Ken Hempel (Figure 1) has lived virtually his entire life in Dallas, Texas. He was born on October 25, 1934. He graduated from public schools, including Highland Park High School, where he was a star athlete. He married Ruth Barrett, his sweetheart from the eighth grade, as a senior in high school, and they have been married ever since. Ken attended Southern Methodist University (SMU) and after 3 years there entered Southwestern Medical School, where he obtained his medical degree in 1959. He did a rotating internship at Baylor University Medical Center (BUMC) and then entered the general surgery program of Parkland Hospital after a brief stint in Iowa City. After completing his residency in 1965, he spent 1 year in Houston at Methodist Hospital doing a cardiovascular fellowship under Dr. Michael E. DeBakey and his colleagues. In 1966, he entered the US Army Medical Corps, where he remained for 2 years before returning to Dallas and beginning a private practice of both vascular and general surgery. Within a few years, he became a major player at BUMC, where he has practiced for over 40 years. He and Ruth are the proud parents of three children. Ken is truly a great guy and a pleasure to be around. I met him years ago when we were both attending SMU, and I have kept up with him periodically since that time. It was a pleasure interviewing him; I am grateful he agreed.
Figure 1.
Dr. Ken Hempel.
William Clifford Roberts, MD (hereafter, Roberts): Ken, I appreciate your willingness to talk to me and therefore to the readers of BUMC Proceedings. To start, could you talk about your early life, some of your early memories, your experiences growing up, and your parents and siblings?
George Kennedy Hempel Jr., MD (hereafter, Hempel): Bill, I was born on October 25, 1934, at Scott & White Hospital in Temple, Texas (Figure 2). My dad was raised in Bartlett, a little town in south central Texas on the Katy Railroad connecting Dallas to Austin. My mother was born and raised in Georgetown, Texas. Her father was a physician for Southwestern College, a small liberal arts college in Georgetown. At that time, the Scott & White Clinic in Temple was like the Mayo Clinic of the South, and my maternal grandfather wanted my mother to have her first child there, even though my parents lived in Dallas.
Figure 2.
At age 2.
My dad got a liberal arts degree from SMU in 1928 and then went to work for the Travelers Insurance Company. When World War II began, he couldn't get into the military because of kidney stones. As a consequence, he decided to go to law school at night. He gradually moved up the ladder at Travelers until he was in charge of the claims department in the North Texas region. My mother got her college degree from Southwestern and taught school until they married on September 5, 1933. My family lived in the Park Cities area of Dallas.
I grew up during World War II. As a child we saved tin foil and had rubber gun wars and watched the airplanes. We rode our bicycles nearly every place we went. I grew up across the street from George Hurt, another Baylor physician, and down the street a block lived Doak Walker, the famous Heisman Trophy winner at SMU. It was a close-knit group. Everyone knew one another.
Roberts: What was the actual address of your home in the Park Cities?
Hempel: 3432 Stanford.
Roberts: Do you have brothers and sisters?
Hempel: I have a sister, Susan Smith, who is 4 years younger (Figure 3). She also lives in the Park Cities.
Figure 3.
With his sister, Susan Hempel Smith, and their mother, Lorena Hempel.
Roberts: What was your father like?
Hempel: My dad was fairly strict and very smart. I always thought of him as the smartest man I ever knew who was in a nonacademic position. He was first in his class at the SMU Law School. He graduated from college and started his professional career right after the Depression, and like a lot of people at that time, he was very conservative. He wasn't a risk taker. He was a pretty stern taskmaster.
Roberts: Were you and your father pretty close?
Hempel: Yes.
Roberts: Did you go hunting and fishing together?
Hempel: Yes. He was a big hunter and fisherman. He brought his empty shell casings home for me to play with. I would fill them up with sand from the sand pile. I was always around guns and fishing equipment when I was a kid. I like to hunt and fish and continue both today.
Roberts: He stayed with Travelers all his life?
Hempel: Yes (Figure 4).
Figure 4.
His parents, George and Lorena Hempel, in May 1968, at his dad's retirement from Travelers Insurance Co.
Roberts: What was his name?
Hempel: George Kennedy Hempel. I'm a junior, but he went by George. His dad was George Augustus Hempel, so my father was always called George Jr. When I came along, since I was truly a junior, they lifted the Ken out of Kennedy and called me Ken. When I eventually went into practice, I went professionally by the name of “G. Ken.”
Roberts: When was your father born?
Hempel: He was born in 1907 and died in 1968, at age 61, from a heart attack.
Roberts: What was your mother's name?
Hempel: Lorena Moses. She was born in 1906 and died in 2000, at age 93.
Roberts: Was she in pretty good health most of that time?
Hempel: She had breast cancer twice. Both her mother and her sister also had breast cancer. She had breast cancer the first time when I was relatively young and then again 25 years later, but she survived both episodes.
Roberts: What was your mother like?
Hempel: She was a very attractive, prim and proper Southern lady.
Roberts: Were your parents close, as far as you could tell? Was it a good marriage?
Hempel: Yes, it was a good marriage.
Roberts: What was your home like?
Hempel: We were encouraged to read and keep ourselves occupied. Because we had a lot of friends in the neighborhood, we played outside—games like hide and seek and kick the can. No one locked their houses, and we wandered in and out of everyone's house. I don't think we used the key to our house except when we went on vacations. We spent a lot of time at Snider Plaza, where there was a Varsity Theater, and every Saturday we went to watch a movie. A quarter would buy the ticket plus some food and drink. Life was pretty simple back then. It was also about this time that I became involved in scouting. I attained the rank of Eagle Scout and later was surprised to be “tapped” in the Order of the Arrow.
Roberts: You said that your father was the brightest person you had known. That judgment was based on what? What did he do when he came home at night?
Hempel: My early recollections are of his studying for his law school classes. He would be home in time for dinner. We had only one car, so he would either ride the bus or carpool or my mother would pick him up. The Travelers office at that time was in the Magnolia Petroleum Building, which was the tallest building west of the Mississippi. After getting home from work he sometimes played ball with me. He had lettered in baseball at SMU, so he was interested in sports and athletics and encouraged me in those activities. We would throw a football or baseball around in the neighborhood.
Roberts: Were there a lot of books in your house? Did your parents read a lot?
Hempel: Yes. My mother was an English teacher, so we had a lot of the classics around. We were encouraged to read books like Tom Sawyer and Moby Dick.
Roberts: Where did your mother teach?
Hempel: In Georgetown, where she grew up.
