UT Health San Antonio, The Joe R. and Teresa Lozano Long School of Medicine
1968 - 2018, Caring for People
By James L. Holly, MD

(Author’s Note -- Selective History -- This is not an exhaustive history of UT Health and it is not told in order to exaggerate my role in that history.  It is “a” history of the school told from the perspective of my experience.  There are many founding faculty, students, alumni, administrators and staff whose stories are not acknowledged, not as a diminution of their role in UT Health’s history.  In an exhaustive history of UT Heath San Antonio, it may be judged that the events related here in are not worthy of inclusion. That will be for others to judge.  This document is intended to tell “a” story of UT Health as I experienced and as I remember it.  It is selective because my memory is long and it is deep.) 

The Two Events Which Motivated This Document - Drs. Bill Henrich and Ruth Berggren

Two events occurred in June of 2017 which resulted in the preparation of this summary of my thoughts and recollections of the events which have transpired since my first contact with what is now the UT Health San Antonio Long School of Medicine but which once was named the University of Texas Medical School at San Antonio (UTMSSA).

These recollections will be presented chronologically so far as is possible.  Some of the documents referenced will be out of order by time because they were produced many years after the events but are presented here for the part of this story they tell.

The first event was the receipt of Dr. Bill Henrich’ s invitation to the Presid3ent’s Annual UT Health Gala in September, 2017, in which he announced that this celebratory event would be the first in a series of events which will be held in 2018 to commemorate the 50th Anniversary of UT Health and the Long School of Medicine.  (See Letters - 1968-2018 University of Texas Health, San Antonio Lozano School of Medicine's 50th Anniversary)

In my June 17, 2017, response to Dr. Henrich, I commented that my career spans all 50 years of UT Health.  In the following link there is a picture of my 1968 acceptance letter to the 1969- Freshman Class (see Letters - 1968-2018 University of Texas Health, San Antonio Lozano School of Medicine's 50th Anniversary.  Significantly, it is signed by Dr. Fitzhugh Carter Pannell, the first Dean of the School of Medicine and a key figure in this history. 

The second event was the receipt of a note from Dr. Ruth Berggren, Director of the Center for Humanities and Ethics at UT Health San Antonio, which was entitled “God Bless America You are All Patriots.”  Dr. Berggren expressed pride in the compassionate caring of UT Health for the citizens of Bexar County and of Texas.  She said, “There is not a more noble way to show patriotism than by demonstrating care and compassion to our neighbors. We care for our country by caring for the PEOPLE in our country. You are all patriots. Happy Fourth of July to all!”  Her full note can be read at:  God Bless America: You are all patriots.

In response to and in agreement with Dr. Berggren, I responded:

“Our appropriate pride in UT Health Long School of Medicine's commitment to the care of Bexar County's and Texas' most vulnerable citizens and non-citizens is built on the foundation of the lives and legacies of men and women like Marvin Forland, Leon Candor, Carter Pannill and numerous others.  Some of these paid for our school's legacy at the cost of their careers and jobs.  Their nobility bring tears to my eyes and pride to my heart as I laud and admire those who have so ably walked in their steps, filled their shoes and fulfilled their dreams as they expand that vision.

“Dr. Berggren's note reminds me of Hubert Humphrey's 1977 ‘Moral Test of a Government,’ which is emblazoned upon the entrance to headquarters of the Department of HHS, in which he said:  ‘The Moral Test of a Government is how it treats those in the dawn of life, the children, those who are in the twilight of life, the elderly and those in the shadows of life, the sick, the needy and the handicapped.’   (We would change the identity of the third group today, as Dr. Berggren does in her note, but the point is made.)  As an alumnus, I applaud Dr. Berggren's declaration and embrace her heart and vision.  God bless us everyone and fill us with perpetual passion and continuously renewable resolve.” 

With these two bookends, this story is told.

The Beginning

The first faculty/student gathering of the Class of 1973 was held in September 1969, in the main auditorium at the Long School of Medicine.  At that time Bexar County Hospital (to be renamed University Hospital), the Medical School and the Humanities Center were the only three structures which existed.   Ironically, forty-three years later, due to the benevolence of a friend, that auditorium would undergo a major upgrade and would be renamed, “The Dr. and Mrs. James L. Holly Auditorium” (see   In The News - Auditorium named for HSC alumnus James Holly, M.D.).

The Dr. and Mrs. James L. Holly Auditorium

In 2012, it was the occasion of the dedication of the auditorium which resulted in my writing Dr. F. C. Pannill and of my receiving a note from him (See:  Your Life Your Health - Memories on the Dedication of the Auditorium  (February 23, 2012).   My letter to Dr. Pannill included the following:

“I don’t know if you remember where we first had close contact.  I was leaving the school one afternoon and your secretary rushed out and said, ‘Larry, you have to go downstairs.  The Dean is there for a meeting with students who are interesting a forming a health-careers program for Hispanic children.’  I said, ‘I have to go home.’  She implored me and I went.  You and I, and the other student with me, were the meeting.  As a result of that meeting, I ran the Health Careers Program for two years.  (The Health Careers program was designed to introduce students to medicine.  On Saturdays we had a group of students at the Medical School with tours, lectures, discussions and encouragement to consider a career in health.  All of the students were Hispanic.)

