Clark at the Oaks

By Bryant Boutwell and Charles M. Balch

When Lee Clark arrived at the Oaks in August 1946 to take the helm of the new cancer hospital, he was more than appreciative of all Ernst Bertner had accomplished as acting director the previous four years. Walking the grounds his first day, Clark explored the main residence, which had been converted into an administration building that also housed diagnostic radiotherapy and radiological equipment. Finding lead to line the walls and ceiling for the X-ray equipment had been no easy task for Bertner. The carriage house had been converted to research laboratories, and a small animal house was built off the curving brick wall that led to the carriage house. Nearby, a newly built one-story, 16-room brick building served as the outpatient clinic.  

From 1942 until Clark’s arrival, Dr. Bertner had spent about $40,000 on these remodeling and construction projects. Because of the war, he and his business manager, John Musgrove, faced ever-increasing construction costs along with a decreasing availability of skilled carpenters. The situation required both men to personally oversee the work while finding money (always in short supply) to pay the bills.

For staffing, Bertner had enlisted 11 local physicians to be available as needed for consultation and patient care. Each doctor, with private practice income to fall back on, served on a voluntary basis without pay. The four researchers borrowed from The University of Texas Medical Branch at Galveston (UTMB) primarily addressed biochemical studies with much of their equipment, also loaned from Galveston. In 1943, Bertner started adding staff including a secretary, a nurse, a librarian, a carpenter, two gardeners (both were sons of Capt. Baker’s gardener) and a night watchman, Mr. Smith. Smith’s job included shooting rats that roamed the grounds at night. When he missed, which was often, steam pipes needed repair. The one carpenter also served as painter, plumber, electrician and sheet metal worker.  

In those early days only patients who were medically indigent, were citizens of Texas and had no treatment facilities in their communities were seen at the new cancer hospital. The plan was to open MD Anderson to every Texan once a permanent director was hired.

John Spies, the progressive UTMB dean who might have held Bertner’s position on a permanent basis had he not gotten crosswise with the old-guard faculty in Galveston and been fired by UT Regents in August 1942, helped with the purchase of furniture and equipment for the new cancer hospital. He also oversaw the purchase of something that especially pleased Lee Clark — 313 milligrams of radium at a cost of $7,194.02.  

The radium was a bonus and spoke to the futuristic thinking of The University of Texas to support and build a cancer hospital unlike any other. As Clark’s father and grandfather had demonstrated, building great institutions requires making no small plans. Clark would follow that advice, but first he had to organize and upgrade the temporary hospital at the former Baker estate.

Bertner’s early efforts at the Oaks were a good start, but only a start. Clark knew much more was needed. He would be hiring full-time physicians, researchers and staff while building clinics with wards to care for outpatients and inpatients. He needed additional clinic space and patient wards with beds, as well as an operating suite ─ not to mention support facilitates for research and clinical departments. In short, he would take everything Bertner had started and grow it into a campus of facilities.

Rice University, the estate’s previous owner, had retained the judge’s gardeners to maintain the 6-acre grounds in immaculate condition. One could hardly miss the massive cypress tree outside the back door, the stable house draped in wisteria and the fragrance of the late Alice Baker’s well-tended rose garden. Lee Clark set up his office in the Bakers’ second-floor bedroom, which had a spacious sun porch opening off the room to provide a grand view of the grounds. “Sun porch” is a bit misleading, as its main function was not for sun but for cooling, as any breeze one could find provided a respite from Houston’s hot summer months. Throw in humidity, and the heat often became unbearable. Clark’s executive assistant, Marian Wall, and her assistant would take over the sun porch upon arrival in 1949.

Clark’s office bathroom likely caught his eye as it had a bidet, not something one would expect in a state-owned building. Down the hall from Clark’s office were multiple bedrooms, a sewing room, storage closets and various nooks and crannies that would fill with new administrative hires and stacks of blueprints for MD Anderson’s permanent home in the Texas Medical Center.   

Frances Goff, Dr. Clark’s right hand in navigating budgets and legislative funding matters, would in time wallpaper her office with working blueprints for the new hospital. She recalled her cramped Baker estate office space in a 1976 interview. Its dimensions, all of 6 feet by 6 feet, made arranging furniture a challenge. The space was a former sewing room, with a full-length mirror on the wall. An extra chair for guests was out of the question, so visitors met with Goff out in the hall. 

Small as her office was, another early hire had it worse. Roy Heflebower’s desk consisted of two sawhorses and a piece of plywood. Rumor has it that one day his office reached a balmy 108 degrees. In time, Goff bought her own air conditioner ─ actually, she bought half, as she shared it with Heflebower, whom Clark appointed hospital superintendent in 1947. When set on high, the air conditioner offered welcome drifts of cool air for the secretaries down in Dr. Clark’s nearby sun porch.

