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In 1890, Dallas was a growing center of commerce for North Texas. The population had gone from roughly 400 people in 1850 to nearly 38,000. The city was thriving, but its potential as a leading American city was far from understood.

The medical care offered in Dallas was primitive. Science-based medicine was in its infancy. Dallas doctors had not yet accepted the germ theory of disease. Surgical hygiene and the sterilization of medical instruments were virtually nonexistent.

The average life expectancy was just 47 years. Infections such as pneumonia, diarrhea, influenza and tuberculosis were leading causes of death. Yellow fever, scarlet fever and dengue fever were common.

Patients with contagious diseases were isolated, often along with their families, in “pest houses” where they remained quarantined without care until they died or it could be shown they no longer had the illness.

While qualified and notable doctors were practicing medicine in Dallas at the time, many more were poorly trained. Most received only basic training from small medical schools, which required only one to two years of study following three years of high school.  

Fake medical licenses were common. An MD degree could be conferred by return postage in exchange for a letter of intent and a fee of fifteen dollars. In fact, a stranger could come to town, say he was a doctor, register with a health officer and be allowed to practice medicine.  

The majority of births and medical care – even surgeries – took place in the patient’s home. Surgeries were performed without the benefit of anesthesia.  

There were a few private, for-profit hospitals operated by doctors and one small, public City Hospital, which by most accounts was unsanitary, poorly equipped and “in every way unqualified for use as a hospital.” 

Against this background in 1890, a young man named Edward Cary came to Dallas at the age of eighteen. He quickly fell in love with the city — its busy streets, imposing houses and warm friendly people. Cary had come to work at his older brother’s dental, medical and hospital supply business, where he soon gained confidence as a salesman. 

But Edward Cary had dreams of becoming a doctor. 

During business trips, he saw medical schools in Oklahoma, Texas and Louisiana, but he was determined to attend Bellevue Hospital Medical College in New York (now the NYU School of Medicine), at the time considered the finest medical school in the country. 

In May 1894, a new 100-bed hospital opened on a 17-acre, wooded site, which lay just outside the Dallas city limits at Oak Lawn and Maple avenues. It became the new “City Hospital,” and immediately and dramatically improved the quality of public hospital care in Dallas. It was named Parkland because it was built on land originally purchased for a city park. 

Cary left for New York in 1895. Bellevue’s department of ophthalmology had an outstanding reputation, and the medical specialty immediately attracted him. After graduating in 1898, he interned at the Eye Infirmary at Bellevue (famous at the time) where he was properly fitted with glasses that corrected a troubling eye condition, something he had suffered from all his life. 

In Dallas, the Daughters of Charity of St. Vincent de Paul, a Society of Apostolic Life for women within the Catholic Church, honored an urgent request of area businessmen and physicians who determined that the rapidly growing city was in need of additional hospital facilities. 

On June 15, 1898, the Daughters of Charity opened a 110-bed hospital, called the St. Paul Sanitarium (later renamed St. Paul Hospital in 1927). It was staffed by nine sisters and featured spacious wards, large private rooms and well-lit operating rooms equipped with fine surgical instruments. Like Parkland, its facilities were open to the public and Dallas physicians. 

Dallas’ first general medical school resulted from a call issued by Mayor Ben E. Cabell to bring the city’s “reputable” physicians together. 

The meeting quickly turned into one of harsh disagreements. Only 15 of the 55 physicians in attendance were in favor of forming a new medical school. 

The doctors who opposed it argued that there were already too many medical colleges in the country, that Dallas was not large enough to support such a college and that Dallas physicians were not capable of instructing medical students. 

Dr. Charles Rosser, who led the effort for the new school, answered, “May the Lord have mercy upon a sick man who must have at his bedside a doctor who cannot teach a student how to study.” 

On September 15, 1900, the new school filed for a charter with the Texas secretary of state as The University of Dallas Medical Department (even though there was not a University of Dallas at the time). On November 19, it opened in an abandoned synagogue across the street from what is now the Adolphus Hotel. 

The medical school was open only two months when infighting occurred — an echo of earlier disagreements — and Dr. Rosser emerged as dean. 

In 1900, the principal method of medical school education was by lecture. Dissection was rare. The only cadavers available were unclaimed bodies “snatched on the sly” before (or sometimes immediately after) burial in a pauper’s grave. 

But perhaps the largest obstacle in producing qualified physicians was the lack of a teaching hospital in which medical students could receive training. After considering the school’s request, Dallas municipal authorities agreed to allow the new medical school students to attend to patients at Parkland Hospital.  

Three times a week, they would travel by wagon across town for clinical practice and observation. 

The medical school’s first year was a modest success, primarily attracting transfer students from a medical school in Fort Worth and a few “doctors” who had previously been practicing in Dallas without a diploma. At graduation, 19 students received their diplomas. 

In 1901, Dr. Cary was making plans to settle in New York, considering an offer of professorship from the Polyclinic, a prestigious postgraduate medical school, when his life took an unexpected turn. His brother, Albert, had died, leaving their mother without someone to care for her in Dallas. So Cary returned to comfort her and settle his older brother’s affairs. 

Uncertain of how long he would need to stay, Cary established what he believed would be a temporary ophthalmology and otolaryngology practice. In no time, the ophthalmology side of his practice flourished — as the city had almost no qualified specialists. 

Dr. Rosser soon learned of Cary’s skill and successful practice, and asked him to teach at the new medical college. Dr. Cary was made professor of ophthalmology and otolaryngology. Six months after serving in the volunteer faculty, he was named dean. 