“It was (the Health Careers Program) work which led you to send me with the School’s official representative to the Student AMA meeting in Los Angeles in the Spring of 1970.

“At that meeting, a discussion was held about the Association of American Medical Colleges (AAMC) planning to launch the Organization of Student Representatives (OSR) which still exists today.  When the students were going to elect a Founding Chair of the OSR, I asked the student who was the official School of Medicine representative if he was interested in the job.  He was not and I asked him if he minded if I volunteer.  He did not.  I spoke to the group and was elected the Founding Chair of the OSR.  As a result, I was the Chair for two years, one during the organization of the group and the second during its first year of existence.”

In that note, I said to Dr. Pannill:  “I still stand in awe of having the privilege of being a physician.  As I watched and re-watch the movie Secretariat, I am moved almost to tears at the portrayal of his running of the Belmont Stakes.  After a brief moment, he is no longer running to beat other horses.  He is running for the sheer joy of running. His owner shouts to the jockey, ‘let him run, Tommy; let him run!!’  The jockey was holding on for dear life.  Secretariat is competing only with himself and his achievement was breathtaking.

“Dr. Pannill, our school, your school, the School of Medicine, like Secretariat, is running toward a goal, not before imagined possible in South Texas.  You started us; Dr. Henrich and many others carry the torch, and many of us, in communities around the country, run this race with the abandon and joy of a Medical-Practice Secretariat.  When I stand tomorrow night in the auditorium paid for by my dear friend, Wayne Reaud, with my family, friends, professors, fellow students and colleagues, these are the thoughts I will have.  You are central to them all.

“God bless you, my mentor and hero.  Thank you for your love and care.  It places wind under my wings.  Remember what the trainer of Secretariat said the night before the Belmont Stakes, ‘Tomorrow, he is going to take wings and fly.’  Dr. Pannill, our tomorrow has come and many of us, having taken wings, which you helped fashioned, are flying!  Amazing.”

The AAMC - Dr. Henrich’s and Dr. Berggren’s Correspondences

This link is to a letter which I wrote on June 18 , 2017 to the President of the AAMC.  It gives a history of a small part of the AAMC.  Letters - A follow-up from the 1970 AAMC Planning Meeting, June 28, 2017) The AAMC is part of UT Health San Antonio Long School of Medicine’s history because for two years, I was a voting member of its Executive Committee.  Twice, while a student, I voted on the accreditation of UT Health San Antonio.  And, it was the second accreditation report which was used in June, 1972, by the Chancellor of the UT System to fire UT Health’s School of Medicine’s Dean, F. C. Pannill, MD. 

As the Chairperson of the OSR’s Steering Committee, I served as a voting member of the AAMC’s executive committee for the school years 1970-1971 and 1971-1972.  As a result, I:

1. Attended the AAMC’s 1970 Strategic Planning session at Airlie House in Virginia
2. Attended the AAMC/AMA Annual Education Meetings in Chicago each January
3. Served on the Executive Committee of the AAMC for two years, as a voting member
4. Was the first medical student to be a voting member of an accreditation site visit which was at Cornell Medical College in New York City.
5. Voted on the accreditation of UT Health San Antonio Long School of Medicine twice while I was a student.

At the first meeting of the OSR in December 2, 1971, I gave the following inaugural address.  Its message is consistent with Dr. Berggeen’s, June 2017 note; I said:

“The irony of which American medicine finds itself a part, is aptly described by Rosemary Stevens in her book, American Medicine and the Public Interest.   She said:

Recent developments in medical education represent a striking success.  The average doctor has been transformed in sixty years from an incompetent physician, whose strength lay in the “beside manner” of his mystique, to a specialist... buttressed by an array of diagnostic and treatment aids and techniques.  American doctors are among the best trained technological physicians in the world.  Together, however, they are not providing optimal medical care; and it is this factor which has become the educational paradox- the manpower crisis- of the 1970’s.

Simply stated the irony is, “Good Doctors but Bad Medicine.”

“You and I upon completion of post-graduate training will be among the best qualified physicians in the world today.  We will not practice in the anecdotal medicine of herbs and spices as did our great grandfathers; rather we will practice the medicine of EKG’s, EEG’s, TIDEL VOLUMES, SERUM CREATININES and TISSUE BIOPSIES.  In short, we will be Good Doctors.

“But, what of our medicine, that is, the delivery of daily health care to John Doe, Susie Smith and Clarence Jones?  In the middle of a crisis, if in the right place, or if financially able, they will receive excellent medical care.   However, if in the wrong place, or if financially unable, they may in fact receive no care at all.  In addition, the facilities for non-crisis, or preventive medicine are almost exclusively restricted to infectious disease and even those are inadequate.  In short, we have a description of the remaining half of our irony, ‘Bad Medicine.’

“Why is this ironical?  Listen to the definition of irony, ‘an incongruity between the actual results of a sequence of events and the normal or expected result.’  In 1910, the Flexner Report addressed itself ‘to the task of reconstruction of the American medical school on the lined of the highest modern ideas of efficiency and in accordance with the finest conceptions of public service.’  This report facilitated the assurance that our M.D.’s would be Good Doctors. 

