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TCU Magazine Feature

Read about the nationally recognized "Scribe" program

Practicing medicine

I will impart this Art by precept, by lecture and by every mode of teaching. . . according to The Law of Medicine. --Hippocratic Oath

By Nancy Bartosek

Nearly 18,500 applications were filed at seven Texas medical schools in 1997--all vying for only 1,150 slots.

TCU students filled nearly 40--an acceptance rate and bill of health that is almost two times the national average.

"But numbers are really not what it's all about," said Biology Prof. Phil Hartman, prehealth professions committee chairman."What we plug very highly is that we can deliver three things: a quality, rigorous education, personalized context and extracurricular activities like the observation program, things that don't make it into the transcript but are commodities when one goes applying."

Adam Graff, a student whose"extracurricular" work includes a position in patient services at Harris Methodist Hospital, describes the value of TCU's premed efforts a bit differently.

"A premed student has got to be into everything and succeed at everything if he or she wants to get into medical school," he said."They (medical schools) want you to walk on water."

No, just to be well-prepared, said Dr. Barbara Waller, associate dean of student affairs at UT Southwestern Medical Center.

And, she adds, TCU students are.

"We get excellent students from TCU. . . and certainly have no concerns about the kind of education they get from TCU."


LAILA WANG '97 remembers the smells.

And the cold, which didn't chill the odor of cauterized blood vessels but did seep past the paper slippers before settling deep into her scrub-clad bones.

And she remembers the fatigue. Standing in one spot for four hours, focusing intently on a gaping hole in a living person will do that to you. The oldies radio playing in the background helped a bit, as did the chatter of the nurses and doctors who were removing the troublesome gall bladder.

But when her first surgical observation was over the then-premed freshman was finally sure.

"You see it on TV but to actually be there was really amazing," said Wang, now a first-year med student at UT Southwestern Medical Center at Dallas."I had thought about it in theory, but being there and watching the doctors perform surgery made it a reality, gave me a sense of what it would really be like.

"I didn't go away thinking that I want to do surgery, but I did know then that I wanted to be a doctor."

That's what most students say they figure out during"observations," opportunities for students to shadow doctors during surgery, in the emergency room, with a family practice physician or maybe in an oncology unit. Dr. Stan Speegle, one of 10 Harris Methodist Hospital emergency room doctors who work with observers, says students need to have that kind of experience before embarking on a life-long career path. "These students see a lot of illness and how it's dealt with," he said."They know ahead of time if they can handle taking care of sick people or not."

Considered the pulse of the premed program, these O.R.-type experiences throb from what may be the heart of the premed track, Alpha Epsilon Delta (AED), the pre-health professions honor society that has historically nurtured some of the brightest and best doctors in the country. And TCU's Texas Zeta chapter is among the most-accomplished in the state in providing the practical experience often lacking in an undergraduate education, giving students the chance to stand side by side and talk face to face with practicing physicians--sort of a litmus test for future Marcus Welbys. (The chapter is also among the most active. Two years of student planning and undergraduate elbow grease brought some 400 AED scholars from around the country to Fort Worth for the TCU-sponsored national convention in March.)

Hartman, TCU's AED adviser, said the extracurricular activities become part of the total package presented at medical school entrance interviews.

"We like to think our students help, rather than hurt themselves during the interview," he said."Strong experiences like the observations or the"scribe" program (see story on page 9) and their activities with AED help them learn how to interact and communicate. We do some good things that round them out."


RIC BONELL '96 agrees, for profound reasons.

After returning from Duke University in 1991 with a business degree, a new wife and plans for a family, he found his place in the Fort Worth banking industry.

But then there was the accident. Suddenly widowed and emotionally distraught, the former national merit scholar packed up his gear and went on a two-month, 17,000-mile search for meaning that took him east to Maine, north to Alaska and south to California before landing at TCU's door with a dream.

With careful guidance, the future pediatrician, then 26, punched out the medical school prerequisites in two years, took the Medical College Admissions Test and began applying. But because of his less-than-stellar GPA from Duke, the nontraditional applicant didn't look that great. That's where TCU's premed reputation and Hartman's expertise came in.

