Gaining Momentum, Achieving Renown

When Charles Sprague arrived at UT Southwestern, the institution consisted of three small academic buildings attached to Parkland Memorial Hospital. He initiated a $40 million building expansion, unprecedented in Texas; doubled the medical school's enrollment within 10 years; and expanded allied health and research training programs. Under his leadership, UT Southwestern was transformed into a vibrant, comprehensive medical and life sciences center.

Guido Currarino, in later years
Guido Currarino, in later years

In the early 1960s, Children's Medical Center became the primary pediatric teaching facility for UT Southwestern Medical School. Guido Currarino, M.D., was named its chief radiologist in 1965. Over the course of his career, he published 122 articles, was a longtime member of the John Caffey Society, and contributed to Caffey's Pediatric Diagnostic Imaging. Currarino was particularly interested in congenital abnormalities, two of which bear his name: the Currarino syndrome, and the Currarino-Silverman syndrome.

"Guido Currarino was an incredibly talented pediatric radiologist who was renowned locally and nationally for his description of many radiologic syndromes and for his unique personality," said Charles Ginsburg, M.D., senior associate dean for academic administration at UT Southwestern Medical School and professor of pediatrics. "He was a fascinating character — a charming, puckish curmudgeon who was one of the famous early second-generation pediatric radiologists but, what few people knew, he was also fully trained as a pediatrician before he obtained radiology training in Boston and Cincinnati."

Dr. Currarino was a charter member of The Society for Pediatric Radiology (SPR). In 1995, in recognition of his many contributions, the SPR presented him its Gold Medal, the organization's most distinguished honor.

Thomas Curry
Thomas Curry

 

William Kilman
William Kilman

Writing in Pediatric Radiology at the time, Walter E. Berdon, M.D., described how other pediatric radiologists eagerly awaited Dr. Currarino's scientific presentations, saying his research was "usually of an entity we all knew nothing of and had missed on films; as an example, The Ductus Calcification was of 'only' 75 cases gleaned over two years of looking with two proved pathologically...The overwhelming response after each talk or paper ended was, 'Why didn't I think of that?' He surely has one of the best eyes in pediatric radiology."

Throughout the 1960s the radiology department's residency program continued to gain momentum. Reflecting on the period, Frederick Bonte recalled when Tom Curry, M.D., and William Kilman, M.D., took their board certification exams.

"Kilman and Curry were candidates for certification by the American Board of Radiology at the same time," Bonte said. "I was one of the examiners, and it was customary for all of us to get together at the end of the day and swap stories about what went on. This particular day, Kilman and Curry had gone back to back. The old gentleman who operated their station came up to me and said, 'Where in the hell did you get these people? Kilman sits down, I showed him a film and he immediately shoots it down with a thick Texan accent. I couldn't show him anything he couldn't get. It was wonderful. What's worse is the next man who came through was just as good and was from the same program.'"

"Back then you could find out where residents trained," Bonte continued. "That did wonders for the reputation of the department because examiners from all over the country were listening to this story about these cowboys from Southwestern acing their board exams. Our applicant pool really began to grow and we were able to add more first-rate faculty."

Both Drs. Kilman and Curry joined the faculty. Several years later, George Curry, M.D., Tom Curry's younger brother, also graduated from UT Southwestern, completed his residency, and joined the faculty.

Mary Ann Mullican Becomes First Woman Radiology Resident

Mary Ann Mullican's First ID Badge
Mary Ann Mullican's First ID Badge

In 1967, Mary Ann Mullican became the first woman resident of the program. Her fascination with X-rays began as a child, when she and her brother would go to a department store in the northeast Texas town of Henderson to have images made of their feet to determine proper fits. The first image she saw as a resident at Parkland made quite an impression.

"They put a stack of films in front of me and on top was an X-ray of a skull with an axe in it," Dr. Mullican said. "The patient was talking and doing very well, so to speak. He'd had a fight with someone. A problem arose when they needed to take him to surgery because of how the axe handle was positioned and [the maintenance department] had to get involved. Back then the anesthesia equipment wasn't very flexible. Needless to say the case grabbed my attention."

