 2000 I recommend you watch it. 

Residency

I enjoyed my time in the Air Force.  I met a lot of people and learned some medical skills.  One of the people was a young ENT physician, Dr. Ward Litton.  He had just finished his residency at the University of Iowa, which was one of the leading training programs of that era.  He was assigned to the School of Aviation Medicine and was bored stiff.  He was looking for an opportunity to practice medicine.  He assisted me in setting up an ENT examination room with equipment that was readily available including a Ritter examination chair, the “Cadillac” of all chairs.

 

I also made friends with a radiologist who was in the same boat, Dr. Glen Dalrymple.  He read all the X-rays we took as part of the annual physical process.  My dad had recommended that I pursue either urology or radiology.  He said radiology “was an up and coming field” and in urology “there would be a never-ending stream of old men who can’t pee.”  I was never really interested in urology, although I had good mentors during my training at Methodist, Dr. Ted Boone, and Dr. Warren Greene.  I had spent a summer working in the radiology department in my dad’s clinic before I went to medical school.

 

After much thought, I decided to pursue training in otorhinolaryngology (ENT).  I liked dealing with children and you could do the work sitting down.  By that time, I was having major difficulty with my ankle.  If I played a round of golf, I could hardly walk the next day.  I applied for several residency programs and was accepted by two, the programs in Houston and in Dallas.  I applied for the program in Iowa but was told their program was full for the next two years.  If I was willing to come and do research for a couple of years, I might be considered for their program.  I chose the program in Dallas, where my training would be at Parkland Hospital, where I had spent time as a medical student.  I did not like the program in Houston, as you rotated among several hospitals during your training.  The humidity in Houston was another big factor.  We also had family in Dallas.

 

I remember getting a letter from Dr. Claude Winborn who was the chief of the program at Parkland.  I had not heard back from my application in Dallas, and my dad contacted Dr. Ed Newell, who was on the clinical faculty.  Dr. Newell was working in the same clinic as my dad at that time.   He apparently chastised Dr. Winborn for not being timely in his reply to my application.   I received a very sarcastic letter from Dr. Winborn but was accepted to start the program in the summer of 1964.  I would do my year of general surgery training at Dallas Methodist Hospital, and then start my ENT training program at Parkland in July 1965.

 

Our first child, Sharon, was born when I was an intern.  Our second child, Mark, was born while we were in the Air Force.  Our third child, Paul, was born while I was a resident at Parkland.  As I look back on it now, it is a miracle I survived as a young father.  It was difficult to balance medicine and marriage and parenthood.  I am certain I was not a very good husband either that proved to be true.

  

I was working at Parkland 60 hours a week and was on call every third night.  I worked for a general practitioner, Dr. Warren Shoecraft, every other weekend from Friday evening to Monday morning.  I worked for Dr. Shoecraft during some of my vacation time as well.  I was earning $75 dollars a month at Parkland and Dr. Shoecraft paid me $250 a month!  Dr. Shoecraft kept Saturday and Sunday office hours.  He got a myriad of phone calls.  I also did insurance physicals in my “spare” time.

 

While I was a resident, I became active again in church activities.  I had not done much in that way during my time in college or when I was in the Air Force.  I attended my wife’s church, the Oak Cliff Christian Church.  I taught an adult Sunday school class part of the time.  I remember getting up very early on Sunday morning to prepare the lesson for that day.  The Holy Spirit was very much at work in those preparations.  I was elected a deacon during my time spent in this church.

 

By then Dr. Don Alexander had become the chief of ENT at Parkland, who wanted me to consider taking a fellowship in head and neck surgery.  One of his close friends was a surgeon at Iowa City in the Iowa Medical School.  I made a visit to Iowa City and decided that was too far from home.  I was not sure I wanted to spend the remainder of my medical career dealing with head and neck cancer.

Private practice

I began my private practice in July 1968.  I was invited to join Dr. Winborn in practice.  I decided practice in Dallas and not in Oak Cliff.  The handwriting was on the wall that the Oak Cliff section would never be as prosperous as North Dallas.  Dr. Winborn’s practice was near Baylor in a “downtown” area.  I decided that if I was going to practice in downtown Dallas, I should live in Dallas as well.  We moved from our south Oak Cliff home to a home on Hallmark in what was then “far” north Dallas.  There was nothing north of us.  This was when Forest Lane was a two-lane blacktop road and well before the construction of the North Dallas toll way or LBJ Freeway.

 

While I had been with mother at Mayo Clinic in 1957, I sought information about my bad right ankle.  It had started giving me big trouble after walking or running.  I was diagnosed as having a congenital flat foot.  As my foot and ankle became increasingly a problem, I decided to have corrective surgery in May 1968.  I had my surgery at Parkland performed by Dr. Charles Gregory, the chairman of the orthopedic department at UT Southwestern Medical School.  Dr. Bill Head was the chief resident, and I suspect was responsible for most of the work.  I started my practice on crutches wearing a long leg cast.  I was on crutches for four months.

 

I just recently heard Dr. Bernie Siegel speak on mind, body medicine.  He said if you wanted to get in touch with your patients, wear a patch on your eye sometime.  I am sure I generated some genuine interaction with patients while I was wearing that cast on my leg.

More stories

I have a Parkland story to tell.  The night after my surgery at Parkland, my leg was propped up on several pillows to keep it elevated above the level of my heart.  I was in a lot of pain, mostly in my right hip area where a bone graft was obtained from my pelvic bone.  Sometime during the night, my leg fell sideways off the pillows.  I could not begin to replace it myself, as the cast was very heavy and still wet.  I called for the nurse, who came to access the situation.  She spoke no English, a common situation at that time at Parkland.  The shortage of nurses was resolved by importing nurses from all over the world.  The nurse reappeared and rather than put my leg back up on the pillows, she gave me a pain shot.  This happened a second time during the night.

 

I finally got my leg put in the proper place by my roommate’s girlfriend, who came in to see him very early each morning.  It was a game he was playing.  His wife visited him in the evenings!

The surgery was successful for many years.  I finally had to give up golf about five years ago due to ankle pain after playing.  I was also having knee pain.  I am a candidate for knee replacement surgery, but I am holding off as long as I can.  I learned later that I had torn my ACL in the left knee during a skiing accident.

 

  I remember getting an opinion from Dr. David Henry prior to my ankle surgery.  Dr. Gregory was performing what was called a “block” triple arthrodesis.  It was a new procedure and left you with a foot of the same size as the opposite one.  The “standard” operation made the operated foot smaller.  Dr. Henry predicted correctly, that the long-term result was in doubt.  My main goal was to be able to walk without having pain the next day.  It worked well for a lot of years.

 

When I was younger, I loved to hunt quail, which involved a lot of walking.  I was also an avid golfer.  There was a lot of walking involved in quail hunting.  Over time, my knees began to give me trouble.  I had my first knee operation for a torn cartilage, which was damaged while working with one of my bird dogs in my driveway.  As I write this message I am recovering from a total left knee surgery.  It only took me 10 years to make the decision to have it done.  It has been recommended at the time I had a torn meniscus operation.  This too is a potential another story to tell.

Last edited 2/16/18 

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