STRONG VITAL SIGNS

Back in 1975, when restaurants still put ashtrays on every table, the American Heart Association shifted its headquarters from New York City to Dallas. Heart disease was the number one killer across the United States and association executives felt they could better orchestrate their crusade from a central location.

But even twenty years ago and certainly by 1980 when the American College of Emergency Physicians moved down from Michigan to Las Colinas, the national medical community knew that Dallas had a lot more going for it than the convenience of DFW International airport.

No one at the Mayo Clinic, for instance, was shocked when Dallas physicians Joseph Goldstein and Michael Brown solved a key part of the heart disease puzzle. Nor were the teaching staff at Johns Hopkins surprised when Alfred Gilman, another Dallas doctor, deciphered the mechanics of certain forms of cancer.

All three men were awarded Nobel Prizes for their work. Brown and Goldstein in 1985 and Gilman just last year.

Then there’s Johann Deisenhofer, a world expert on protein structures. When the German doctor simply outgrew Europe’s top medical research center, none of his colleagues blinked when he packed up his Nobel Prize for chemistry and bought a one way ticket for UT Southwestern Medical Center.



A Deep Pool Of Talents



The big surprise is that not many people who actually live in Dallas know much about its stellar health care assets. The four Nobel laureates are simply the brightest stars in a growing family of healers, teachers, scientists and businesses dedicated to the human mind and body.

“Health care directly employs 178, 000 residents and has become the largest base industry in the Metroplex, ” according to Jacob Spies, president of the Health Industry Council of the Dallas/Fort Worth Region. “The growth has been dynamic. Only two years ago, the health sector ranked third behind defense and tourism. “

Big picture, well over 200, 000 regional workers owe their paychecks to the business of making folks better and keeping them well. Bottom line, these jobs represent $13 billion worth of local economic activity.

Some of that activity is electric. Emergency rooms may make for great TV, but the trauma centers at Parkland, Baylor, Presbyterian and Methodist Medical Center are no place for the squeamish on a Friday or Saturday night. Lifesavers at the city’s three officially sanctioned emergency facilities are among 57, 000 regional hospital workers.

Many local jobs are rooted in technology a traditional Dallas strong suit. Medical equipment manufacturers employ more than 2200 workers. One exemplary product: a machine whose pulsing electromagnetic current helps broken bones knit together more quickly.

Drug companies employ 4000 Metroplex workers. Scientists at firms like Carrington Laboratories and Cytoclonal Pharmaceutics ate true alchemists, transforming natural substances like tree bark fungus and aloe vera extracts into cures for the worst symptoms of cancer and AIDS.

World Class Healers



Everyday, 200 babies are born in the Metroplex. Every 90 seconds, somebody needs a blood transfusion. In recent years, more than 3000 organ and tissue transplants have been performed: hearts, livers, corneas, bone marrow. Transplant wizards at Methodist Medical Center made history nor too long ago for the worlds first combined heart/kidney/pancreas transplant, a process of mind boggling complexity.

Let’s face it: no place is a great place to be sick. Not even Dallas. Some real comfort does exist, however, in the excellent odds of finding qualified care in a metropolitan area with more than 7700 physicians.

Consider everyone’s worst nightmare. This year, more than one million Americans will be horrified to learn they have cancer, which stole the lives of approximately 3000 Dallas county residents in 1994. For the afflicted, it is a transcendent relief to know that North Texas is home to some of the finest cancer doctors in the world.



In April, a major agreement was announced between Texas’ two cancer fighting titans. Their plan to found the new UT South western/M. D. Anderson Cancer Center at Dallas is a milestone in the area’s history of excellence in oncology, the study of cancer and its cures.

“Our goal is to enhance the range of life saving cancer services to patients and the physicians who care for them, ” according to Dr. Charles Balch, executive vice president for health affairs at M. D. Anderson. “This agreement will ensure that patients from North Texas have access to state of the art services without having to travel great distances from their homes and families. “

Cancer care is just one field in which Metroplex doctors have world class reputations. Others include pediatrics, cardiovascular diseases, burn care, disorders of the central nervous system and brain, digestive diseases and craniofacial reconstruction.

