Parkland Hospital: A Dallas Icon the History

Parkland Hospital: A Dallas Icon

The history of the City of Dallas would hardly be complete without consideration of Parkland Hospital and its contributions to the Dallas community. Parkland Hospital began in the Civil War Reconstruction era and has always maintained operations that were state of the art for the time. Parkland hospital has always aligned itself research and the academic community and it is for this reason that Parkland has always offered the latest in techniques and technology. Parkland Hospital has a long tradition of caring for the poor and those who cannot otherwise care for themselves. The following research will highlight the major accomplishments of the hospital from its primitive beginnings to its present position as a leader in patient care and technology Seven years after the end of the Civil War; Dallas became a thriving city. In 1885 the Dallas Morning News began publication, at that time the hospital consisted of a two room hospital and county poor farm.1 Since 1872, the city had employed a physician to give medical attention to prisoners at the county jail.2 This first hospital was rudimentary and resembled a military encampment consisting of wooden buildings arranged in a circular fashion. The conditions were primitive. However, one must remember that at that time there were many places still not served by physicians, let alone a hospital. Much of the medical knowledge at the time sprang from the care of soldiers during the Civil War. The first Dallas hospital resembled a Civil War field hospital and lacked even the basic necessities, such as running water. This is the atmosphere from which the first Dallas hospital sprang. For its time, it was the best medicine had to offer.

The Dallas newspaper urged the citizens of Dallas to donate food to the city hospital in 1888. It needed to feed the patients at this facility and had little means to accomplish this. By that time the hospital was divided into wards and was state of the art for its time. The city government was its chief source of funding at the time. It urged the citizens of Dallas to donate and help those needy citizens convalescing in the hospital.3 This started Parkland's long history of providing services for the needy, a philosophy that it is still proud of today.

The Dallas Daily Times reported that in 1889, the city council had recommended a new location for the city hospital or at least an addition to the new one.4 It was clear that the needs of the community had outpaced the ability of the facility to provideservices. This was only the first of one of many growing pains for Parkland Hospital. It had to grow as the community grew and this was not always easy with the funds available. In 1889 the Dallas Daily Times championed the cause and asked the citizens of Dallas to donate for the building of a new hospital.5 The community responded with enthusiasm and the first formal building was started.

In April of 1890 the new hospital building was located on South Lamar Street.6

The Health inspector reported the facility of be in "good average condition, clean and comfortable."7 At that time, the hospital had 50 beds, and had treated 599 patients in 1889. The hospital had trouble keeping pace with the growth of the Dallas area, which was attracting a growing number of trades and businesses. Dallas was becoming one of the largest cities in the west. In the 1890 report the health inspector recommended that the hospital had outgrown its capacity and recommended that plans be made to build a new building.

In April of 1890, the inspector reported that a small cottage had been built of the Physician to occupy in case of a smallpox epidemic. The inspector noted that the hospital did not yet have a well and had to travel to obtain water. This was a primary concern for sanitation, however, was a common situation at that time. A well was considered a luxury to many, but for sanitation reasons was necessary for the running of a hospital. He generously recommended salary increases for all employees.8

In November of 1890, Dr. W.R. Wilson, city health officer, approached council for $75,000.00 to be used to build a new modern hospital.9 This new proposal was a new concept in hospital management. Instead of being entirely supported by the city, the new hospital would produce its own revenue to cover operating expenses. This was an innovative idea and led to the establishment of one of the first private hospitals in the nation. The hospital would have apartments to rent to patients for their use when physicians recommended that they stay for treatment. The apartments would offer patients personal attention form physicians and nurses.10 The old hospital would be maintained and reserved for emergency cases. The old hospital would also have a dispensary (pharmacy) where the poor could obtain free medicines.11 Dr. Wilson proposed that if the city could not raise sufficient funds to build the hospital, then a tax levy should be proposed to fund it.12

Parkland Hospital still wished to maintain its services to the poor. However, the reality was that operating in this manner would not allow them to provide the best service possible. This new financing idea gave the wealthy an alternative to the wards where many patients were housed and cared for in assembly line fashion. It benefited those who could afford it as well as providing an income that allowed the hospital to become self-supporting.