"Getting into the school of my choice was in large part due to Phil's guidance and assistance," said Bonnell, now in his second year at Baylor College of Medicine in Houston."It was his relationships with the deans of the medical schools that made the difference. If they only took a cursory look, my application would go in trash. He (Hartman) made sure through his contacts that they took a little harder look." As this year's AED President Paul Whatley pointed out, the first half of the premed track lets students know what they must do to maximize their chances of getting into med school. "The other half," said the senior who has already been invited to four medical schools,"takes you past acceptance, past med school and paints a realistic picture of what it will be like after you start practicing."


DR. MARY ANN BLOCK '81 didn't begin her practice until 1990, but she was intimately acquainted with illness long before then. Daughter Michelle, then 12, was sick and doctors, she said, were making it worse. After her anger cooled into determination, the full-time mother decided her job description included finding out what would heal her daughter--even if that meant becoming a 37-year-old student.

Now a successful osteopathic physician and author with two new books due out, Block's discoveries about treating children with attention deficit hyperactivity disorder are attracting patients from around the globe at a rate of about 50 a week. They come because they want to treat their child's learning problems without drugs.

Block has discovered that ADHD is generally caused by a combination of allergies, dietary and nutrition problems and learning differences. In her Hurst office she helps families discover what causes the difficulty and develops programs to overcome it. "What I do is rather unique because rather than just treating symptoms with drugs, I try to find underlying reasons and try to treat that," she said.

Her latest project is a school, opening in the fall, where ADHD children can come and learn how to learn before returning to mainstream schools. It's an extension of the home training program she developed for parents to help their children become better learners.

"Much learning in schools requires the use of the left brain, the logical side, and using eyes and ears to learn," she said."These children use the right, or creative side, of their brain and their hands for learning, so they fiddle with stuff, mess with things, bother other children, because that's just how they learn. They're doing the best they can with what they've got, it's just that no one has taught them a better way."

The lifeline she offers thousands of children today nearly ruptured her first semester at TCU. An initial stab at biology produced a failed exam; a caring professor convinced her it was only a little prick and dusted off the discouragement.

"He said give it a chance, you've got nothing to lose, so take the next test," she said."He really is the reason I stayed. I did fine after that."


DR. STEPHEN BROTHERTON '78, an orthopaedic doctor and team surgeon for TCU athletes for 11 years, came back to Fort Worth after medical school so he could work with the institution that gave him more than a leg-up for medical school. In addition to doctoring the dancers at TCU and the Fort Worth Dallas Ballet, and the cowboys who compete at the Southwestern Exposition and Livestock Show in Fort Worth, Brotherton spends his days patching together problems like the foot starting quarterback Max Knake broke while running ropes on the first day of practice in 1994, the year he helped lead the team to the Independence Bowl. After surgery, Brotherton, a former bullrider and TCU wrestler, helped Knake through rehab, getting him back on the field by the first game. Knake, now a backup quarterback with the Dallas Cowboys, was named Southwest Conference Offensive player of the year that season.

"I had (coach) Pat Sullivan on the phone, calling me Sunday night, and he's about to cry--it's the most emotion I've ever heard out of him--and he's saying ŒDoc, I've gotta have this one,'" Brotherton said, laughing."So we got (Knake) in, stuck a screw in his foot and he didn't miss a play. He missed a few two-a-days (practices), but he didn't miss a game."

Brotherton said his years at TCU also prepared him in unexpected ways, like the medical history class that led to his later involvement on the board of the Presbyterian Night Shelter."It was the first time I really ever clued in to the fact that not everybody was disadvantaged because it was their fault," he said."It was an eye-opening experience."

And there was a theater class that introduced him to a world in which he now volunteers as president of the board of Fort Worth's Casa Manana theater."You'll be well-prepared in the sciences but being a liberal arts school. . . . some of the most valuable things to me were not premed courses."


DR. ED ROBINSON '84, a pathologist and University of California at Irvine assistant professor for six years, recalls that when he headed to Vanderbilt's medical school in 1984, he was quite apprehensive.

