We are our history: Baylor University Medical Center and Black physicians in Dallas

Abstract

The Texas Baptist Memorial Sanatorium, the hospital that later became known as Baylor University Medical Center, dates back to 1904. With this long-lived history comes the truths that affected all hospitals during the Jim Crow era: segregation and inequality. This paper attempts to place Baylor University Medical Center, which aimed (and continues to aim) to be a “great humanitarian hospital,” in its historical context. Understanding this history may help explain and combat the inequities we continue to see in health care today.

“History is not the past. It is the present. We carry our history with us. We are our history.”—James Baldwin

What would you do with an extra 16½ years of life? How would you live differently if you knew you’d die 16½ years before you had hoped? These are not just thought experiments; these are questions at the heart of the harsh reality of the discrepancy in life expectancy between one of Dallas’s richest and Whitest zip codes, 75205, and one of Dallas’s poorest and Blackest zip codes, 75215—both zip codes served by Baylor University Medical Center (BUMC).

How did we get here? The answers are too many to count, and the locus of control is often presumed to lie wholly outside of the house of medicine. However, this is a false narrative. In fact, organized medicine played a large role in the segregation of access to medical care for the African American population. The history of BUMC is inextricably tied to this story.

LAYING THE GROUNDWORK FOR BAYLOR UNIVERSITY MEDICAL CENTER

Dr. Charles Rosser, son of a Confederate preacher, came to Texas from Georgia as a child and began his medical practice in Dallas in 1889.¹ In 1900, at the age of 38, he single-handedly led an effort to open the first medical school in Dallas, against the will of a larger number of local physicians.² He dubbed the school, which would go on to become Baylor College of Medicine, the University of Dallas Medical Department, despite there being no associated university at the time. Dr. Rosser reportedly chose to call it a university so that it would be held in higher esteem.

A medical school requires patients for teaching, and, given the local opposition to the school itself, Rosser proceeded with opening his own private hospital where his medical students could be trained. This “hospital” was in fact a two-story brick mansion once owned by Captain William H. Gaston, the man for whom Gaston Avenue is named, and opened in 1901 under the name of Good Samaritan Hospital.¹

It quickly became apparent that the medical school would require a larger clinical facility for teaching. In 1903, Dr. Adolf Lorenz, the famous “bloodless surgeon of Vienna,” gave a week-long clinic at the Good Samaritan Hospital, drawing patients, medical students, and physicians from far and wide. At the end of this week, a banquet and reception was held for Dr. Lorenz, which brought together leading citizens from Dallas and kindled interest in the growing medical school and hospital. It was at this banquet that a young Reverend George W. Truett stood up and famously said, “Is it not now time to begin the erection of a great humanitarian hospital, one to which men of all creeds and those with none may come with equal confidence?”

Truett, who would go on to serve on the board of Baylor Hospital for decades after its founding and for whom a prominent hospital tower is named, helped galvanize the Baptist community to donate money for the erection of a new hospital.³ And so, beginning with a generous $50,000 donation by C. C. Slaughter, a former Confederate colonel and the largest taxpayer in Texas (owning over 1 million acres of ranch land), ground was broken in 1904 for the Texas Baptist Memorial Sanatorium, adjacent to the Good Samaritan Hospital.¹

The Texas Baptist Memorial Sanatorium (Figure 1) opened in October of 1909 with 250 beds across six wards, one of which was reserved for African American patients. The location of the African American ward within the hospital, what the ward was like for patients, and the extent to which it was used by the African American community are unclear. But it is known that to be admitted to the ward, a Black physician would have had to refer his patient to a White physician. We also know that the entire physician staff at Texas Baptist Memorial Sanatorium was White, including the physicians in the African American ward. Why? With historically Black medical colleges such as Howard and Meharry opening in the 1860s and 1870s, respectively, there was no shortage of Black physicians. To contextualize the all-White staff, one must go back to the 1870s and take a closer look at organized medicine.

Figure 1.

Texas Baptist Memorial Sanatorium.

THE ROLE OF ORGANIZED MEDICINE IN SEGREGATING MEDICAL CARE

The American Medical Association (AMA) was founded in 1847 with the goal of standardizing medical education, promoting scientific advancement, improving public health, and launching a program of medical ethics.⁴ Race was not mentioned in early founding documents of the AMA, but after the end of the Civil War in 1865, it became clear that the AMA would have to decide to what extent Black physicians would be included within the organization.