Roberts: Once your parents were married, she didn't work anymore?
Hempel: Correct. She became a homemaker after that.
Roberts: How did your parents meet?
Hempel: I'm not sure how they met. I think it was at a high school baseball game.
Roberts: Your father must have gone down to Georgetown.
Hempel: Yes. His hometown, Bartlett, was just a few miles away.
Roberts: Did he have a lot of brothers and sisters?
Hempel: He was an only child, and my mother had a single sibling, a younger sister.
Roberts: Did her sister live in Dallas?
Hempel: No, she lived in Corpus Christi.
Roberts: Did you have a lot of cousins?
Hempel: No, I did not. My aunt had only one daughter, who was adopted relatively late in life.
Roberts: You and your sister were sort of the whole family?
Hempel: Yes.
Roberts: Did you ever smoke cigarettes?
Hempel: I never smoked cigarettes, but I did smoke a pipe a little bit. My dad smoked cigarettes and a pipe.
Roberts: Was there alcohol in your home when you were growing up?
Hempel: Not much; a little bit.
Roberts: Did your father have a drink when he got home at night?
Hempel: Rarely.
Roberts: When you were growing up, did you go to church every Sunday?
Hempel: Yes, we went to Highland Park Methodist Church.
Roberts: Have you continued that?
Hempel: Ruth made a Presbyterian out of me, so we go to Park Cities Presbyterian Church now.
Roberts: Did you have much contact with Doak Walker?
Hempel: He was ahead of me, but I knew him. Of course, we went to see him play in high school and then at SMU. During the first Highland Park High School game I ever saw, my dad held me up along the fence by the sidelines. The opponent was Marshall High School. That was when both Doak and Bobby Lane were on the same high school team (in 1943). I was 9 years old.
Roberts: They got back together in the pros.
Hempel: That's right, with the Detroit Lions.
Roberts: Were studies in grammar school, junior high, and high school easy for you, or did you have to study relatively hard to make the grades?
Hempel: It was relatively easy, I think. I enjoyed school. I probably enjoyed sports more than school, but I had a couple of good elementary teachers, Ms. Allen and Ms. Estell, at University Park Elementary. We learned phonetics and subjects like that, which aren't taught anymore.
Roberts: When you came home in the evening, was dinner a big deal in your family? Did you all dine together?
Hempel: Yes, meals were a big deal, both breakfast and dinner. Everybody was there. We might have been out playing but were called in when it was time to eat. Everyone sat down together, said a blessing, and then ate. Then we usually sat around the table and talked. Back then there wasn't any television, just radio. In the summertime we were outside because it was hot; in the wintertime the weather was bad, and we'd stay in and read or play games, like checkers.
Roberts: Do you remember any conversations? Did you talk about what each of you did during the day or what was happening in school or World War II? Were there political or intellectual discussions?
Hempel: There were some political and intellectual discussions. World War II was going on, and I was fascinated by airplanes. In fact, my third-grade teacher thought I would be an aeronautical engineer because I drew airplanes all the time.
Roberts: When did you really get involved in sports? Was that junior high?
Hempel: I grew up playing sports in the street. We all participated, and it was the shirts versus the skins. We would choose sides, and one team would take their shirts off and the other would keep them on. That's how we identified who was on which team because we all knew one another. Sometimes the sides changed from day to day. The Park Cities YMCA opened when I was 10 or 11. I was a charter member. We met by what is now the University Park Fire Department. We started playing sports with uniforms at that time. It was the eighth grade before I played on a school team with school uniforms.
Roberts: What sports did you participate in? I know you were a football player in high school.
Hempel: At that time one could play any number of sports. I played baseball, football, and basketball. I lettered in all three. We were encouraged to do that; at that time we didn't have to confine ourselves to one sport.
Roberts: What position did you play in baseball?
Hempel: I started out as a third baseman and then was a left fielder.
Roberts: In football, you were a fullback?
Hempel: A halfback and a fullback.
Roberts: Tell me about your football career at Highland Park.
Hempel: The 3 years I played were 1949, 1950, and 1951. I was one of only two sophomores who lettered in 1949, and I started in two games that year because the starting fullback was hurt. At that time, only two other sophomores had started the full season at Highland Park High School. I started on defense my junior year and on offense toward the end of that year. I was captain of the 1951 team as a senior.
Roberts: How did your team do?
Hempel: I played on two semifinalist teams (Figure 5). The 1950 team had the best record in the state. We went to the semifinals and lost 34 to 27 to Wichita Falls, losing on the last play of the game. We had actually beaten them earlier in the year, but a couple of guys got hurt in the quarter-final game against Breckenridge and didn't play, which kind of hurt our chances. At that time the Dallas Independent School District played a City Conference State Championship with the other city schools in Houston and San Antonio. We had beaten Sunset High School that year, and they won the City Conference State Championship. Thus, we had a legitimate claim to being the best team in the state.
Figure 5.
Carrying the football in a game against (a) McKinney High School in 1950 and (b) Wichita Falls in the semifinals on December 23, 1950.
Roberts: Back then, what percentage of offensive plays were running plays versus passing plays?
Hempel: Probably 70% were running and 30% passing. Maybe a little bit more for us. We had a few pretty good passers. Malcolm Bowers was the quarterback the first 2 years, and then Don Alexander was the quarterback my last year.
Roberts: What was your best personal game?
Hempel: Probably against Jesuit as a senior. I scored three touchdowns and ran for about 130 yards, which is nothing in this day and age.
Roberts: Did you have 40-yard dashes back then?
Hempel: Yes.
Roberts: What did you do the 40-yard dash in?
Hempel: I don't remember. I was actually pretty fast. I was on the track team for a while.
Roberts: What did you run?
Hempel: I ran the sprints. We held the 440 relay record for ninth graders for about 10 or 15 years, which is kind of unusual because relay records are broken fairly quickly.
Roberts: What was your best time in the 100-yard dash?
Hempel: I think as a 14-year-old I ran it in 11.2 seconds.
Roberts: That is great. Did you play first team in basketball?
Hempel: I did in junior high, but because we were usually in the football playoffs, I didn't get out to basketball practice until a third of the way into the season. It was kind of hard to start. I started a few games as a senior.
Roberts: In baseball, how did you do?
Hempel: In my junior year we lost in the state finals to a Beaumont team. We went down to Austin and played at Disch Field. We won the first game and lost in the finals.
Roberts: What did you hit in baseball?
Hempel: My senior year I hit .344. I was the all-district left-fielder.