"I wondered how, coming from TCU, was I going to compete with people from schools like Harvard and Stanford," he said."But I was pleasantly surprised to discover early on that I was very prepared, and maybe even more so than others."

Apparently. Robinson's work today may one day save millions of lives. It's work that actually began in Bolivia several years ago when researchers began collecting indigenous plants for TCU chemistry Prof. Manfred Reinecke. Reinecke, premed chairman from 1974-91, extracted chemical compounds from the plants and shipped them to Robinson's California lab where they were tested for their ability to inhibit one of the growth stages of HIV, the virus that causes AIDS.

Of the more than 500 extracts taken from 100 different plants, five had potent application in the fight against AIDS. This year, those five were used as lead compounds to create six new compounds that are more powerful than anything they isolated from the plants.

"We are moving toward better and better drugs and better and better chemicals that might go into people," Robinson said.

Such a possibility generates a great deal of excitement in the friendly pathologist who says he's"absolutely hooked on biomedical research." "There's nothing like working in a field that at any point in time I could make a discovery that could heal people," he said.

THE PRESCRIPTION for success is different for every premed student. For Laila Wang, it was the emotion of the operating room that confirmed her choice to be a doctor. Ed Robinson's was the assurance that he was as well-prepared for medical school as his Ivy League colleagues.

Yet, they all seem to need that dose of reality, those extra steps beyond organic chemistry or genetic engineering.

And that's what the premed track delivers.

"As a freshman, I saw a lady die on the operating table," said sophomore Stephanie Mills, who has taken part in at least 15 observations."It's just a shock, but you'll have to deal with it in your career."

Fortunately, said biology sophomore Matt Barfield, you get to deal with joy, too. "I got to tell this lady that she was pregnant," he recalled, eyes gleaming."She'd been trying for a long time and was really, really happy about it.

"It was just great."

Those experiences expand perspective, reminding students that they aren't going to spend the rest of their life in a lecture hall, studying DNA synthesis, Whatley said.

"Because of this program, I always know there's something better that I'm going toward."

Charting medicine

The nationally recognized "scribe" program at the Harris Methodist Hospital emergency room puts TCU students in the middle of the action while they give doctors the write stuff.

Bad handwriting. That's why emergency room physician Elliott Trotter called TCU three years ago, asking for premed students who might want to keep charts for him.

"Really," Trotter says, laughing."I have extremely poor handwriting and thought I could provide some students with jobs in the hospital and get some much better charts at the same time."

That call has evolved into a unique"scribe" program that is spreading to hospitals around the nation. It provides on-the-job training for students with medical ambitions and, of course, decent penmanship.

It's a symbiotic relationship, Trotter said, one that benefits the doctor, the patients and the student workers, all 20 of whom are hired by the emergency room doctors to keep track of the charts.

That's what the scribes do. Write it all down. Track down x-rays or lab reports. Remind the doctors who is next, or what still needs to be done. The scribes become organizational orderlies for doctors who must juggle rooms full of emergency cases.

"It really does speed up the process," said Bert Chauveaux, an emergency room physician who admits that he wasn't very excited about the program at first."They really smooth things out so we can spend more time with the patients. And this way the charts are much better documents."

Better patient service is a nice side effect, Trotter said.

"We can deal with the patients now," he said."I look them in the eye without fumbling around with some chart. This way I give them immediate feedback since I'm calling out things in the room for the scribe, they also hear what they're saying. It makes for a more intimate situation."

Fiona Barriac '96, a full-time scribe who plans to enter medical school in the fall, said the practical experience has been invaluable.

"I'm not only learning about diseases and treatments," she said."I'm also learning the doctors' thought processes, why they do or don't order tests or treatments. I'm also getting clinical experience that you normally wouldn't get until your third year in medical school."

And it seems that Barriac isn't alone in her feelings.

"Out of 40 scribes we've hired, we've only lost three to attrition," Trotter said."That's an impressive thing to say about the dedication of these guys."

The doctor's are in...

