The Daily Practice of Compassion: A History of the University of New Mexico School of Medicine, Its People, and Its Mission, 1964-2014

By Dora L. Wang and Shannan L. Carter

Published in honor of the fiftieth anniversary of the founding of the University of New Mexico School of Medicine, this book provides more than an institutional history. Rich with anecdotes and personality, Dora Calott Wang’s account is a must-read for anyone curious about health care in New Mexico.

Celebrated for its innovations in medical curricula, UNM’s medical school began as an audacious experiment by pioneering educators who were determined to create a great medical school in a state beset by endemic poverty and daunting geographic barriers. Wang traces the enactment of the school’s mission to provide medical education for New Mexicans and to help alleviate the severe shortage of medical care throughout the state. The Daily Practice of Compassion offers a primer for policy makers in medical education and health-care delivery throughout the country.

• Language: English
• Publisher: UNM School of Medicine
• Release date: Dec 30, 2014
• ISBN: 9780826355263

Dora L. Wang

Dora Calott Wang is an assistant professor and a historian for the University of New Mexico School of Medicine. She is the author of The Kitchen Shrink: A Psychiatrist’s Reflection on Healing in a Changing World.

Book preview

PART I

The Story

MEDICINE IN THOMAS POPEJOY’S NEW MEXICO

1902–1957

Chapter 1

WHEN THOMAS POPEJOY was born on a ranch outside of rural Raton in 1902, New Mexico was not yet a state but a sparsely populated territory of the United States, ceded by Mexico in the 1848 Treaty of Guadalupe Hidalgo.

In 1912, when Popejoy was ten, New Mexico became the forty-seventh state.

During Popejoy’s childhood, people came from around the world to New Mexico, seeking a cure for tuberculosis. New Mexico’s dry, warm air was thought to have curative powers. Indeed, New Mexico’s climate helped patients feel better, even if an actual cure for tuberculosis wouldn’t be discovered for another half century.

Tuberculosis had a large role in establishing New Mexico’s early medical institutions, including the St. Joseph, Presbyterian, and Lovelace systems, which would serve the state for most of the twentieth century.

Albuquerque’s first hospital opened in 1902, the same year Popejoy was born. The St. Joseph Sanatorium was founded by the Sisters of Charity from Cincinnati, Ohio, with the mission of helping the poor and underserved, especially those with tuberculosis. Sister Hyacinth meticulously oversaw the building of the hospital and its first days. St. Joe’s, as it came to be called, would grow into a major medical system that would provide care to New Mexicans for most of the next century.

Seeking a cure for his own tuberculosis, the Reverend Hugh Cooper arrived in Albuquerque in 1903. In 1908 he founded the Southwestern Presbyterian Sanatorium, devoted to caring for tuberculosis patients. Thus began the Presbyterian Health Care System, which continues to serve New Mexicans today as the state’s most dominant private medical system.

William Randolph Lovelace, who also suffered from tuberculosis, arrived in Fort Sumner, New Mexico, in 1906. By 1913 he had moved to Albuquerque to begin what would become Lovelace Clinic. By 1947 when the organization had grown to employ twelve physicians, the clinic was incorporated as a nonprofit organization that would serve Albuquerque well into the twenty-first century.

In 1910 Carrie Wooster traveled from Ohio to Arizona, seeking a warmer climate for relief of her tuberculosis. She was accompanied by her mother and a male suitor, Clyde Tingley. An attack caused her to stop just short of Arizona, in a city she found agreeable and that had good TB facilities. They decided to stay in Albuquerque. Carrie and Clyde were married the next year. Clyde Tingley was soon elected governor, and among the twelve hospitals he built during his term was the Carrie Tingley Hospital for Crippled Children in Hot Springs, named for his wife.

(counterclockwise from top left) Presbyterian Hospital, St. Joseph Hospital, tuberculosis treatments circa early 1900s, Valmora Sanatorium.

In the early 1900s, when Popejoy was a boy, a physician’s saddlebag typically contained lances for bloodletting, opiates, and chemicals designed for purging, including nux vomica, buchu, and calomel. Indeed, a cure for tuberculosis would not come until the 1940s with the discovery of streptomycin. By then, antibiotics and vaccines were also widely in use.

