Meet Norman Ferrell Gant, Jr., M.D.

After six months as interim chair, on June 1, 1977, Norman Ferrell Gant, Jr., M.D., became the fourth Chair of Obstetrics and Gynecology at The University of Texas Health Science Center at Dallas (as UT Southwestern was named then).

Dr. Gant was the first native Texan to serve as chair. He succeeded Paul C. MacDonald, Jr., M.D., (Chair, 1970–1976), who resigned to devote full time to the Cecil H. and Ida Green Center for Reproductive Biology Sciences.

An authority on hypertension in pregnancy, Dr. Gant pioneered studies in vascular responsiveness to angiotensin II in human pregnancy. With more than 25% of Parkland obstetrical patients suffering from pregnancy-induced hypertension, he developed a comparative blood-pressure test, called the “roll-over” test, to predict the likelihood of a woman’s developing hypertension in the later stages of pregnancy. With early diagnosis, steps could be taken to minimize the risk to both mother and child. 

Like his predecessor, Dr. Gant was a graduate of Southwestern Medical School (UTSW Class of 1964) and had completed his residency in obstetrics and gynecology at Parkland Memorial Hospital while Dr. Jack Pritchard was chair of the department (1955–1970). He had been schooled by his predecessors and embraced the challenges of the chairmanship with enthusiasm.

“I like to think of the department as a true academic department. … We provide patient care. We provide teaching that’s necessary to perpetuate our race, so to speak. That’s what the word “doctor” means is “teacher”. And, we do research so that we hope we can at least advance our discipline — leave it better than we found it. Now, those are all noble terms that everybody would like to address. But I think this department really does address them — all of them.”
Norman F. Gant, M.D. from transcript of interview for Jim Murray film, 1977

In 1977, the full-time faculty numbered 34 and the staff 300. The Department was responsible for 8,620 deliveries annually at Parkland Memorial Hospital. With a house staff of 44, the faculty oversaw some 270,000 outpatient visits at nine maternal health and family planning and Parkland complications clinics. In addition, approximately 12,000 private and referral patients were seen at the Faculty Clinic in a near-by shopping center on Medical District Drive between the railroad tracks and North Stemmons Freeway. 

These were exciting times. The face of the University was changing as a $50 million dollar campus expansion program entered its final stage with construction of the Harry S. Moss Clinical Science (J) Building. In the summer of 1977, the Department of Obstetrics and Gynecology’s Cecil H. and Ida Green Center for Reproductive Biology Sciences, led by Paul C. MacDonald, Jr., M.D., moved to its first real home. The Center shared the sixth floor of the Moss building with the McDermott Center for Human Growth and Development and the seventh floor with the Moss Heart Center. 

Recognizing the significance of basic research to the Department and the Green Center, in 1981, Dr. Gant established two department-funded endowments honoring Ph.D. faculty members. On April 9, 1981, John C. Porter, Ph.D., the scientific director for the Green Center, was named The Arthur Grollman Professor of Neuroendocrinology in the Department of Obstetrics and Gynecology. And on June 12, 1981, John M. “Jack” Johnston, Ph.D., was named The Frank C. Erwin, Jr., Professor in Obstetrical Biochemistry.

The founding of the Center for Reproductive Biology Sciences in 1970 had signaled the importance of basic research to the Department. And in 1974, the Department had received one of the first NIH program-project grants to be awarded. Entitled “Initiation of Human Parturition: Prevention of Prematurity”, the multi-project grant set out to determine what caused a woman to go into labor. That quest would occupy investigators like Drs. Porter and Johnston for decades to come and result in unanticipated changes to business operations during Dr. Gant’s administration.

Program-project grants included multiple principal investigators, each with his/her own project and project budget. The funds for these individual projects were aggregated into a lump-sum award. This led to problems not seen with individual grants. Now, with all the money in one pot, a principal investigator could exhaust his entire project’s supply budget and continue spending because the account still showed an available balance — albeit the funds belonged to other investigators.

At the time, the University’s accounting system was relatively primitive. Everything from personnel forms to purchase orders was done on NCR paper and later keyed into the University’s mainframe. Nothing was “real time”. And, no one in the University knew what the true balance was in an account because there were always pending transactions waiting to be keyed. Overdrafts were inevitable. Dr. Gant saw a need for the Department to automate its bookkeeping.

There was just one problem. While departments could acquire word processing equipment in the 1970s, they could not purchase their own computers. Although a few exceptions were made for specialized laboratory functions, departments were expected to satisfy their programming and computing needs by contracting with the central computer facility operated by David Mishelevich, M.D., Ph.D. And, because it was a “cost-recovery” operation, services were expensive.

With a deftly worded justification, Dr. Gant was able to acquire an IBM 5110 computer as an “accessory” to the IBM Office System/6 Information Processor; and the Department was on its way to automation. Through the efforts of Barry Schwarz, M.D., and Judy Wagers, M.B.A., the Department of Obstetrics and Gynecology developed the first automated bookkeeping system in the University — and the only one capable of reconciling program-project grants. 

Clinically, the Department continued to look for ways to improve patient care and advance the understanding of the underlying mechanisms behind diseases affecting women. The Department received funding to continue services to examine alleged victims of criminal sexual assault — a program begun in 1973 under Dr. MacDonald. The Division of Maternal Health and Family Planning, led by Stephen Heartwell, D.Ph., became one of eight centers in the nation to study the risks associated with intrauterine devices (IUDs).

Following the hiring of Jan Friedman, M.D., Ph.D., and Mary Jo Harrod, Ph.D., in 1978, the Department opened a Genetics Counseling Clinic to identify possible hereditary links to familial diseases. And in 1980, as the Board of Regent’s approved the building of a $1.3 million Ambulatory Care Teaching Center to abut the new Parkland Outpatient Clinic, the Department made plans to expand its consulting services and begin an in vitro fertilization program for childless couples when the new Ambulatory Care Center opened (1984).

While chair, Dr. Gant continued his predecessors’ practice of covering Parkland clinical services and mentoring medical students, residents, and fellows. He also continued his research on angiotension II responsiveness in human pregnancy. Teaming with other faculty, he published more than 45 peer-reviewed articles and book chapters while chair. And, in 1980, he and Richard J. Worley, M.D., co-authored the book Hypertension In Pregnancy. Concepts and Management.

Meanwhile, back at Parkland, the babies kept coming. In 1982, the number of women delivered at Parkland topped 10,000 and showed no signs of stopping. While volume and clinical services had expanded during Dr. Gant’s tenure, the mission remained as it had been since Dr. Pritchard became chair in 1955. As Dr. Gant summarized — “We want to provide patients from the surrounding area with total care — including genetic counseling as well as quality prenatal care and prenatal diagnosis.”

But, like his predecessors, Dr. Gant found the administrative duties of the chair burdensome. They ate away at his time for research, teaching, and patient care. At 44, he was ready for a change. After several months on administrative leave, Dean Kern Wildenthal accepted Dr. Gant’s resignation as chair May 31, 1983. F. Gary Cunningham, M.D., who had been acting chair while Dr. Gant was on leave, was named interim and later permanent chair (1983–2004).

During his six years as chair, the Department’s faculty grew as the clinical load increased at Parkland and in the private practice. By the end of 1982, the number of women delivered at Parkland had risen to10,612. In 1983, it was 11,244. The economy had gone into recession. Grant funding was being reduced, and graduating residents were turning away from academic medicine toward more financially rewarding private practice. The future facing academic medicine was troubled.