About 2,000 Frog physicians, dentists and veterinarians have measured their pulses in the premed program since 1905. Here is just a sampling:

Dr. Aubrey E. Taylor '60 admits it was nerve-racking to be among the first to testify before the U.S. Senate in 1994 about the dangers of secondhand smoke, but he still considers it one of the highlights of his 40-year career in microcirculatory research."Of all the things I've done, I'm most proud of that," he said of the chance to defend the ground-breaking paper he compiled for the American Heart Association on the now well-documented subject. That's a strong statement considering Taylor's other accomplishments: In the fall the former math major was awarded the American Heart Association's highest honor, the Research Achievement Award, for his discoveries in how nutrients and oxygen are exchanged between blood and cells; he's published seven books (one is considered the classic textbook on respiratory physiology) and more than 700 scientific papers and abstracts; and as endowed chair holder, professor and now chairman of the department of physiology at the University of South Alabama College of Medicine, Taylor has been a mentor for hundreds of students, 33 of whom earned their PhDs under him.

Dr. E. Sherwood Brown '85 (PhD '89) is an assistant professor in the department of psychiatry at UT Southwestern Medical Center in Dallas. He was awarded a NARSAD Young Investigators Award of $50,000 to support his research on schizophrenia and mood disorders.

Dr. Ai-Xuan (Marie) Le Holterman '80, Assistant Professor of Surgery at the University of Illinois at Chicago, shares a pediatric surgery clinic with husband Mark. The two are setting up a Microbiology and Immunology department lab where they spend two days a week doing research in cellular immunology.

Dr. Rogers K. Coleman '53, president and chief executive officer of Blue Cross and Blue Shield of Texas, Inc., has been elected to the company's board of directors. He has served as president and CEO of BCBSTX since 1991 and has been with BCBSTX for over 20 years. Before joining the organization, he was in private practice in Brownwood, specializing in general medicine and surgery. In 1975, he was promoted to the position of Chief of Staff at Brownwood Community hospital. He has received a number of awards for his work in the federal Medicare program including an Award of Exceptional Service (in fraud investigations) from the U.S. Government's Office of Inspector General.

After two internships, Kelly E. Helmick D.V.M. '88 is a third-year wildlife and zoological animal resident of a combined master's and zoo residency program at the University of Florida in Gainesville. She has also been researching drug administration in exotic animals.

Dr. Lawrence Probes '75, an expert in geriatric neuropsychiatry, is developing a regional geriatric mental health initiative that uses distance-learning technology to provide services to nursing homes in outlying areas. Active in local nonprofit efforts, Probes spent time in Russia and Copenhagen working for the International Red Cross and World Health Organization.

Dr. John Murphy '76 limits his general dentistry practice to dentures in order to allow more time for his other vocation, stage acting and directing and producing films. His latest work, a '40s film noir spoof called Flowers on a Moo Moo, will premier this year and be featured at a fall film festival in Fort Worth.

Dr. Joe Webb '79, a board certified anesthesiologist, works at the Fort Worth-based Center for Assisted Reproduction, where his work includes research into what impact anesthesia during surgical procedures has on the reproductive processes. Dr. Jim Fox '64, an Austin plastic surgeon, continues his work with Austin Smiles, a nonprofit organization he helped form that sends medical teams to Mexico and Central America where they repair cleft lips and palates for the poor.

After several years as a clinical psychiatrist and assistant administrator at Duke University Hospital, Dr. Bruce Capehart '87 is now Director of Market Development with Allegiance Healthcare Corporation where he is in charge of business development and marketing for the health care services company.

Dr. Jim Montgomery '73, a Dallas orthopaedic surgeon, served as the team physician for the U.S. Olympic hockey and soccer teams in 1985-86, head physician for the 1987 Olympic Festival, and in 1992, the head physician for the entire summer Olympic team, some 1,200 athletes. Montgomery's knee-surgery skills are renowned. Dr. Mark Redrow '80, is one of a 300 member team of physicians with Texas Oncology who work frontline duty for cancer treatments. His work includes clinical research trials and new treatments including gene therapy in tumors.