Roberts: So you were a good athlete. When you were in high school, did you get opportunities to play in college?
Hempel: Yes. I had a football scholarship to Texas Christian University and a 1-year football scholarship to SMU. But I had hurt my knee as a junior (Figure 6), missing about six games in the middle of the season. At that time, they couldn't determine exactly what was wrong with the knee. My interest in medicine started then a because I spent about a week in traction at the old Methodist Hotpital, and every day an orthopedist, Albert Loiselle, MD, came by and drew out bloody fluid from my knee with a big syringe. My maternal grandfather, who died when I was 4 or 5 years old, was a physician, but I never knew him. It was Dr. Al Loiselle who first got me interested in medicine.
Figure 6.
After he injured his knee in a football game in September 1950. Shown are Ruth Barrett, his future wife. The players are the late Jay Fikes and Don Alexander, an otolaryngologist practicing in Atlanta, George. The three served as cocaptains at Highland Park the next year, 1951.
My dad took me to see various physicians. One was Dr. Don O'Donough in Oklahoma City, who made a name for himself taking care of Bud Wilkinson's Sooners. He was the first orthopedist to write a book solely about the knee (Internal Derangements of the Knee). His “bottom line” was that he didn't know what was wrong with my knee. My dad took the view that if he didn't know what was wrong, then he shouldn't operate on me. When I was finally operated on, it was discovered that I had O'Donough's “malignant triad,” a combination of knee injuries frequently seen in athletes. It involved the medial cartilage, the medial collateral ligament, and the anterior cruciate ligament. That injury cost me a lot of speed, and that was one of the reasons I didn't play in college.
I was a little discouraged by my injury and got interested in other things in college. My dad challenged me a little bit, and I told him I wasn't going to play sports anymore; I was going to get married. He asked me what I was going to do, and I told him I would become a doctor. And that is in fact what I did with the aid of a good wife.
Roberts: When you were growing up, did you take family vacations?
Hempel: I don't remember an extensive vacation. We would always visit our grandparents in Bartlett. My father's father was an immigrant from Germany and a watchmaker. He had a jewelry store in the town. I remember his wearing that magnified monocle in his eye, working on all sorts of watches. Because I was fascinated by his work, I loved to go down to Bartlett and spend the mornings in the jewelry shop, which was only 3 or 4 blocks from my grandparents’ house.
The Missouri-Kansas-Texas (also called MKT or Katy) Railroad came right through town. There were three trains a day, and then about three times a week there was the Texas Special, a nonstop train that went from Dallas to Austin. It also came through Bartlett. I loved to go down to “the depot” and watch the people hold up a message for the Texas Special on Y-shaped apparatus that was made out of bamboo. When the train went by, the guy would reach out and grab the message or the train would stop and they would unload the boxcars or put the milk cans on the train. All that fascinated me as a youngster.
Roberts: How big a town was Bartlett, Texas?
Hempel: Its population was about 1500.
Roberts: What about Georgetown?
Hempel: Georgetown had a population of maybe 25,000.
Roberts: When you were taking science classes in high school, did you develop an interest in science, or did you know medicine only from the standpoint of being treated yourself?
Hempel: I was a good math and biology student. I didn't do very well in Spanish and history but did well in English.
Roberts: When you graduated from Highland Park High School in 1952, did you have class standings?
Hempel: I graduated in spring 1952 and was in the middle third (Figure 7). I was actually not a real good student. I was a solid middle-of-the-pack student. I did better in college and medical school than I did in high school.
Figure 7.
With Ruth at the old Highland Park High School graduation, May 28, 1952.
Roberts: You got married as a 17-year-old senior in high school and have been married to Ruth ever since?
Hempel: That's correct.
Roberts: The odds of being married for 56 years when you marry at 17 are not very good.
Hempel: I realize that!
Roberts: When did you start dating Ruth?
Hempel: In the eighth grade. She came from Pampa, Texas, in the Texas Panhandle.
Roberts: Eighth grade? You went steady from that point on, more or less?
Hempel: More or less, yes! Unusual story.
Roberts: What were the characteristics of Ruth that attracted you to her?
Hempel: She was pretty, bright, and athletic.
Roberts: You hit it off right from the beginning?
Hempel: That's right.
Roberts: Where did she live?
Hempel: She lived on McFarlin, right off of Preston Road, down the street from the Highland Park Presbyterian Church.
Roberts: When you got married as a senior in high school, had any of your classmates gotten married by that time?
Hempel: We ran off and got married, and nobody knew about it for several months.
Roberts: Where did you go get married?
Hempel: Rockwall, Texas. There were only two places then where a couple could elope: Rockwall, Texas, and Durant, Oklahoma.
Roberts: When you started at SMU, where did you live?
Hempel: We lived in an apartment owned by Ruth's grandfather on Lemmon Avenue, right off of Oak Lawn. After a short while, we moved to 3616 Granada near Highland Park Junior High.
Roberts: How did SMU work out? Was deciding where to go to college an easy decision?
Hempel: My dad was an SMU Mustang, and we hung out around SMU when I was a kid. We would ride our bicycles there to shoot baskets in the gymnasium or to sell programs when SMU still played on campus. When they began playing their games in the Cotton Bowl, we'd ride the street car to Fair Park and sell programs there. SMU was a logical place for me to go. I gave up that 1-year football scholarship, but I was also a Dallas Morning News carrier, so I got a Dallas Morning News scholarship, which helped provide for the first year.
Roberts: You would get up at 5:00 in the morning?
Hempel: No, 4:00 am! I started doing that when I was in high school and did it all through college.
Roberts: Don Alexander had a paper route too?
Hempel: Yes. Paper routes are good jobs, but they are everyday jobs—365 days a year. You couldn't go anywhere unless you had a buddy who could cover for you. He would throw two paper routes when I wanted to be away, and I would throw two when he wanted to be away.
Roberts: How much sleep do you get a night?
Hempel: Maybe 5 hours.
Roberts: And you feel good on 5 hours?
Hempel: Yes, but I can take about a 15-minute nap just like an old cat. I can sit down and go to sleep for about 10 or 15 minutes and feel rejuvenated.
Roberts: You went to medical school after 3 years at SMU?
Hempel: Correct. I went 3 years and 2 summers and then after my second year in medical school, SMU awarded me a bachelor's degree. SMU had such a program then.
Roberts: What did you major in during college?