Medical care may not have had much to offer until then, but the vulnerability of patients is age old. In the early 1900s, when seeking cures from sickness, or when faced with mortality, even the most rational grasped at irrational hope. Quack medicine men preyed on the hopes of the ill and dying, to the point that physicians, the public, and muckraking journalists united. Upton Sinclair wrote The Jungle. These actions prompted the federal government to found the Food and Drug Administration in 1906 for the protection of the public. The term snake oil salesmen remains in the American vocabulary, a cultural memory of health care reform of that time.

The dangers of for-profit medical entrepreneurship prompted the American Medical Association, courts across the country, journalists, and the public alike to declare that corporate profit in medical care was simply against sound public policy.

Like hospitals and medical institutions across the country, New Mexico’s first medical institutions were charitable, named for saints, founded for humanistic purposes. For most of the twentieth century, those who sought to profit from the illness of others were disdained and referred to by such derogatory terms as ambulance chaser.

Stories of early doctors in New Mexico are colorful. Some were more readily found at saloons than at hospitals and were more likely to have a beer in hand than a stethoscope. Some were more likely to contact one another with their fists than to contact patients for medical care.

As a boy, Thomas Popejoy walked a half mile each day to the one-room schoolhouse where he began his education. To attend high school, he and two sisters moved from the family ranch into town, to Raton, where they maintained their own home. Young Thomas became the man of the house at an early age, as a teenager.

In high school, Popejoy played football and found himself good at the sport. He also found romance with a fellow student, Bess Kimball. Crazy in love, it is said, the couple eloped to Trinidad, Colorado, because Bess was just seventeen, too young to be married in New Mexico.

Popejoy, who was a year older than his bride, soon moved to Albuquerque to begin college at the University of New Mexico, while Bess stayed in Raton to complete high school. At UNM, Popejoy was one of but six married students on campus.

After graduating from UNM with a bachelor’s degree in economics in 1925, his first inclination was to return to football and to be a coach. But Bess refused to be married to a coach. Popejoy was subsequently hired as an instructor in the UNM economics department, while he worked long distance toward his master’s degree at the University of Illinois, completing the degree in 1929.

In 1927 he began working for UNM’s seventh president, James Fulton Zimmerman. Popejoy became known as a trusted all-round fixer, who lobbied for the school when needed and helped Zimmerman with UNM’s internal operations. Zimmerman had ties in Washington, D.C., and to the Franklin Delano Roosevelt administration. He appointed Popejoy to run the New Mexico branch of the National Youth Association, a New Deal organization. This brought federal funds to New Mexico during the Great Depression, to administrate the NYA’s training programs for young men and women in New Mexico.

Popejoy was soon hired as a national officer for the NYA. The farm boy, for whom Raton and Albuquerque were big cities, moved with his wife to Washington, D.C., where he acquired a taste for opera and classical music. Popejoy was especially fond of Bizet’s Carmen. He also traveled to visit NYA programs in most states. Popejoy’s son, Albuquerque attorney Thomas Popejoy Jr., who grew up listening to Carmen, recalls, In Washington Dad learned to talk with people in the ‘big time.’ He was charismatic because he could talk to anybody—he could talk to a farmhand, and he could talk to President Roosevelt. He learned we all put our pants on the same way, whether you’re president of the U.S. or a farm boy. I had a great life as his kid.

In 1941 UNM president Zimmerman suffered his first heart attack. Popejoy returned to UNM from Washington, D.C., to run the university during Zimmerman’s infirmity.

In 1945 Zimmerman suffered his second heart attack and decided to retire permanently. The Board of Regents of the University of New Mexico searched for a new president. Overlooking Popejoy, they appointed John Phillip Wernette from Harvard as UNM’s eighth president. Wernette’s term was short and controversial. Within three years the Regents were again looking for a new president.

A New Mexican had never served as president of UNM. The Regents decided it was time to take a chance. They asked Thomas Popejoy to be the ninth president of the University of New Mexico and the first president from the state.

Marie Hillerman, wife of novelist Tony Hillerman knew Popejoy. She described him: He always looked like a country boy, not anything like a slick New York lawyer.

Nevertheless, on July 1, 1948, Popejoy assumed the position of UNM president as the first New Mexican in the post.

