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The Surgical Legacy of Randolph Lee Clark, Jr, MD: First Director and Surgeon-in-Chief of University of Texas MD Anderson Cancer Center II. Surgical Practice and Leadership at University of Texas MD Anderson Cancer Center (1946–1978)

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Abstract

Dr. R. Lee Clark Jr brought a broad-based cancer surgery experience to MD Anderson Hospital for Cancer Research when he became its first Surgeon-in-Chief and full-time salaried physician in 1946. He performed major surgery until 1971 including major head and neck operations, thyroidectomy, mastectomy, radical melanoma and sarcoma surgery, gastric and abdominal-perineal resection, and even hemipelvectomy. He initiated major programs in radiation therapy and mammography breast screening, and organized teams of specialists in a group practice providing multidisciplinary cancer care. Dr. Clark was elected into membership by the James Ewing Society (currently the Society of Surgical Oncology), the Southern Surgical Association, and the American Surgical Association, and was a founding member of the Society of Head and Neck Surgery. The Society of Surgical Oncology honored him with the Lucy Wortham James Award in 1965 and the James Ewing Lecture Award in 1977. Dr. Clark also provided invaluable leadership in the American College of Surgeons, leading a fledgling Committee on Cancer into a robust organization that became the Commission on Cancer. The College of Surgeons honored him with their Distinguished Service Award in 1969. Dr. Clark recruited major surgical leaders and personally designed the new hospital that opened in 1954, described in Time magazine as “the most modern, most ingeniously designed hospital in the U.S.” R. Lee Clark, Jr. was an accomplished and busy clinical surgeon, a visionary and charismatic leader, and an organizational genius. Indeed, he was one of the first pioneers in the specialty of surgical oncology.

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Notes

  1. Dr. Clark’s title was changed to President and Surgeon-in-Chief in 1968.

  2. Alando J. Ballantyne, MD, was the first salaried physician hired by Dr. Clark as a surgical resident. He went for further training at the Mayo Clinic and then returned to the MD Anderson surgical staff in the Head and Neck Department in 1952, at the same time that Dr. William MacComb was recruited from Memorial Hospital to become Chief of Head and Neck Surgery.7 Dr. Ballantyne served on the surgery faculty until he retired in 1994.

  3. Dr. Ernst Bertner was the Acting Director of the MD Anderson Hospital for Cancer Research from 1942 to 1946 (Fig. 3). He also was Professor and Founding Chair of the Department of Gynecology for the Baylor College of Medicine from 1943 to 1950. In addition, he served as Chief of Staff at Hermann Hospital (1935), President of the Texas Surgical Society (1935), and the Texas State Medical Association (1939). In 1946, he became the first President of the Texas Medical Center (Fig. 3b). Dr. Clark operated on him twice, and Dr. Oschner removed a pulmonary metastasis. Despite these efforts, he died of metastatic sarcoma in 1950.

  4. Karl Kamrath, a student of Frank Lloyd Wright, was strongly influenced by Wright’s concept of organic architecture throughout his five-decade career. The buildings of MacKie and Kamrath reflected the modernism style and character of Frank Lloyd Wright, and their firm was one of the first Houston firms credited with creating modern architecture. Their buildings displayed a predilection for horizontal alignment, dramatic structural engineering, and finely executed material and ornamental detailing.25

  5. Dr. I. S. Ravdin, Chair of the ACS Board of Regents, wrote a highly critical letter on 6 July 1960, concluding that “a great many people now feel that we are not interested in our cancer program. I think if we really don’t do something about the program, we are going to get into serious trouble, and I think you really ought to start something that is vigorous and vital.”38

  6. This was a testament to Dr. Clark’s organizational leadership nationally by greatly expanding the scope of the Committee on Cancer into a Commission staffed by the College of Surgeons, with the staff including liaison members from the Colleges of Physicians, Radiology, and Pathology, as well as members from the American Cancer Society, American Hospital Association, American Medical Association, and National Cancer Institute, and others.37 The Commission on Cancer currently comprises 56 organizations including those representing medical specialties, government agencies (research and education), cancer registries, allied health, patient advocacy, and support groups.

  7. The Distinguished Service Award was established by the ACS Board of Regents in 1957. The award is given to a Fellow who has provided outstanding service and has been a distinguished contributor to the College. In addition to Dr. Clark, other awardees include Allen O. Whipple, William Altemeier, Seymour Schwartz, Claude Organ, and Murray Brennan.

  8. At the Society of Surgical Oncology meeting on 3 April 1978, Dr. Clark explained his cancelation from giving the Ewing Lecture in the previous year: “Thank you for an honor which I revere as no other honor that I have received, that you conferred last year, and it was most welcome because it made me think that you really thought I was going to make it when Denton [Cooley] was giving me my coronary bypass, which prevented me from being here at that time.”49

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Acknowledgments

Many thanks for providing the historical documents used in this manuscript to Ms. Sandra Yates and Philip Montgomery at the McGovern Medical History Library of the Texas Medical Center; to Jose Javier Garza, Senior Librarian for the Historical Resources Section, UT MD Anderson Research Medical Library; to Drs. Edward Copeland, Walter Lawrence, Raphael Pollock, Kelly McMasters, and Mr. Bryant Boutwell for their editorial suggestions and historical perspective; and especially to Ms. Deborah Whippen and Ms. Krista Manning for valuable editorial assistance.

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  1. Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Charles M. Balch MD, FACS, FASCO

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Correspondence to Charles M. Balch MD, FACS, FASCO.

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Balch, C.M. The Surgical Legacy of Randolph Lee Clark, Jr, MD: First Director and Surgeon-in-Chief of University of Texas MD Anderson Cancer Center II. Surgical Practice and Leadership at University of Texas MD Anderson Cancer Center (1946–1978). Ann Surg Oncol 28, 4794–4804 (2021). https://doi.org/10.1245/s10434-020-09514-2

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