By Bryant Boutwell and Charles M. Balch
When Lee Clark married Bertha Davis in 1932, she was the only woman in his medical school class in a medical world then dominated by men. She was a talented anesthesiologist who assisted him on a thousand or more surgeries. In Houston she achieved great success at Hermann Hospital while he built the cancer hospital.
In the 1940s, only about 5% of U.S. physicians were women. Clark’s mother, Leni, an accomplished music teacher, taught her seven children, daughters and sons alike, that through hard work and practice each could accomplish great things.
In Paris during the Drs. Clarks’ early training, Marie Curie, a Nobel laureate twice over, was the talk of the town. Lee Clark understood that women would play an important role in the building of a great cancer hospital. Just as he found Frances Goff to teach him the ropes working with the Texas Legislature, he would recruit talent over gender to grow his small cancer hospital into an international force.
In 2019, women accepted to U.S. medical schools outnumbered men according to the American Association of Medical Colleges, while hospital organizational charts nationwide reveal a growing number of women in key leadership positions. Lee Clark was ahead of the pack in understanding, even shaping, this trend.
So, who were some of MD Anderson’s early heroines?
In 1960, Anna Hanselman was among MD Anderson’s first retirees. Recognized for 17 years of service, most at the Oaks, she had joined Ernst Bertner at the old Baker estate to oversee the first outpatient clinic. As Clark added larger clinics and wards, Hanselman got busier. The only nurse in the beginning, she was the face of MD Anderson for patients walking in the door. Most early patients had no idea who Lee Clark was but could tell you all about the kind Miss Hanselman.
She answered questions and calmed fears, always with a smile. Those needing hospitalization were transferred to leased beds at Hermann Hospital or the Houston Negro Hospital (later renamed Riverside General Hospital), and to get there they were driven in an old blue station wagon. Often at the wheel — Miss Hanselman.
As construction of the new hospital began, Clark added a nursing department in August 1951 and hired Mary Patterson to oversee the administrative side. Patterson coordinated the transitional years as the staff expanded and temporary quarters became permanent in the new Texas Medical Center. On March 19, 1954, she coordinated the transfer of 46 patients from the Baker estate to the new hospital.
Six months later, she left for a new challenge. Clark then searched the country for a director of nursing who could grow and train a highly specialized nursing team capable of working with complex treatment regimens that increasingly included radiotherapy and chemotherapy. He found her in Missouri. Renilda Hilkemeyer (Hilke to all who knew her) arrived in September 1955. She would become a force in oncology nursing nationwide over the next three decades.
Hilke put MD Anderson on the map as an international destination for nurse training when she launched the institution’s Foreign Exchange Nurse Visitor Program. If the topic was pain management, postoperative care procedures, surgical intensive care protocols or nurse-led research, Hilke was instrumental.
During Clark’s many visits to New York’s Memorial Hospital (Memorial Sloan Kettering today) he met Eleanor J. Macdonald, an epidemiologist of the first order who had served both Massachusetts and Connecticut state cancer programs. In Connecticut she established the Connecticut Cancer Registry and Follow-up Program, the first and only complete cancer registry in existence at the time.
Having trained at the Mayo Clinic, Clark understood the importance of good data. The Mayo brothers, Will and Charlie, were meticulous about their patient data and walked into many a medical meeting with the numbers in hand to document their advances. In those early days, few hospitals kept good records on cancer. Deaths were often recorded as pneumonia to avoid the stigma. Date of initial diagnosis, tumor type, staging, treatment history — all were loosely recorded if that. You might say much of the data was apples and oranges. Tumor registries on a statewide, even nationwide scale were needed so that apples were apples and research was reliable.
Macdonald knew good data and how to work with it. Her boss in New York was retiring, so Clark’s timing couldn’t have been better. She arrived at the Oaks in September 1948 to lead MD Anderson’s new Department of Epidemiology, the hospital’s first woman-led department and a first in the nation for the field.
“Evaluate us,” Clark said, and she did just that for the next three decades. When you hear words like patient outcomes, demographics, study design, tumor registries and statistical trends, know that Macdonald was involved.
Faculty increasingly sought her for assistance as she worked closely with Clark organizing the Texas Cancer Coordinating Council and a statewide Cancer Record Registry that became the largest in the nation with more than 30 hospitals and 60,000 cases. MD Anderson became the repository for that data, overseen by Macdonald, who also found time to train over 200 medical records librarians and an army of data collectors nationwide.
