Deep in the heart of Texas stands the University of Texas Southwestern Medical Center (UTSWMC), a public academic health science center in Dallas with 13,568 employees, 2,445 faculty, and 2.7 million outpatient visits annually. Applying the adage “everything is bigger in Texas,” it's no surprise then that UTSWMC represents the largest medical school in the UT System and in the state of Texas.
Standing in the heart of UTSWMC is the Anesthesiology and Pain Management Department, which became a department in 1955, is Charles Whitten, MD, chair since 2008, who can attest to the growth knowing he “has seen it all.”
“Since joining the faculty following a fellowship in 1988, I've watched it grow with a front row seat, from 78 professors/faculty members in 2008 to 250 ‘strong’ today,” said Dr. Whitten.
Indeed, the department's clinical footprint has increased in scope and size with nine ICUs, 12 pain clinics, and 240 anesthetizing locations.
UTSWMC was established in 1943, followed by the division of anesthesiology within the department of surgery in 1948.
That same year, UTSWMC hired its first chair of the department of anesthesiology: the renowned M.T. “Pepper” Jenkins, MD, whose legacy of leadership through mentoring would carry his “mentee” in Whitten into the next 44 years.
Praise over pressure to push through
As the department entered 2020, the COVID-19 pandemic didn't slow them down or halt production. In fact, Dr. Whitten said the team persevered with grit on the front lines.
“Not surprisingly, given our incredible faculty, last year was our most productive academic year,” he said. “Our hospital partners and affiliated departments recognized the importance of our specialty in the fight against COVID-19.”
As obligations increased across the entire department, the team implemented COVID-ICUs while creating a “COVID Airway Team” and organizing departmental telehealth pain and pre-op screening areas.
Throughout the pandemic, Dr. Whitten met every day for seven months with his senior leaders: Drs. James Berry, Steve Kimatian, Gloria Cheng, David McDonagh, James Griffin, and Catherine Barden.
Dr. Whitten specifically praised his department members who are also parents, highlighting “the incredible group of women who were stretched during the pandemic as they balanced unknowns at work with the responsibilities of family while also teaching their children, whose education became homebound overnight.”
“I am not sure how they did it all,” he said.
Mentorships and awards
“To be a good mentor, you need a good mentor,” said Dr. Whitten. “As an international leader of our specialty, Pepper demonstrated tremendous empathy and interest in all people. He reminded me of my parents, who taught me to find good mentors. I found one in Dr. Jenkins, who I met during my third year of medical school.”
Like Dr. Jenkins, Dr. Whitten said one of the basic tenets of his coaching leadership style is to provide his team good news through his “Monday Morning Shout Outs” that recognize achievements, big and small.
Dr. Whitten and his wife invested in a new leadership program, the Charles E. Whitten, Jr. and Dorothy D. Whitten Perioperative Leadership Development Program, which graduated its first cohort in 2020. Each graduate assumed additional leadership responsibilities during the pandemic.
Blending generations and cultures
Like the Center's tagline, “The Future of Medicine, Today,” the department's faculty boot camp, established by the chair and department leaders as a complement to the Reverse Mentoring Program, prepares junior faculty for tomorrow through the wisdom of the senior members today in an effort to bring junior colleagues from different backgrounds together to discuss multiple issues monthly.
The past year, Dr. Whitten has spent a great deal of personal introspection reflecting on growing up during the civil rights movement.
“We are focused on diversity, equality and inclusion [DEI] training, and believe shared governance is vital to integrate diverse backgrounds within our clinical footprints,” said Dr. Whitten. “To expand these programs, I am in the process of recruiting a vice chair of DEI.”
In 1992, UTSWMC was the first school to add pain management to the department title, emphasizing the relationship between the specialties. That same year launched the Eugene McDermott Center for Pain Management ,beginning the novel process of managing pain without the use of opioids, said Dr. Whitten, who was awarded the endowed title as the Margaret Milam McDermott Distinguished Chair, Anesthesiology & Pain Management in 2008.
Another initiative is the department's Enhanced Recovery After Surgery (ERAS) Program, which helps to optimize patient recovery while boosting health after major surgery.
“Our perioperative acute pain and chronic pain management program was a significant part of the ERAS Program, as well as our pediatric chronic pain program in pain medicine this year,” he said.
Research, clinical trials, and publications
With his research interest on the perioperative inflammatory response, economic factors influencing academic anesthesiology, and managing generational differences in the workplace, Dr. Whitten highlights his prolific academic leaders who produced 184 original articles, nine editorials, 11 case reports, and edited or co-edited two books during a challenging pandemic.
Leading the advances in medical research are the Center's Gerald Matchett, MD, Associate Professor; Amanda Fox, MD, MPH, Division Director, Cardiovascular and Thoracic Anesthesiology,and A.H. “Buddy” Giesecke Jr, MD, Distinguished Professor; and Tom Floyd, MD, Professor and S.T. “Buddy” Harris Distinguished Chair, who was honored for his research on a fiber optic epidural device capable of monitoring spinal cord ischemia; the device received FDA Breakthrough Devices designation and will likely be tested in humans in late 2022 or early 2023, said Dr. Whitten.
The department has also been active in COVID-related clinical research: optimizing therapeutics, protecting its workforce, and exploring the anesthetic implications of current or past infection, he said. One recent study explores perioperative adverse events in pediatric patients with a history of SARS-CoV-19, while another examines palliative care utilization and end-of-life issues in COVID patients.
‘The Future of Medicine, Today’
“Through the professionals we employ and the pathways with our partners, we will continue to emphasize the importance of diverse programs in all departments,” Dr. Whitten said.
“The momentum and incredible support prompted an upward trajectory in our clinical translational research in pain management, building on our formidable medical school with prominent research scientists who continue their ground-breaking research generating discoveries in all areas of medicine, while improving the procedures of anesthesia practices,” he said.
Dr. Whitten said an 800% increase in funded research during the past four years will enable the department to continue its scientific productivity.
Dedicated to expanding training programs for medical students, residents and fellows, Dr. Whitten is excited about the new generation of medical school graduates entering the residency program after personally interviewing 360 applicants this past year.
In 2023, the UTSWMC celebrates its 80th anniversary while the department of anesthesiology and pain management celebrates 75 years, and will continue providing ‘The Future of Medicine, Today.’
Amy Gallagher is a certified English teacher and an internationally published journalist who has covered the health, medical, aviation, and military-rescue fields.