Chapter 06: Adjustments to the Rehabilitation Center

Authors

• Albert E. Gunn JD, MD, The University of Texas MD Anderson Cancer Center
• Allison Sáenz PhD

Files

Description

Dr. Gunn discusses changes made to the Rehabilitation Center following budget issues experienced by the institution. The Center was part of a land swap to help build the Lutheran Pavilion; however, the institution continued to provide rehabilitation services. Following the closure, Dr. Gunn became section chief in Geriatrics. He also mentions the book on cancer rehabilitation while affirming that rehabilitation services remain present at the institution.

Also, he discusses his experience as a physician with legal training, patient screening at MD Anderson’s Station 27 Clinic, and his prior experience screening patients in Suffolk County, New York.

Identifier

GunnAE_20240627_C06

Publication Date

7-27-2024

City

Houston, Texas

Interview Session

Albert E. Gunn, MD, Oral History Interview, July 27, 2024

Topic Covered

Institutional Change; Professional Path; The Clinician; Obstacles, Challenges; The Business of MD Anderson; The Institution and Finances; Growth and/or Change; Obstacles, Challenges; Evolution of Career

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

Disciplines

History of Science, Technology, and Medicine | Oncology | Oral History

Transcript

Allison Sáenz, PhD :

In terms—yeah, in terms of the rehab center, I don’t know when it is that you retire, right, but what does it look like? How long were you there, what did it look like by the time—?

Albert E. Gunn, MD:

I came in 1975, and the rehab center, unfortunately, it was costing MD Anderson quite a bit of money, and MD Anderson occasionally goes through spells where it didn’t have a lot of money. Now, that’s not true. Dr. Clark’s vision for founding it was that MD Anderson would have every service with itself. It had its own hotel, the Anderson Mayfair when I got there, later the Rotary House International Hotel. It had its own gift shop, its own pharmacy, its own nursing service, its own medical staff, its own buildings. What doesn’t MD Anderson have? I mean you think of the ordinary hospitals, they don’t have any of that. It’s all separate fiefdoms inside the hospital, all separately. And Dr. Clark with his team approach, he applied that not only to patient care, but to the whole hospital. Everything was under one control, the president of the MD Anderson and the chief administrator, [Mr. Boyd?], when I got there, legendary figure. [Mr. Gilly?], the business manager, who put MD Anderson on a firm footing financially. But anyway, sometimes though, MD Anderson didn’t bring in the amount of resources that it was assigned to do, and there’d be cutbacks. And the rehab center was unfortunately one of those, and it was traded to the city of Houston for property that—where the Center Pavilion Hospital was. There was an apartment house in the Center Pavilion Hospital, and that was used for MD Anderson patients, it was sort of an annex. MD Anderson didn’t have the hospital space that it needed. And the Lutheran Pavilion had opened while I first came there, but it still didn’t have enough space, and they had to use—for instance, the protected environment facilities when I first got there were over in the Center Pavilion Hospital. And they were moved to the top floor of the Lutheran Pavilion for isolation of cancer patients in aseptic circumstances. But a lot of that was taken care of at Center Pavilion plus patients. And Hermann Hospital had an MD Anderson service, so the patients were spread all over. And, of course, that revenue was lost to MD Anderson, a lot of it, that these places shoot up. But anyway, they traded the rehab center for the Center Pavilion and the property around it, and that solved some of MD Anderson’s financial problems, and goodbye rehab center. But the rehab service was continued, and I was changed in my title through time to the head of rehab service, and then I was made the chair—the chief of the section of geriatrics. This is a Jim Bowen idea, and that was my title for many years. So anyway, that was where I continued. But the—as I say, the rehab center and the Center Pavillion, the city turned the rehab center into a AIDS clinic. They had a hospital that they had purchased along Route 45, and they put AIDS patients into it when it first started, but it was inadequate, and so they—when they took over the rehab center, they turned it into a patient care center, and the AIDS patient were the people. Adan Rios was a doctor on the staff at MD Anderson. He was in the Department of Developmental Therapeutics, and he went to work taking care of AIDS patients. The AIDS patients were originally seen at MD Anderson. I’ll digress a second. I remember my clinical assignment was in the Anderson Mayfair Hotel. We had a clinic there called Station 27, and myself and Dr. [Stephen C. Dale?] who was an old timer at MD Anderson, and I saw patients there. And these were patients that were coming to MD Anderson for cancer therapy, but that they were unknown medical. And so we would evaluate the patients to see whether they had conditions that could interfere with the cancer therapy. And we would see them, particularly patients staying at the MD’s—at the Anderson Mayfair Hotel, those patients would be seen for their initial evaluation and referred to services. And also, departments like radiotherapy and so forth, radiology, some other services referred patients to us to be evaluated and examined, and to see what medical conditions they might have and how to take care of them, so that they could receive the cancer therapy. So Dr. Rutledge also had his offices in our clinic area. He was the head of gynecology, a rather famous figure and very well known around in gynecological and carcinoma circumstances. He was known all over the United States. So it was a clinic facility, and I was leading into what on this? That facility was later taken over by Dr. Howe. And one of the things they did was examine the medical staff. That was added on to its mission, which was one of Dr. Clark’s idea, I think he borrowed from the service, where you had a yearly physical, and you were examined each year. When I was in the air force for instance, each year, I had to go for a physical to ensure that I was still in the same condition. And he wanted the same thing for the medical faculty because there’d been some instances of people who were seriously ill, and they didn’t know about it, and they had to take care of it, and they wanted to make sure that the medical staff were well doctored and so Dr. S.C. Dale, Stephen C. Dale initially took it over , and he used to examine me, I recall. And then Dr. Clifton Howe retired as associate director of hospitals, and then he took it over. And this was in Station 27, the Anderson Mayfair clinic, and that was a—quite a good facility for its purpose with something I did. Go ahead, what are we saying?