Hempel: It was called “premed curriculum” and involved a lot of science. I took 3 years of chemistry, 2 years of biology, and 1 year of physics. Every semester I took 18 or 19 hours with at least 2 science courses.
Roberts: You were a busy guy during college.
Hempel: I was, but I didn't realize it at the time.
Roberts: How did you come out in college from a grade standpoint?
Hempel: I did pretty well. I wasn't on the dean's list, but I did very well in the few courses, such as organic chemistry, that were necessary to get into medical school or dental school. Dr. Harold Jeskey at SMU was probably responsible for getting more students into medical school and dental school than any other professor who ever lived. He was one of my early mentors. I served as his lab instructor during the regular fall and spring semesters my last year. He and I got to be pretty close, and I think that more than anything else was my ticket to medical school.
Roberts: Did you apply to any medical school other than Southwestern?
Hempel: Yes, I applied to the University of Texas Medical Branch at Galveston. At that time, there were only three schools in Texas: Southwestern in Dallas, the Medical Branch in Galveston, and Baylor College of Medicine in Houston. I applied to Galveston and got accepted. I chose Southwestern because I had a place to live and it was relatively easy to go there.
Roberts: By that time you were living on Granada. How did medical school hit you? Were there any surprises going from college to medical school?
Hempel: It was a tough ride, but I was prepared for it. One thing about an athletic career is that it teaches you about hard work and that hard work can get you somewhere. I adapted to it pretty well. My wife worked, so I didn't have to throw the papers anymore. We got by pretty well. After my second year in medical school, the Hoffmann-La Roche Pharmaceutical Company gave me an award for “the most outstanding medical student.” By the time I graduated I was chosen for Alpha Omega Alpha, which is the top 10% of the class, so I'd say I adapted to the medical school curriculum pretty well.
Roberts: How many students were in your medical class?
Hempel: At the start, there were 100, but we lost 10. Some students from 2-year medical schools transferred for the junior and senior years. There were 108 to 110 at graduation.
Roberts: When you were going through the various clinical rotations in your junior and senior years, was it easy for you to decide on surgery? Or did you like all of them?
Hempel: I liked them all. I was attracted to internal medicine early on because of Dr. Donald Seldin, who was the chief of internal medicine at Parkland and Southwestern. He brought a lot of students into medicine. I had a summer job working in surgery at the old Gaston Hospital between my sophomore and junior years and also between my junior and senior years. I got interested in surgery there, and, of course, I had some interest in orthopedic surgery already because of my experience with my knee injury. When I had a surgery rotation as a senior, I thought it was like internal medicine with surgery thrown in. At that time, I deviated away from internal medicine. The surgery residents managed patients with diabetes and heart failure and were encouraged to do those kinds of things rather than call a consultant. It seemed to me at the time that surgery was practicing internal medicine with the addition of the operating room.
Roberts: Were there teachers or professors besides Dr. Seldin who had a particular impact on you?
Hempel: Yes. Dr. Ben Wilson, chief of surgery. He was one of Dr. Carl Moyer's residents. He was very bright and very handsome; he almost looked like a South American prince. He was one of those guys who, if you asked him what time it was, would tell you how to make a watch. I was attracted to him. He accepted me into the surgery residency. He had a falling out with the dean and went into private practice in Grand Junction, Colorado. Before leaving, he had brought Dr. Tom Shires onto the faculty. Dr. Shires had also been in private practice in Dallas for a while. At that time, private practice was a little bit difficult. BUMC, for instance, had a closed staff. He struggled a little bit and worked at the old St. Paul Hospital when it was close to BUMC on Hall Street. He was a very bright guy also. Jay Sanford was the infectious disease specialist in the internal medicine department. He was very interesting and got a lot of people interested in infectious disease. I liked him.
Roberts: During two summers in medical school, you worked at the Gaston Hospital?
Hempel: Gaston Hospital had a program where externs assisted in the operating room in the mornings, and after lunch they worked up new patients who were admitted to the hospital. I saw the patients the day before their operation. Several excellent surgeons were there, and they stimulated my interest in surgery. Dr. John V. Goode was an old Halstedian type of surgeon. In the early days of Southwestern Medical School, he had been chief of surgery. He did thyroidectomy under local anesthesia. He probably had the best survival rate for radical mastectomy in the country. He had a big practice. Dr. Dan Gill was an excellent surgeon. Dr. Billie Aronoff was a big cancer surgeon in Dallas. He was a small guy who worked rapidly and had a good personality. The first day I went in with Dr. Aronoff, he said, “What are you, Ken?” I said, “I'm a junior medical student.” He said, “Okay, Junior Gillium, come on in.” (Junior Gilliam was a second baseman for the Brooklyn Dodgers.) He called me Junior Gillium for the rest of the summer. He was a good surgeon. I got to know him much better later on. He would assist when I was a resident at Parkland or the Dallas Veterans Affairs (VA) hospital.
Roberts: When it came time to apply for internship, did you apply to places other than Parkland?
Hempel: It isn't quite that simple. I was interested in the surgical subspecialties, particularly orthopedics. I always liked working with my hands. By the time I got out of college and into medical school, we had two children. My next-door neighbor on Granada was a guy named Dr. Marvin Shepard. “Shep,” as everybody called him, was an ear, nose, and throat specialist. He gave me my first stethoscope, my first sphygmomanometer, and some medical books. Shep was in the later stages of his training, and he went to New York City for his fellowship. He asked me to go into ear, nose, and throat and come into practice with him when I got through. That kind of interested me.
I took a rotating internship at BUMC. At that time, I wasn't sure exactly what I wanted to do, but I was interested in all the surgical subspecialties. At that time, all the surgical subspecialties required a year of general surgery. I applied to Parkland because I was in the top 10% of my class; it wasn't too hard to get a year of surgery residency at Parkland. I got accepted, but Dr. Ben Wilson left before I started that first year in surgery, and Dr. Tom Shires became the acting head of the department. They interviewed a lot of candidates to be the department head. They ended up giving it to Tom. Tom tried to surround himself with some of his residents as staff people. He wanted to send me off for ear, nose, and throat training.
I actually got accepted into the big otolaryngology residency program in Iowa, and we moved to Iowa City. Dr. Dean Lierle was the head of that specialty board. The Iowa ear, nose, and throat department had about six or seven full-time faculty members—including full-time faculty for head and neck surgery, bronchoesophagology, and plastic surgery. (At Parkland, in contrast, one part-time clinical professor served as head of the ear, nose, and throat department.) When I was in Iowa City, Adrian Flatt, the hand surgeon, was also there. Bill Bean was the internal medicine guy there. I still remember his talks. He wrote a paper, “Cutaneous manifestations of the carcinoid syndrome,” and talked about all the color changes in the hand and called it something like the “fickle phantasmagoria of the Aura borealis.” I still remember his saying that. He was an eloquent speaker and writer in Iowa City.