 The good news was that the war was over and restrictions on construction were lifting. The bad news was that material and labor costs were rising fast. Those costs would complicate Clark’s plans for the Oaks as well as construction of the permanent hospital in the medical center, so he added fundraising to his growing to-do list. While he had the use of leased beds at Hermann Hospital (22) and the Houston Negro Hospital (10), he needed inpatient wards on-site.   

The generosity of Lamar Fleming Jr., who joined Anderson Clayton & Co. in 1911 and became president of the company after Monroe Anderson’s death in 1939, provided Clark a pilot location for inpatient care. In 1947, Fleming purchased a four-unit apartment house at 406 Webster St. and donated it to MD Anderson. It was called the Webster Street Annex (or just the Annex) and remodeled to accommodate 30 patients requiring intermediate nursing care. The leased beds at the two other hospitals were then used for patients requiring intensive care.

To build inpatient wards directly on the grounds of the Oaks, Clark needed bargain basement prices, and he found them. The year Clark had taken the MD Anderson job, the War Assets Administration closed Camp Wallace, a training center for antiaircraft units during World War II, and declared it surplus. 

Near the town of Hitchcock in Galveston County, Camp Wallace proved to be a fortuitous solution to Clark’s needs, and he acted quickly. Again, the M.D. Anderson Foundation stepped forward, giving the hospital $55,000 in 1948 to purchase 12 buildings including the camp’s officers’ quarters and hospital ward units. All were one-story and wood-framed. The buildings were cut into 16-foot sections, delivered to the Oaks by truck and reassembled with furnishings. 

The hodgepodge of 13 reconstructed war surplus buildings (one additional building was acquired from Camp Wallace in 1949) turned the estate’s 6 acres into a maze of dovetailing and unattractive structures. But they were practical and in the coming years would provide essential functions including expanded clinic space, a mess hall, administration space, a physics laboratory and workshop, hospital beds and two operating rooms. Each operating suite had something special — an air conditioner. Other buildings had attic fans. Interesting to note, Dr. Michael DeBakey arrived at Baylor that same year and started seeing patients at the old Methodist Hospital (the former Norsworthy Hospital) located at San Jacinto and Rosalie streets near downtown. DeBakey’s first request — an air conditioner for the operating room.  

The first inpatient at the Oaks arrived on June 27, 1949, to occupy one of Ward A’s 24 beds. Ward B (also 24 beds) opened the following year and Ward C soon after. By 1951, MD Anderson had 98 beds, including 66 at the Oaks, 22 at Hermann, and 10 at the Houston Negro Hospital. 

Clark had other war surplus buildings that had been purchased for the Oaks converted into the main kitchen for the wards, a building for administrative functions related to inpatient care, quarters for the Department of Epidemiology, a photography laboratory and a supply building with a linen room. Four buildings added to the original clinic building served to enlarge the clinic quarters and provide an auditorium for educational meetings as well as a physics building with laboratories and a workshop. 

Clark, by 1950, had on-site outpatient and inpatient care facilities, departments with leadership, ongoing research activities, a growing library and conferencing space and a plan to start the Cancer Bulletin to expand the MD Anderson’s educational mission statewide and beyond. These additions more than doubled the cancer hospital in size, with 66,597 total square feet of usable space. Yes, the layout may have appeared a bit scattered with a barracks motif, but together the facilities provided for a complete pilot plant operation. Every detail of the institution’s activities could be worked out, evaluated and incorporated into planning underway for the permanent hospital that would open in the Texas Medical Center in March 1954.

It’s important to remember that while many surgeons of the day fiercely defended their specialties from encroachment by other treatment options, Lee Clark championed a multidisciplinary approach to cancer care that would create multiple modalities of treatment beyond surgery including, for starters, radiotherapy and chemotherapy. His teams worked across departmental disciplines in the interest of improved patient outcomes. Clark also knew that a better understanding of the biology of cancer could lead to better treatment of the disease. About a third of the facilities at the Oaks focused on research activities, and clinical departments incorporated research as they were created. 

Clark maintained that those he recruited would have to have faith in him, given the temporary nature of the temporary quarters, not to mention the modest state salaries he had to offer. He had to persuade them to share his vision for a permanent facility that existed only in his mind. Together, working through the hot days of summer (rats and fleas included), recruits joined Clark on a mission to build something special that would be much more than a state cancer hospital: an international leader in cancer care with a comprehensive approach. With that in mind, Clark picked his employees carefully.

Next article: Early recruits