My daily role with Dr. Tony Gotto was to run administrative interference for him with the heads of the various sub-specialties making up the Department of Medicine, which he chaired. I often experienced what might have been felt by a quarterback, even if I never played football. I believed that I knew what it might feel like to be sacked before throwing the ball, as the coach had wanted it to be done. The game included a variety of offensive and defensive strategies associated with the department’s budget cycles, when I negotiated with the section chiefs about their needs and demands. Since much of Medicine’s income depended upon the clinical fees derived from the private practice of its physicians, the discussions were often complex. I did manage, most of the time, for them not to be overly disappointed or angry after our negotiations were completed.
To add to the department’s financial complexity, we had to manipulate simultaneous incomes for diverse fiscal years. Baylor College of Medicine did not have its own teaching-hospital. Instead, the College, for the training of its medical students and interns, had special arrangements with TMC’s independent medical institutions. The College’s Department of Medicine relied upon the resources of The Methodist Hospital, the Veterans’ Affairs Hospital, the Ben Taub General Hospital of the Harris County Hospital District, and St. Luke’s Episcopal Hospital. Each organization had its own budget cycle, which varied among three periods: January through December, July through June or September through August. It was an ongoing challenge not to run out of funds for salaries of professional and support staff during any particular month. On the other hand, for most days, my managerial experiences were actually fun.
I could have continued to devote substantial effort to the administration of the Department of Medicine, but Mr. Johnson, BCM’s treasurer, had different ideas. When he learned, after several years, that my salary came from both Baylor and The Methodist Hospital, he demanded I should not have a divided loyalty or a potential conflict of interest. The Department of Medicine hired a full-time replacement for my position with it, and the College assumed the responsibility for my entire salary, although a small portion of it came from a grant from the NIH for our Heart Center, directed by doctors DeBakey and Gotto, in which I served as the Deputy Director for Administration. Fortunately, I had an Administrator who managed the day-to-day elements for the Center’s operation. I handled policy issues on behalf of MED and AG whenever problems arose for adjudication. Almost all of the investigators in the Heart Center were also members of the faculty of the Department of Medicine, so there was a high overlap of their clinical and research missions.
As Deputy Director for Administration of the National Heart & Blood Vessel Research & Demonstration Center, the major event I coordinated directly was the site visit by the NIH for the renewal of the multibillion-dollar grant funded by this federal agency. The site visit was a major event for both the NIH and the College. At the time, this was the largest site visit ever held by the NIH. We welcomed seventy-nine visitors to review our program!
Our Heart Center, colloquially known as The DeBakey Heart Center, had three divisions: Research, Education, and Demonstration. It was a challenge to aggregate all three elements into a united effort in the control of heart and blood vessel diseases. The seventy-nine visiting consultants met, over a three-day interval, with all of the research scientists, educators and clinicians involved in our project. I managed, with the help of a young administrative assistant, Bruce Stewart, to organize dozens of simultaneously scheduled presentations of what we were doing and expected to do if the grant were renewed. Cellphones were still in the future; fortunately, their precursors, two-way walkie-talkies, were available for the two of us to coordinate the movement of all of the faculty involved in these presentations.
Our application was renewed in excess of three million dollars, an amount that would be about ten times greater in current dollars. This, too, was a fun experience.