After about 3 or 4 months, I called Dr. Shires and said that I didn't know if I could do otolaryngology. He told me to come back and he would put me in the laboratory or in the VA hospital for a while. As it turned out, I had a little bit of a bastard residency because I had to spend a year here, a year there to get through. I came back as a second-year resident, but the main part of my job was working in the laboratory. Dr. B. L. Reynolds had come to be part of the surgical department, and I was working for him, studying radioactive isotopes—which the military considered a classified topic then. My name was on the research grant as one of the workers. About that time the Berlin Crisis came along, and the military drafted four or five guys out of the surgical residency program at Parkland. Because my name was on that grant, I didn't get drafted. I had been in the Reserve Officers’ Training Corps at SMU for the first 2 years but got out when I saw that I was going to be able to get into medical school.
I spent some time at the Dallas VA Hospital and decided I would like to practice in Dallas. At that time, one couldn't get privileges at BUMC unless going into practice with somebody who was already on BUMC's staff. I looked at the other general surgery subspecialties and thought that vascular surgery, which had been around for only 10 to 12 years, was best for me. There were three vascular surgeons in Dallas at the time: Dale Austin, Jesse Thompson, and LeRoy Kleinsasser. They were all excellent surgeons, but the operations took them a long time: 3 or 4 hours for a carotid endarterectomy, 6 to 8 hours for resection of an abdominal aortic aneurysm.
I looked around during the end of my surgical residency for a vascular surgery fellowship. There were no official vascular fellowships at the time, but there were five preceptor-type residencies that involved working with a surgeon who did a lot of vascular surgery. Wiley Barker and Jack Cannon had one in Los Angeles; Edwin J. Wiley had one in San Francisco; Emerick Szilagyi had one in Detroit; Andrew Dale had one in Nashville; and Michael DeBakey, Denton A. Cooley, E. Stanley Crawford, and George C. Morris had one in Houston. The Duke of Windsor was operated on by Dr. Michael DeBakey in Houston, and it took 75 minutes to resect the abdominal aortic aneurysm. I decided those guys in Houston knew something we didn't know in Dallas. The Houston program was part of the Baylor surgery department and was structured such that fellows spent 3 months with each of the four staff surgeons.
I decided to go to Houston. I got there during the middle of the academic year and was put on Dr. DeBakey's service. He was a stern taskmaster. He was a little bit hard to work with and occasionally would throw an assistant out of the operating room. He believed that the learning process was painful, and he wanted to make it as painful as he could. But I learned. Then I rotated on George Morris’ service. He and I hit it off real well. George did a lot of the small-vessel work—tibial artery vein graft (below the knee), renal artery grafting, etc. When coronary bypass started, he was one of the early and best surgeons doing that procedure because he was already good working with small vessels. He took a liking to me. I was like his junior partner. I first assisted him on every case, did all his general surgery cases, and took care of patients just like they were my patients. He would ask me what I thought and wouldn't even come in on weekends or at night to see the patients. I'd take care of all of them. He talked to Dr. DeBakey about getting me back on his service. I missed Stanley Crawford's service altogether because they got me back on DeBakey's service.
That was the way you started in Houston if you wanted to stay there for your career: you got on Dr. DeBakey's service, and if you could work with him and he liked you, then you became a junior associate. They offered me a junior associate job. By the time I left, I was going to take that position and probably would have ended up being a thoracic surgeon or a coronary surgeon if I hadn't gotten drafted.
Roberts: You got drafted after 1 year?
Hempel: Yes. Seven days after I finished the “fellowship,” I went to the Medical Field Service School in Fort Sam Houston to be in the US Army.
It was a good time in Houston. At Parkland, I had never seen someone with a descending thoracic aneurysm operated on and survive. I think I'd seen four operated on, and a couple of them were closed without doing anything. One died on the table and another died a few days later. We operatively excised five descending thoracic aneurysms the first week I was on DeBakey's service, and all five patients walked out of the hospital 10 to 14 days later. They used left heart bypass and the patient's own lungs, cannulated the left atrium, and perfused via the femoral artery. It was amazing. I learned quickly that they did know more than we did in Dallas.
They had a huge service. DeBakey had over 200 patients on his service at that time, including 70 patients on his preoperative list; Cooley had about 50 to 60 patients on his service; Crawford had maybe 30; Morris had about 25 patients on his service. It was like a surgical factory. Everything was first class, and you got what you needed. An occasional patient became hypotensive in the intensive care unit (ICU) and had to go back on the pump. This was before the days of left ventricular assist devices. One fellow told Dr. DeBakey that we needed a pump in the ICU, and about 3 days later, we had it. Then if a patient got in trouble, he or she was put back on the pump right in the ICU before having to go back to the operating room.
This also was before the days of coronary vein grafts. Ed Garrett, who was the number-one DeBakey associate, actually did the first coronary bypass with a vein graft. It was a bit of serendipity. The operation for coronary artery disease at that time was endarterectomy, but the narrowing had to be short and in the proximal portion of a coronary artery. Dr. DeBakey planned on doing a coronary endarterectomy on one patient, but during the procedure the coronary artery was damaged such that a large gap was left in the artery. The patient was on cardiopulmonary bypass fortunately. Ed was a very resourceful guy and also one of my early mentors. He had been in the Korean War and had come back on the GI Bill and gotten interested in medicine. He was mature and could deal with Dr. DeBakey. He suggested going into the patient's leg, removing a piece of vein, and hooking the end on to the distal coronary artery and then to the ascending aorta proximally. The patient came off the pump and did just fine. They made an angiogram and showed it at the Annual Scientific Session of the American Heart Association. Coronary artery bypass surgery took off thereafter.
Mason Sones at the Cleveland Clinic had already developed coronary angiography. A young cardiac surgeon at the Cleveland Clinic, René Favaloro from Argentina, started doing coronary bypasses and pretty soon they had a huge series of patients. The operation for coronary artery disease up to that time had been the Vineberg procedure. Arthur Vineberg had been working in Canada for about 10 years implanting internal mammary arteries directly into the left ventricular myocardium. Most investigators thought he was a little crazy. He had done about 100 cases, and one of his patients came to Houston to be studied for cerebrovascular insufficiency. At that time, our standard way to do carotid and vertebral arteriography was to do direct needle sticks. We did carotid sticks in the neck and then we did subclavian sticks to see the vertebral circulation. We injected the left subclavian of this patient, and contrast material lit up the heart like a Christmas tree via the mammary artery. Dr. DeBakey looked at that angiogram and said, “Maybe Arthur has got something.”