By April of 1892, the population of Dallas had grown to 45,000 people. Once again the needs of the community outpaced the abilities of the hospital at an alarming rate. The hospital struggled to provide adequate services, but found itself unable to provide even the minimal services in many cases. In 1991, the hospital treated 506 patients. The health inspector noted that the hospital had a low mortality rate. However, it is now grossly inadequate for the size of population that it serves.13

In 1892, Edward Cary began the department of academic opthamology in Dallas. In 1902, the department officially opened under his direction.14 In 1939 Dr. Cary began the Southwestern Medical Foundation to promote medical education. In 1943, the department lost funding and moved to Houston. Dr. Cary remained at Southwestern Medical College and in 1949, Southwestern Medical Collage became part of the University of Texas. Dr. Cary participated in many community and philanthropic activities and stands one of Dallas' greatest community leaders.15

The opthamology department has been the driving force behind many achievements in modern opthamology, including a glaucoma diagnostic and treatment clinic. Currently the Opthamology department is listed as one of the top ten in the Nation and as a result received funding from the National Institute of Health (NIH) to continue its research efforts.16 Members of the team are recognized leaders in many areas including "corneal transplantation, contact lens-borne diseases, corneal wound healing, blepharitis, ocular tumor immunology, regulation of ocular inflammation, the genetic basis of retinal diseases, cause and treatment of age-related macular degeneration, and biochemistry of the meibomian glands."17 Research and treatment at this facility will continue to make it a world-class facility in the are of Opthamology. The Opthamology depart is on eof the oldest at the hospital and has been a driving force of he institution.

By 1894, overcrowding had caused conditions at the old hospital to become highly unacceptable. They lacked a surgical ward, and were located in a part of the city that was now near a freight yard.18

Conditions at the hospital had become unsanitary. The Times Herald brought the issue to the attention of the people and petitioned for the funding of a new hospital. The people complied once again and by 1894, the new building had been completed. It was located at Maple and Oaklawn. The building could hold 22 patients and was two stories high. The new hospital was divided into male wards, female wards, maternity wards, children's wards and a surgical ward.19 The new hospital had a separate ward for colored patients. It had electric lights, an artesian well, a dead house, a well pump ran by a generator. The first ambulance was purchased in 1894. 20

The second story of the hospital was reserved for wealthy patients where they could receive personal care from doctors and nurses.

This was the first version of a modern hospital room. The person would receive food, medicine, and a private physician. The rates were from $7 to $12 per week. The patient would pay $2.50 per day of the room, $2 a day for nurse, $1 for medicine, and $2.50 at the lowest, for a physician, making a sum total of $8 a day.21

The meningitis epidemic of 1911 closed schools, churches, and theaters. This epidemic emphasized the need for a newer, more modern hospital. In 1912, a new building was built in back of the old building. The old building was to be torn down.23 By 1913 the first brick building of the Parkland system was built.24 In 1914, the hospital opened a school of nursing. In 1914 Parkland hospital served 9,405 patients and performed 74,042 clinical treatments. There were other units added in 1922 and 1930.25 This hospital consisted of a group of wooden buildings laid out in the plan of a military encampment. This plan was efficient and allowed the ability of house patients in different wards. For instance, contagious patients could be kept separated from newborns in the maternity ward. In 1934 funds were approved for expansion of existing facilities.26 By 1935, thee hospital had grown considerably. It now consisted of four separate facilities. One was for needy invalids and one was for contagious diseases such as tuberculosis. The hospital now contains a clinical laboratory, operating rooms, a maternity department and an electro-therapy department. 27

In 1948, Dr. M.T. Jenkins started the department of Anesthesiology at the University of Texas Southwestern Medical Center. Dr. Jenkins was the recipient of several distinguished service awards.28 Parkland hospital had one of the first anesthesiology departments in the nation and was a leader in its field.

In 1954, once again responding to the needs of an ever-growing population. Parkland Hospital moved to the current site at Harry Hines. The old building at Maple and Oaklawn has since been used for a variety of purposes including housing the Dallas County correctional facility 29

On April 2, 1957, Dallas was devastated by a tornado. The tornado cut a 16-mile swath through downtown Dallas. The tornado left Parkland Hospital untouched, but the hospital saw 175 patients in two hours that day 30 The tornado left 10 dead, 200 injured, and did $4 million in damage 30 Coincidentally, Parkland hospital had practiced a mock disaster drill only a few days before the tornado hit. The path of the tornado headed toward the hospital and then apparently veered North and missed the facility. 31 It might be noted that actual death and injury reports vary from 10-20 deaths and 175-200 injured depending on the news source.

Parkland Hospital is accustomed to being the recipient of media attention. Most of the time the news has historically centered on new medical breakthroughs or innovations in the medical industry. However, in November of 1963, Parkland Hospital would once again be in the news, only this time it would be one of the saddest occasions in our nation's history. On November 22, 1963, First Wife Jacquelyn Kennedy accompanied her husband on a 10-mile motorcade through streets of Dallas. At 12:30 PM as the motorcade passed in from of he Texas School Book Depository Building, Lee Harvey Oswald supposedly fired three shots from the sixth floor of the building. President Kennedy was hit in the head and Governor John Connally, who was accompanying him, was also injured. They were rushed to Parkland Hospital where doctors furiously attempted to save the life of the 35th President of the United States. However, despite their best efforts, the President died 30 minutes after his arrival 32.

