Chapter 01: Growing Up in a Small Town; Medical Education
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Description
Dr. Foxhall gives a brief overview of his family life then notes his first interests in science. He touches on his experiences at the Baylor College of Medicine and explains that his interest in primary clinical care and in health populations began at this time, particularly when he spent time in his home town working with family physicians and saw a wide range of health problems. He also cites the influence of school integration –the seventies were a time when the nation was changing and there were opportunities to learn and grow.
Dr. Foxhall notes that his interest in cancer and cancer prevention grew during his residency and the first years of his private practice at Houston Northwest Medical Center where he was able to follow patients over many years and recognized the missed opportunities to intervene with patient and avert cancer risk.
Identifier
FoxhallLE_01_20140205_C01
Publication Date
2-5-2014
City
Houston, Texas
Interview Session
Lewis Foxhall, MD, Oral History Interview, February 05, 2014
Topics Covered
The Interview Subject's Story - Educational Path; Personal Background; Inspirations to Practice Science/Medicine; Influences from People and Life Experiences; Professional Path; Cultural/Social Influences
Transcript
Tacey Ann Rosolowski, PhD:
All right. We are recording, the counter is moving, and I’m Tacey Ann Rosolowski interviewing Dr. Lewis Foxhall. Am I pronouncing your name correctly?
Lewis Foxhall, MD:
Yes, ma’am.
Tacey Ann Rosolowski, PhD:
Great. For the Making Cancer History Voices Oral History Project run by the Historical Resources Center at MD Anderson Cancer Center in Houston, Texas. Dr. Foxhall came to MD Anderson in 1993. At that time, he was working in an administrative capacity for Dr. Joseph Painter—and I’m sure we’ll be talking about that—and he was also a faculty member in Internal Medicine on his first arrival. Since 2005, Dr. Foxhall has served as Vice President for Health Policy. This interview is taking place—
Lewis Foxhall, MD:
Someone’s talking. It sounds like it’s on playback.
Tacey Ann Rosolowski, PhD:
It is. That’s very weird. How odd. All right. Well.
Lewis Foxhall, MD:
You just recorded over somebody else. No. (laughter)
Tacey Ann Rosolowski, PhD:
Actually, I just want to— (end of audio file)
Tacey Ann Rosolowski, PhD:
All right. So let me just resume. The interview is taking place in Dr. Foxhall’s office in Pickens Tower on the main campus of MD Anderson. Today is the first of a number of planned interview sessions. It is February 5th, 2014, and the time is 11:35.
Tacey Ann Rosolowski, PhD:
So, thanks very much for participating in this project. I wanted to just start with some general background questions. I wanted to ask you where you were born and when, and if you could tell me a little bit about where you grew up.
Lewis Foxhall, MD:
So I’m a native Texan, born in a small town in the northern part of the state near Amarillo, Texas, and grew up there and then went to school at the University of Texas in Austin and graduated with a degree in biomedical engineering.
Tacey Ann Rosolowski, PhD:
What’s the small town near Amarillo?
Lewis Foxhall, MD:
Memphis, Texas.
Tacey Ann Rosolowski, PhD:
Memphis, Texas, okay.
Lewis Foxhall, MD:
We have a little bit of everything in Texas.
Tacey Ann Rosolowski, PhD:
All right. And do you mind sharing your birth date?
Lewis Foxhall, MD:
1950.
Tacey Ann Rosolowski, PhD:
And the actual date?
Lewis Foxhall, MD:
November 17th.
Tacey Ann Rosolowski, PhD:
November 17, 1950. All right. What about your family? What did your parents do? What do your parents do?
Lewis Foxhall, MD:
My father worked in the cotton business and also as a rancher, and he had been also educated at the University of Texas and actually received a law degree, but decided that was not really his calling, and pursued this work after serving in the air force in World War II. Came back to Memphis, where he’d grown up, and decided to raise a family, married my mother, who was from another small town nearby. She was also educated at the University of Texas and had pursued a career in journalism and was one of the first women war correspondents during World War II that traveled to Europe and report on the war. So she continued to write after she came back, and was in the midst of raising a family with three kids.
Tacey Ann Rosolowski, PhD:
And your parents’ names?
Lewis Foxhall, MD:
Lois and Lewis. (laughter)
Tacey Ann Rosolowski, PhD:
That’s neat.
Lewis Foxhall, MD:
Good combo.
Tacey Ann Rosolowski, PhD:
There you go. And are you the oldest child, named after your father?
Lewis Foxhall, MD:
Yes. I have two younger sisters, so there were three of us kids growing up.
Tacey Ann Rosolowski, PhD:
When did you realize that you were going to be in the sciences, become a physician? How did that happen?
Lewis Foxhall, MD:
Well, I was interested in science from an early time, and initially was interested in engineering and became more interested in medical sciences in college and pursued a biomedical engineering degree there at the university. During that time, I became acquainted with some physicians who were on the faculty and encouraged me to consider a medical career. The more I thought about it, the more that it sounded pretty good. So I decided to apply and wound up in Baylor College of Medicine here in Houston.
Tacey Ann Rosolowski, PhD:
So just for the record, you received your bachelor’s of—is it engineering science?
Lewis Foxhall, MD:
Mm-hmm, correct.
Tacey Ann Rosolowski, PhD:
From UT Austin in 1973. Is that correct?
Lewis Foxhall, MD:
Sounds good.
Tacey Ann Rosolowski, PhD:
Okay. (laughter) And then with Baylor, I have that you got your MD in 1976. So tell me about your experience in medical school. How did that make you grow, and did you start thinking about underserved populations and other areas that you’re working in more administratively at that time?