In 1870, a racially integrated medical society, the National Medical Society of Washington, DC (not related to today’s National Medical Association), attempted to be seated as a delegation at the AMA national meeting alongside White-only societies. AMA members voted 114 to 82 to deny admission to the integrated delegation.⁵ Hoping to prevent future racist decisions regarding who would get a seat at the table of the AMA, Dr. John Sullivan of Massachusetts proposed a motion that “no distinction of race or color shall exclude from the Association persons claiming admission,” but this motion was defeated 106 to 60.⁵ A resolution was then proposed stating that the refusal to seat the integrated medical society had nothing to do with race, despite the clear appearance to the contrary. This resolution was adopted after a 112 to 34 vote, effectively publicly exonerating the AMA from what was clearly racist decision-making.⁵

Black physicians continued to attempt to become members of the AMA without success for some time. In 1873, Dr. Nathan Davis, often credited as the father of the AMA, proposed that the AMA should restrict delegations to one state society per state, with each state determining which local societies could be members of the state society. This policy, which was adopted in 1874, effectively excluded Black doctors from the AMA because over 90% of the Black population in America at the time lived in the South, and the state medical societies in the South did not admit Black physicians. African American physicians were thus excluded from the AMA without the AMA ever adopting a policy explicitly excluding Black doctors.

Dr. Nathan Davis, who was opposed to opening the AMA to both Black and female physicians, remained an important figure in the AMA for generations. In fact, a prestigious award given out by the AMA to honor elected and career public servants for outstanding government service was named after Davis until 2021, when it was renamed the AMA Award for Outstanding Government Service.⁶

By the 1890s two state medical societies existed in Texas: the Texas Medical Association (TMA) (for White physicians) and the Lone Star State Medical, Dental, and Pharmaceutical Association (for Black physicians and other Black medical professionals). Although the TMA did not admit any Black physicians prior to 1893, it was not until this year that the TMA’s bylaws were amended to explicitly exclude Black physicians. Who was the TMA member who proposed to add a “White” requirement to admission? Dr. Charles Rosser of the University of Dallas Medical Department and the Texas Baptist Memorial Sanatorium, whose portrait still hangs prominently today in the Truett rotunda.

The Dallas County Medical Society, founded in 1876, followed the lead of the TMA in excluding Black physicians, for without doing so, it would not be able to join the TMA for statewide representation. And, unlike today where medical society membership is not required in order to have hospital privileges, White hospitals required membership in the local county medical society in order to have hospital privileges at the behest of the AMA.¹

And so it was that the entire staff of the Texas Baptist Memorial Sanatorium was White, even in the Black ward. To get credentialed to practice in the hospital, you were required to be a member of the Dallas County Medical Society, which required you to qualify for TMA membership, which required you to be White.

BLACK HOSPITALS IN DALLAS IN THE EARLY 1900S

At the turn of the century, African Americans had two options for medical care: seek out care from a White physician who was willing to see them but “often treated those of African or Hispanic origin differently from their White patients,” or get medical care from an African American physician.¹ Because Black physicians were excluded from hospital membership at all major Dallas hospitals at the time, it is thought that many qualified Black specialists, particularly those that would require hospital admitting privileges for performing procedures, chose not to move to Dallas due to lack of opportunity.¹

In 1888, Dr. Benjamin Bluitt moved to Dallas. A native Texan, the son of emancipated slaves, and a graduate of Meharry Medical School, Bluitt became the first African American surgeon in Texas. His arrival was an important milestone for the city’s Black population at the time, which was reported to be nearly 5000.⁷ In the years following, a growing number of African American physicians and surgeons opened practices in the city, including Dr. Charles V. Roman, who practiced in Dallas from 1893 to 1904 and after whom the Dallas branch of the National Medical Association is named.⁸

In 1905, Dr. Bluitt opened the first hospital for African Americans in Dallas, the Bluitt Sanatorium (Figure 2). Located at 2034 Commerce Street, the original building still stands and is now protected as a City of Dallas Landmark.⁹ The facility provided medical care for inpatients as well as office and clinic space for Dr. Bluitt and several other local African American physicians. The basement had a “cleaning establishment” run by Bluitt’s nephew, the second floor contained Dr. Bluitt’s office as well as a dental office and an attorney’s office, and the top floor was used for patient care.⁷ At the time of its operation, this was the only hospital in Dallas at which Black doctors could practice.⁷

Figure 2.