Marion Wall Lowery
She grew up in North Dakota, so you can imagine her reaction to summers in Houston upon her arrival in 1949. As Clark’s executive assistant, Marion Wall Lowery oversaw the director’s office — managing personnel, correspondence, calendars, travel, meeting itineraries, reports and much more.
When her family had moved to Rochester, Minnesota, her mother noted the town had a good stenographer school. Graduation soon led her to the Mayo Clinic. Her office was often a busy operating room where she took copious notes. Her attention to detail and beautifully typed surgical reports caught Clark’s eye, and he made a mental note. His fellow surgical colleague, Randy Lovelace, also made a mental note and convinced her to join him in Europe. He was now Col. Lovelace assigned to the U.S. Air Force Aviation Medicine Laboratory in Heidelberg, Germany. With a civilian appointment, she jumped at the chance to see the world and hone her skills with military precision.
By 1949, Clark persuaded her to come to Houston.
“I remember my first visit to the Baker estate,” Lowery recalled in a 2001 interview with MD Anderson’s Leslie Brunet. “It was a beehive of activity with carpenters and construction. Dr. Clark was walking across the grounds with blueprints and several men in tow.”
After a quick tour, Clark put Lowery to work. She officed next to Clark and kept his staff organized and efficient for the next 28 years.
“Dr. Clark had such charm and persuasiveness and always a clear vision of what was next,” Lowery told Brunet. “James Anderson [nephew of Monroe Anderson] was a frequent visitor in Dr. Clark’s office and was such a nice man.”
In 1957, Clark named Anderson the first president of the institution’s new Board of Visitors. More on that to come.
“I remember looking for somewhere to live when I arrived, and Eleanor Macdonald said she had an apartment she would share until I found my own,” Lowery recalled. “We were such a small family then and so close. I remember having dinner with the Clarks at their home (1909 Sharp Place near River Oaks) in those early years. His wife, Dr. Davis, had a wonderful sense of humor and minced no words with her opinions. Dr. Clark always liked that about her.”
In later years Lowery received the MD Distinguished Service Award for her “loyalty, enthusiasm, efficiency, accuracy and uncommonly good judgment.” She and her husband moved to Nacogdoches in East Texas after retirement, and in 1999, she returned to live her final years in The Woodlands, about 30 miles north of Houston. Her death in 2017 was a great loss, as her institutional memory was an invaluable resource reaching back to those early days when air conditioning was in short supply and all MD Anderson employees could gather in one room.
Lee Clark understood that great medical institutions don’t just drop into communities. They must become a part of the community and grow with the community. In the late 1940s, some 12% of MD Anderson patients outright refused treatment for a variety of reasons including fear. Community outreach and reducing treatment refusal was high on Clark’s list in 1947 as he hired Edna Wagner to direct a new Department of Medical Social Services. In a day of Jim Crow laws, she and Dr. Clark had to find creative solutions around color and race barriers because this was a cancer hospital for all Texans.
Wagner worked with churches and gatekeepers in Houston’s black and Hispanic communities, lining up living accommodations for patients’ family members. MD Anderson’s Holman Street Annex opened in December 1950 with accommodations for 16 patients and family members, as another segment will tell. Wagner also collaborated with Hispanic community gatekeepers to open another annex named La Posada at 2702 Helena St. offering special accommodations for patients and their families.
Word of mouth in Houston was that MD Anderson was an involved and caring member of the community and not just any another hospital. Nurse Hanselman and her staff at the Oaks got busier as trust was built and more people came, regardless of race or nationality, for evaluation and care.
Wagner’s early efforts as Jim Crow laws faded like a bad memory speak to Clark’s insistence that every cancer patient matters and that compassionate care involves the entire family. Over the years, Wagner and her staff developed innovative patient education programs (families included) as well as social services training programs for MD Anderson employees and medical professionals throughout the community. She also added training programs for the next generation of medical social workers working on advanced university degrees.
Heroines of the early cancer hospital included physicians as well. Dr. Elsie McPeak, for example, was the institution’s first full-time pathologist. She followed Dr. Violet Keiller, who served on a part-time basis.
Dr. Marga Sinclair arrived in 1951 to head the plastic surgery service. An outstanding surgeon and pioneer as a plastic surgeon, she worked closely with the Department of Head and Neck Surgery to reconstruct disfigurements to restore patients’ dignity and enable them to live a more normal life after cancer.
These are but a few of the heroines of early MD Anderson. They were talented and devoted and should never be forgotten.
As Marion Lowery noted, Lee Clark always had a plan for what was next. His perspective was national, not local — an approach he fine-tuned through participation and leadership in numerous professional organizations.
Next article: Clark and professionalism