Creating a new state cancer hospital

By Bryant Boutwell and Charles M. Balch

Since its beginnings in the early 1940s, The University of Texas MD Anderson Cancer Center has called Houston its home. The cancer hospital and Texas Medical Center seem a natural fit destined to be. Yet many historical twists and turns almost led the cancer hospital to be in Dallas, Galveston or Austin. It’s also interesting to note that before Dr. R. Lee Clark Jr. was named permanent director of the new enterprise, other physicians were offered the position.  

In 1941, the Texas Legislature approved House Bill 268 creating the Texas State Cancer Hospital and the Division of Cancer Research, to be operated by The University of Texas. Gov. W. Lee (Pappy) O’Daniel signed the bill on June 30 —the same day Germany was invading Russia and six months before Pearl Harbor. The bill was written by Rep. Arthur Cato of Weatherford, Texas, who had lost a father and several family members to cancer and was determined Texas needed a cancer hospital. Once his bill passed, the question of the day was where in Texas to place the new hospital. 

In early drafts, House Bill 268 had problems. It needed medical input, and Cato found the able help he needed in Galveston. Dr. John Spies, dean of The University of Texas Medical Branch at Galveston (UTMB), needed support for his legislative budget request, and Cato needed Spies’ expertise. The two joined forces, and the Texas Medical Association pitched in as well to finalize the bill that passed.

Spies was more than qualified as a physician and as an administrator with prior experience building a cancer hospital in Bombay, India. Growing up in Bonham, Texas, he cut lawns and stoked furnaces as a student at The University of Texas at Austin. His grades were so good, he was admitted to Harvard Medical School during his junior year. With his Harvard medical degree, he studied for two years in Belgium, gained surgical experience at two New York hospitals and taught at Yale’s medical school and the Peking Union Medical College in China. He was a member of the Royal College of Surgeons, the American Association for Cancer Research and more. 

Spies was much more than dean and a professor teaching preventive medicine in Galveston. He was a young, progressive change agent at a time when change was needed. Abraham Flexner’s 1910 scathing report on medical schools in the United States and Canada had sparked a revolution, using The Johns Hopkins’ University School of Medicine as the gold standard. Medical schools that did not take the combination of clinical care, research and education seriously were out, and many across the country took the Flexner recommendations seriously or closed doors. 

Yet for UTMB’s old guard, change threatened their lucrative private practices and comfortable status quo. Following Spies’ arrival in 1939, they challenged his progressive ideas including a proposed cancer clinic. Early in 1941, while engaged in an ugly fight to save his job as dean, Spies confided to Dr. Fred Elliot (dean of the Texas Dental College soon to join UT System) that he was open to the idea of putting the new cancer hospital and the dental school in Houston as a springboard for moving the UTMB campus to Houston — a line of thinking that would only fan the flames.

The turmoil in Galveston reverberated all the way to Austin. The UT System Board of Regents called for an investigation of faculty accusations against Dean Spies and sent the Texas Rangers to join the public hearings. Denton Cooley, a young UTMB first-year medical student, recalled he was so concerned about the faculty discord that he transferred to Johns Hopkins to complete his medical degree. Spies had the support of the UTMB students, the alumni, led by1911 graduate Ernst Bertner, and a number of professional organizations. In the end, it would not be enough.

In Austin, UT President Homer P. Rainey also was a progressive change agent, a new-deal liberal supportive of Spies’ ideas. Rainey was well-liked and known for his support of his faculty and academic freedom. Hoping to calm the waters in Galveston, in July 1941, he offered Spies the directorship of the new cancer hospital if he would give up the UTMB deanship. Spies surprised everyone when he chose his deanship.   

How different things may have been if he had accepted the offer. Many feel the cancer hospital would have been placed in Galveston, perhaps an arm of John Sealy Hospital. While no evidence was found for any of the faculty claims that Spies was a communist and pro-Nazi, he was fired on June 5, 1942. 

Despite the rancorous politics, we should not overlook that Spies left a legacy of promoting education and research at UTMB while significantly increasing state appropriations for the Galveston campus. Without his input, House Bill 268 might not have passed.