Advertisement for Bluitt’s Sanatorium.

Bluitt’s Sanatorium closed in 1914, when Dr. Bluitt moved his offices to Deep Ellum along with several other local Black physicians.¹⁰ Although he remained in practice, the closure of the sanatorium is said to have “left the local black population without medical facilities for five years.”⁷ The next sanatorium to open which served the Black community was the Morgan-Busch Sanatorium (later the Morgan-Busch-Trotter Sanatorium), which had a short-lived existence from 1919 to 1920.⁷ McMillan Sanatorium followed in its footsteps, opening in 1921 (Figure 3). This two-story complex included surgical stations, doctor’s offices, waiting rooms, a druggist, an insurance company, a barbershop, and other businesses. McMillan Sanatorium is also said to have had the only facility in Dallas that had a nurse training school for Black women.⁷

Figure 3.

McMillan Sanatorium.

Dr. Lee Gresham Pinkston began his practice at the McMillan Sanatorium in 1921, later opening his own hospital for Blacks, the Pinkston Clinic Hospital, in 1927 (11) (Figure 4). The hospital had 14 beds, and when McMillan Sanatorium closed, Pinkston Clinic Hospital became the sole hospital for Blacks in Dallas. In comparison to White hospitals at the time, it was lacking in diagnostic facilities, equipment, educational activities, and continuous nursing staff. Yet, Pinkston Clinic Hospital remained an essential locus of medical care for the African American population of Dallas.¹²

Figure 4.

Pinkston Clinic Hospital.

DALLAS AND TRUETT IN THE EARLY 1920S

For many of those whose Baylor pride runs deep, George W. Truett’s vision of the “great humanitarian hospital” open to men of all creeds and those of none provides solace that the intent of the founding fathers of BUMC was to serve all of humankind in an equal capacity. Unfortunately, equality was not the hallmark of the era in which the hospital was erected. Truett’s First Baptist Church has been described from a leader within the church as “steeped in a spirit of Southern culture, deeply imbedded with the stain of White supremacy.”³

Around the same time that McMillan’s Sanatorium opened, Ku Klux Klan (KKK) chapter 66 rose to prominence in Dallas.¹³ The KKK’s growth of power over the coming years was exponential and at one point the Dallas chapter was believed to have the highest per capita membership of any city in the country, with one of every three eligible men in Dallas being a member of the Klan¹⁴ (Figure 5). KKK members and Klan-supported candidates were elected to major offices across the city, including sheriff, police commissioner, district attorney, and police chief.¹⁴ Top leaders of the Klan were active members of the Dallas Chamber of Commerce.

Figure 5.

Klan parade in Dallas, Texas.

On April 1, 1921, just under a half mile from the First Baptist Church of Dallas, which Truett led, Alex Johnson, a Black employee of the Adolphus Hotel, was abducted from his workplace, beaten in the presence of journalists, and branded on his forehead with the letters KKK before being returned to the Adolphus, where he was forced to walk into the lobby naked and bleeding.¹⁵ By 1922, the KKK was boasting of having beaten 63 men after tying them to a “torture tree” in the Trinity River Bottoms.¹³ And by 1923, the KKK had an official day at the State Fair of Texas as well as its own cigar company, the Klansman All-American Cigar Company, housed in Dallas, Texas (Figure 6).

Figure 6.

Flyer for Ku Klux Klan day at the State Fair of Texas.