We started studying patients with coronary artery disease. Ed Garrett and I did 50 Vineberg procedures in 3 months, half the number that Arthur Vineberg had done in 10 years, because all patients coming to Houston got worked up angiographically for coronary artery disease. We did a Vineberg procedure if they had anterior wall disease; if they had posterior wall disease, we would take a vein graft off the descending thoracic aorta and run it to the back of the heart. That didn't work very well. Then we would do the old Beck procedure—abrade the epicardial surface of the heart with instruments that looked like little rasps to try to excite collaterals—and then we would open the diaphragm and pull up a piece of omentum and drape that over the heart to encourage collaterals. Because we had over 200 patients in the hospital, it was pretty easy to find candidates for all these procedures. Ed Garrett and I were doing those procedures on DeBakey's service. It was a great time to be involved in cardiovascular surgery.
Then I got drafted in 1966, and Dr. DeBakey said that if I wanted to come back they would have a place for me. But by the time I got out after a 2-year stint, one of my children was in junior high school, and it was time to put down some roots and get back to Dallas and practice.
Roberts: Who were some of your classmates in medical school who might be known by the BUMC Proceedings readership?
Hempel: Pat Evans was an orthopedist who took care of the Dallas Cowboys early on. He took care of all the rodeo cowboys and I think is still involved with them. Dan Polter, a gastroenterologist, works with a lot of the transplant faculty now. Jim Caldwell was in BUMC's physical therapy department; Ed Harrison, in the obstetrics and gynecology department;Weldon Tillery, in the pathology department; and the late Dr. Law Sone, in the anesthesiology department.
Roberts: George Hurt was ahead of you?
Hempel: George Hurt was 2 years ahead of me in medical school and, of course, he went into urology. Bob Vandermeer was a year ahead of me and is an orthopedist. He took care of the Dallas Cowboys during the last three Super Bowls.
Roberts: Did DeBakey ever leave the hospital during your time there?
Hempel: Not much. I guess he left because he lived close by, but he was there all the time. He would start early in the morning and grab the first anesthesiologist he could get. He would get the sympathectomy done in about 5 minutes and then turn it over to one of the fellows to do the femoropopliteal bypass. Then he would do a carotid endarterectomy and get a patch on the carotid. By that time, the third operating room (he ran three operating rooms at once) was ready to go. The third case, usually a pump case, was started by probably 8:00 am. He'd do maybe 16 to 20 cases a day in three operating rooms.
Roberts: Was Cooley doing about the same?
Hempel: Cooley was running two operating rooms, but he would sometimes do 14 to 16 cases in those two operating rooms.
Roberts: Did you work with Cooley at any time?
Hempel: Yes, for 3 months.
Roberts: Was Cooley technically as good as his reputation?
Hempel: Yes, he was the master surgeon and fun to work with. He and I still keep up a dialogue. In fact, I communicated with him recently because I was interested in a condition called thoracic outlet syndrome. When I was working with him as a fellow, he had operated on Whitey Ford, one of the famous New York Yankee pitchers. I thought I would do a little talk and paper entitled “What do Whitey Ford and Kenny Rogers (Texas Rangers pitcher) have in common?” I wrote and called Dr. Cooley and asked him if he had operative notes. He said he didn't have an operative note anymore, but he would send me a paper that he wrote. The paper, “Lesions of the throwing extremity,” appeared in an obscure orthopedic journal, and the first patient listed is Whitey Ford, a 36-year-old left-handed Yankee pitcher.
Dr. Sparkman put on the Blalock Heritage Program a number of years ago here at BUMC. Because I knew Dr. Cooley, we invited him to speak, so I squired him around. He and Louise came up and we spent time together. We played some tennis with him and Bill Boss, the tennis pro at the Dallas Country Club at that time.
Roberts: You came back to Dallas in February 1968. Who did you go into practice with?
Hempel: The first year in the military, I was at Fort Jackson, South Carolina. The second year I was at the 121st Medical Evacuation Hospital in Korea. This was during the latter phases of the Vietnam War, which is when I got drafted. They were sending people from places like Cameron Bay and the Highlands to the 121st Evacuation Hospital. I was overseas and worried about going into practice. Dr. John Bagwell, an internist who was a good friend of my parents, knew Dr. Gene Wheeler from the First Baptist Church in Dallas. Dr. Wheeler had come from the Massachusetts General Hospital. (He and Hal Urschel had been roommates as interns there.) Initially when he came to Dallas, Gene had practiced with Dale Austin and Jesse Thompson. After a while, he was doing 40% to 50% of the surgery and making only 17% of the money. He decided to go on his own. That was a year before I was ready to return to Dallas. Dr. Bagwell talked to Dr. Wheeler, and then I communicated by letter with Dr. Wheeler. When I came home around Christmas, before getting out in February, I met Dr. Wheeler. He indicated that he would take me in as a partner. That appealed to me since I had three children. The partnership began in February 1968.
Roberts: Where did you initially operate in Dallas?
Hempel: At that time, a young guy does much like he does now. I'd go anywhere. I worked at Presbyterian, which had been open for only a year, as well as Doctor's Hospital, St. Paul's Hospital, and of course BUMC. I kept a vascular set (Dacron grafts) in the trunk of my car. Once I went to Greenville, Texas, to operate on a ruptured aneurysm in a patient who wasn't able to move.
Roberts: Why was vascular surgery in Dallas so “slow” compared with Houston? Was it because of the surgeons’ limited experience because of fewer cases?
Hempel: Yes, I think so. The surgeons who did it were good but sort of learned on their own. They didn't have any formal training in it because little formal training was available. They learned by hearing other people talk about it and reading papers about it.
Roberts: When you started, were you performing mainly vascular surgery? You kept up your general surgery throughout your career?
Hempel: At that time, people who did vascular surgery also did general surgery. I can remember making rounds with Dr. Austin, and he would get upset if one of his patients was in the hospital and had been operated on and he hadn't been informed. I always thought that the vascular fellowship was like a year of finishing school. That training made you a better general surgeon because you learned to work around great vessels without any fear or trepidation. I enjoyed doing the Whipple procedure and adrenalectomies. I did a fair number of those cases. I had two long-term survivors after a Whipple procedure.
