Building the cancer station

By Bryant Boutwell and Charles M. Balch

The media was abuzz in late 1953 as MD Anderson’s permanent home emerged from the forest that was to become the Texas Medical Center.

“A doctor with new ideas wanted an unorthodox cancer hospital in which to practice revolutionary treatments,” the Daily Texan in Austin reported. “So, Dr. R. Lee Clark Jr., energetic director of the MD Anderson Cancer Hospital in Houston, conceived the modern building that is called a cancer station rather than an ordinary cancer hospital because its functions will include teaching and research, as well as patient care. This combination, according to Dr Clark, is the key to success in the fight against the disease.”

The completion of the new cancer hospital in December 1954 was a milestone event in Lee Clark’s life — a grand accomplishment echoed in platitudes from far and wide. After all, he was a Clark. Like his father and his father’s father, he now joined the family tradition of building institutions of learning. Moreover, Clark’s institution added medical research and saving lives to its mission. The Georgia Etowah pink marble that clad his new hospital cast a spiritual glow of hope, as he intended.

The Dec. 13, 1954 issue of Time magazine called it “the Pink Palace of Healing.” Architectural Forum wrote: “The Cancer Station breaks old rules, establishes new precedents, and points to higher standards in the future. Houston’s new Anderson Hospital...It will be as modern a cancer station as any in the US — very probably the most modern. American hospital planning is not likely to be quite the same after Anderson opens its doors.” 

While such heady praise was well deserved, it is remarkable that a surgeon with no experience in hospital construction personally led the design and supervision of a world-class medical care and research facility. From the day he took the job in 1946, he never doubted himself.

Clark’s directive was simple — the new MD Anderson would be a resource for all Texas citizens, regardless of their ability to pay or their ethnicity. 

“An institution becomes really great when it is the property and the will of the people who make it possible,” Clark noted at the December 1950 groundbreaking ceremony. “The institution that rises here today does so as an expression of the will of the whole people of the state. It does not belong to you, to me or to the University alone, but to all of us.” 

He envisioned a 300-bed hospital with major research and educational capabilities that would set new standards of excellence and functionality in design and operation. The process required eight years from start to finish — two years for Clark to visit over 30 cancer facilities and multiple academic hospitals in America and in Europe, two years of architectural planning and four years of construction. During that time, he was simultaneously building, directing and caring for patients in temporary quarters at the Oaks.

His lack of experience in building a hospital failed to dissuade Clark, who didn’t want to be trapped by old ideas and traditions. In June 1947, he selected the Houston architectural firm of MacKie & Kamrath because “they had never designed a hospital.” His strategy was to “break the mold” of hospital design. Karl Kamrath was a disciple of Frank Lloyd Wright’s Usonian style of architecture with its horizontal alignment, dramatic structural engineering, finely executed materials and attention to detail. 

That same month, Clark hired Schmidt, Garden and Erikson, based in Chicago. The firm, with a portfolio of over 150 hospitals, added a layer of experienced know-how as consulting architects. 

The plan was to marry the creative, organic architecture of Frank Lloyd Wright with old-school, experienced practitioners to maximize functional efficiency and create a “hotel-like” ambience. It would require a mind-boggling 23 sets of blueprints to integrate all the functional areas into a single building.

It was a rule of The University of Texas that construction bids could not be let until the necessary funds for construction were in hand. While Clark started in 1946 with an unrealistic sum of $1.75 million, he worked tirelessly with the Texas Legislature, university officials and statewide community organizations to raise funds. The Radiological Institute and nuclear medicine laboratories, for example, added $1.35 million to the cost — money Clark did not have., Thanks to the guidance of Frances Goff, his administrative assistant, and a special legislative session in February 1950, he secured the funds. The state added a new tax to cigarettes to make that happen.

By April 1950, the architects came back with an estimated cost of $5,437,800. Clark was again on the short end and went back to work raising money. In the end, the entire project cost nearly $9 million, almost five times more than the funds he started with. While rising construction costs constantly threatened the project, Clark and his staff never wavered, displaying extraordinary resourcefulness and determination to find new funding sources. 

On July 13, 1950, the UT Regents approved construction bids in their final form. Three months later the lowest bid came in at a disappointing $7.5 million, exceeding the funds in hand by $2.5 million. On Oct. 28, 1950, the UT Regents awarded the contract to Farnsworth & Chambers Company. The Korean war had started in June, causing construction costs to surge at a rate of 11.1% annually, meaning Clark needed to amputate sections of his building from the budget. 