Mary Ann Mullican, in later years
Mary Ann Mullican, in later years

It was during this time that Dr. Mullican and her classmates became "guinea pigs" for a textbook that would revolutionize the way physics was taught in diagnostic radiology. Ed Christensen had reorganized the radiology residency-training program and was now lead author of the textbook Christensen's Introduction to the Physics of Diagnostic Radiology, published in 1972. Four editions would eventually be published, and for several decades it was the reference standard and mandatory reading for all radiologists taking board examinations.

In the preface to the book's third edition, authors Tom Curry, James Dowdey, Ph.D., and Robert Murry Jr., Ph.D., described Christensen's inspiration.

"He soon recognized that residents' frantic efforts at studying radiological physics were producing little more than frantic residents," they wrote. "Thus began a modest series of informal conferences dealing with physics. Soon handouts began to appear, and by 1968 an in-service quiz tested both the teacher and his students. Ed was, but should not have been, surprised to find that this written material he had so painfully produced was finding its way about the country as friend traded with friend. In this manner was born the framework for the first edition of Christensen's Introduction to the Physics of Diagnostic Radiology. This text was the direct result of a teacher's effort to teach where he was most needed."

Christensen's Introduction to the Physics of Diagnostic Radiology
Christensen's Introduction to the Physics of Diagnostic Radiology

Robert Parkey Joins the Faculty

In June 1971, the National Research Council named George Curry and Robert Parkey, M.D., Picker Scholars. Dr. Curry was investigating the splanchnic circulation after interruption of the superior mesenteric artery, while Dr. Parkey focused on small computer processing of scintigram data. Dr. Parkey had joined the radiology faculty in 1970 after completing a fellowship in computer applications in radiologic data processing at the University of Missouri in Columbia, Missouri. A graduate of UT Southwestern Medical School, Parkey completed his residency in diagnostic radiology at Parkland hospital.

The division of nuclear energy was also mushrooming. In an interview with radiology professor Dana Mathews, Ph.D., M.D., for the Southwestern Chapter of the Society of Nuclear Medicine, Bonte shared memories of the time.

"The nuclear medicine laboratory in Parkland hospital was quite busy," said Dr. Bonte, who was ninth chapter president from 1964 to 1965. "We would frequently have 30 patients a day. We not only did the work for Parkland, but we did it for Children's Medical Center and some of the patients from St. Paul. And patients would be referred in from the community because there wasn't wide access to nuclear medicine in the community hospitals at that time."

In 1971, Dr. Bonte was one of 10 founding members of the American Board of Nuclear Medicine. The board was the nation's first "conjoint" board, an interdisciplinary entity that brought together physicians from existing medical specialties — in this case internal medicine, pathology and radiology. At the time, Texas' only approved post-graduate and residency-training program in nuclear medicine were in Dallas — a cooperative effort involving UT Southwestern, as well as Parkland, St. Paul and Veterans Administration hospitals.

Ernest Stokely
Ernest Stokely

The following year, Ernest Stokely, Ph.D., joined the radiology department faculty and helped establish the Radiology Imaging Center, which was one of the earliest minicomputer-based medical imaging research groups.

"Our group was primarily involved in software development for interfacing and imaging applications of minicomputers in nuclear medicine," Dr. Stokely said.

"Nuclear medicine saw the first applications of computers in medical imaging long before CT scanners or MRI appeared. Our imaging lab developed software using bit level, assembly level, and higher-level language coding. We wrote software for drivers for new equipment, and we wrote our own graphics software packages when none were available."

Several years later UT Southwestern and the University of Texas at Arlington launched the first joint graduate degree biomedical engineering program in the state. Dr. Stokely served as co-chairman of the program from 1974 to 1984.

In November 1972, the name and scope of the medical school was changed with its reorganization into The University of Texas Health Science Center at Dallas. In approving the concept of a health science center, the UT System Board of Regents provided for the continued growth of coordinated but separate medical, graduate, and undergraduate components, interacting creatively on the problems of human health and well-being.

Frederick Bonte Becomes Dean of the Medical School

With Dr. Sprague as president, a faculty search committee was formed to find a new dean of the medical school. Bonte was chosen unanimously for the role, and he accepted. On March 16, 1973, a press release made the announcement official.

Frenderick Bonte
Frederick Bonte

"Under Dr. Bonte's leadership, Southwestern's Radiology Department has achieved a national reputation for its pioneering contributions to the relatively new science of nuclear medicine," the release quoted Sprague.