Despite having a pulpit from which to preach, there are no records of Truett ever speaking out against the atrocities of the KKK in Dallas.³ When the tides were turning against the Klan and prominent Dallas leaders and clergymen were being called to publicly denounce the KKK in the local paper, Truett’s signature was notably missing.³ Why did Truett not speak out? In truth, it would have been hard for him to denounce the KKK in public or from the pulpit because “an alarming and embarrassingly significant percentage of the [Klan’s steering committee of 100] were members and deacons of Truett’s church.”³ Even more were rank and file members of the Klan. While Truett is not recorded as preaching racism, his silence on the atrocities committed by the KKK speaks volumes. A successor of Truett’s at First Baptist Dallas, Pastor O. S. Hawkins, wrote,

It is not what he said, but what he did not say in the face of such flagrant disregard for human dignity and life. Truett spoke many poignant and powerful words from some of America’s greatest platforms, but in the end … what he did not say in the face of the blatant and brutal White supremacy that permeated his culture speaks louder than the rest.³

ACCESS TO HEALTHCARE FOR AFRICAN AMERICANS IN DALLAS, 1920S TO 1950S

After the decline of the KKK in Dallas in the late 1920s, Dallas hospitals remained segregated. Jim Crow laws and organized medicine continued to uphold a barrier that prevented Black physicians from practicing in White hospitals. There were no exceptions to this rule in Dallas until 1954.

Baylor, and presumably other local hospitals, had segregated wards for Black patients. However, these were likely hard for Black families to access and were unlikely to be perceived as viable places for receiving healthcare. A statement from Dr. Robert Prince, an African American physician who grew up in Dallas, is illustrative:

We could not go to any other hospital. Parkland, we could go to Parkland. But, Saint Paul, Baylor, Methodist … did not allow Blacks.¹⁶

Dallas Black hospitals, which remained diminutive in comparison to the White hospitals of the time, continued to be essential places for local African Americans to receive medical care. In an oral history, Julia Jordan, wife of pioneering Black Dallas physician Dr. Frank Jordan, explained:

The only two places that a woman who … didn’t want to have her baby at home could have her baby was at Pinkston’s Clinic or at McMillan’s Sanitarium. Other than that, she had to have her baby at home because White, or predominantly White hospitals, did not accept Black patients. Or you could have the patient at Parkland Hospital, but it would be delivered by intern.¹⁶

Black women would not have access to obstetrical wards in Dallas other than Parkland until the mid 1960s, most certainly contributing to the infant and maternal mortality gap between Black and White populations at the time.

Cracks in organized medicine’s position excluding Black physicians from membership began to emerge in Texas in the late 1940s. In 1949, during an outgoing address as president of the TMA, Dr. Tate Miller, a prior president of the Dallas County Medical Society, suggested to the audience that Black doctors should be allowed to join the TMA.¹² The following year he introduced a resolution to remove the word “White” from requirements for TMA membership. But after being deferred for study for another year, the resolution was tabled. Again, in 1953, Dr. Miller pleaded with the TMA:

[Membership] is open to all other races and creeds, friends and national enemies alike, whether they be white, yellow, brown or deep mahogany…. [Membership] should be open to our American born, friendly, loyal Negro doctors.¹²

Despite continued activism on the part of Dr. Miller and others, it was not until 1955 that the TMA formally struck the word “White” from its membership requirements. Within 1 month, the Dallas County Medical Society met at Baylor Hospital and presented a resolution to remove the “White” requirement from the society’s bylaws. This resolution was formally adopted a month later, opening up Dallas’s White hospitals to practicing Black physicians.¹²

THE BEGINNING OF HOSPITAL INTEGRATION IN DALLAS

Although the TMA removed the “White” requirement for membership officially in 1955, the TMA House of Delegates had informally planned to make this constitutional change in 1954. Constitutional changes required a 1-year delay for final action.¹² It was during this interim period that St. Paul’s Hospital, a Catholic hospital that had been in operation in Dallas since 1898, extended admitting privileges to five Black physicians. An article appeared in the Dallas Morning News on June 25, 1954, titled, “Negro MD’s to Practice in St. Paul’s.”¹² The article stated that although there were 18 Black doctors practicing in the city at the time, the limited number of hospital beds meant that only five of these physicians could be granted admitting privileges. The five physicians were “chosen by a committee of Negro physicians from Dallas” and included Dr. Frank Jordan, Dr. Joseph Williams, Dr. William Flowers Jr., Dr. George Shelton, and Dr. Lee Pinkston¹² (Figure 7). Notably, while they were granted admitting privileges, they were not extended the privilege of staff membership until 1956.¹²

Figure 7.

From left to right, back row: Dr. Frank Jordan, Dr. Joseph Williams, Dr. William Flowers, and Dr. George Shelton. Front row: Dr. Lee Pinkston.

