In 1938, Alton Ochsner hired Guy Alvin Caldwell as a professor of Orthopedics at Tulane University School of Medicine. An accomplished orthopedist, Dr. Caldwell had developed surgical treatments that allowed crippled children to run and play. His hiring moved the imminent organization of the Ochsner Clinic a large step forward (1). Dr. Caldwell believed in the concept of group practice and became interested in creating a clinic in New Orleans. When he mentioned his idea to Dr. Ochsner, who had also been thinking about organizing a local clinic, Dr. Ochsner answered with his characteristic enthusiasm, “Guy, that's what I've been dreaming about. We've got to do it. Why don't you keep working on it?” (2).
The eldest of the Ochsner Clinic founders, Dr. Caldwell had a great understanding of medical administration and had a clear vision of what the Ochsner Clinic should become. During World War I, while an adjutant of his medical unit, he also served as the manager of an army hospital (3). Upon returning to Atlanta after the war, he served double-duty as an assistant administrator of the Henry Grady Hospital and as an instructor in fractures at Emory University. In New Orleans, Guy Caldwell emerged as the administrative architect of the Ochsner institutions.
Life and Medical Career
Guy Alvin Caldwell was born on January 24, 1891, in Alcorn County, Mississippi. He earned his medical degree from the Columbia University College of Physicians and Surgeons in 1914. During World War I, he served as adjutant of his medical unit in France and, upon the end of the war, he returned to practice at Henry Grady Hospital in Atlanta and was named an instructor at Emory University (3, 4). In 1922, he relocated to Shreveport, Louisiana, where he was named the Chief of Surgery at the Shriners Hospital for Children and began his private practice in orthopedics. On a visit to Shreveport, Alton Ochsner was invited to make hospital rounds with Dr. Caldwell. Dr. Ochsner was very impressed with Caldwell's work and the two developed a close friendship.
When Dr. Ochsner hired Dr. Caldwell at Tulane University in 1938, he was able to continue his scientific and academic work, becoming one of the leading orthopedists in the country. Dr. Caldwell founded and led the Ochsner Clinic Department of Orthopedics. He later served as president of both the American Academy of Orthopedic Surgeons and the American Board of Orthopedic Surgery and was elected to the Council of Medical Education of the American Medical Association. In 1957, he retired from practice except for occasional consultations and became the full time medical director of the Ochsner Clinic. After a productive career spanning almost 7 decades as a surgeon and administrator, Dr. Caldwell passed away November 1, 1981.
Character
…A tall, erect man with the courtly manners of a southern planter, Caldwell exerted telling influence in partnership councils because he was the best informed of the founders and presented his views with both force and tact. He sometimes clashed with Edgar Burns, who had his own ideas about the way the clinic should be run. They might not speak to each other for a while, but eventually ruffled feelings would be mollified…. Subordinates found Caldwell formal and demanding, but they knew, too, he advocated good pay and working conditions for them, and they respected him…(3)
Frank Riddick, medical director of the Clinic from 1975 to 2001, and John Ray, former head of the Section on Colon and Rectal Surgery, recalled Guy Caldwell as a “Southern gentleman, an excellent physician with a great vision regarding the future of medicine and the Ochsner Clinic.”
Dr. Caldwell's grandson, Guy Alexander Caldwell, followed, as his grandfather did, the scientific path: he is an assistant professor of Biological Sciences at the University of Alabama in Tuscaloosa. The son of Dr. Caldwell's only son, Marc Guy Caldwell, a successful artist and sculptor, Guy Alexander Caldwell, PhD grew up in New York City, but spent many summers in New Orleans in his grandfather's house and playing in Audubon Park. He also has fond memories of trips to Grand Isle during those summers. “[My grandfather] was very kind and nurturing. He had a calm intensity in his voice and was very helpful in instilling interest for my future career in science.” Dr. Caldwell also remembers his grandfather as “a great carpenter; he built the house in Grand Isle and also made many frames for my father's paintings.”
Letters from Grandfather to Grandson
Guy Alexander Caldwell, PhD was very kind to provide some excerpts of letters from his grandfather. Guy A. Caldwell, MD: age 88. The future Guy A. Caldwell, PhD: age 15…
February 6, 1978
Dear Guy,
This is my first attempt at writing for others to read (since falling ill). Do you consider yourself honored or dishonored?
I appreciate your very informative letter which gave me much needed information about your school work-and your many related activities. Remember not to spread yourself too thin!
I am sure you are tired of trying to ready my poor writing, but I wish you to know I love you and appreciate your letters.