"I am pleased that Dr. Bonte is enthusiastic about serving our institution in this important new capacity. He will provide strong leadership in a climactic period of development, as the medical school grows towards its goal of doubling in size by 1978."

Dr. Bonte retained his faculty appointment in the radiology department and continued to participate in nuclear medicine research. Dr. Christensen assumed the position of acting chair of the department, a position he held until 1974.

That same year, Dr. Bonte and his colleagues made a significant discovery. For the first time, thanks to a new nuclear scanning technique, physicians could see the exact area of damage caused by a heart attack.

A 'Major Breakthrough' in Diagnosing Heart Attacks

Bonte's Breakthrough
Bonte's Breakthrough

Technetium 99m pyrophosphate, a radioactive substance with an affinity for calcium, was shown to accumulate in necrotic and severely injured heart muscle after it was injected into patients. Within an hour after injection, damaged areas of the heart with sufficient calcium accumulation would bind to the radiopharmaceutical and show up as a bright spot on the screen of a scanner, or scintillation camera. The image could be enhanced by computer processing and could be stored on videotape for later replay.

This discovery was somewhat serendipitous and prompted by Dr. Bonte's position. "I was dean of the medical school and the president came to me with a dilemma," Dr. Bonte recalled. "He told me he'd scrounged together enough money to buy one electron microscope, but two departments wanted it. So I had the pathology chairman and cell biology chairman come to my office to make presentations about why their department should get the microscope. It came up that, as a cell dies, hydroxyapatite [a bone-like substance] appeared in the mitochondria. It struck me you could tag calcium with radioactivity. I told these two chairmen we had money for one microscope, but what if it was divided it into two, giving each half. They leaped up, said that was a great idea and vanished out the door. I immediately called Parkey."

Dr. Bonte asked Dr. Parkey to set up an animal experiment in which a heart attack was induced, followed by an injection of Technetium 99m stannous pyrophosphate, a well-known radioactive substance used in bone scanning. When Dr. Parkey pointed a scintillation camera at the animal, "the thing lit up," Dr. Bonte said.

This new technique was a clever adaptation of some very well known practices used in nuclear medicine to diagnose thyroid and bone tumors. It was, in fact, practically identical to a method used in bone scanning, and knowledge of this method provided Dr. Bonte the key to the new technique.

With this new tool of diagnosis, doctors could determine, usually within an hour, if a person was actually suffering a heart attack or simply pain from other sources. Additionally, where the scan shows an infarct, knowledge of its size and position enabled faster, more effective treatment.

"It was a major breakthrough for Southwestern," said Kern Wildenthal, M.D., Ph. D., then dean of the graduate school and future president of the medical center.

Following the discovery, a new portable scanning camera and computer was assembled for Parkland. The Southwestern Medical Foundation donated more than $100,000 for this equipment.

"The nuclear medicine group began to apply its improving instrumentation to the study of cardiovascular system, which led to an important collaboration with the Cardiology section of internal medicine, headed by James T. Willerson, M.D., and with the department of pathology and L. Maximilian Buja, M.D.," Dr. Bonte wrote in an essay for Selected Recollections of The University of Texas Southwestern Medical School.

"A good deal of what has come to be known as nuclear cardiology resulted from this collaboration and from the efforts of numerous residents, fellows, and graduate students who trained at Southwestern in the early 1970s."

Robert Berk Becomes the Department's Second Chair

Robert Berk
Robert Berk

In August 1974, Robert Berk, M.D., became the second chair of the Department of Radiology at The University of Texas Health Science Center at Dallas. A native of Pittsburgh, he graduated from the University of Pennsylvania and its medical school. Dr. Berk completed his internship at St. John's Hospital and served as chief of radiology at Castle Air Force Base in Merced, California. He later served received his radiology residency training at Peter Bent Brigham Hospital in Boston.

Dr. Berk's academic career began as a teaching fellow at Harvard Medical School in 1961. In 1962, he joined the University of Pittsburgh's School of Medicine as an instructor in radiology. He became an assistant professor the following year and later joined the medical school faculty at the University of California–San Diego. There, Dr. Berk was associate professor and chief of gastrointestinal radiology before being recruited by UT Southwestern.

The early 1970s were proving to be an exciting time for the radiology department. And things were just getting started.

 

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