The Birth Of The Texas Medical Center

An eyewitness account of the founding of the Texas Medical Center.

In 2008, the University of Pittsburgh Medical Centers (UPMC) hoisted its logo atop the U.S. Steel Building in downtown Pittsburgh, symbolically declaring that the era of big steel had been replaced by the era of big medicine for this once industrial city. More than 1,200 miles to the south, a similar sense of optimism pervaded the public discourse around the relationship between health care and the future of Houston's economy. While traditional Texas industries like oil and natural gas still played a critical role, the presence of the massive Texas Medical Center, billed as "the largest medical complex in the world," had helped to rebrand the city as a site for biomedical innovation and ensured its stability during the financial crisis of the mid-2000s. Taking Pittsburgh and Houston as case studies, The Medical Metropolis offers the first comparative, historical account of how big medicine transformed American cities in the postindustrial era. Andrew T. Simpson explores how the hospital-civic relationship, in which medical centers embraced a business-oriented model, remade the deindustrialized city into the "medical metropolis." From the 1940s to the present, the changing business of American health care reshaped American cities into sites for cutting-edge biomedical and clinical research, medical education, and innovative health business practices. This transformation relied on local policy and economic decisions as well as broad and homogenizing national forces, including HMOs, biotechnology programs, and hospital privatization. Today, the medical metropolis is considered by some as a triumph of innovation and revitalization and by others as a symbol of the excesses of capitalism and the inequality still pervading American society.

In 2012, Richard E. Wainerdi retired as president and chief executive officer of the Texas Medical Center after almost three decades at the helm. During his tenure, Wainerdi oversaw the expansion of the center into the world’s largest medical complex, hosting more than fifty separate institutions. “I wasn’t playing any of the instruments, but it’s been a privilege being the conductor,” he once said to a newspaper reporter. William Henry Kellar traces Wainerdi’s remarkable life story from a bookish childhood in the Bronx to a bold move west to study petroleum engineering at the University of Oklahoma. Wainerdi went on to earn a master’s degree and a PhD from Penn State University where he immersed himself in nuclear engineering. By the late 1950s, Texas A&M University recruited Wainerdi to found the Nuclear Science Center, where he also served as professor and later associate vice president for academic affairs. In the 1980s, Wainerdi took charge of the Texas Medical Center, embarking on a “second career” that ultimately expanded the center from thirty-one institutions to fifty-three and increased its size threefold. Wainerdi pushed for and ensured a culture of collaboration and cooperation. In doing this, he developed a new nonprofit administrative model that emphasized building consensus, providing vital support services, and connecting member institutions with resources that enabled them to focus on their unique areas of expertise. At a time when Houston was widely known as the “energy capital of the world,” the city also became home to the largest medical complex in the world. Wainerdi’s success was to enable each member of the Texas Medical Center to be an integral part of something bigger and something very special in the development of modern medicine.

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Pot Luck Spokesman? The information void in the hours following the shooting of US President Ronald Reagan late Monday afternoon, March 30, 1981, spawned many false rumors and misinformation, which White House political adviser Lyn Nofziger understood threatened the credibility of the White House. He therefore took the podium before the 200 plus assembled press in Ross Hall to tell them that he would be bringing with him a credible physician to brief them once the president was out of surgery. However, he didn’t have many options to draw from for that credible physician. At the hospital, the surgeons tending the three shooting victims had first-hand information about the afternoon’s events, but each surgeon knew only about his own injured patient. White House physician Dan Ruge meanwhile had been at the president’s side throughout the afternoon and was a possible candidate, but his White House association made his credibility suspect according to White House aides. The job became the drafting of the most logical person to be spokesman. That would have been the seasoned physician CEO of the George Washington University Medical Center Ron Kaufman, but he was out of town. Next up was Dennis O’Leary, the physician dean for clinical affairs, as the preferred spokesman. To the White House, O’Leary was a total unknown, but a review of his credentials would hardly have been reassuring. He had originally been recruited to George Washington University as a blood specialist. Reticent by nature, he had minimal public-relations and public-speaking experience, save two years as a member of his hometown high school debate team. He had no surgical or trauma training or experience. But beggars can’t be choosers, as the saying goes. Kindly stated, O’Leary was probably the least bad choice to serve as White House/hospital spokesman to inform the world of the status of the wounded President Reagan, special agent Tim McCarthy, and press secretary Jim Brady. Yet, with a little bit of luck, it might all work out. And it did.