Roberts: In your heyday, when you were operating every day, what percent of your cases were vascular?
Hempel: About 50%.
Roberts: How did it work out? You went into practice with Gene Wheeler and what happened after that?
Hempel: Dr. Wheeler offered me a salary of $36,000 a year. He said that after 1 year, we would sit down and talk about it. If I was happy with the arrangement, we would be partners. That's exactly what we did. Gene was very bright. He had the intellect to be the chairman of the department. He was first or second in his class at medical school. He and Lazar Greenfield were in the same class, and I think Gene was first and Lazar was second.
Roberts: Lazar became chairman of surgery at Richmond and then at Ann Arbor?
Hempel: Yes. Actually he started in Oklahoma and then moved to Richmond when Dave Hume was killed in a plane crash. Then he moved and became the Coller Professor of Surgery and head of the department at the University of Michigan. Of course, he developed the Greenfield filter, used widely to prevent pulmonary embolism.
Roberts: You and Dr. Wheeler worked together for a long time?
Hempel: We worked together for 25 years. We had a fellowship program here at BUMC. Dr. Thompson had a fellowship program too. We later combined the fellowship. We began to have these young guys train with us, much like we had trained, and we kept some of the trainees on. We kept Hassan Bukhari, Don Hunt, and John Anderson and grew our group. All these guys came through the fellowship program. We got progressively busier with time and added to our group accordingly. At one time, we had five guys. I started with Dr. Wheeler in the Doctor's Building, on the corner of Gaston and Washington. The building later was torn down for a parking lot. Later we bought some property on the corner of Worth and Hall and built our building.
Gene was an astute businessman. He could give you an hour talk on the religious beliefs of the American Indians, or on Peking glass, or on Oriental rugs—a lot of obtuse things that you don't think many surgeons would be interested in. Gene grew up in Arizona, and his dad had a bunch of Indian trading stores. He grew up doing business with the Indians. His dad also had a boiler-making company in California, and during World War II he made a lot of money making boilers for the government. Gene made a lot of money buying and selling property around Dallas. He and I worked well together. He was left-handed and I was right-handed, so we were both on the “correct side” of the table.
Roberts: What was your life like during the late 1970s and early 1980s during the heyday of your surgery days? What time did you get up in the morning?
Hempel: I usually got up at 5:30 am. An old paperboy likes to get up early. I tried to be in surgery by 7:30 am. I wasn't interested in doing a whole lot of surgery. I did two or three cases a day. I tried to be through by noon. We did our own translumbar and femoral arteriograms. I tried to do one or two arteriograms between 1:00 and 2:00 pm and was back in the office from 2:00 to 5:00 or 6:00. I then made rounds and tried to be home by 7:30 pm for the family dinner. I was home for dinner most nights. An occasional emergency would interfere with that schedule.
Roberts: What about your weekends?
Hempel: We had family time on the weekends. After 4 or 5 years, we bought a lake house at Tanglewood at Lake Texoma. We had a boat and would go up there for the weekends when I was not on call.
Roberts: How often were you on call?
Hempel: After we got to be a group of four physicians, it was only every fourth weekend, which was pretty pleasant. We would try to take one day off during the week and work Friday through Sunday as a group.
Roberts: After you got home at 7:00 or 7:30, you would have dinner. What was the rest of your evening like? What time did you go to bed?
Hempel: I usually got to bed around 10:30 or 11:00, after the TV news.
Roberts: You got about 6 hours of sleep? How much time would you take off during the year?
Hempel: I took a week or two at a time several times a year. I was in several of the vascular and surgical organizations, including the Society of Vascular Surgery and the North American Chapter of the International Cardiovascular Society. I tried to go to those meetings, and they always met in June. The Southern Vascular Society met in February, so I would go to every other vascular meeting and then most of the southern vascular meetings because they were always in good places.
Roberts: Your athletic activities have been hunting, fishing, and golf. How often did you play golf during heavy practice days and how often now?
Hempel: Back when I was practicing, I would play once a week. Now I play two or three times a week.
Roberts: What was your handicap when you were at your best?
Hempel: Ten is the best handicap I have ever had.
Roberts: When do you hunt, where do you hunt, and what do you hunt?
Hempel: I've hunted just about everything but big game. Now I am mainly a bird shooter—wing shooter. I like it because it's a challenge. I like to hunt doves, quail, ducks; primarily ducks (Figure 8). I have hunted deer but eventually felt like I was killing a big dog out in the backyard in the Texas Hill Country. Also there was a lot of card playing and whiskey drinking during deer hunting. I wasn't too interested in that. One son is interested in hunting, and we did a lot of that together and still do.
Figure 8.
Duck hunting in 2004.
Roberts: What about fishing?
Hempel: We have a place in Angel Fire, New Mexico, and we spend some time there fishing. It's in the northeast corner of New Mexico, near Taos and the Red River.
Roberts: You fly up to Albuquerque?
Hempel: We drive. It is 650 miles from our front door. Ruth was from the Texas Panhandle, and we have the old family wheat farm in Pampa, so we drive up there, spend the night, and check on the farm and then go on to New Mexico. It's about a 5½-hour drive to Pampa, which is just north of Amarillo.
Roberts: How many acres is the wheat farm?
Hempel: It's a section: 640 acres.
Roberts: Who takes care of that for you?
Hempel: We have people up there who work for us. We are not actually too involved in wheat anymore. It's harder to do that, particularly for nonresident farmers.
Roberts: Tell me about your children.
Hempel: I have three children (Figure 9). Charles Barrett Hempel was born on November 14, 1952, during my freshman year in college. He is a computer designer for an architectural firm in San Antonio. Architects don't work from blueprints like they used to. They create a building with a computer, cut right through it, and show a client exactly how much room they will have.
Figure 9.
His three children. (a) Charles Barrett Hempel, a CAD designer with a San Antonio architectural firm. (b) Robert Kennedy Hempel, a petroleum engineer with DeGolyer and MacNaughton in Dallas. (c) Emily Hempel, a teacher in the Lewisville School District.
Roberts: What was his training?
Hempel: He went to Rice University. He was a very bright kid, a National Merit finalist. He got interested in architecture.
Roberts: What about your second child?
