Chapter 07: Background: The Three-Building Plan

Chapter 07: Background: The Three-Building Plan



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Mr. Daigneau provides an overview of MD Anderson's scope when he arrived in 1994: the Main Campus, Bastrop, and Smithville, with buildings totaling about 3.5 million square feet. David Bachrach had just launched the Three-Building Plan (also referred to as the "major building project") which would add another million square feet. Mr. Daigneau talks about the management team responsible for the building project and how it fit into the current Master Plan. He also describes the silos created in the current system and describes Dr. Charles LeMaistre's management style. He also explains that translational research was emerging at the time and MD Anderson needed to connect research and clinical activity. The Three-Building Plan included: a new research building with animal and other laboratory space; Alkek Hospital to replace the old hospital, expand operating room space and provide new technology; and the LeMaistre Clinic. Mr. Daigneau notes that the latter was an "add on" to spend a great deal of cash that MD Anderson had accumulated. Mr. Daigneau notes that there was no real Master Plan at the time in that there was no vision of how the organization would evolve. When he arrived, the funding and design of the Three-Building Project was completed and construction on the Alkek had begun.



Publication Date



The Making Cancer History® Voices Oral History Collection, The University of Texas MD Anderson Cancer Center


Houston, Texas

Topics Covered

The University of Texas MD Anderson Cancer Center Building the Institution; Overview; MD Anderson History; MD Anderson Snapshot; MD Anderson Past; Institutional Processes; Critical Perspectives on MD Anderson; Building/Transforming the Institution; Multi-disciplinary Approaches; Growth and/or Change; Obstacles, Challenges; Institutional Politics

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


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


William Daigneau, MBA:

So here's the beginning of the story. When I went in '94 to MD Anderson, we had the three campuses the main complex in Houston, Smithville, and Bastrop. The outposts obviously Smithville and Bastrop, very specialized mission, very small campuses, very simple buildings. The main complex, roughly about three" let's say about three-point-five" just for round numbers. It was actually less than that, but about three-and-a-half million square foot, all contained" except for the Bob Smith Research Building" all contained in the Texas Medical Center proper. I mean, we owned Houston Main Building across the street. Rotary had just opened the year before I got there. We had Smith on the south campus. But everything basically was right there in the main complex, the bulk of it. At the time David Bachrach recruited me, they were just launching" I told you, two years before they were just planning it" but they were just launching what was called the Major Building Project, which was going to add a million square foot to the campus. David Bachrach tells me, at the time I was hired, that, Things are going to be pretty busy around here the next couple years as we add this million square foot," which at the time was a lot of building. But Bill, things are then going to quiet down." I said, Great."

Tacey A. Rosolowski, Ph.D:

And just let me say, because I want to make sure that we have on record, the Major Building Project, as I was doing my research, is also referred to as the Three-Building Plan, so people may encounter different names for that as they look through articles and everything, and institution records.

William Daigneau, MBA:

Yeah, within the organization, they had created" it was headed up by Mary Ann Newman, who had come from strategic planning. She had no background in construction, but she was a good planner.

Tacey A. Rosolowski, Ph.D:

Okay, and you're talking about the management team for this project?

William Daigneau, MBA:

For the Major Building Program. She headed that up, and she had put together a team primarily robbing the physical plant of various people like Gary Kimbrell. So she had assembled a team, but she hired some people. She hired Janet Sisolak, for example, who is still with MD Anderson. So is Gary, by the way. But she robbed some people out of their planning and design group, and then hired some folks and created what was called the Major Building Program, which was over in a temporary building. I say temporary; it was originally a motel, I think, that had been converted to offices over on what was called Andy's Backyard, which is right where the parking garage now is, at the intersection of Braeswood and Holcombe. But there were some buildings there. You look at old photos, and you can see them. We had a daycare center there, and then we had the Major Building Program offices there.

Tacey A. Rosolowski, Ph.D:

Now, if I'm derailing you, just let me know, and we can answer this question later, but I wanted to ask you" you talked about the master plan, so I'm obviously curious. How did this Major Building Plan, or the Three-Building Plan" was that the master plan, or how did that fit into the master plan? And where does Charles LeMaistre fit into all this?

William Daigneau, MBA:

Well, Mary Ann Newman was in charge of strategic planning and reported directly to Dr. LeMaistre. Dave Bachrach is the executive vice president for Administration, had all of the physical plant operations" Security, Information Technology" you know" just the traditional stuff. Remember I told you about the silos that were created when you have different organizations? So they were encountering some rough water because here they had Mary Ann, who didn't report to David Bachrach, kind of running the physical plant-type thing. There was a lot of" you know" within the organizations" a lot of finger pointing. And of course, whenever Mary Ann had a problem, she would run to the president. I won't say that. She'd go to the president with the problem. And Dr. LeMaistre was very accommodating. But I wouldn't say one of his management styles was to kind of let people work things out, so he didn't issue edicts at all. He wasn't that type of leader at all. So while the decision was made, it wasn't necessarily communicated, so there was lack of clarity. There were a whole bunch of issues going on at the time. So David Bachrach, in creating this chief facilities officer" and the arguments that had been made in the report are to get, again, better communication, better integration, better results overall. So they put together a master plan to try to site these buildings" to figure out where to put these buildings. So that had been done, which basically justified the locations.

