History of colon and rectal surgery at Baylor University Medical Center

A group of 13 physicians met in Columbus, Ohio, on June 7, 1899, and formed the American Proctologic Society. The Columbus founders had been meeting informally for a number of years to discuss mutual problems regarding anorectal disease. Mainstream medicine had largely ignored this area, leaving patients in the hands of quacks and charlatans. Furthermore, the curriculum in medical schools throughout most of the 19th century had no instruction in rectal disease. The society continued to grow, and the first meeting of the Section of Proctology of the American Medical Society occurred in 1917. Another seminal event at that time was the establishment of a training program in proctology at the University of Minnesota. By 1929 when the “Roaring ′20s” ended, the society had increased to almost 100 members.

During this initial growth period, the members′ goals were threefold: 1) to establish a journal dedicated to proctology; 2) to create an objective certification process in the specialty; and 3) to promote research and education in the specialty in the nation's medical schools. The society's 1933 annual meeting, held in Chicago, was to have major historical importance, as President Curtice Rosser of Baylor devoted his presidential address to progress made in the specialty and a discussion of the specialty board movement begun by ophthalmology in 1916. Dr. Rosser recommended that proctology establish a board and asked for the formation of a committee to be composed of 3 members from the society and 3 members from the American Medical Association to initiate the process. When the American Board of Proctology finally achieved independent status in 1949, Dr. Rosser was elected its first president (Figure 1).

Figure 1.

Original members of the American Board of Proctology. Dr. Curtice Rosser, the board's president, is second from the left on the bottom row.

CHIEFS OF COLON AND RECTAL SURGERY

The department has had 5 chiefs since 1946 (Figure 2).

Figure 2.

Chiefs of the Department of Colon and Rectal Surgery. Dr. Curtice Rosser, 1947–1960 Dr. Alvin Baldwin, Jr., 1961–1970 Dr. Wallace Bailey, 1971–1991 Dr. R. D. Dignan, 1991–2000 Dr. Warren Lichliter, 2001-present.

Dr. Curtice Rosser

In 1946 following World War II, Baylor University Hospital was completely reorganized, with the board of trustees appointing a chief of service of each department. Dr. Rosser was designated as the first chief of colon and rectal surgery, and several years later he established the residency program, making it one of the earliest such programs in the USA. Other members of the department during this period included Dr. Jack Kerr, Dr. Robert J. Rowe, and Dr. Alvin Baldwin, Jr. During the early 1950s, the department was joined by Dr. H. Gray Carter and Dr. Malcolm McNatt. Dr. Rowe was active nationally and internationally and served as president of the American Proctological Society from 1960 to 1963.

Dr. Rosser was born on January 3, 1891, in Dallas, the son of surgeon Dr. Charles M. Rosser, whose dream of building a great hospital in Dallas was the primary impetus that eventually led to the founding of what became Baylor University Medical Center (BUMC). The younger Rosser initially studied law and was admitted to the Texas bar in 1913, but he never engaged in the practice of law. He was awarded a medical degree (with distinction) by Northwestern University Medical School in 1917 and later studied at the University of Vienna. In 1919, he entered general surgical practice with his father. During this period his interest in proctology developed, and in the ensuing 4 decades he studied and wrote prolifically on topics covering the entire spectrum of colon and rectal surgery.

Dr. Rosser conducted his professional activities in Dallas from 1919 until 1969, primarily at BUMC. He joined the American Proctologic Society in 1925 and served as its secretary-treasurer from 1929 to 1932 and as president from 1932 to 1933. He was a fellow of the American College of Surgeons and represented the American Proctological Society on the American College of Surgeons′ board of governors from 1949 to 1951. He also served as president of the Southern Medical Association in 1951 and in 1957 was the first recipient of the association's Distinguished Service Award. He was widely known as a skillful surgeon, an outstanding speaker, and a teacher of unusual capability. Dr. Rosser's articles appeared in many of the major surgical journals as well as JAMA. In a seminal paper in the American Journal of Surgery (1931;11:328–333), he was the first to describe the formation of adenocarcinoma of the anal canal in long-standing anorectal fistulas. A life member of the Golden Key Society in Vienna, Dr. Rosser wore his countless professional honors with disarming humility, and he viewed each new honor as a privilege of service. He died on October 23, 1969, at the age of 78.