These physicians were all remarkable in their own right. Dr. Frank Jordan (Figure 8), who grew up in a shotgun house without indoor plumbing, graduated valedictorian from Booker T. Washington High School in Dallas and attended Howard University for college. He then attended Meharry Medical College, one of four historically Black medical schools in the country. Although he served his country as a flight surgeon in the US Air Force from 1942 to 1946 as part of the Tuskegee Airmen, the first all-Black fighter squadron in America, he would not be allowed to practice in a White hospital until 8 years after his return from the war.¹⁷ Before being granted admitting privileges at St. Paul’s, he worked at the Pinkston Clinic where he was able to perform surgeries and deliver babies. His dedication to his patients is evident in the stories told by his wife, Julia Jordan, who stated, “On a house call, Frank delivered a baby in the wee hours, and the mother started hemorrhaging. He knew no hospital would admit her. He literally had to give the woman a transfusion with blood from his own vein.”¹⁷

Figure 8.

Dr. Frank Jordan.

Dr. Joseph Williams also graduated valedictorian from Booker T. Washington and attended medical school at Meharry. He shared a medical practice with Dr. Frank Jordan before being granted admitting privileges at St. Paul’s. He was one of the first three Black physicians granted membership in the Dallas County Medical Society, and he went on to become the director of the Public Health Department for the City of Dallas in 1976, remaining in that role until his retirement in 1982.¹⁸

Dr. William Flowers Jr., the son of successful Black physician Dr. William Flowers Sr., joined his father’s practice on Hall Street in Dallas after graduating from Meharry Medical College. He was active in improving the health and well-being of Dallas’s Black community and was chosen to speak to a special commission called by President Harry Truman on the health needs of the Black population.¹⁹ On March 8, 1981, Dr. Flowers was found gravely beaten and almost dead in his office building. He was rushed to Parkland Hospital and subsequently transferred to St. Paul’s, where he died from his injuries on March 25, 1982.¹⁹ Police never found the assailants and suspected that Dr. Flowers was the victim of a robbery gone wrong, as many of his belongings had been stolen. However, his family has always suspected that he was the victim of a hate crime (Personal correspondence, Dr. Kara Toles, October 11, 2022).

Dr. George Shelton, yet another graduate of Meharry Medical College, began his medical practice in Dallas in the late 1940s. It is noted that “patients were many, and payment often came in the form of a litter of puppies or a plate of cupcakes.”²⁰ Dr. Shelton commanded great respect, holding leadership positions in the Greater Dallas YMCA, the American Cancer Society, the Youth Foundation, and the United Fund. Additionally, he served on the board of Liberty National Bank of Dallas, Dallas’s first integrated bank.

Dr. Lee Pinkston (Figure 9), like all the other physicians in this esteemed group, graduated from Meharry Medical College. As noted previously, he began his practice at McMillan Sanatorium, later opening up his own hospital, the Pinkston Clinic Hospital. Dr. Pinkston was politically active, helping found the Democratic Progressive Voters League. He served as president of the Negro Chamber of Commerce and was the publisher and president of the Star Post Newspaper. Julia Jordan, Dr. Frank Jordan’s wife, stated, “In those days, the Black doctor was everything to everybody. He was minister, sociologist, psychologist, law enforcement—he just did it all.”²¹ Reading the abbreviated biographies of these pioneering physicians, this is undoubtedly true.

Figure 9.

Dr. Lee Pinkston.

THE INTEGRATION OF BAYLOR UNIVERSITY MEDICAL CENTER

St. Paul’s integration in 1954 was a bellwether of change, drawing talented Black physicians into the state. Dr. Emmett Conrad, a Black surgeon who would go on to become the chief of staff at St. Paul’s, stated, “Saint Paul opened its doors before the hospitals in Chicago, New York, San Francisco, and all the so-called bastions of liberty…. I chose Dallas because it was the first place that gave me an opportunity to practice in a first-class hospital.”^12,22 Despite these accolades, it is important to note that hospitals, including St. Paul’s, remained physically segregated with separate wards, water fountains, dining rooms, and waiting rooms. After all, Jim Crow was still the law of the land.