Lewis Foxhall, MD:
Well, the program at Baylor was interesting. That was a period of time when they were trying a three-year curriculum for medical school. So it was sort of constant medical school for three years. We had no breaks, no summers off, and that was an interesting endeavor. But it worked out, and we all got through. Only a few people fell off the deep end, I think, during that time, but it was an interesting educational experience.
Tacey Ann Rosolowski, PhD:
So it was very—
Lewis Foxhall, MD:
Intense, yes.
Tacey Ann Rosolowski, PhD:
Yeah, very compressed.
Lewis Foxhall, MD:
Instead of the usual four-year thing with the normal academic time off and these sorts of things.
Tacey Ann Rosolowski, PhD:
And what was the reason for compressing the schedule, trying to get it into three years?
Lewis Foxhall, MD:
I’m sure someone had a great idea how that would benefit society, but I don’t recall it.
Tacey Ann Rosolowski, PhD:
(laughs) I’m mean, looking back—
Lewis Foxhall, MD:
I’m sure it was an attempt to increase the output of physicians and perhaps reduce cost to the state, those sorts of things. But [unclear].
Tacey Ann Rosolowski, PhD:
What are your thoughts about it now?
Lewis Foxhall, MD:
So it was fine. It worked fine. It was very intense and wasn’t a good time to really concentrate and focus on the educational activities that [unclear], so it was a good [unclear]. But during that time, I became more interested in clinical work and decided that I was interested in primary care, and some of that revolving around my interest in serving, you know, working in population health, working in low-access communities developed during that time. So I spent some time going back to my hometown and working with my local family physician, and really felt that was a sort of patient population that I really wanted to work with over time, so I felt a more direct connection with the patients. And the broader aspects of primary care, especially preventive care, were very interesting to me. So that’s what led me down that path.
Tacey Ann Rosolowski, PhD:
I was going to ask you if growing up in a fairly rural area, small town, had affected you in any way. I mean, what did you see at that time that then led you back to serve that kind of community after your medical experience?
Lewis Foxhall, MD:
Well, I mean, it’s a small town, so you get to know the whole spectrum of people. It’s the sort of situation where if you’re in a larger community, you might only interact with a subset of the population, so you really get to know them. There was a time when schools were integrated, and that was also another factor, I think, that really kind of helped raise my awareness of the rest of the world out there and that we were really very fortunate in our living situation. My parents worked—my dad worked in farming and ranching, but we lived in a very comfortable situation, and it was, I think, a good opportunity to broaden my own personal horizons. I’m not sure I realized it as much at the time as I do now thinking back on it, that that was a formative sort of period of time and inspirational time in my life. So [unclear].
Tacey Ann Rosolowski, PhD:
Did you say “inspirational”?
Lewis Foxhall, MD:
I can’t remember what I said now, but I’m sure it was. (laughter)
Tacey Ann Rosolowski, PhD:
Yeah, I was curious because that’s [unclear].
Lewis Foxhall, MD:
You know, I think it was a time when a lot of things were changing in the country, and even in our little tiny town these things were playing out and were certainly opportunities to try to learn and grow. And my parents were very supportive and open and encouraged us to participate and reach out and try to better understand everyone’s situation in the community. So I think that was a good growth experience at that time.
Tacey Ann Rosolowski, PhD:
Yeah, I’ve interviewed a number of people who recall that time as being a real, real formative period for them. I mean, you kind of couldn’t avoid it. (laughs)
Lewis Foxhall, MD:
That’s right.
Tacey Ann Rosolowski, PhD:
The sixties were a real watershed for the country.
Lewis Foxhall, MD:
Yeah, it really was.
Tacey Ann Rosolowski, PhD:
Yes. So tell me about either during medical school, when you began to focus on some of these interests, or afterwards, going back to your hometown, what were the types of activities you took part in that helped you develop more knowledge and skills in this area?
Lewis Foxhall, MD:
Well, I think, you know, a lot of the things that happened in my career that led me to my interest in focusing on cancer prevention and on the application of that to low-income populations were during my residency training program and then during my years in private practice. So I participated in a community-based residency program in Corpus Christi, Texas, so we were working out of the county hospital and were basically the primary physicians serving a large patient population, most of whom were low-income and uninsured. It became very evident at that point that access to care and the lack of preventive interventions, which were being well documented by that time, were a serious detriment to that population. So that, I think, was sort of the earliest time. But after residency, I decided to go into private practice and came back here to Houston, and went into practice with one other physician in the northern part of the county and worked at a local community hospital and was able to build up a really great patient population. It was an early time when that part of the county was growing rapidly, lots of new people moving into the community, and opportunity to grow the practice quickly. But then following those patients over time, which is one of the real joys of primary care, working with people over time, it became obvious that there were many missed opportunities, and it was despite our best efforts in our practice, it was unavoidable that we would see patients who presented with cancer often, cancers that could have been detected early and could have had a much better outcome [unclear] people who developed problems related to tobacco use, in particular, that were, sadly, related with bad outcomes.
Tacey Ann Rosolowski, PhD:
Can I ask you—I’m sorry, I don’t mean to interrupt you, but I wanted to make sure that I have the name of the hospital where you worked when you were [unclear].
Lewis Foxhall, MD:
Houston Northwest Medical Center.
Recommended Citation
Foxhall, Lewis E. MD and Rosolowski, Tacey A. PhD, "Chapter 01: Growing Up in a Small Town; Medical Education" (2014). Interview Chapters. 850.
https://openworks.mdanderson.org/mchv_interviewchapters/850
Conditions Governing Access
Open