In Houston, John Spies’ problems were of less interest to the trustees of the M.D. Anderson Foundation than the potential of the new cancer hospital he helped create. They watched with interest but stayed clear of the fray. Monroe Anderson had died two years before the bill passed, and they had had an obligation to create “good works” with the fortune he left them to manage. 

“Mr. Anderson had some rather definite ideas as to its purpose, but nothing regarding specific activities had been put to paper,” Freeman recalled.  

Upon learning House Bill 268 had passed, the Anderson trustees moved quickly.

Late in life Col. William Bates recalled that upon learning the bill creating a state cancer hospital had passed, he asked Spies to “come up and talk to us.”

“Dr. Spies asked Dr. Homer Rainey, the University's president, to join us,” Bates said in a 1973 interview with Don Macon. “One or two Regents came to the meeting too…We met on my back porch [and] we explained to the university people that we didn’t want to induce them to locate the cancer hospital in Houston if it wasn’t the proper place [but] we thought it was. We told them the Anderson Foundation would match the legislature’s appropriations with a $500,000 grant… [and] we’d provide temporary quarters and also a permanent building site. We specified that the hospital should be named for Mr. Anderson.” 

Money speaks, and the M.D. Anderson Foundation trustees had plenty of it. A week after Spies was fired, the UT Regents approved the Anderson Foundation proposal establishing the M.D. Anderson Hospital for Cancer Research of The University of Texas, in Houston. Dr. Ernst Bertner was named interim director. Within months of Spies’ removal, Dr. Chauncey Leake, a noted pharmacologist and ethicist, was recruited from California to lead UTMB. Leake would bring peace to the Galveston campus and prove a valued friend and adviser to Bertner and the M.D. Anderson Foundation trustees in the years ahead as they conceptualized and built the Texas Medical Center. 

Ernst Bertner was a popular choice given he was a UTMB alum and a highly respected Houston physician knowledgeable for his day in cancer care who was well-versed in networking throughout the statewide medical community. It also didn’t hurt that he was a trusted adviser to the M.D. Anderson Foundation trustees and lived in the Rice Hotel down the hall from John Freeman where the trustees often met. Jesse Jones had a residence in the Rice Hotel as well and would be among Bertner’s closest friends. The task now was to find a temporary home in Houston for the temporary director of the cancer hospital to get permanently started.

As a new-deal change agent, UT President Rainey had student and faculty support but was on the wrong side of several powerful UT System Regents. In defiance, he spoke before 400 faculty members, listing 16 grievances against the UT System Board of Regents and suggesting moving the UTMB campus and the new cancer hospital to Austin to end the turmoil in Galveston. That plan, and his UT presidency, was short-lived. Despite the strong support of academics and citizens statewide, Rainey’s tenure at the helm of UT ended Nov. 1, 1946. It was filled on an interim basis (later made permanent) by a the highly accomplished and respected geneticist from the UT faculty, Theophilus S. Painter.

Col. Bates recalled finding temporary quarters for the new cancer hospital in Houston was easier than expected.  

“It so happened that Capt. James A. Baker, a prominent lawyer in Houston … had died and left his large home and 6 acres of land to Rice University,” Bates summarized in the 1973 interview with Macon. “The Rice trustees offered to sell the estate for $68,000 as I recall [so we] purchased that property at 2310 Baldwin and turned it over to The University of Texas as a temporary site for the cancer research hospital.”   

Now the trustees needed a permanent home for the cancer hospital. Bertner helped them envision the future Texas Medical Center, and the 134-acre forest behind Hermann Hospital seemed like an ideal location. Given this was potential park land, the city required a vote of the citizens. The foundation’s full-page ad appeared in local papers Dec. 13, 1943, urging readers to “Vote for the New Texas Medical Center.” The citizens of Houston did just that. 

All the while, Dr. Lee Clark was building his own surgical legacy in Jackson, Mississippi, far from these events taking place in Texas during the early 1940s. Yet they frame the backdrop for his meeting with Theophilus Painter in Austin to discuss his interest in becoming the first permanent director of the new cancer hospital. 

Next article: Knowing Ernst Bertner