Allison Sáenz, PhD :

Oh, no, I was just, yeah, nodding in an agreement with you. But I do—am curious when—with everything that you’ve mentioned so far, it seems also that the legal hat and the medical hat and your legal training, your medical training intersected at many points. Do you think that brought a different dimension to the kind of work that you were able to do, considering not everyone can say they have both a law and a medical degree?

Albert E. Gunn, MD:

Doctors have a funny respect for lawyers. I guess they’re sued by them so much, so it’s a funny thing, but that people always treated me very nicely, better than I deserve, I think, sometimes because I was a lawyer and a doctor. And many times, I was asked like the rehabilitation—Texas Rehabilitation Commission and things like that, the lawyer-doctor reassured them that I was knowledgeable about things to do with rehab procedures, and processes, and funds, and funding, and things. And the surveillance committee certainly was a good example, because I was a lawyer and a doctor, where they thought I would make a contribution because I understood the legal ramifications of a lot of what was going on in medicine. Sometimes, I was asked to sit in, in meetings for my legal. I remember Mr. Boyd, who was the administrator, he was a legendary figure around MD Anderson. And when I first came there, he complained to Dr. Howe that I hadn’t paid a visit on him yet in my coming to MD Anderson. And so I made an appointment to see him, and I—he said—I said, “I was sorry that I hadn’t come but lieutenants don’t speak to generals.” He said, “Well, I’m not a general,” and he was—he got very, very gracious about, gracious with it. But anyway, he wanted me present for certain things because I was a lawyer. Personnel matters, I recall he would ask that I sit in on a meeting to listen to it and give my opinion. And people, there were problem areas that they were having with personnel problems and things, sometimes he would ask me to sit in, I remember in particular, and to give my opinion on what the course of action should be, what our next step should be. Such as it was, I did have legal experience. I’ve been a claims officer in Southern Spain, many court-martials or adequate court-martials, also giving legal advice. I take several courses, the Internal Revenue Service, so I did have a broad-based legal background. I didn’t have the full three years of experience, or else I would have been admitted to the Texas Bar then. The head of the Texas Bar analyzed my credentials, [Mr. Barrow?], and told me, “You’re one—two months shy of having three years in.” So anyway, that’s another matter. Well, yeah, my relationship with the medical school lent a certain [lessened?]—presence at MD Anderson, but I still kept active with Station 27, with the section in geriatrics and also with a variety of other little jobs that people from time to time. One of the things I was asked to do was to be involved in the screening program. They had set up, Dr. Bernard Levin and his associates had set up a screening program for companies, and they sent a screening team out. And they would examine the people who worked for the company from certain parameters and give them a an evaluation of screening as it were for cancer probability or whatever. And I was asked to become involved in that because when I was in Suffolk County, I ran a screening program. We had a van, which had an x-ray machine on it, examining room, had its own generator, which was nothing but problems because it kept coming off the back of the van. I received so many calls, “The generator crashed into a car,” I had to go out and look into it. But anyway, I had been in charge of the screening program. We did tonometry, we did the gynecological exams, we did so many different things for people, went to nursing homes, community centers, right, things. Then I was in charge of a migrant health program. We did screening at that because of the migrant health, a lot of them were people in very poor health. They recruited a lot of people off the streets of New York City. It was a kind of [oppressed?] gang, I was always shocked by it a little bit. Migrant health camps that they had in Suffolk County to me were something that needed a lot of attention. I can recall driving into one once. The man who worked under me, running the screening program had a [variety?]