“Unfortunately, good medicine which was expected to follow as a result did not.  In 1970, the Carnegie Commission Report was concerned with the ‘vital importance of adopting the education of health manpower to the changes needed for an effective system of delivery of health care in the United States.’  Here it is implied that academic and scientific excellence alone in the training of a physician will not insure ‘Good Medicine.’

“What relevance does a discussion of Good Physician and Bad Medicine have to do with an organizational meeting of the OSR? A great deal, I think.

“In 1967 Bob Graham, a Student American Medical Association (SAMA) officer, first made the suggestions that the AAMC have an organized student input.  At the Annual meeting in the fall of 1968, the assembly of the association passed a resolution supporting the inclusion of students in the activities of the AAMC.  In the fall of 1970, each medical school dean was asked to send a representative of his institution to the Annual SAMA meeting in Los Angeles.  From that group of representatives, a steering committee was elected to meet with the president and chairman of the association and devise a plan for student input.  In February of 1971, in Chicago, the assembly approved the recommendation made by the steering committee for the formation of the Organization of Student Representatives.

“Now to the relevance of the irony, Good Doctors and Bad Medicine.  We have in name an organization and in fact an irony.  It is my hope that the OSR within the AAMC can while maintaining the academic excellence in medical educations begun by Flexner in 1910, move toward the accomplishment of the concerns of the Carnegie report of 1970, that is, Good Medicine for the United States.”  (Text of the Opening Address to the First OSR Meeting, By James L. Holly, Chairman, OSR, AAMC, December 2, 1971)

This address made forty-six years ago and the events at UT Health about to transpire, I believe are consistent with the hopes and dreams which Dr. Berggren addresses in her note above.  And her note and the President of UT Health San Antonio’s response to this address.

 In an April 22, 2016 note, Dr. Henrich said:

“I read the attachment (Letters - OSR Address December 2, 1971, Addenda Election, Auditorium, Distinguished Alumnus), and enjoyed every word.   It is clear your compass has been set on truth from the start, and that, in the end, it is the wisest path to follow.   I admire the courage it took to stand up for Dr. Pannill to the Chancellor, and I appreciated hearing how meaningful your defense of him was to him.  

“Your devotion to our School of Medicine and to the highest standards of professionalism began early in your career, and continues today.  The approach you have informs the actions you have taken with your practice.   SETMA reflects your values, your tireless efforts to avoid ‘bad medicine’.     Your example is meaningful to everyone touched by your approach:   your patients, their families, your partners, your family, and, your alma mater.    I count myself among most fortunate to have had our paths cross.   You are an inspiration to me and to us.

“With great respect, admiration and devotion, Bill, William L. Henrich, M.D., MACP. University President, University of Texas Health Science Center San Antonio, Professor of Medicine, School of Medicine, Division of Nephrology”

As, UT Health celebrates its 50 Year Anniversary next year, Dr. Berggren’s congratulatory note memorializes initiatives begun 50 years ago.  They celebrate advances in healthcare delivery which were rooted in the culture of UT Health San Antonio at its founding, advances which continue apace at the present time.

Dr. Pannill ‘s Humor

In above referenced link, I related a humorous event that took place at the AAMC/AMA Annual Education Meeting at the Palmer House in Chicago in February 1971.  I led a meeting of all of the Deans of Schools of Medicine.  You and I sat on the podium.  The oldest dean of a school of Medicine was dominating a discussion session.  I leaned over and asked you what I should do. You said, “Tell him to sit down!”  With consternation, I struck the gavel and said, “Sir, we must move on, will you yield the microphone.”  You said, “My goodness, Larry, I didn’t expect you to do that!”  The audience applauded.  I shall never forget that and the Deans stood up and applauded.  Your sense of humor and of propriety was part of what I so admired about you.

Trouble was Brewing

As a student and particularly of one in clinical years of training in academic years 1971-1972 and 1972-1973, I was unaware of many of the undercurrents threatening UT Health San Antonio, until they erupted in the firing of Dr. Pannell in June 1972. 

Texas healthcare politics were active during these early years.  My class (1969-1973) was the first full class to go through all four years at UTMSSA.  The Founding Faculty members were outstanding clinicians and academicians with strong teaching and research credentials. They also were socially conscience and immediately began to seek ways to expand excellent healthcare into the minority and indigent communities of San Antonio.   The Chairman of the Department of Medicine, Dr. Leon Cander, led many of those efforts and ran afoul of the Texas Medical Association and state healthcare leaders.

My Letter to UT Regents Published in San Antonio Express News

A number of those leaders and local physicians pushed for Dr. Cander’s dismissal.  Dr. Pannill refused.  In June 1972, the Chancellor of the UT System fired Dr. Pannill.  Unfortunately, for the Chancellor he based his action upon the AAMC Accreditation Site visit reports, both of which I had read.  Knowing that the Chancellor had misrepresented the reports, I wrote a letter to each of the University of Texas regents which included Mrs. Lady Bird Johnson.   I sent a copy of the letter to the San Antonio Express News which, rather than publishing it as a Letter-To-The-Editor, published my letter on the front page of the paper above the fold in 40-point type.  The title of the article was, “Senior Medical Student Challenges Chancellor’s Truthfulness.”  (Regrettably, all of this material was lost in a move of my medical office in 1996.  The archives of the Express News do not include this material.)