In 1959, five years after the integration of St. Paul’s, a survey of American hospitals found that 83% of northern hospitals offered integrated inpatient care, while only 6% of southern hospitals provided desegregated care.²³ Of the remaining 94% of southern hospitals, one-third did not admit any Black patients at all, while the rest admitted Black patients to segregated or partially segregated wards.²³ Baylor was in line with most southern hospitals, admitting Black patients to segregated units in the Veal Building.¹

The Baylor University Board of Trustees passed a racial nondiscrimination resolution regarding student admission on November 1, 1963. The university board did not create guidance for the integration of BUMC, instead deferring plans for integration of the hospital to the Dallas board. In January of 1964, a multidisciplinary group of the hospital’s medical board, trustees, and administrators met to “explore the question of hospital facilities and services for Negro patients.”¹ By this time, local hospitals including Methodist and St. Paul had integrated medical, surgical, and most obstetrical units. Baylor, on the other hand, was not only segregated but had also not offered any obstetrical care for Black patients for the prior 10 years after closing its obstetrical ward for Blacks due to high cost and underutilization in 1954.¹

In addition to segregated wards, Baylor’s medical staff remained segregated. Due to a bed shortage at the hospital, Baylor had closed its medical staff to new physicians requesting membership and admitting privileges in 1950. This moratorium was partially relaxed in 1955 to allow prominent Baylor physicians to add partners to their practice. In the same year, Black doctors in Dallas were allowed to join the TMA and Dallas County Medical Society and, as such, potentially gain privileges at local White hospitals. However, Black Dallas physicians at the time were not a part of preexisting Baylor private practices, so they would have been subject to the continued moratorium on staff privileges. Even in the absence of the moratorium, which was variably enforced until at least 1966, it has been noted that “tradition and [claimed] concerns about the professional qualifications of African American physicians who had trained at predominantly Black medical schools held back rapid progress in admitting African American physicians to the Baylor Staff.”¹

In July of 1964, the passage of the Civil Rights Act created a legal prohibition against discrimination on the grounds of “race, color or national origin” for all hospitals receiving federal funds.²³ BUMC made efforts to comply with this act, and hospital President Mr. Boone Powell, Sr. delivered a report on the status of integration at the hospital in June of 1965. The details of this report and the status of integration of the hospital at this time are unclear, although it is known that many services at the time were integrated, including “outpatient clinic[s], diagnostic radiology, radiation therapy, laboratories, operating rooms, post-anesthesia recovery [and] intensive care.”¹

Although the Civil Rights Act of 1964 made discrimination in hospitals receiving federal funds illegal, the federal government was unable to examine all of the nation’s hospitals for compliance, and many hospitals did not comply with the act.²³ Enter Medicare (which was aggressively lobbied against by the AMA).²⁴ Written into law in July of 1965, Medicare promised a running faucet of funding for the medical care of elderly patients that would only be available to hospitals that were compliant with the Civil Rights Act. The faucet would be turned on in July of 1966. One year after the Medicare Act’s passage, however, with just 3 months to go before its funding deadline, only 49% of hospitals in the country had desegregated and were in compliance.²³ Through incredible efforts on the part of the federal government and volunteers, by the time Medicare officially launched in the summer of 1966, the vast majority of the nation’s 7000 hospitals had integrated.

Importantly, and in contrast to most southern hospitals, BUMC had adopted nondiscrimination policies that included “policies in regard to the admission of patients, medical and dental staff privileges, employment, educational programs, and facilities” a month before Medicare was signed into law and over a year before Medicare funds would be doled out.¹ Despite this, it was not until 1968 that Baylor got its first Black doctor.