Dr. Cary proved himself to be a dynamic, energetic and tough leader. He divided the 120 students into four classes and quickly pruned less qualified students by imposing strict academic standards. At the end of his first year, The University of Dallas Medical Department awarded diplomas to 15 men. But by 1903, just four graduates received diplomas as Dr. Cary was determined to hold the school to the highest standards of medical education. 

Later that year, during an American Medical Association (AMA) convention in New Orleans, Dr. Cary listened as the AMA president predicted that within five years, no medical school without university affiliation could survive. 

Dr. Cary contacted Baylor University in Waco, and three weeks later the medical school had an affiliation contract with the university. In return, the medical school donated its property to Baylor. The school was reorganized, and Dr. Cary became dean of what was now Baylor College of Medicine. 

In 1905, the AMA Council on Medical Education was founded and began inspecting and grading U.S. medical schools. It quickly discovered most schools were so bad that it was reluctant to publish results. This prompted the Carnegie Foundation to conduct an independent investigation, which was led by Abraham Flexner. 

The “Flexner Report” was released in 1910. Flexner praised quality medical schools but reported “scandalous conditions” in inferior ones. 

Four medical schools were evaluated in Texas — two in Dallas, one in Fort Worth and one in Galveston. Only The University of Texas Medical Branch at Galveston was given high marks. 

The report emphasized that those schools “…whose total annual resources are below $10,000… [ have] so small a sum that the endeavor to do anything substantial… is futile.” At the time, Baylor College of Medicine’s annual income was $7,735 — all of it from tuition. 

Inadequate financing and a lack of philanthropic support would continue to plague the school. The faculty was often in turmoil, and medical research, because of the expense, was rare. That same year, the AMA Council lowered the school’s ranking to “B” — meaning it was no longer fully accredited. (It regained its “A” rating in 1916.) 

On March 18, 1913, the cornerstone for a new Parkland Hospital was laid on the same grounds as the original Parkland, and a gleaming brick building opened on February 1, 1914. 

It was the first brick hospital building to be built in the state and immediately became the most modern medical facility in the region. The renewed Parkland had an overwhelmingly positive effect on the quality and availability of medical care, and the hospital became a symbol of pride and hope for the future. 

In 1916, Cary organized the Greater Medical Center campaign of Dallas, which raised $500,000. He announced his goal was to make Dallas one of the seven great medical centers of the United States. 

On April 16, 1917, President Wilson declared war on Germany. As a result, doctors across the country were rapidly mobilized. At Baylor, a military hospital unit was quickly assembled and sent overseas. Dr. Cary, who was also president of the Texas Medical 

Association (TMA) at the time, wanted to volunteer, but President Samuel Palmer Brooks at Baylor University in Waco convinced him he was needed more at home. Dr. Cary took over responsibility for the organizing and training of the Baylor Medical Surgical Unit. 

After WWI, the school’s clinical facilities were reorganized and the Texas Baptist Memorial Sanitarium became designated as its official teaching hospital. (The name was changed to Baylor Hospital in 1920 and to Baylor University Hospital in 1936.) Only medical school faculty and members of the sanitarium staff were permitted to practice there. 

While it continued to struggle, Baylor College of Medicine still fared better than other schools in the area. By 1918, it was the sole surviving medical school in North Texas. 

But the money needed to improve and expand the school remained a critical and unsolved issue. After years of struggle, personal investment and hard work, Dr. Cary stepped down as dean in 1920 to devote more time to his medical practice and pursue a bold, new business idea. 

By 1923, Dr. Cary had completed the first skyscraper in Dallas, the 18-story Medical Arts Building. The building was a revolutionary concept, containing over 300 physician’s offices, complete with a small hospital and operating rooms. The building received national publicity. 

As a result, Dr. Cary became a man of substantial financial means and acclaim. 

In 1932, Dr. Cary’s charisma, reputation and national visibility led him to election as President of the American Medical Association (AMA). While president, Dr. Cary traveled 100,000 miles across the U.S. gaining critical insights into the state of medical education in America, as well as seeing the financial challenges facing other medical institutions firsthand. 

By 1938, Baylor College of Medicine was in dire financial straits. There was little research conducted, instruction was primarily in the form of lectures and the school was again in danger of losing its Class “A” academic rating. 

Dr. Cary, however, was now more than ever dreaming about “a truly great Southwestern Medical Center,” which he knew could only develop through sustained philanthropic support. 

One last, bold attempt to raise $5 million to support medical research was launched, but the endowment failed to materialize, in large part because the country’s attention was being drawn to the escalating war in Europe. 

Elsewhere, Dr. Cary watched the continued growth of medical centers with strong philanthropic support, such as Johns Hopkins, the Cornell Center, Northwestern and the Mayo Foundation, that set new standards of excellence. 

The thought “Why not a great medical center in Dallas?” became firmly planted in his mind. After years of experience in nearly every facet of medical education and stepping onto the national stage to lead the discussion in key issues facing the growing healthcare industry, 

Dr. Cary was fully aware of the many challenges that such an effort would entail. 

At the turn of the century, a young doctor made an unexpected return to Dallas from New York, to set up a temporary medical practice. Nearly 40 years later, that same man, now an elder statesman of American medicine, would find the philanthropic and business leaders of the city he’d fallen in love with so many years before eager to help him turn his dream into a reality.