 During this time, Bob Dale, the internationally known editorial cartoonist for the Express News, did four original sketches on this subject.  One day, during the controversy created by the publication of my letter, I was at the Express News’ office.  Walking past Bob Dale’s desk, I saw his original pen and ink sketches, and he gave them to me.  Framed, these sketches hang in my son’s office to this day.
The following are reproductions of all four cartoons.  One shows Drs Pannill and Cander’s names, and depicts them as victims of the Chancellor.  (See:  In The News - The dismissal of School of Medicine Dean, F. C. Pannill, M.D.)

Click Each Image for a Larger View

A more detailed history of my activities with the AAMC is given at the following link:  Addendum Written April 20, 2016 - 45 years later - Dr. Holly Elected OSR’s First Chairman. 

In August 2012, I attended Dr. Pannill’s Memorial Service; on October 10, 2012, I wrote his children and grandchildren and said:

“Today, I am preparing to leave tomorrow for San Antonio.  On Saturday night, I shall receive the 2012 Distinguished Alumnus Award.   I shall carry with me to this event, the framed copy of my letter of acceptance to the 1969 entering class, signed by ‘MY’ Dean, Dr. Carter Pannill.   My greatest regret is that your father and grandfather will not be there.  In my professional career, no person has influenced me more than Dr. Pannill - I could no more call him Carter, than I could stop breathing.  He shall always be the epitome of professionalism, leadership, scholarship and the kind of physician I have always wanted to be.

“You know these things but as I stand before the convocation on Saturday evening, I want to know that I have laid this honor at his feet and expressed my gratitude that I knew and loved him and that he respected me.  No honor could be more valued by me.  I am pleased for you to know that in my judgment, Dr. Henrich and your father are men of the same caliber and cut from the same cloth.  I think your father would like that.”

Additional insights to the continuity of UT Health’s care for others can be found in the following documents.  Remember, there are many other evidences of the same, these just happen to be ones in which I was involved.

An Invitation to a Celebration and to a Contribution
By James L. Holly, MD
President, Alumni Association
University of Texas School of Medicine at San Antonio
Spring, 2007

The 1951 movie, People Will Talk, is concluded with of a School of Medicine student orchestra performing Gaudeamus Igitur, as the students sing the words in Latin:

Gaudeamus igitur
Iuvenes dum sumus;
Post iucundam iuventutem
Post molestam senectutem
Nos habit humus...

The words mean:

Let us live, then, and be glad
While young life’s before us!
‘After youthful pastime had,
After old age hard and sad,
Earth will slumber o’er us...

Brief is life, and
Briefly shall be ended...”

Which of us hearing the melancholy words of Gaudeamus igitur will not call to mind our own experiences as young physicians-in-training?  Which of us do not recall with delight and perhaps even sometimes with dismay experiences and events which helped define who we are today?  Which of us will not remember with pride and pleasure that cap-and-gown evening when we officially became “MDs”?

Whether we revisit those halcyon days “on-line,” with fellow alums in our communities, or at the annual alumni gathering in San Antonio, each such contact allows us to complete that circle of life which brings significance and substance to our past, our presence and even to our future.

The invitation to participate in the alumni activities of the University Of Texas School Of Medicine at San Antonio is an opportunity to celebrate the life and work which we prepared for years ago.  This invitation is the opportunity to celebrate what our School of Medicine has become in the intervening years.  It is an invitation to contribute to the future of the School in the same degree as the School contributed to each of us.

For those of you who have not visited your School of Medicine for some time, you will be surprised what has become of the “cow pastures” which surrounded the school in the early days.  You will be amazed to read the words of the President of the Health Science Center as he announces that 2006 was a “transformative” year with the highest private contributions in the history of the school.  You will be astonished to hear the Dean of the School of Medicine related the value of the research grants awarded to the school.  You will be gratified to see how the School of Medicine has morphed into a leading center of health education, research, innovation and advancement.

Each time that I return to the campus and each time that I participate in the Alumni Board activities, I hear the melody of Gaudeamus igitur echoing in my mind.  I am reminded that life is brief and that which gives definition to my life now is continuity with my life then. 

It is a great honor to serve as your President, but whether in that role, or as a fellow alumnus returning to my roots, I am delighted to join you in mind and in heart to reunite with our School of Medicine.  It is more than a “walk down memory lane” to which we are invited; it is actually to a vision of our future.  I look forward to hearing from you, to seeing you and to sharing with you what OUR School of Medicine is and anticipating with you what it is becoming.

Address to Freshman Weekend
March 24, 2007
University of Texas School of Medicine San Antonio
By James L. Holly, MD

I envy you, but it is not your youth that I envy - I envy that you are the inheritors of the experiences and achievements of the first 40 years of our School of Medicine and I envy that you have your lifetime to compound that inheritance.  You are the recipients of the legacy and of the trust estate of two generations of students, alumni, faculty, administrators and staff of the University Of Texas School Of Medicine at San Antonio. 

Furthermore, you face the challenge and opportunity of a time when medicine has a greater capacity to change the lives, the health and the future of those to whom you minister your art than in any previous generation.  You have a virtual tabula raza upon which to record your contribution to the history of your college and to the advancement of your profession. 