BAYLOR PIONEERS: DR. WILLIAM J. FRAZIER AND DR. WILLIAM F. LARKIN

William J. Frazier (Figure 10) was accepted to medical school at the Indiana University School of Medicine at a time when four Black students were accepted per year (Personal correspondence, Dr. William J. Frazier, November 6, 2022). It was known that half of these students would not graduate from the school. When it came time to apply for internship, Frazier sent applications to the University of Texas Medical Branch in Galveston, Baylor Houston, and BUMC. After sending his transcript and his resume, but without sending a head shot, he received invitations to interview everywhere he applied. When he arrived for his interview in Galveston, he stated “they wouldn’t talk to me,” having now realized he was an African American applicant. Things weren’t much better in Houston. “They would talk,” said Dr. Frazier, “but they wouldn’t give me the time of day” (Personal correspondence, Dr. William J. Frazier, November 6, 2022). Then he came to BUMC where he was met by Dr. Ralph Tompsett, the chief of internal medicine at the time, and Dr. Merrick Reese, who helped run the internship program and later went on to found Texas Oncology. Dr. Frazier described a warm and hospitable welcome. He was invited into their homes and was even told, “If you put us at the top, we will put you at the top” (Personal correspondence, Dr. William J. Frazier, November 6, 2022). And so it was that Dr. Frazier only ranked one hospital, and only one hospital ranked him: BUMC. In doing so, Dr. William J. Frazier became the first Black physician to practice at BUMC.

Figure 10.

Dr. William Frazier.

His intern year was a “mixed rotating internship,” which meant rotating through both surgical and medical services. He enjoyed his intern year, though none of the other physicians looked like him. At the end of the year, his chief resident, Dr. Bailey, asked how his experience had been. Dr. Frazier replied that it had gone well. Dr. Bailey then replied, “We prepared for you by trying to figure out who would be willing to work with you.” They made sure anyone who wasn’t willing to work with Dr. Frazier was assigned to another floor (Personal correspondence, Dr. William J. Frazier, November 6, 2022).

After his mixed rotating internship, Dr. Frazier became the first Black resident at Baylor, completing a year of residency training in surgery before being drafted into the Air Force in Vietnam as a part of the Berry Plan. After serving 2 years in the Air Force, Dr. Frazier moved to St. Louis to complete a urology residency at Barnes Jewish Hospital, the teaching hospital for the Washington University School of Medicine. He ultimately came back to Baylor where he practiced as a urologist until 1988. Reflecting on his time at Baylor, he commented on the great people he met at the hospital: Dr. Albert Roberts, Dr. Brian Williams, and Dr. Robert Sparkman. “I can’t say enough about how gracious and decent those people were. They were not fake; they were genuine people” (Personal correspondence, Dr. William J. Frazier, November 6, 2022).

Asked to recall accepting Dr. Frazier as the first Black intern at Baylor, Dr. Merrick Reese noted that some staff members were concerned that bringing in a Black intern would mean needing to open the medical staff up to other Black doctors as well. Dr. Reese was firm in his conviction, stating he hoped that further integration would be the case. “It was a pivotal moment when we opened up. [Dr. Frazier] was truly a trailblazer” (Personal correspondence, Dr. Merrick Reese, November 9, 2022).

Close on the heels of Dr. Frazier starting his internship at Baylor, Dr. William F. Larkin (Figure 11) became the first Black physician to join the medical staff at Baylor, joining in 1968.¹ Dr. Larkin, like Dr. Frank Jordan and Dr. Joseph Williams, graduated as valedictorian from Booker T. Washington High School in Dallas. He attended Prairie View A&M University, a historically Black university, for college and then applied to UT Southwestern for medical school. Unfortunately, at that time Southwestern did not accept any Black applicants, and his application was automatically rerouted to the University of Texas Medical Branch at Galveston, where he ultimately matriculated (Personal correspondence, Dr. Sharon Larkin, November 8, 2022). He became board certified in general surgery and also worked as a vascular surgeon, sharing an office with Dr. George Shelton, Dr. Emmett Conrad, and Dr. Robert Prince. Before being granted privileges at Baylor, Dr. Larkin was on the staff at both St. Paul’s Hospital and at Parkland. His daughter, internist Dr. Sharon Larkin, who also worked at Baylor for some time, suspects that his colleagues encouraged him to apply for privileges at Baylor at a time when there were no other Black attending physicians on staff:

Figure 11.

Dr. William F. Larkin.

He was very well educated, very well spoken, respected, very good looking, very engaging, very confident. He wasn’t going to be intimidating, and he was not going to be intimidated. He was the perfect person to put in that position. People who were ambivalent about it could accept him (Personal correspondence, Dr. Sharon Larkin, November 8, 2022).

Dr. William Larkin was a founding member of the Sickle Cell Anemia Foundation in Dallas and took pride in his mentorship of medical students and residents.