Dr. Alvin Baldwin, Jr.

Dr. Baldwin succeeded Dr. Rosser as chief of the department in 1961 and served until 1970. Dr. Baldwin was born in Tenaha in East Texas but spent most of his boyhood in Memphis, Texas, in the state's panhandle. He received his bachelor of arts degree from Baylor University in Waco and his medical degree from Baylor University College of Medicine in 1931. After an internship at Charity Hospital in New Orleans, he practiced general medicine in Olney, Texas, from 1933 to 1940. During this time, Dr. Baldwin developed an interest in colon and rectal surgery and became a fellow of the American College of Surgeons in 1939. He decided to leave Olney in 1940 to continue his education at the Graduate School of Medicine at the University of Pennsylvania. He returned to Texas in 1941 and joined the staff at BUMC.

Dr. Baldwin spent more than 40 years in the active practice of colon and rectal surgery at BUMC. He served as president of the medical staff and president of the Dallas Southern Clinical Society. Throughout his professional career, he remained keenly interested in continuing developments in his field. “Al was a real ‘people’ person. He genuinely cared for others, not only about their health but about all aspects of their lives,” said Boone Powell, Sr., president emeritus of BUMC and a longtime friend. In recognition of his many contributions, the Alvin Baldwin, Jr., Chair in Surgery was established in the Department of Surgery at the University of Texas Health Science Center by former Dallas Mayor Erik Jonsson and his wife, Margaret.

In 1986, Dr. and Mrs. Baldwin presented a generous endowment to BUMC to establish the Alvin Baldwin, Jr., MD, visiting professorship in radiology. After his death in 1988, the BUMC Foundation, from contributions in Dr. Baldwin's honor, established the Alvin Baldwin, Jr., MD, Endowed Residency in Colon and Rectal Surgery.

Dr. Wallace Bailey

Dr. Bailey was appointed chief of service in 1971 and held the position until 1991. During Dr. Bailey's tenure, he served on the board of the American Society of Colon and Rectal Surgery and the training program was increased to 2 residents per academic year.

Dr. Bailey graduated from the University of North Dakota with honors in 1951. He entered the University of Illinois School of Medicine and graduated in 1953. His surgical residency was completed at the Latter-Day Saints Hospital in Salt Lake City and his colon and rectal surgery residency at BUMC from 1959 to 1961. He subsequently entered private practice and joined the staff at BUMC. Dr. Bailey was president of the medical staff for 2 terms, from 1987 to 1989. He was a member of the American Board of Colon and Rectal Surgery from 1981 to 1989 and president of the board from 1988 to 1989. He also served as chairman of the Residency Review Committee for Colon and Rectal Surgery from 1986 to 1990. Dr. Bailey retired from active practice in 1991 and lives with his wife, Eleanor, in Leadville, Colorado.

Dr. R. D. Dignan

Dr. Bailey was succeeded by Dr. R. D. Dignan in 1991. Dr. Dignan graduated from the University of Texas Medical Branch at Galveston in 1969. He then entered the surgical internship program at Parkland Memorial Hospital. The subsequent year he was a research fellow in general surgery at the University of Texas Southwestern Medical School under Dr. Robert N. McClelland. Following his general surgical residency, he completed a residency in colon and rectal surgery at the Ferguson Hospital in Grand Rapids, Michigan. In 1975, he returned to Dallas and entered private practice with Dr. Alvin Baldwin at BUMC. Dr. Dignan served as department chief from 1991 to 2000 and as a board examiner for the American Society of Colon and Rectal Surgeons from 1990 to 1994. He was also chairman of the awards committee of the Research Foundation from 1984 to 1992.

Dr. Warren E. Lichliter

Dr. Lichliter was appointed chief of the department in 2001 and has served in that capacity until the present. Dr. Lichliter was an honors graduate from the University of Tennessee and an Alpha Omega Alpha graduate from the University of Texas Medical Branch at Galveston. He completed his general and colon and rectal surgery training at BUMC, entering private practice with Dr. Wallace Bailey in 1984. Dr. Lichliter served as president of the medical staff in 1997 and chairman of the medical board in 1998. In 2003, he was elected president of the Dallas County Medical Society.