As you consider your opportunity and your obligation, picture the scene portrayed in Chariots of Fire, when the Master of Caius (pronounced “Keyes”) College, University of Cambridge, speaking to the Freshman Dinner in 1918, said:

“I take the war list and I run down it.  Name after name, which I cannot read and which we that are older than you cannot hear without emotion.  Names which will be only names to you, the new college, but which to us summons up face after face, full of honesty, and goodness, zeal, vigor and intellectual promise.  The flower of a generation, the glory of England, and they died for England and all that England stands for and now, by tragic necessity, their dreams have become yours.

Let me exhort you, examine yourselves; let each of you discover where your chance of greatness lies; for their sakes, for the sake of your college and your country.  Seize this chance, rejoice in it, and let no power or persuasion deter you in your task.”

By 2011, you of the new School of Medicine will have laid the foundation for who you will be as healthcare professionals.  You will have collected the experiences and the memories which will guide you in your quest for greatness. 

Hopefully, you will have learned the skills of collegiality and collaboration which must supplant the competitiveness which has brought you this far. It is sage counsel to admonish you:  Seek greatness; not conquest; seek greatness; not surmounting others.  It is in building and in participating on a healthcare team, and in working for the success of that team that each of you will have the greatest chance of greatness.  Greatness is not defined by winning or by wealth; greatness is defined by honesty, goodness, zeal, vigor and of intellectual promise fulfilled in service to others. 

Hear and remember the words of Dr. Peter Senge of MIT:

“Most of us at one time or another have been part of a great ‘team,’ a group of people who functioned together in an extraordinary way - who trusted one another, who complemented each others’ strengths and compensated for each others’ limitations, who had common goals that were larger than individual goals, and who produced extraordinary results. 

I have met many people who have experienced this sort of profound teamwork - in sports, or in the performing arts or in business.  Many say that they have spent much of their life looking for that experience again.  What they experienced was a learning organization.  The team that became great didn’t start off great - it learned how to produce extraordinary results.” 

Recognize and embrace the debt you incur when you accept the opportunity of membership in the class of 2011   Watch another scene in your mind as in the movie, Saving Private Ryan, the title character, tremulously, now in his seventies, approached the headstone of Captain John Miller who gave his life that Ryan might live.

In perhaps the most poignant moment in a great film, tears streamed down his face as Ryan plaintively said to his wife, "Tell me that I have lived a good life; tell me that I have been a good man." The sacrifice of others imposed upon Private Ryan a debt only a noble and honorable life could repay.  Everyone owes such a debt to someone. The circumstances of that debt may not be as dramatic, but it is just as real.

There are few gifts as great as that of the opportunity to be a physician. Caring for others has always been a sacred trust. It is a trust which should cause each person so honored to tremble with fear that he or she will not have lived worthily of that honor. It should cause us to examine our lives for evidence that we have been good stewards of the treasure of knowledge, skill, experience, and judgment which has been bequeathed to us by our university, by our professors and by the public which funded our education.

What nobler calling could one have than the opportunity to collaborate with others in their quest for health and hope? The honor of trust and respect given by strangers, who share their deepest secrets, knowing they will be held sacrosanct, is a gift which exceeds any pecuniary advantage. The pursuit of excellence in the care of others is a passion which is self-motivating.

Passion is the fuel which energizes any noble endeavor. It is what makes a person get up early in the morning, work hard all day, and go to bed late at night looking forward to the next day. It is a cause of great sadness that today's society is so devoid of true purpose-driven passion. Sadly, many only vicariously experience passion through the eyes and lives of athletes, movie stars, or musicians. Yet, ultimately, personally-experienced passion and purpose are what make life worth living. Those of us who have been allowed the privilege of being physicians, can and should know the passion of a noble purpose every day of our lives.

Never has there been a time when a physician's knowledge and skills could have more positive impact upon the lives and futures of others. Never has there been a time when the role of the physician has been more defined by the concept of "team," in which each participant - doctor, patient, family, nurse, clerk and others - coalesce into a vanguard against illness and pain.

Now, well into the last half of my career, I do not crumble by the headstone of one who has given his life for mine, but I do stand humbly before the cornerstone of my life as a physician. I stand there grateful to God, to my parents, to my wife and children, to my University of Texas School of Medicine at San Antonio, to my professors -- among many, Drs. Pannill, Taylor, Wesser, Beller, Fuller, Forland, Gold, Sears, George, Persellin and Cander -- to medical school class mates who challenged me with their abilities and drive. Each has contributed and continues to contribute to the passion and drive born of the honor of being a physician.

The tale is not yet told as to whether you and I shall have been faithful to this great honor, but it is a responsibility which motivates me daily and which must motivate you. To our university and to all who have contributed to the honor of our being physicians, we say, "Thank you."

Today, you begin accumulating a debt of gratitude which can only be repaid with your excellence in service to all who seek your medical counsel or care.  As the President of the Alumni Association of the University Of Texas School Of Medicine at San Antonio, I welcome you; I applaud you and I admonish you.  Under the leadership of our new Dean and of the faculty, your school will make you proud - it is your responsibility between now and two thousand eleven and for a life-time afterwards, to make your school proud.

In two thousand eleven, I shall purpose to return for your commencement and inquire as to how well you have pursued your chance of greatness.