 “It was a blue day,” Clark told Corrine Crow during a 1976 interview for East Texas State University. “It was hard to bear after we had already waited from 1946 to 1950 and had planned it and were ready to go and had gotten that extra money from the state.” 

Clark and UT President Theophilus Painter spent a day with Dunbar Chambers to work out a solution. Clark proposed eliminating three of five floors designated for research and one of two wings for cancer beds, enabling the contract to be let for $5,250,000.

Chambers generously agreed to hold prices for 18 months to build the deleted items. It was a risk he took and a challenge of the first order for Clark to raise the difference or lose the full hospital he had designed. Clark pulled out all stops. Thankfully, the M.D. Anderson Foundation stepped up with $1.2 million to build the Bertner Memorial Pavilion, a nursing wing. On Nov. 24, 1951, the Houston Chronicle reported the good news of the foundation’s gift along with the bad news that despite the donation, the M.D. Anderson Hospital for Cancer Research would be half-furnished “unless an additional $918,000 can be raised through individual gifts.”  

The M.D. Anderson Foundation gift along with additional federal funds acquired from the Hill-Burton Hospital Survey and Construction Act and other new grants and donations made it possible to issue change orders increasing the construction contract to $6,511,565 by the fall of 1951, and to $7,031,239 by the fall of 1952. Yet Clark was still short and lacked funds for furnishings and key equipment.   

“Whether the institution opens as a complete facility will depend upon the support of the citizenry of Texas,” Clark said, noting a “crucial time” in MD Anderson’s brief history.

Having exhausted all his usual funding sources, he got permission from The University of Texas, unusual at the time, to turn to private citizens and initiated a “Living Memorial” gift program so that Texans could contribute directly. 

Additionally, he engaged local women’s organizations throughout the state to generate donations. While these gifts were mainly small in amount, they were high in volume. He acknowledged their valuable role at the 1950 groundbreaking, with representatives of the American Legion Auxiliary, the Texas Federation of Women’s Clubs and the Texas Business and Professional Women’s Clubs taking the first spades of dirt.

Frances Goff was a natural to work with these groups as she was well-known to all. Additionally, she continued to advise Clark behind the scenes on fundraising efforts with the Texas Legislature. With her office walls covered in blueprints, she hit the road to work directly with community organizations across the state, carrying a plastic model of the proposed hospital building in the trunk of her Buick Riviera and on airplanes as well. When not on the road, she orchestrated delegations of lawmaker friends for visits to Houston to hear directly from Dr. Clark and see the work in progress.

As for the needed furnishings and equipment, she and Clark went to New York and worked directly with Florence and Hans Knoll, owners of Knoll Associates, a world-famous interior design company that specialized in modernistic, high-end furnishings. Hospital furnishings were new to the Knolls, and Clark liked that. He wanted bright and colorful, and Goff oversaw the final selection, delivery and placement of every stick of furniture.

With 90% of the funds needed in hand, the new hospital’s cornerstone was laid on March 19, 1953. A year later, on Feb. 26, 1954, vans began loading equipment for the transfer from the old Baker estate to its new Texas Medical Center home. Inpatients were transferred by ambulance on March 19, and the hospital’s formal dedication was on Oct. 23, 1954. 

Clark not only built his cancer station as planned but also spearheaded a name change to capture the full scope of the enterprise. On May 13, 1955, the UT Regents formally changed the institution’s name to The University of Texas M.D. Anderson Hospital and Tumor Institute.

Of the hospital’s final $9 million price tag, the M.D. Anderson Foundation had provided about $2.5 million, with federal funds covering slightly less than a third. The Texas Legislature paid the remainder of the cost, slightly more than a third, allowing Gov. Allan Shivers to declare at the dedication that the new MD Anderson Hospital was the result of a unique joint fundraising effort by federal, state, county and local governments.  

All along, Clark had considered Memorial Hospital in New York as a gold standard. Senior leadership in New York had opened their doors, shared blueprints and watched his progress with great interest. Memorial’s chief surgeon, Dr. Frank Adair, came to Houston to take a look. Adair’s reaction, summarized in a two-page letter, no doubt fueled Clark’s resolve to find the funds at every turn to build the hospital in its entirety. One can only imagine the smile on Clark’s face upon reading Adair’s words: “I think your plans are perfectly magnificent and I am extremely jealous of the whole setup.”

What was so special about Lee Clark’s new cancer station, this pink palace of healing that was the talk of the town and all the buzz in medical circles? The answer deserves a closer look.

Next article: The pink palace of healing