Hempel: Robert Kennedy Hempel was born on December 1, 1956. He is a petroleum engineer. He got his degree from the University of Texas and works for DeGolyer and MacNaughton, a very famous Dallas geophysical company. (Everett DeGolyer developed the Mexican and South American oil fields, and the Dallas Arboretum is his old estate. He is very well known in geophysical circles and gave SMU the Oil and Gas Library.)
Emily Hempel was born on June 15, 1966, when I was at Fort Jackson in the army. She is a teacher in the Lewisville Independent School District and lives in Corinth, Texas.
Roberts: Do you have grandchildren?
Hempel: No.
Roberts: What do you and Ruthie do now?
Hempel: As you know, I work one day a week at the Baylor Hyperbaric Oxygen and Wound Care Center with Charles Shuey and have been doing that for a couple of years. I actually had to retire from surgery in July 2003, a little before I was ready to retire. I got a methicillin-resistant staphylococcus septicemia from a patient, and it settled in my spine (T8–T9). I was pretty sick with an illness that used to kill people when we were medical students and houseofficers. It was good that the infection didn't settle on a heart valve or on my knee replacement, which was done about 18 months earlier. I lost weight and weighed what I did when I was 14 years old. I didn't do anything for about a year. When I was sick and beginning to get better, Dr. Shuey, a pulmonologist, started the hyperbaric center. He used to help me with some of my major general surgery and vascular surgery patients who had to be on a ventilator. He asked me if I wanted to do a little work because they could use some surgical expertise in the Hyperbaric Oxygen and Wound Care Center.
I actually had a brief exposure to hyperbaric oxygen early in my practice. Ross Love, whom I grew up with, called me in 1975. His dad had head and neck cancer; he had been treated with surgery and radiation and had an ulceration in the floor of his mouth that wouldn't heal. I thought I would put a skin graft inside his mouth, but it broke down because it was radiated tissue. There was one hyperbaric unit in Texas at Brooks Air Force Base in San Antonio. They agreed to take Mr. Love Sr. on a compassionate basis. Ross, who was very active in the commercial real estate business here in Dallas, got his dad an apartment in San Antonio and moved him there and then spent the weekends with him. They treated Mr. Love every day for about 8 weeks and healed that sore inside his mouth. I learned then that there was something to hyperbaric oxygen!
After talking to Dr. Shuey, I decided that that might be something I wanted to do. I always liked to work. I didn't need to work, but I needed to have a little something to do. I work on Mondays when the golf course is closed.
Roberts: Do you read much outside of medicine?
Hempel: I read hunting and fishing magazines and some sport magazines and a few other things too.
Roberts: What is your home like?
Hempel: Since it's just Ruth and me, we have downsized. We lived on Miramar for 21 years, but after the kids left, we were rattling around in that house and the taxes got to be too much. Additionally, I was to have a knee replacement and we thought the stairs might be a problem. We bought a smaller house that had a downstairs master bedroom on Livingston, close to Highland Park Village. We travel a lot (Figure 10). We go on cruises and spend time at our home in New Mexico. Ruth says that the older she gets, the less she likes Dallas in the summertime, so usually in June and July we head to New Mexico and spend the rest of the summer there. I shuttle back and forth. I'll go up there for 2 weeks and then come back home for 2 weeks, and I'll do that three or four times during the summer.
Figure 10.
With Ruth at Sea Island, Georgia, in April 2000.
Roberts: What is your place like in New Mexico?
Hempel: It's a 3-bedroom, 2-bath house that looks toward Wheeler Peak with a great view of the mountains. We have all the comforts of home. The elevation there is 8500 feet, so we don't need air-conditioning.
Roberts: Is there anything you would like to talk about that we haven't covered?
Hempel: One surgical interest of mine we did not discuss was the Warren shunt. I did the first successful operation in Dallas using that shunt for bleeding esophageal varices related to portal hypertension. Dean Warren had described that operation initially. It's a distal splenorenal shunt with gastric devascularization. It's good because it's not a complete portal systemic bypass; there is still some blood going to the liver. One problem with the old portacaval shunt is that too much of the blood is shunted away from the liver, and sometimes liver function deteriorates and the patients die from hepatic failure. Ernie Poulos and I did the first two successful operations in the same month. I'm not sure who was first and who was second, but they were both done in April. I've forgotten the exact year. That procedure was an interest of mine because of my vascular training and my abdominal and retroperitoneal surgical background. I did a good number of those cases.
Roberts: How many operations do you figure you have done in your lifetime?
Hempel: I don't really know—a good number, though. In the thousands, I guess.
Roberts: I asked that question of DeBakey, Cooley, and also John Kirklin. I'm not sure anybody knows.
Hempel: I've never tallied them up: 3000 to 4000 for sure. Those guys did many more than that because they did 12 to 15 a day for many years. During practice, I did two a day several days a week and took some time off; 200 to 300 cases a year was a pretty good number for me. When I was in the army, I had a B-MOS in general surgery (which is boards in general surgery) and a C-MOS in thoracic surgery. I did a lot of thoracic operations. I did a number of pulmonary lobectomies, decortications, and other thoracic procedures because patients with chest wounds from shrapnel were sent to us. They airlifted them to Korea in those big C-141 Starlifter planes.
Roberts: You faced a major choice of whether to return to Dallas or go to Houston. Do you ever look back and wonder what would have happened if you had decided on Houston?
Hempel: Maybe briefly, but I'm not the kind of guy who looks back with regrets. I decided what I thought I ought to do and did it, and I did not think about “what-ifs.” Had I gone to Houston, my life probably would have been a lot different, but I think eventually I would have come back to Dallas because it is my home. Vein grafts were just starting to be done then. At that time, most cardiac surgery was valve replacement, because a large number of patients had rheumatic heart disease and the surgery hadn't caught up with all those patients yet. Cooley did a lot of procedures for congenital heart disease too. He operated on a lot of infants and small children. I probably would have been a coronary surgeon if I had stayed in Houston.
Several years into my practice I got approached indirectly through Bob Vandermeer to join the Thompson-Austin group. That move might have gotten me more involved with academic vascular surgery and more involved with some of the societies. I would have written more papers. I wanted to do private practice and wasn't particularly interested in academic surgery, so I've been very happy with my career. It's been very rewarding. One reason I'm still doing what I do is because I like the involvement with patients.
Roberts: Ken, thank you, not just for myself but on behalf of the readers of the BUMC Proceedings, for pouring out your soul, so to speak.
Hempel: You are very welcome, and it's always good to visit with an old friend.
Roberts: We have known each other for a long time.
Hempel: That's right.