 James L. Holly, MD
President, Alumni Association
University of Texas School of Medicine, San Antonio
CEO, Southeast Texas Medical Associates, LLP
www.jameslhollymd.com

13th Annual
School of Medicine Convocation
And
White Coat Ceremony
Sunday, July 26, 2009
School of Medicine Alumni Association Greetings
James L. Holly, MD
President,
UT Health Science Center School of Medicine at San Antonio
Alumni Association
CEO, SETMA, LLP
www.jameslhollymd.com

Forty years ago next month, I stood where you stand today.  As I on that day, so you today begin to incur a debt of gratitude to:

• The state of Texas
• Your School of Medicine
• Your Professors
• Your colleagues
• Your Family

That debt is for the privilege and honor of being a physician.  From now, your life will be a collage of your efforts and of those who will contribute a part of their lives to yours.  Make certain that you are a good steward of that investment.
The debt of gratitude which you will incur over the coming forty-eight months and the years thereafter, can only be satisfied by the living of a life of

• Honor
• Nobility
• And, of service to others

All of you have the ability to succeed in medicine.  Some of you have the ability to excel.   Only you, with your diligence, devotion and determined persistence will determine into which group you will fall.

Today, you would do well to remember the words which Charles Dickens put into the voice of David Copperfield:

“Whether I shall turn out to be the hero of my life or whether that station will be held by any body else these pages must show.”

In regard to your medical career, you are a kind of tabula rasa, an empty slate, upon which you will write a story which will reflect credit upon your school, your teachers, your profession, your family and upon yourself.  Only you can write that story.  Write it well.

Today, I charge you as the Master of Caius College, Cambridge University did the freshman class almost 100 years ao; he said:

“Let me exhort you.  Examine yourself.  Let each of you discover where your chance of greatest lies.  Seize this chance. Rejoice in it and let no power or persuasion deter you in your task.”

In four years, I or my successor will welcome you to the Alumni Association and to the opportunity for you to serve your School of Medicine with your:

• Reputation
• Achievement
• And, with gifts of your monetary resources.

Congratulations in being here today.  Wear your white coats with dignity and pride.  I and 6,000+ of your alumni colleagues wish you God speed.

James L. Holly, MD
President, University of Texas Health Science Center School of Medicine at San Antonio Alumni Association
CEO, SETMA, LLP
www.jameslhollymd.com

Welcome to the Alumni Association
2010 Graduating Class
University of Texas Health Science Center at San Antonio School of Medicine
May 22, 2010
James L. Holly, MD
President, Alumni Association

As you stand today to receive the symbol of a lifetime of achievement -- your doctor of medicine diploma. -- you stand on one hundred years of progress since Abraham Flexner challenged the nation with the need for a sound scientific foundation to the teaching and practice of medicine.  Today crowns "a lifetime of achievement" for your medical education did not begin four years ago, nor will it end today

Without doubt you are the smartest and most knowledgeable generation of physicians ever and you fulfill every hope and expectation of the 1910 Flexner report.  Yet, contained in that report was a potential unintended consequence:  the possible replacement of a personal, trusting physician/patient relationship with a trust only in technology. 

You face the reality that the care which will improve the health of your patients, while based on your knowledge, is the care they are able to access and receive.  You face the dilemma created by the success of scientific progress, which is:

• "How do I balance technology with humanity?"
• "How do I overcome the seduction of entrepreneurism which like a cancer has eaten at the soul of medical professionalism?"
• "How do I re-establish patient confidence in my counsel, supported by appropriate technology, rather than my patients simply trusting in more procedures, tests and operations?
• "How do I balance the tension between more care and more health?" 

As your President, I welcome you to your alumni association. Your school and your colleagues need your participation and support.  Welcome to the future of a profession which not only desires to help others to live longer but to help them have a life every day they live.

Today, we pass the healthcare leadership baton to your generation of physicians. We will carry it with you part of your journey, but if we all are to succeed, our hopes and passions must be incorporated into yours. We pass this baton to you confident of your fidelity to the profession you join and to the vision and mission of your University.

Congratulation and welcome to the task.

James L. Holly M.D.
President, Alumni Association
UTHSCSASOM

Commencement Address 
UT Health San Antonio
 School of Health Professions
May 25, 2013
By James L. Holly

(For Full Text see:  Your Life Your Health - May 25, 2013 Commencement Address for University of Texas Health Science Center at San Antonio School of Health Professions)

Never has there been a time when the Commencement Ceremony for the University of Texas Health Science Center at San Antonio School of Health Professions marked such a seminal moment in healthcare.  Today, what has always been the case, i.e., that each of you is an integral and critical member of the healthcare team, has become obvious to everyone.  The eight disciplines represented by the School of Health Professions are critical to the future of excellence of healthcare in the 21st Century and you individually are critical to the continued transformation of modern healthcare.

Transformation and Reformation

Healthcare does not so much need reform, as our healthcare system and our healthcare delivery need to be transformed.  “Reform" comes from external pressure, while "transformation" comes from an internalized passion and dynamic.  Anything can be reformed - reshaped, made to conform to an external image - if enough pressure is brought to bear. However, reshaping healthcare under pressure can fracture the system in such a way as to permanently alter its structural integrity.  Additionally, once the external pressure is eliminated, old ways are resumed as nothing has fundamentally changed.

