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27 agosto 2010 5 27 /08 /agosto /2010 13:14

A Half Century of Love

by Ruth SoRelle, M.P.H.

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Dr. Carlos Vallbona at work


 

Fifty-one years ago, Dr. Carlos Vallbona fell in love—with a medical center and a medical school. It's a romance that continues to this day.


 

He came to Houston and Baylor College of Medicine to learn how to treat polio and to prepare himself for a career in academic medicine in Spain.

He became one of the leading polio doctors in the United States, and never took up an academic career in Barcelona.

In fact, he never left Houston or Baylor. His career transitioned from pediatrics and polio to rehabilitation medicine and then to community medicine. Always, he was fulfilled when treating those most in need of his care and sharing that knowledge with others. The professor of family and community medicine, pediatrics and rehabilitation has no regrets.

"Frankly, I fell in love with this place," he said. Perhaps that was the pediatrician in him because when he arrived in Houston Aug.1, 1955, the Texas Medical Center was in its infancy.

"The friend of one of the residents took me on a tour of the Texas Medical Center. It was a very unusual place. It was a forest, and in that forest there were several buildings," he said. Today, those edifices make up the heart of TMC—Baylor College of Medicine's Cullen Building, The Methodist Hospital, St. Luke's Episcopal Hospital, Hermann Hospital, Texas Children's Hospital and The University of Texas M.D. Anderson Cancer Center.

All of that was set to change, again and again.

"Every day since I came to Baylor, there has been some construction going on at the Medical Center," said Vallbona.

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Stamping out polio: This 1957 U.S. postage stamp certianly applied to Dr. Carlos Vallbona, who dedicated many years to helping polio paitents.

For his first four years in Houston, he lived and breathed his patients at the Southwestern Poliomyelitis Respiratory Center, the first polio center in the United States opened in 1950 by the National Foundation for Infantile Paralysis. (The organization is now called the March of Dimes.)

Dr. William A. Spencer, legendary founder of The Institute for Rehabilitation and Research, recruited Vallbona from the University of Louisville. A native of Spain, Vallbona knew he wanted a career in academic medicine. To achieve that in Spain, he had to pursue postgraduate studies out of the country. He first went to Paris and then, fortuitously, to the United States and Kentucky.

After two years of residency in Louisville, he was looking for a place to spread his wings. Texas and Spencer beckoned.

When Vallbona arrived in Houston, he thought he was prepared, but his first patient was a 41-year-old man in an iron lung.

"I said, 'Wait a moment. I'm a pediatrician.'

"And they told me, 'All these patients are older than children. Haven't you heard of FDR?' (President Franklin Delano Roosevelt had had polio.)

"That was my introduction to medicine that was not exclusively pediatrics," he said.

At Jefferson Davis Hospital, where the polio center was housed in an annex, he and Dr. Gunyon "Guy" Harrison, who had a fellowship, virtually lived in the center.

"Bill Spencer said the reason the Baylor Center had the lowest polio mortality in the world was because he had two fellows spending day and night there," said Vallbona. "There was a couch and a shower. I spent many nights on that couch."

It was preferable to the apartment he shared with Dr. Leighton Hill at Jefferson Davis Hospital. The incinerator chimney went up through the center of the room, so even though there was air conditioning, the room was the hottest in the building. Situated on the 11th floor of Jeff Davis, just above the psychiatric ward, it was not conducive to rest or sleep, and Vallbona said he much preferred the cooler polio center.

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In 1994, Vallbona was honored by the BCM Alumni Association as a Distinguished Faculty Award winner. He continues making vital contributions today.

When there was a patient with acute bulbar polio (which attacks the central nervous system and affects the ability to breathe), neither he nor Harrison left the hospital. If a patient needed a tracheotomy (a hole in the windpipe) to prevent them breathing in secretions, he called a resident in the department of otolaryngology. One of the most able and willing, he said, was Dr. Bobby Alford (currently BCM's chancellor and chair of otolaryngology.)

By the time Vallbona arrived in Houston, the Salk polio vaccine was already available. It was licensed in April 1955. However, because of a scare related to the vaccine and slow acceptance, Houston suffered through bad polio summers in 1955 and 1956.

The cases continued even after all the patients–including those in iron lungs—moved to TIRR in February 1959. Each made an impression on Vallbona, who recalls not only the names, but also the circumstances of each patient he admitted to that facility.

Even before the move to TIRR, he and others in the newly formed department of rehabilitation began to see patients with spinal cord injuries and other problems. He worked in that field until 1969, when a new venture called.

The needs of poor patients in the Harris County Hospital District were becoming more and more apparent, while the county's public hospitals, Jefferson Davis and Ben Taub, were becoming more and more crowded. BCM and its leadership sought to establish a state-of-the-art community health center and a department of community medicine.

In 1969, they offered Vallbona the chance to head the department and build that clinic.

"That was my beginning in community medicine," he said. His mentor in that effort was Dr. Joseph Merrill, now a professor in the department of family and community medicine.

County politics and the exigencies of the Harris County Hospital District resulted in the establishment of two centers in rapid succession—one in Baytown and one at Settegast in the heart of the county's African-American community. In the succeeding years, other clinics followed, and today the hospital district has 11 community health centers, the Thomas Street Clinic for treatment of AIDS, eight school-based clinics, a dental center and a program for the homeless.

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Vallbona's career began in pediatrics, shown here with the 1964-65 Pediatrics faculty, but evolved to include polio, rehabilitation, and community medicine.

He laughs when he describes the battle scars he still bears from disputes over which clinics should be built when and where. However, he credits the support of BCM, its board and that of the Harris County Hospital District with making it all possible. Today, the community health program provides care to thousands of Harris County residents, many of whom would go without treatment without that program.

"Of everything, I hope people will look on it as my legacy," he said.

However, another early venture reared its head in the 1980s, and Vallbona once again leapt into the fray. Today, he treats patients with post-polio syndrome—the late effects of the disease that he knew all too well.

"I've come full circle," he said. "Not too long ago, I saw a gentleman who must be 70 years old now. When I treated him in the 1950s, he was one of the sickest patients I had ever had. I had lost track of him, but now he is my patient again. I see many who were children when I had them the first time, and now they are grandparents."

Vallbona credits academic medicine with keeping him vital and interested in practicing.

"I had the vocation for academic medicine from the first year of medical school," he said. "It's what brought me to the United States."

His commitment to the Baylor College of Medicine mission kept him at the College for more than half a century.

"I really believed in Baylor. I liked what Baylor was doing and enjoyed the contact with students and residents." That, coupled with the fact that his family was settled in the city and did not want to move, kept him here, rejecting several offers he received to chair other departments in other institutions.

"I don't regret it," said Vallbona.

 

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