Tacey A. Rosolowski, Ph.D:

Now, let's just go through. So there's the Charles LeMaistre Clinic Building, the Alkek Hospital, and the Clinical Research Building. So what was the function? I mean, is now the time to talk about the proposed function of those three buildings and their location, or do you want to let that evolve as you tell your story?

William Daigneau, MBA:

Well, Dr. LeMaistre was a physician, and he had Dr. [Frederick] Becker run the research. Dr. Becker ran the basic sciences, which were all the theoretical research" why cells work the way they do. Well, there was a growing, at the time" you know" Dr. LeMaistre was an innovator. He came up with a lot of things at the time, especially on the smoking issue, that were taking on some behemoths in terms of the tobacco industry, for God sakes. Movies" people were smoking. And to say this is no good? So he wasn't a shy man about doing what was right. And at the time, there was just an emerging field called translational research, where you're taking things out of the basic science side and trying to create medications or treatment protocols that you could actually use in patient care, and that was kind of the stepping stone between the basic research to the actual protocol, or practice, in health care. That was emerging, and Anderson, frankly, over the years, had been" bench to bedside" had been pretty innovative, especially on radiation. So there was a culture that had been created as well as evolving. I mean, Dr. [R. Lee] Clark started it when he demanded research to be combined with the tumor hospital. He wanted to understand what was causing this and treat it. So that whole culture at Anderson had been, from its earliest years, started, and it was growing. So at the time, they needed another research building and an animal facility to support the clinical side. That's where the name came from" the Clinical Research Building. It was more to support some of the translational research that was going on without taking space away from the basic science side of things. So that was the clinical research side. Then the original hospital was" you know" it was a double-loaded corridor, older, inefficient, couldn't supply the advanced technology, both on imaging. The surgical suites were constrained. You couldn't expand them. There were a lot of good reasons that led to it, but the idea was to create a replacement hospital. Alkek was designed to replace the old Anderson hospital. It wasn't a brand-new hospital. It was a replacement hospital that would allow expansion of the ORs, allow increased use of technology that the older parts of the building would not" of the original building built in the fifties. So that's where the hospital came from. And then the LeMaistre Clinic, from what I understand, and Dr. LeMaistre probably has a better recollection of this. Anderson had accumulated a lot of cash, and the Clinical Services Building basically was, Well, okay, we're building this replacement hospital, but we're not doing anything for the outpatient clinics. Let's do"" it was more of an afterthought" " and add on to the project." And basically to use up some of the cash because there was some fear at the time that the legislature would look at the cash sitting at Anderson and just say, Well, let's use it for parks." And Dr. LeMaistre wanted, as president" wanted to further the mission of Anderson and so wanted to commit some of those funds to improve health care. He was doing it on the inpatient side. He was doing it on the research side. Let's do something on the clinical side of things. So that became the Clinical Services Building. And that basically was designed to support expansion of the outpatient clinics. It would create" you know" there was the library for the patients and more diagnostic imaging. I allowed replacement of the emergency" it upgraded the Emergency Center. So it did a lot of things to enhance quality. So that was added on. That was probably the last piece that was added on.

Tacey A. Rosolowski, Ph.D:

And how do all of those buildings fit into what the master plan was at that time?

William Daigneau, MBA:

There wasn't really a good master plan. And they were just looking for places to put these buildings, and these were the open plots of land. They were parking lots, basically. All of them were parking lots. I mean, you can see the Lutheran Hospital. The original entrance to Lutheran is still there. Now it's our Emergency Center. But that was the main door to the hospital. And from Lutheran, then you went to the Anderson wings, where the rest of the hospital is. And then there was the Clark Clinic entrance for the ambulatory side of things. And the rest of it was surrounded by parking lots" surface parking lots. So where are we going to put a new hospital? Well, let's put it here. Where are we going to put a clinic? Well, let's put it there. All constrained by the boundaries of the original deeded portion to Anderson from the Texas Medical Center. So they basically built in the remaining open spots. And that's why I say the master plan that was created was more a justification to put the buildings there as well as per thinking it through, well, how do we want this to evolve? Now, there's where my experience came in, because when I got to Rochester, the original medical school that had been constructed in 1925, over the years they built right around it. So now I was faced with the dilemma of, well, how do you get into the interior where your oldest buildings are because you built newer buildings all around it? So by the time I got to MD Anderson, I was familiar with this issue about encapsulate your oldest facilities in the center. But basically the buildings had been funded by the time I arrived there, so there was" you know" if I had gotten there when I was first recruited, I would have, time out, let's think this through, because this may get bigger someday than even what you think. So someday we've got to get back inside this center core and fix it. How are we going to do that? But that had all passed by the time I did arrive. It had been approved by the regents. Design had basically been completed, and construction had just started on the Alkek. We were still in the foundations. It was a big open hole when I got there.

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Chapter 07: Background: The Three-Building Plan