Today, Dr. William Larkin’s legacy lives on through BUMC’s Dr. William F. Larkin Lecture Series (Figure 12). Playing a role in various grand rounds throughout the hospital and recorded for posterity, the lecture series aims to use education to address and curtail overt and systemic racism, sexism, and xenophobia influencing healthcare access, delivery, and outcomes. In the wake of the events of the summer of 2020 (the murders of George Floyd, Ahmaud Arbery, and Breonna Taylor), it became increasingly important for the medical community to better understand existing healthcare disparities contributing to unequal healthcare outcomes. Naming the lecture series after the first Black physician granted privileges at BUMC—a man who had first-hand experience with these inequities and, notwithstanding them, became a successful physician—seemed like an obvious choice.

Figure 12.

Celebrating the first year of the Dr. William F. Larkin Lecture Series. From left to right: Dr. Lauren Fine, Dr. Sharon Larkin, and Dr. Tanisha Hamilton.

A GREAT HUMANITARIAN HOSPITAL

Over the ensuing years, the medical staff at BUMC continued to integrate. Drs. James and Carol Gray (Figure 13), a married power couple, were just two of the physicians to follow in the footsteps of Dr. Frazier and Dr. Larkin. Dr. James Gray came to Baylor in 1978 and went on to become the chief of ophthalmology. Dr. Carol Gray joined the BUMC staff in 1980 as a pediatrician. Their daughter, Dr. Nakia Gray Scott, is now a child psychiatrist in Austin, Texas. While Dr. Carol Gray came to Baylor 13 years after Dr. William J. Frazier, time did not wholly protect her from racism. She described many times being ignored during departmental meetings and not introduced in groups when other White physicians would be (Personal correspondence, Dr. Carol Gray, November 8, 2022).

Figure 13.

Drs. James and Carol Gray.

As the hospital’s medical staff integrated, so did its leadership. One notable example is Albert Black (Figure 14). Growing up in the Frazier Courts housing projects in South Dallas, Black was placed as an assistant in BUMC’s kitchen at the age of 15 through a Dallas Independent School District Program (Personal correspondence, Tre Black, July 6, 2023). At the age of 23, he cofounded a very successful company distributing janitorial supplies. In part due to his business savvy and success, he went on to become a trustee and then chairman of the Baylor Health Care System. In total, he served for almost 30 years on the Baylor Health Care System Board of Trustees. He helped launch the Baylor Diabetes Health & Wellness Institute in the same neighborhood he grew up in, where diabetes was killing local residents at a rate far higher than the national average. Reflecting on his accomplishments, Albert Black stated,

Figure 14.

Albert Black.

It certainly was very unlikely for me to go from the main kitchen at Baylor to the chairman of the system’s board. It has been the honor of a lifetime to serve on the board … and [to] be a champion for people who were unaccustomed to receiving quality, accessible, and equitable health care in our community (Personal correspondence, Tre Black, July 6, 2023).

Humanitarian is defined by the Oxford Dictionary as “concerned with reducing suffering and improving the conditions that people live in.”²⁵ There is no “White only” clause in the dictionary’s definition, yet our great humanitarian hospital was born into a segregated and unequal country, and as such the Baylor medical community must grapple with the dissonance created by a proclamation of humanitarianism and the reality of separate and unequal. All of these things are true: that a founder of our hospital proposed and supported policies that perpetuated racism in organized medicine at the state and local level, but also that our hospital accepted a Black intern at a time when he could not get an interview anywhere else in the state of Texas; that the namesake of one of our hospital towers did not speak out against the atrocities of the KKK at the time that other leaders were doing so, but also that our hospital worked to comply with the Civil Rights Act of 1964 at a time when most Southern hospitals were resisting compliance. There is no single salve that can heal the wounds that hatred, fear, and racism have sown in our country. But we should take solace in the words of Dr. James Gray: “Baylor is walls, mortar, and bricks. It is who comes to Baylor and tries to change it” (Personal correspondence, Dr. James Gray, November 5, 2022).

This should serve as a cri de coeur for our hospital: our work is not done. We are responsible for understanding the history of our institution, we are responsible for the continued growth of our institution, and we are responsible for the continued commitment to the goal of being a great humanitarian hospital—one to which men and women of all creeds and those with none may come with equal confidence.

DISCLOSURE STATEMENT

The author reports no funding or conflicts of interest.