. He was a male nurse, but he was a great motorcycle, motorcyclist, motorcycle, like the [Bandidos?] or something. I forgot what he belonged to, but he was a pretty tough person. And we went into a migrant camp one time, and somebody shouted at him to get out, and he told them off in no uncertain terms, and took me into them, at the heart of these places. And I was a little dismayed by the fact that the migrants were people that they had, more or less, found on the street corners, homeless people in New York City. And they had said, “Well, you guys can come out and do farm work.” And so these people had terrible health problems, and as the medical health director for the migrant project, it was my job to vouch for it. And so we went into the camps and tried to screen them, find out what’s wrong. But this experience was what they relied on for me to be involved. Like I went to various companies like the telephone company, Prudential insurance company, Aramco, the Arab American oil company. They had a building floor, we screened their employees for cancer, and I was the medical advisor to this. I would go to the sites and interface with the medical director of the company. They always wanted to see a doctor available, and then I would talk with the staff who were handling it. They had nurses who did the actual screening and a variety of people, and it was a good program. I enjoyed it, but those are the kind of jobs that I was doing. Once the rehab—unfortunately, Dr. Villanueva left, and that was a big loss. He went into the valley and went into practice for himself, I think, down in Laredo or McAllen, one or the other, I forgot which, and he became quite successful down there. We had a variety of other physiatrists came to take over, but they had no structure like they had when he was the chairman there. And, in fact, Dr. Hickey took an interest in it and tried to get it going, but I think later on, they did hire people that were full-time. And I published a book on rehab, and I think that that was our contribution over those years. The Cancer Rehab was a selection based on what I told you about, the way I saw rehab of Dr. Udugama with his maxillofacial rehabilitation, pain control by Dr. Stratton Hill who left being associate director of clinics and became chairman of pain control, nutrition by Dr. Teddy Copeland who had been so important in hyperalimentation. We had chapter by Linda Peterson, whose psychiatrist, had seen MD Anderson patients, very good chapter on psychiatry. A chapter by the lady who was such a pioneer on colon, collection of stool and so forth. So the book had a survey more or less of all of these things. The idea of the book was to say what does a rehab program consist of. And actually we did have a good rehab program at MD Anderson. We had outstanding people in all of those fields. And the physical medicine rehab, we did have good people in, but we didn’t have the structural—the department that they have now, which I think is very good from what I’m told. That they have a number of specialists, and they have a status, and I haven’t followed it since, but I think rehab is alive and well at MD Anderson.

Recommended Citation

Gunn, Albert E. JD, MD and Sáenz, Allison PhD, "Chapter 06: Adjustments to the Rehabilitation Center" (2024). Interview Chapters. 1611.
https://openworks.mdanderson.org/mchv_interviewchapters/1611

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