Popejoy proved that a New Mexican could indeed be a successful university president. By the time Popejoy left the position in 1968, he was UNM’s most longstanding president. It was during his two decades of leadership that UNM grew from a provincial college to a university of national prominence.

THOMAS POPEJOY

1902–1975

NINTH PRESIDENT, UNIVERSITY OF NEW MEXICO

For Thomas Popejoy, establishment of the UNM School of Medicine during his term as president, 1948–1968, was a highlight of his career. Born on a ranch outside Raton, Popejoy was the first UNM president born in New Mexico. In 1975 he died at the age of seventy-two in the Bernalillo County Medical Center (now UNM Hospital).

POPEJOY’S PRIDE

The Founding of the UNM School of Medicine, 1957–1961

Chapter 2

IN 1949, POPEJOY’S FIRST YEAR as UNM president, Congress granted funds to construct a new hospital to focus on providing medical care to Native Americans, and to the indigent. The land and funds were given through the Bureau of Indian Affairs. In 1952 a federal contract clarified that Bernalillo County would be responsible for operations and funding of the hospital, but that the federal government would continue to be involved and also provide reimbursements to Bernalillo County.

To facilitate the building of the hospital, the city allowed variances of building codes, even though building codes were few at the time. The contractor ran out of money, not an unusual occurrence. He finished building the hospital anyway, cutting corners along the way. At the end of construction, parts of the hospital seemed obviously makeshift. But the hospital was indeed built. All had rallied around the mission and pride of the hospital.

The Bernalillo County Indian Hospital opened its doors in 1954. It was required to reserve one hundred beds for Native Americans, with the Pueblo Indians taking priority. P. G. Cornish Jr., MD, served as the first Medical Staff president; Albert G. Simms II, MD, was vice president; and Fred Hanold, MD, was secretary.

Randolph V. Seligman, MD, an obstetrician, delivered the first baby at the new BCIH and served as chief of the hospital OB/GYN Service from 1955 to 1960. Seligman was the son of Julius Seligman, owner of the Bernalillo Mercantile Company. As a boy, young Randolph went on house calls with his neighbor, Lincoln Smith Hemmings, MD, the only physician in Bernalillo County and surrounding areas. Seligman said that his early exposure to medicine was because Dr. Hemmings wanted companionship to alleviate the boredom that accompanied the hours spent traveling between communities.

The BCIH began training residents even before the medical school opened. Alice Cushing, MD, began her pediatrics residency at the BCIH in 1962. She later served on the faculty of the Department of Pediatrics at the School of Medicine and was interim chair in 1975–1976. Another early trainee was Thomas McConnell, MD, a pathology resident who would later join the faculty in the Department of Pathology at the school. As a hobby, McConnell was active in Albuquerque’s hot-air ballooning culture. Over the years he would bring balloons to grace the campus during events.

Bernalillo County Indian Hospital, 1954. Over the years, the hospital on Lomas Boulevard served many key functions for New Mexico. It was called the Bernalillo County Medical Center from 1968 to 1978 and the University of New Mexico Hospital thereafter.

Randolph V. Seligman, MD, holding the first baby delivered at the Bernalillo County Indian Hospital. Seligman delivered more than 10,000 babies during his career. The handwritten note at the bottom of the photo reads: August 18, 1956. Thank you, Dr. Seligman.

Fred Hanold, MD, Secretary, Bernalillo County Indian Hospital.

Early in his presidency, Popejoy was a founder of the Western Interstate Commission on Higher Education, which consisted of twelve states, including Alaska, Hawaii, California, North Dakota, Montana, Colorado, and Utah. Through WICHE, students could receive a professional education in another WICHE state at resident tuition, if his or her home state lacked the same program. Since New Mexico had no medical school, students from New Mexico could attend medical school in another state, through WICHE.

Alice Cushing, MD.

Nevertheless, few New Mexican students took advantage of this opportunity. According to Popejoy, in an interview with the Albuquerque Journal, In the fall of 1958, the state of New Mexico had only nineteen students accepted in medical schools over the nation.

At the same time, the need for more doctors in New Mexico became evident. A WICHE study, The West’s Medical Manpower Needs, concluded that by 1970 New Mexico’s shortage of doctors would be dire. In 1957 Popejoy began the process of starting a new medical school at UNM, feeling that this was the best solution for the state’s growing doctor shortage.