“A member of the Saudi royal family was badly injured in an automobile accident in North Africa not too long ago, ” recounts John Meagher, director of international services at Baylor University Hospital. “After his conditioned stabilized, he was air lifted to Baylor to be treated by Dr. Robert Jackson. Dr. Jackson is our chief of orthopedics and a one of the original pioneers of arthroscopic surgery. ” In fields like neurology, a major Dallas forte, local residents have regular access to the same experts who occasionally treat foreign royalty.

A neurosurgeon at Zale Lipshy University Hospital, Dr. Hunt Batjer, recently saved the life of a Fort Worth carpenter suffering a hemorrhage from a rare form of aneurysm tucked up in the base of the brain. Finding, “clipping” and repairing an artery surrounded by sensitive nerves is a delicate, dangerous procedure few medical centers in the country are willing to attempt.

Dr. Batjer is a perfect example of the kind of healer who makes Dallas a very safe place to be sick.

A Breath Of Fresh Air



Super surgeons steal headlines, bur every specialty contributes to the well being of the Dallas family. Take something as common as allergy related diseases, which cost employers 3. 5 million lost workdays each year. There’s a serious side to all the sneezing and sniffling. In 1993, asthma killed 38 Dallas County residents. Low income inner city children are particularly vulnerable.

Parkland Hospital’s Community Oriented Primary Care physicians are currently in the midst of a family focused, bilingual asthma education program in West Dallas. In conjunction with Saldivar Health Center, Hispanic community organizations and the DISD, the doctors have identified 200 asthmatic kids between ages 6 and 12.

“When you and 1 feel the first symptoms of a headache, we take an aspirin, ” notes Dr. Rebecca Gruchalla, project manager of the program. “Children who grow up without primary’ care don’t know how to recognize the first signs of an attack. That’s why they keep ending up in the emergency room. “

Whether English or Spanish is the first language, children must be taught in ways a child can understand. Interactive role playing and game playing sessions require coordinated teams of translators, social workers, school officials and doctors. In Dr. Gruchalla’s eyes, the teamwork is paying off.

“Empowerment is kind of a cliche these days, but that’s basically what we’ve been able to achieve. The children and their parents are gaining a level of control over the disease.



Special Treatments For　Everyone



Regrams control in the lives of the injured is the goal of programs at specialized facilities like Dallas Rehabilitation Institute. DRI is well known for innovative treatments of stroke, chronic pain, amputation, brain and spinal cord injuries and other orthopedic accidents.

“Unfortunately, we get more spine and head injuries during these summer vacation months, ” says DRI respiratory therapist Sherry Morris Tomazevic. “Diving board accidents can end up resulting in paralysis and there was a movie out not too long ago that apparently got young males into “car surfing”. We’ve seen our share of car surfers end up in wheelchairs. “

Miracle stories of metroplex residents who have benefitted from the area’s healthcare resources abound. A Dallas attorney would have been a prisoner of his home without a rehab solution that included an innovative respirator. Today, He goes to his West End office each day and fights for the rights of others with disabilities. A Fort Worth woman, paralyzed from the neck down, helps manage a dairy farm with skills and confidence regained in therapy.

Dallas fitness fanatics tend to overdo it. While they would like to believe otherwise, local golf nuts, tennis freaks, white collar boxers, Turkey Trotters and Hoop It Uppers are not made of steel. Wrenched backs, blown out knees, locked up elbows and carpal tunnel syndrome are a few common complaints.

HealthSouth Rehabilitation Network operates a number of local sports medicine centers that offer weekend warriors the same recuperative strategies officially provided to members of the Texas Rangers, Dallas Freeze and LPGA. As part of a community support program, HealthSouth rehab pros also share their expertise with coaches and trainers in the athletic departments of local high schools.

