Foster explains 'facts of life' for physicians,
medical schools

I believe that weight for physicians comes from maintaining a way of life - a way of life that has been lifted up by true physicians since antiquity. I speak here of what Lionel Trilling called sincerity, using the 19th century definition of the word which did not mean "without guile or with out hypocrisy" as we usually mean it, but "meeting the expectations of one's social role, living one's social role truly." If one is a king, to be kingly, if a peasant, to be a worthy peasant, hard working and responsible. In our case, if one is a physician, to be a true and whole physician.
- Dr. Daniel Foster, May 8, 2004


When Dr. Daniel Foster speaks, people listen. Raptly. Admiringly.

"I've heard him many times over the years," said Tyler internist Dr. Richard A. Anderson, a long-ago student and resident of Dr. Foster. "His talks are so good. Are they inspirational? Absolutely."

On May 8 an audience of 150 alumni, spouses and others, including Dr. Anderson, gathered to hear Dr. Foster's reunion talk on South Campus. They came from across Texas and beyond, and their attendance bespoke not merely a desire to be enlightened but an affectionate tribute to an esteemed colleague, friend and, to many and most important, mentor; the 42-year faculty member who from 1988 until 2003 served as chair of internal medicine.

"To me, of course, he was more than anything a mentor," said Dr. Anderson, class of '74. "What I remember most was his intellect, he was so well read, and he was kind."

Plaudits for the 73-year-old Dr. Foster seem to flourish as richly as facts ad infinitum from a 20-page curriculum vitae. That is how it is when you're internationally renowned for work in your field - as in Dr. Foster's case, diabetes - for which in 1984 he was awarded the Banting Medal for Scientific Achievement from the American Diabetes Association for his long-term contributions to the under standing, treatment and prevention of the disease. That is how it is when you have earned the warm admiration of legions of students and colleagues in more than four decades as teacher-scientist at UT South western, where you are holder of the Donald W. Seldin Distinguished Chair in Internal Medicine and winner of countless honors for teaching (NIH Great Teacher Award) and contributions to medicine. That's how it is when you are Dr. Foster, the genial host of "Daniel Foster, M.D.," the PBS weekly medical show in the 1970s, the member of the Institute of Medicine of the National Academy of Sciences who in 2002 was named to President George W. Bush's Council on Bio ethics.

This, though, is but a mere toe-dip into an ocean of honor and achievement by the Texas native who in 1955 graduated first in his Southwestern Medical School class, did postdoctoral research training at Southwestern and -the National Institutes of Health, and returned to UT Southwestern to teach in 1962, the physician-scientist whose research for many years focused on the intermediary metabolism of carbohydrates and lipids.

In his reunion weekend talk, an engaging 3,100 words, Dr. Foster spoke to the challenges facing both teaching and practice. Both have to deal with the massive increase in medical knowledge. The knowledge is good, trying to master it is hard. There are dispiriting issues. In academia nationally teaching is at risk because of lack of economic support and the demands on faculty time to attend on wards. Teaching is also disrupted by restrictive new rules on the hours residents may work. In practice there is man aged care, higher malpractice premiums, declining salaries.

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"Much of medicine has been demoralized," he said.
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I had my dog in for routine shots and a checkup a few weeks ago. The dog was not sick, but the bill was $234 cash up front. Would that I got paid like that! The lawyer, the dentist, same thing. It is demoralizing.

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Dr. Foster, his admirers say, extols hope for his profession - I have the distinct impression that our medical students and residents perform in superb fashion, both in terms of competence and compassion. Dr. Anderson: "He made us feel like we were here to learn, that we were all in this together, and he impressed on us the nobility of our profession."
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What one invests in the students lasts. I recently received a note (when I stepped down as the chair of internal medicine) from one I taught years ago. "I am reminded of the gift you have given to me - the gift of your teaching. Your enthusiasm and joy of teaching (and learning) is truly a gift which keeps on giving." And then he cited a statement about teachers from John J. Chapman in the book Memories and Milestones. Chapman said this: "Benevolence alone will not make a teacher - nor will learning alone do it. The gift of teaching is a peculiar talent, and implies a need and a craving in the teacher himself." That is certainly the way I feel.

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When Dr. Foster was a child, growing up in such West Texas reaches as Colorado City and El Paso, he never labored under career indecision. "I knew from the time I was in grade school that I wanted to become a doctor," he recalled in a recent inter view. "The family joke was that when I was a baby, my mother kept whispering in my ear, 'Be a doctor, be a doctor.'" He laughed, evoking the cultural mandate of every mother's dream: Become a doctor or marry one.
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There were no physicians in his family, though he had a dentist grandfather. His father was a county agricultural extension agent and farmer, his mother, a homemaker who rode herd over young Daniel and a brother. After graduating from El Paso's Austin High School, he attended Texas Western (now UT El Paso), where as a pre-med major he finished near the top of his class. At the time, the early 1950s, there were only three medical schools in Texas - in Galveston, Houston and Dallas. "But when you're from El Paso, the humidity of the Gulf Coast can be intimidating," he said. "So I chose Southwestern. Besides, back then I think the tuition was only $300 for the year."

His intention was to return home one day to practice, but while in medical school he was influenced by "role models who could tell me the underlying reason for disease. I admired the physician-scientists." He planned to stay at the NIH. "But Dr. (Donald) Seldin was very persuasive." Dr. Seldin, for 38 years the chair of internal medicine and himself a revered presence at UT Southwestern, recalled his recruitment of the young Dr. Foster: "I think his special quality was to bring the finest biomedical science to the teaching and practice of clinical medicine." And today why so many hold Dr. Foster with such august esteem: "His commitment and clinical work in the setting of the university."

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I think we should be proud of this way of life. It is to be undivided in the fight against illness and premature death. It is to study until we retire or die, so that we are ever competent, trustworthy in our knowledge for every patient that comes to us. And it is to be kind. Tired or rested, kind.
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Shed of some of his administrative duties, Dr. Foster these days finds more time for research, mentoring, writing, traveling (he frequently evaluates departments of medicine at leading medical centers); spending time with wife Dorothy and keeping up with their three sons (one a physician).

And he makes talks, like the one May 8.

His former students and residents often keep in touch. They communicate by letter or e-mail, and by visits. They give him hugs. They show him pictures of their babies.

"It is touching," he said.

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There are not many things in this world of today that are consistently good. But one thing is: the competent and compassionate physicians that day-to-day prevent premature death and cure when possible, who relieve symptoms when cure is not possible, and who comfort always. These are the classic duties of physicians, and the world would be much worse off without us.

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Michael Blackman
214-648-3404
michael.blackman@utsouthwestern.edu

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