Alice Cushing, MD, with a young patient.

He requested input from the New Mexico Medical Society about the feasibility of New Mexico having its own medical school. He hoped local physicians could eventually teach at the school. The society of physicians, however, responded with a thumbs down, saying that the outlook for a medical school in the state was simply not favorable. Popejoy next met with University of Arizona president Richard A. Harvill about the feasibility of a joint medical school. The University of Arizona’s response was favorable. However, their Medical Education Committee urged a go slow policy, advocating for additional studies and discussion. Yet by the end of the year the University of Arizona had resolved to start its own medical school, leaving Popejoy once again to pursue other avenues.

Popejoy met with potential donors who might fund a new medical school, including the Commonwealth Fund and philanthropist Winthrop Rockefeller, who was soon to be governor of Arkansas. Although Rockefeller declined to fund a medical school, he did decide to collaborate with UNM in building a shopping mall. Winrock Mall, bearing the name of Winthrop Rockefeller, was Albuquerque’s first large shopping center. It opened in 1961 on land that was owned by UNM at the time. It was a significant addition to the lives of New Mexicans that may not have occurred, if not for President Popejoy’s efforts to build a medical school.

Thomas McConnell, MD.

Next, Popejoy lobbied the New Mexico State Legislature for funds. He proposed that the Bernalillo County Indian Hospital could be the primary teaching hospital. Not one to think small, he also proposed that Presbyterian Hospital, St. Joseph Hospital (founded as sanatoriums, but which had evolved into hospitals), and the Nazareth Sanatorium could all relocate to the UNM campus.

Ray Woodham of Presbyterian Hospital answered that it would be costly to relocate. He furthermore concluded that Presbyterian could no longer participate in the medical school project.

Popejoy persisted. He invited a liaison committee of the Association of American Medical Colleges and the American Medical Association to conduct a feasibility study. The committee visited the UNM campus and the Bernalillo County Indian Hospital, as well as the Albuquerque VA Hospital, Presbyterian Hospital, and St. Joseph Hospital, as possible teaching sites.

PHOTO COURTESY OF THOMAS MCCONNELL.

Bernalillo County Indian Hospital staff.

WINROCK MALL

Winthrop Rockefeller was among the potential donors UNM President Thomas Popejoy approached to provide initial funding for a new medical school. Rockefeller declined to fund the school. However, he decided to build a mall. Winrock Mall opened in 1961 on land that belonged to UNM at the time. It was a significant addition to life in Albuquerque that would not have happened if not for President Thomas Popejoy’s efforts to fund the School of Medicine.

The spirit of the sixties swept the nation, a time for new leadership, a time to question traditions.

In 1960 Massachusetts senator John F. Kennedy came to Albuquerque and addressed a crowd at the UNM football stadium, hopeful that the country might be ready to elect its first Roman Catholic president.

UNM students marched before the Albuquerque Woolworth’s in sympathy for African American civil rights demonstrations in the Deep South. The UNM Student Council voted to end the Homecoming Parade, calling it too much work and not worth the effort.

In 1960 the Liaison Committee of the AAMC and the AMA issued a report favoring the creation of a new medical school at UNM. Reflecting the years of groundwork Popejoy had laid, the report stated:

A dedicated board of regents, a capable and energetic administration, and a competent faculty. The apparent full support of the medical profession in the county and state. Hopeful indication by representatives of the State Legislature that their two bodies will back the undertaking. Sufficient clinical facilities at Bernalillo County Indian Hospital for two years of medical work at the beginning.

MARALYN BUDKE, POWER BEHIND THE SCENES

Director of the Legislative Finance Committee under two governors, Budke has been called New Mexico’s first woman governor. Budke sheparded initiatives that led to the creation of the School of Medicine. Some leaders credit her over anyone else with the formation the School of Medicine and the University of New Mexico Hospital.

UNM Board of Trustees.

Thomas Popejoy with the UNM Board of Regents.

LAWRENCE H. WILKINSON, MD

Lawrence Wilkinson, MD, a general surgeon, was president of the UNM Board of Regents when the decision was made to start a school of medicine at UNM.

Born in 1916 on a cattle ranch near Katy, Texas, Wilkinson milked ten cows, twice daily, nearly every day of his childhood. He paid his way through Southwestern University in Georgetown, Texas, by working at a book bindery and washing dishes in a boardinghouse.