Fronts To Backs



Lasers are the latest wrinkle in modern dentistry. Lasers are a painless treatment of early to intermediate stage gum disease, “explains Dr. Jim Martin. “The energy can be used with pinpoint accuracy to vaporize individual layers of tissue. There’s no bleeding, swelling or post operative discomfort. “

Dr. Martin notices a trend among health conscious Dallasites to solicit advice on diet and nutrition from their dentists.

“That’s only natural, ” he adds. “We may see a patient three or more times a year, far more frequently than they see their primary care physicians. There’s a lot of health information being distributed these days and they want us to help them interpret it. “

Technical advances in dental materials have caused a surge of interest in cosmetic and reconstructive procedures. Again, this is only natural. Dentistry, oral surgery and plastic surgery share certain common technical grounds. Students of all three professions train on sophisticated scanners that produce detailed three dimensional images and models of the inner workings of the patients head and neck.

The Craniofacial Division of the Advanced Surgical Institute at Medical City Dallas Hospital and the Division of Plastic and Reconstructive Surgery at UT Southwestern are places of high science. Ask any patient freed from the shadow of disfigurement or a birth defect like cleft palate.

The appeal of cosmetic plastic surgery to Metroplex residents continues to grow especially among middle aged men. Geoffrey Meredith, a leading American demographer, offers this tribute to die spirit of the wrinkling Boomers:

“The people turning 50 next year are the same people who listened to the Rolling Stones and got naked at Woodstock. “

The hardrocking generation is beginning to feel as well as see the first early warning signs of its mortality. The rise in cosmetic surgeries parallels an increased caseload of disabilities related to acute low back pain, a serious medical problem with direct annual costs estimated at $20 billion.

Dr. John Triano, D. C. of the Texas Back Institute in Dallas recently participated in an investigation of low back pain by the U. S. Agency for Health Care Policy and Research. Dr. Triano and his colleagues found that spinal manipulation was among the safest and most efficient methods of treating chronic health problems. ” The study confirmed the experience of the 25 million Americans who cur-rendy rely on chiropractic, ” Dr. Triano said.



A Sharpening Focus



An American turns 50 every 8 seconds. The ongoing debate on health care in America has high lighted the unique needs of an aging population, more than half of which is composed of females increasingly at risk of serious illness.

The Texas Institute for Research and Education on Aging is busy breaking down the processes our bodies pass through as they are broken down by time. An arm of The University of North Texas Health Science Center at Fort Worth, the Institute is developing service models that promote the independence and well being of the elderly.

Women’s health issues, neglected for millennia, have begun to benefit dramatically from recent neurobiological and hormonal research. Treatment parameters are constantly improving for conditions like breast cancer, osteoporosis, high blood pressure, high risk pregnancies, depression and related maladies like anorexia.

The Women’s and Newborn Services at Presbyterian Hospital of Dallas’ Margot Perot Building, for instance, is the only local facility dedicated solely to the care of women and babies. It features a state-of-the-art neonatal unit for high-risk pregnancies.

A Dallas physician, Dr. Steven E. Harms, has pioneered a technique that uses magnetic resonance imaging to identify breast rumors and leakage from silicone implants. The new MRI technique is twice as sensitive for cancer as mammography, and could replace many of the 500, 000 biopsies performed each year.

Dr. Harm’s work at Baylor is underwritten in part by a grant from the Susan G. Komen Foundation, established in Dallas in 1982. The mission of the Foundation is to eradicate breast cancer as a life-threarening disease by advancing research, education, screening and treatment. Since 1982, the Foundation has raised more than $27. 5 million and become the largest private funder of research dedicated solely to breast cancer in the U. S.

A Network That Works



The old red brick building at the corner of Oak Lawn and Maple looks abandoned to passers by caught in traffic. Once upon a time the site, called Parkland because of its beautiful trees, contained the entire Dallas hospital system. Built in 1913 after a horrible meningitis epidemic, the old structure housed 400 beds in 1940. Still the only public tax supported hospital in Dallas County, the modern Parkland complex on Harry Hines holds a mere seven percent of the 14, 000 beds in the 81 member facilities of the Dallas/Fort Worth Hospital Council.