Being from internalized principles and vision, transformation results in change which is part of the nature of the system.  The act of transformation creates a dynamic which is generative, i.e., it creates within the system being transformed the energy, the will and the necessity of continued and constant change and improvement. Transformation is not dependent upon external pressure; it is sustained by an internal drive which is energized by the evolving nature of the organization.   In transformation, creativity and change generate more creativity and change, and it does this without external reward or coercion. 

Rather than attempting to impose change as in reform; transformation initiates behavioral changes which become self-sustaining, not because of rules, regulations and restrictions but because the images of the desired changes are internalized by the organization, which then finds creative and novel ways of achieving that change.

Healthcare Team

One of the tools of healthcare transformations is “team.”  As a team, those of us who welcome you into the healthcare profession, no longer welcome condescending and patronizing terms such as ancillary providers, technicians, physician extenders, or mid-levels.  In a team, we are all colleagues and collaborators.  Today and increasingly in the future, each of you will know more about your area of expertise than most of the nurses, NPs, PhDs, physicians and other healthcare providers with whom you will work.  You will be invited to add your knowledge to the collective competence of “your team.”  The excellence of care which patients will receive will be dependent upon all members of the team.  When that team works at its peak, the results will exceed the sum of each individual’s contribution.  Together, we will be more than we could be working in isolation...

The End of the Beginning

As you receive your diploma today, which recognizes your academic achievement, receive it as your invitation to a life-time of learning and a life-time of contributing to the collective health of the society you serve.  Receive it, knowing that more than any other generation, that what you have already learned will be broadened and deepened as you and your colleagues expand the scope and practice of your profession.  Receive this diploma both as an honor for your achievement and as an invitation to your “continuous professional development.”

As I have the honor of addressing you today, I affirm to you that while as a physician, I may be thought of as the team leader, or as the captain of the ship, those honorifics are accepted by me with the acknowledgment:

• That we are mutually dependent upon one another.
• That our only hope of excellence is in our collaboration.
• That I have a great deal of respect for you and admiration of the value you bring to our team.

Congratulations.  I look forward to working with you; and, as today, I look back  upon my own graduation forty years ago, that in forty years, when you will look back upon your career, that you will be fulfilled and satisfied that you have done well for others, for your school, for your family, for your nation and for yourself.

God bless each of you and God speed to you all.

My Personal History with UT Health Continued

In addition to serving on Alumni Board of the UT Health San Antonio Long School of Medicine, my contact with the school has included:

1. Being Chairman of the Board for four years
2. Being an Adjunct Professor in Family and Community Medicine
3. Having Senior Medical Students Serve a Patient-Centered Medical Home Selective at Southeast Texas Medical Associates
4. Serving on the President’s Council
5. Serving on the Development Board
6. Receiving the Distinguished Alumnus Award in 2012

Presentations - Dr. Holly's Acceptance Address for the 2012 Distinguished Alumnus Award University of Texas Health Science Center San Antonio School of Medicine; the following is taken from this address:

Human Science

In May of 2010, I wrote an article entitled, Technology and Humanity: The Critical Balance in 21st Century Healthcare.  In part that article stated:  “Technology must never blind us to the human...In our quest for excellence, we must not be seduced by technology with its numbers and tables. This is particularly the case in healthcare. In the future of medicine, the tension - not a conflict but a dynamic balance - must be properly maintained between humanity and technology. 

“Technology can contribute to the solving of many of our disease problems but ultimately cannot solve the ‘health problems’ we face.  It is my judgment that the major issue facing healthcare delivery today is that men and women, boys and girls have replaced the trust they once had in their physician with a trust in technology. 

“The entire focus and energy of ‘health home’ is to rediscover that trusting bond between patient and provider.  In the ‘health home,’ technology becomes a tool to be used and not an end to be pursued.   The outcomes of pure technology alone are not as satisfying as those where trust and technology are properly balanced in healthcare delivery.

“The challenge for our new generation of healthcare providers and for those of us who are finishing our careers is that we must be technologically competent while at the same time being personally compassionate and engaged with our patients.  This is not easy because of the efficiency (excellence divided by  time) of applied technology.  A referral or a procedure is often faster and more quantifiable than is a conversation or counseling.

“As we move deeper into the 21st Century, we do so knowing that the technological advances we face are astounding. Our grandchildren's generation will experience healthcare methods and possibilities which seem like science fiction to us today. Yet, that technology risks decreasing the value of our lives, if we do not in the midst of technology retain our humanity. As we celebrate science, we must not fail to embrace the minister, the ethicist, the humanist, the theologian, indeed the ones who remind us that being the bionic man or women will not make us more human but it seriously risks causing us to being dehumanized. And in doing so, we may just find the right balance between technology and trust and thereby find the solution to true healthcare.”

Winston Churchill’s response to the sinking of the Titanic juxtapositioned technology and humanity.  Upon hearing of the tragedy of the Titanic’s sinking, Winston Churchill wrote to his wife and said, "The Titanic disaster is the prevailing theme here. The story is a good one. The strict observance of the great traditions of the sea towards women and children reflects nothing but honor upon our civilization...I cannot help feeling proud of our race and its traditions as proved by this event. Boat loads of women and children tossing on the sea - safe and sound - and the rest - Silence. Honor to their memory."