RETIRED AND ACTIVE STAFF

Dr. H. Gray Carter

Dr. Carter graduated from Oklahoma University Medical School in 1943 and subsequently served in the US Navy until 1946. He entered general practice in Tulsa, Oklahoma, but shortly afterwards left for the University of Minnesota to do his colon and rectal surgery training under Dr. W. A. Fansler. He found his way to Dallas and joined the colon and rectal staff at BUMC in 1952. Dr. Carter was one of the pioneers to champion endoscopy in the prevention of colon and rectal cancer and held semiannual continuing education courses teaching flexible sigmoidoscopy. He retired from active practice in 1988 and lives in Dallas with his wife, Pauline.

Dr. Robert Jacobson

Dr. Jacobson completed his medical degree in 1971 at Temple University School of Medicine. His general surgical training at BUMC under Dr. Robert Sparkman was followed by a colon and rectal surgery residency at the Lahey Clinic in Boston. He subsequently entered private practice at BUMC in 1977. Dr. Jacobson and his associate, Dr. Paitoon Tulanon, joined Dr. Warren Lichliter and Dr. Edward Franko in 1995 to form North Texas Colon and Rectal Associates.

Dr. Paitoon Tulanon

Dr. Tulanon did his undergraduate work at Mahidol University and postgraduate training at Siriraj Medical School in Bangkok, Thailand. He completed his internship and general surgical training at St. Agnes Hospital in Baltimore. After a tour with the US Air Force, he became a resident in colon and rectal surgery at BUMC in 1984 and entered private practice the following year, joining Dr. Robert Jacobson.

Dr. David S. Pita

Dr. Pita attended undergraduate school in Thailand before entering the University of Chiengmai Medical School, from which he graduated in 1964. He served an internship at Wayne County General Hospital in Michigan and a general surgical residency at the University of Chicago and the Upstate Medical Center of New York. His colon and rectal surgery residency was completed at BUMC in 1972, after which he joined the staff in the Department of Colon and Rectal Surgery.

Dr. Edward R. Franko

Dr. Franko graduated with honors from Cleveland State University prior to entering the Medical College of Ohio, from which he also graduated with honors in 1986. He completed his residency in general surgery at Long Island Jewish Medical Center in 1991 and his colon and rectal residency at BUMC in 1992. Dr. Franko joined Dr. Warren Lichliter in practice in 1992.

Dr. Erik G. Fetner

Dr. Fetner graduated Phi Beta Kappa from Tulane University in 1990. After completing medical school at the University of Texas Southwestern Medical Center at Dallas in 1995, he entered the general surgery residency at BUMC (1995–2000). Following completion of his colon and rectal residency at BUMC, Dr. Fetner joined Dr. R. D. Dignan in practice in the Department of Colon and Rectal Surgery.

Dr. Roberto Rodriguez Ruesga

Dr. Rodriguez joined the Department of Colon and Rectal Surgery in 2001. He completed his undergraduate studies, medical studies, and internship in Mexico. He then completed a research year at the Mayo Clinic in Rochester, Minnesota, before entering his general surgery residency at Michigan State University. He completed the residency in colon and rectal surgery at BUMC in 1999.

RESIDENCY PROGRAM

The residency in colon and rectal surgery at BUMC was established in 1955, making it one of the oldest programs in the USA. One residency position was available each academic year until 1983, when the number was doubled. Over 60 residents have completed the program since its inception, with several achieving national recognition: Dr. Whitney Boggs of Shreveport, Louisiana, and Dr. Eugene Sullivan of Portland, Oregon, who were both residents in the late 1950s, went on to serve as presidents of the American Society of Colon and Rectal Surgery. To support the residency program, the Hassie Hunt Foundation, Inc., gave $500,000 between 1997 and 2001 to establish the Hassie Hunt Endowed Fellowship Fund in Colon and Rectal Surgery.