All told, there are almost one hundred hospitals in the immediate area. A small number are strong independents like Arlington Memorial and Zale Lipshy, the areas newest facility, which opened in 1989. The vast majority are members of systems that began to develop as a result of market forces in the ’80s.

Local systems have undergone their share of changes during the merger and acquisition mania still raging across the country. John Gavras, executive director of the Dallas/Fort Worth Hospital Council, believes that Metroplex facilities have an advantage that helps them weather the storm.

“There has always been good dialogue here. When violent crime overloaded the emergency rooms in 1993, the hospitals came together and solved the problem. The same thing happened during the nursing shortage. Not many communities work together that well, bur we are used to it. “

A major benefit of hospitals to Dallas proper is the tendency of jobs and businesses to cluster around these urban facilities.

Because modern hospitals occupy sprawling campus complexes that would be too expensive to duplicate in the suburbs, the medical community is almost permanently wedded to its existing locations. The facilities provide the Metroplex core cities a measure of insurance against the worrisome trend of “hollowing out” that has characterized the past two decades.



Ongoing Investigations



In too many doctor jokes, the patient hears that there is good news and bad news. In reality, the day may come when your doctor tells you in the same breath that you have cancer and that it can be cured on the spot with a simple injection.

This good news comes from the business address of the four Nobel Prize winners, a 100 acre campus just up the road from Parkland. In the same way that Fort Knox is a symbolic cache of all the government’s gold, die University of Texas Southwestern Medical Center at Dallas is a storehouse of modern medicines intellectual bullion.



UT Southwestern is one of the worlds top research, teaching and clinical care centers. Areas of” specialization span the alphabet: Alzheimer’s disease, arthritis, bone and joint problems, burns, cancer, diabetes, heart disease, kidney disease, liver disease, neurological disorders, osteoporosis and pain management.

More than 350 doctoral level researchers are ferreting out the fundamental secrets of fields like immunology, molecular biophysics and genetic developmental biology. That may sound like dusty stuff, but the hunt is intense and the stakes are high.

Where do killer diseases come from? Why do they run in some families and not in oth-ers? If they curse your family, can the chain of vulnerability be broken? UT Southwestern researchers burn midnight oil as they delve into the Human Genome Project, a struggle to crack the chromosome code that hides every human’s vulnerability to death from disease.

Another primary mission at UT Southwestern is the training of new doctors, scientists and health care professionals. Fifty eight faculty members are listed in the 1994 edition of “The Best Doctors in America” and eleven are members of the National Academy of Sciences. These distinguished men and women are a real inspiration to more than 3000 students, residents and post doctoral fellows.

Finally. UT Southwestern is eager to share its knowledge and skills with people who desperately need both. The latest lessons from the lab are brought to the patient’s bedside through a wide range of clinical care programs.



A Healthy Competitive Spirit



In the business arena, groups like the Health Industry Council continue to build on the accumulated strengths of Metroplex doctors. And compared to a few large cities like New York, Philadelphia and Boston, there is still some room for growth.

“The difference between Dallas/Fort Worth and the three eastern seaboard cities may be a function of age, ” says the Council’s Jacob Spies.

’They are mature medical economies that attract a significant number of referral patients. In the Metroplex, we are striving to expand our referral center and position the area as a leader in the delivery of specialized health care.



Since its relocation. The American Heart Association has brought the Dallas medical community invaluable exposure through numerous events like its Scientific Sessions, the world’s largest gathering of people (about 30, 000) focused on various cardiovascular diseases and strokes. From Dallas, the association continues its lifesaving educational programs, including efforts to protect the public from environmental smoke and tobacco products.

The message seems to be sinking in. Restaurant smoking sections are continually shrinking; new Dallas eateries like Natura base their menus entirely on heart smart cuisines.

In fact, Dallas has a long tradition of honoring the spirit of healthy living, Back in 1856, when the city was originally incorporated, its first mayor was a doctor. Samuel B. Pryor, M. D., made his rounds on horseback, possibly along trails that skirt the current site of the American Heart Association headquarters on Greenville Avenue. The ghost of the frontier medicine man must rest easy knowing his hometown has done his profession proud.