After graduating from the Baylor College of Medicine, he came to New Mexico in 1948, where he worked at the Santa Fe Railway Hospital. There he met Charles Beeson, MD, Fred Hanold, MD, and John Abrums, MD, all of whom later worked at the Bernalillo County Indian Hospital (now UNMH).

Wilkinson, who believed that at a true university all disciplines should be taught, including medicine, was involved with all stages of planning the medical school. At one point, planners suggested that the medical school be located on the South Campus, where there was ample land, even if it would be a distance from the hospital. Wilkinson, however, insisted that the medical school be built at its current location: Over my dead body will you locate the medical school on the south campus. The medical school is going to be built by BCI Hospital. . . . We’re not counting on building a huge medical school.

With this endorsement, and with the support of New Mexico Medical Society members Charles Beeson, Robert Derbyshire, Fred Hanold, Lewis Overton, and Albert Simms, Popejoy again lobbied the State Legislature. At the legislature, President Popejoy enlisted the aid of state senator Fabian Chavez. Chavez was a member of the New Mexico House of Representatives from 1951 to 1952 and was then elected to the State Senate in 1955. From 1961 to 1964 Chavez served as the Senate majority leader. His support was instrumental in mobilizing other votes in the legislature, as well as the support of Governor John Burroughs.

In 1961 a two-year medical school was approved by the State Legislature. That year the legislature appropriated $5.3 million for UNM. For the first time an allocation for a medical school appeared on the budget.

The amount allocated was $25,000.

The School of Medicine at the University of New Mexico was born.

As a next step, Thomas Popejoy set out to recruit a founding dean. He set his sights on John A. D. Cooper, MD, a New Mexico native who was a representative of the AAMC. Cooper, however, was reticent about leading a two-year medical school, when four years of medical education was required for an MD degree. He was also conspicuously absent from New Mexico. At one point, Popejoy wrote to Cooper that lobbying the State Legislature to fund a new medical school would be far more effective, if you are on hand to help us.

Eventually Popejoy offered the job to a young associate dean at the University of Colorado Medical School, a gentleman from a well-established East Coast family of physicians.

Reginald Heber Fitz, MD, was the son and grandson of Harvard Medical School deans, Reginald Fitz, MD, and Reginald Heber Fitz, MD.

In the late 1800s the legendary physician Reginald Heber Fitz had discovered appendicitis and pancreatitis, and had coined both terms. One of American medicine’s great innovators, he also advocated for a radical new kind of surgery to remove the appendix, if inflamed. He called this new procedure the appendectomy.

But this wasn’t the 1800s. It was the 1960s, and Reginald Heber Fitz, named for his legendary grandfather, had a countercultural streak. He had majored in English. He was interested in Native American and Hispanic cultures.

He had gone west.

After finishing medical school at Harvard, he completed his residency at the University of Colorado, where he stayed on as a faculty member. He enjoyed his travels through the Southwest, recruiting students to attend medical school at the University of Colorado, through the WICHE program. His travels occasionally brought him to Albuquerque, where he taught residents at the Albuquerque VA Hospital and at St. Joseph Hospital.

He became acquainted with Albuquerqueans, including Thomas Popejoy.

Fitz knew he wasn’t Popejoy’s first choice to be founding dean for the new medical school at the University of New Mexico:

I suspect that they first asked John A. D. Cooper to take on the job as the first dean of the school because he had been born in Las Cruces and spoke Spanish and was a natural for the job, but he felt it was not a good thing to take unless the New Mexico people were committed to go to a four-year school.

But Fitz, who some called a cowboy, was unfazed about founding a two-year school of medicine.

It didn’t bother me quite that much, he said.

REGINALD HEBER FITZ, MD

FOUNDING DEAN OF THE SCHOOL OF MEDICINE

1961–1968

HOW TO MAKE A MEDICAL SCHOOL

Chapter 3

AT THE AGE OF NINETY-TWO, Reginald Heber Fitz, MD, was retired and living in Vermont. He had long ago returned to the East Coast.

Looking back upon his early years in life, he recalled, "When I was growing up, everyone was always saying, are you going to be a doctor like your daddy? So when I went to college, I majored in English history and