“Forty-eight hours later, Churchill added the following comment: "The whole episode fascinates me. It shows that in spite of all the inequalities and artificialities of our modern life, at the bottom, tested to its foundations, our civilization is humane, Christian and absolutely democratic. How differently Imperial Rome or Ancient Greece would have settled the problem. The swells, the potentates would have gone off with their concubines and pet slaves and soldier guards, and then the sailors would have had their chance headed by the captain; as for the rest - whoever could bribe the crew the most would have had the preference and the rest could go to hell. But such ethics can neither build Titanics with science nor lose them with honor."

The Center for Medical Humanity and Ethics

To the excellence of basic science and clinical science, my School of Medicine has added the laboratory for “human science.”  It is here that students learn that without hope and trust science is helpless.  When your greatest hope is that today you will not be shot in a drive by shooting, decisions about your healthcare are not a high priority.

7. Being named as the first member of the Aesculapian Laureate Society in May, 2017

In The News - The Aesculapian Laureate Society

In recognition of Larry and Carolyn’s vision for alumni giving in the Joe R. and Teresa Lozano Long School of Medicine, we have created a special giving society for our School -- The Aesculapian Laureate Society.

We established this distinguished Society to honor School of Medicine Alumni who contribute $1M or more.

Tonight’s dinner celebrates the inaugural members of The Aesculapian Laureate Society, Dr. and Mrs. James L. Holly, for their exemplary philanthropic leadership.

With all gifts, including generous personal giving from Larry and Carolyn, and the support they have engendered from SETMA, Universal American and Beaumont Foundation of America, Larry and Carolyn Holly have contributed just under $3 million to our School of Medicine and University.

It my great privilege as President, former Dean and a proud faculty member of the Joe R. and Teresa Lozano Long School of Medicine, and an incredibly special honor as their friend, to recognize Dr. Larry Holly and his wife, Carolyn Holly as the first recipients of The Aesculapian Laureate Society Award.

Larry, you and Carolyn have raised the bar and changed our School --and our University -- forever. We are incredibly proud and deeply grateful to you both.

From Left to Right:

• William Henrich, MD, President, UT Health San Antonio
• Ruth Berggren, MD, Director, Center for Medical Humanities & Ethics, UT Health San Antonio
• Ronald Rodriguez, MD Interim Dean, Long School of Medicine UT Health San Antonio
• Dr. Holly
• Dr. Marvin Forland, MD, Member of Founding Faculty, UT Health San Antonio Long School of Medicine
• Carlos Jaen, MD, Chairman, Department of Family and Community Medicine and the Dr. and Mrs. James L. Holly Distinguished Chair in Patient-Centered Medical Home

Conclusion

It is fitting that this picture ends this history.  With Founding Faculty member, Marvin Forland, President Henrich, who walks in and fills the shoes of Dr. Pannill with excellence, as does Interim Dean, Ron Rodriguez and Dr. Berggren whose note started all of this.

Dr. Jaen completes the group. In his own right, he is a nationally and internationally known educator and researcher but in the context of this history, he holds the Dr. and Mrs. James L. Holly, Distinguished Chair in Patient-Centered Medical Home. 

The final note is not an after thought but it is the core of my on-going relationship with UT Health San Antonio.  It was written in response to Dr. Henrich ‘s recent note to me as a follow-up to my letter to the President of the AAMC.  His note and mine can be read in full at this link:  Letters - Dr. Holly’s Response to Dr. Henrich’s June 28, 2017 Note. 

In part my note states:

“As UT Health’s 50th Anniversary Celebration approaches, I have thought more and more of how my experience covers almost the entire history.

“Once again, your kind remarks are generous.  At such times, I am always reminded of the words of Charles Dickens’ David Copperfield which begins with:   ‘Whether I shall turn out to be the hero of my own life, or whether that station will be held by anybody else, these pages must show.’

“As I read your words, I sometimes feel that I am reading the life of another as I genuinely feel unworthy of such effusive praise.  I know that in my heart I want your words to be true and I have desired to live a life worthy of such words, but I can’t help but feel like an imposter.

“My words about you are inadequate to express my admiration of who and what you are.  And, of course, Mary is like the icing on the cake - the best part.”

Final Observation

No one would call this brief history, brief; but, in the context of the magnitude of achievement of those who have given their lives to healthcare education, research, advancement and excellence at UT Health, it is brief.  I hope it is a worthwhile albeit incomplete and narrow contribution to the celebratory events of 2018, marking 50 years of the growth of the UT Health San Antonio, Joe R. and Teresa Lozano Long School of Medicine. 

As the 50th Anniversary approaches, UT Health in all of  its divisions has taken its place among the premier Health Education Institutions in the United States and indeed in the world.  Each new generation of faculty, staff, students and alumni continue to make those of us of the old school proud and grateful.

Addendum:

For context, the following can be reviewed.

My philosophy of institutional benevolence and giving is contained in the May, 2016 Commencment address to my undergraduate alma mater.

Your Life Your Health - Northwestern State University Commencement Address 2016

A brief introduction to my professional career can be reviewed at:

Accreditations - A Brief Summary of SETMA’s Achievements, Advances, Awards and Accreditations