The statements of the doctors at Parkland hospital who attended the President became key to the conviction of Lee Harvey Oswald. The most widely quoted source is a book written by Gerald Posner, 33 who supposedly interviewed the doctors who attended Kennedy. Posner's work has recently come under heavy criticism and doubt as several Parkland Doctors came out to dispute that the actual contents of Posner's book reflect what they actually saw or what they actually originally said.34 Posner's statements were obtained long after the incident occurred. 35 The statements contained in Posner conflict with earlier statements made by doctors at an earlier time. Many believe that the earliest statements would be more reliable as the doctors did not have time to consider the implications of what they were about to say.

Several Doctors have eluded that they may have changed their statements due to a fear of negative consequences to their careers if they spoke out against the Warren Commission. One example is contained in the following, found in Kent,36. In an interview with Dr. Charles Baxter, which Posner supposedly conducted on March 12, 1992, Dr. Baxter made the following statement, "I never even saw the back of his head. The wound was on the right side, not the back." However in the original report, Dr. Baxter said "The right temporal and occipital bones were missing and the brain was lying on the table." 37. There are other such examples of the Doctors who originally worked on President Kennedy, who changed their original stories according to the Posner Report. This places Parkland Hospital in the center of the controversy once again. The question now is, did the doctors lie, or is the Posner report incorrect? If Parkland doctors did change their statements, why would they do this and risk their professional credibility?

There are many who contend that the information given by the doctors was influenced by publicity and that they were coerced into making the statements. There are some who say that Lee Harvey Oswald is innocent and that the statements by the doctors are important in proving that the bullet could not have come from the direction where Oswald was standing. The testimonies of the doctors are an important clue in this argument. They were in a stressful situation and had only seconds to make decisions. We may never know the answers to some of the questions regarding these tense moments in our nation's history. The day when Parkland Hospital lost the President of the United States was a grim day in the hospital's history.

In 1970, Parkland hospital added a state of the art Nephrology department to assist patients who needed hemodialysis to keep them alive during kidney failure38 This department soon gained an excellent reputation and still stands as one of the leading facilities in the nation.39 The nephrology department has worked closely with Southwestern School of Medicine and has resulted in many improved techniques that have saved many lives.

In 1998 a meticulous restoration project began on the face of the original Parkland Hospital Building at Maple and Oaklawn.40 After renovation the building will once again be used as a part of the Parkland Hospital System, housing the new Health Services Center, the focus of the new facility will be to provide public educational services. 41

The Maple and Oaklawn building are Dallas Historical landmarks and will once again serve the needs of the community that built them. As the community once gave them life, they will once again give the community life.

In 1992, Parkland hospital became the object of yet another controversy. The controversy this time was whether to allow McDonalds to build a restaurant inside the hospital. 42 The mains issue was that the contract was not awarded to the most qualified bidder and that the selection committee seemed to show favoritism in its choice. This issue is still debated and has yet to reach a resolution.

Parkland is a private hospital, whose mission differs from that of its only major competitor, the County Hospital. The County Hospital admitted 34,000 patients in 1989, while Parkland admitted 40,000. 43 Half of these patients were uninsured at both facilities. Parkland continues to hold to the principles of philanthropy in offering serviced to the needy. There are some who criticize its intention recently however, and contend that it only caters to the wealthy.

Parkland offers a very different atmosphere than County. County is noted for dark halls, where patients are placed in large ward separated by curtains. In Abraham 44 we find a statement by Jack Salmon, a professor of health administration at the University of Illinois,

I've been in a lot of health organizations in the past 20 years, and Parkland was very impressive to me, the feeling you got in clinical areas, how people smiled, how they talked to each other, was very good. It's that energy that makes a healing organization" 45.

However, this was not always the case. Prior to the 1970s all hospitals in Dallas were primarily in the same state. In the 1970s Parkland found itself in a dilapidated state and financial tutmoil.46 The financial crisis became severe and something had to be done. In 1978, a campaign was begun to turn the ailing hospital around. They hired an influential businessman named Anderson as the new hospital administrator. 47 Anderson had no political aspirations and began to pump money into improvements. His key accomplishment has been the completion of a 10-year, $80 million rehabilitation and expansion project 48 Parkland has emerged from the bad times, and has once again become a world-class state of the art facility.

The end of the road has not been reached for Parkland and Anderson now has plans to build a de-centralized system of primary care clinics to serve the local communities.49 The project is expected to be completed in 2008. Parkland retains its commitment to academics and the advancement of the medical field thorough its affiliation with Texas Southwestern Medical School. The faculty, and the residents they teach, comprises all of the hospital's staff. 50