Affectionately,
Grandaddy
Sept. 12, 1978
Already it seems a very long time since you were here beside my desk showing me your fine new typewriter. I am pleased that you are learning to type in the correct way. Believe it or not, I did a lot of typing of notes taken during lectures at the medical school and making typed copies which I sold to other students who preferred to review my notes before taking written monthly tests, etc. to attending the lectures and making their own notes. It was a hard way to earn a few dollars but I did quite a bit of such writing using an old, rusted typewriter and my own “hunt & peck” fingering. You can imagine how poor the results were. However, they were reasonable and my student friends bought them – and most passed their tests! Of course, I learned the notes “by heart” in writing them to sell to my classmates! It was all good fun. I kept the typed notes thinking I would possibly wish to refer to them later when I would be an intern in the hospital, but I never found much use for them!
Enough of my experiences while a medical student, if you stick to your determination you will have your own experiences to relate to your grandson, and they will be very different experiences – but good typing ability will always be a handy asset!
Affectionately,
Grampy
November 7, 1978
“I am glad you take your participation in sports seriously, much as you do your studies. It makes you a better player, just as serious study makes a better student…Your school work average, about B, is not surprising in view of all the activities you take on – sooner or later you must learn your limitations and plan your activities accordingly – pardon me please – I did not intend to preach or sermon.”
Professor
After retiring as medical director of the Clinic. Dr. Caldwell kept a desk in the office of his successor, Dr. Merrill O. Hines, …whom he did not hesitate to second-guess. It was an uncomfortable situation for Hines. But years later, when he was near his 90th birthday, Caldwell came to the hospital in his wheelchair to apologize. He broke into tears as he told Hines how sorry he was that he had given the younger man such a hard time. Hines, embracing his former boss, assured him that he had only respect and affection for the man he had always called Professor” (3).
The Ochsner Clinic
Guy Alvin Caldwell played a key role in the founding and direction of the Ochsner Clinic. Of the five original founders, he had the greatest interest in medical administration and business management and became very involved with the fiscal affairs, staff activities, and negotiations of the Clinic.
Getting Started
It was through Caldwell that the founders were able to find the financial means to begin the Ochsner Clinic. One of Dr. Caldwell's patients was the wife of Rudolf S. Hecht, the Chairman of the Board of Hibernia National Bank (1). After many unsuccessful months of searching for a financial partner willing to take a risk on the five founding partners, Dr. Caldwell arranged a meeting between the chairman and Alton Ochsner. Dr. Ochsner told Mr. Hecht:
“…Here we are at the gateway of Latin America…If we could have an institution here such as the one we are talking about, I think we could attract Latins.” Mr. Hecht listened, and then he said, “This is good; this is good for New Orleans, it's good for Louisiana, it's good for the South and good for the United States.” I said, “Yes, Mr Hecht, but we have no equity.” “Oh”, he said, “but you have your reputation.” Mr. Hecht arranged for the Hibernia bank to lend the partners up to half a million dollars on their signatures alone. Alton Ochsner once said, “If it had not been for Mr Hecht, this clinic never would have been. He took a chance. He is entirely responsible for the organization.”
The Hospital
In 1944, 2 years after opening the Ochsner Clinic, the original partners chartered the Alton Ochsner Medical Foundation to pursue medical education, research, and charity. The new Foundation needed a hospital facility in which to operate. Caldwell and the other founders explored several possibilities, including acquiring a hospital with Tulane and Touro Infirmary, but negotiations failed. Drs. Caldwell and Ochsner went as far as Washington DC to seek the advice of Basil McLean, former director of Touro Infirmary, who was a medical corps colonel serving as a consultant.
On October 26, 1946 the Alton Ochsner Medical Foundation acquired the military medical facility and former POW facility, Camp Plauche, and renamed it Foundation Hospital, which came to be affectionately referred to as “Splinter Village.” The trustees decided that if the clinic took over the hospital it would appear that it was to be run as a for-profit institution and this, in Dr Caldwell's words, “would constitute a breach of good faith.” The trustees anticipated that when the time came to build a permanent hospital, it would be easier to accomplish on behalf of a non-profit organization than a for-profit partnership. They were eventually able to build the permanent medical facility that became today's main campus on Jefferson Highway.
The Legacy
In 1949, Dr Caldwell wrote,
Many of the senior members on our staff feel that it is due them to establish a plan for succession which will give them assurance that the transitional stage will not be too critical, and that as some of them prove their administrative ability, they will soon begin to have some voice in the policies and plans for the Clinic. Those who have given five to eight years of loyal service to the group are due some clarification of this problem before long. (3)
He was planning for the future of the Clinic and Foundation. During a 1955 vacation, Caldwell wrote a poignant memorandum that settled the next 50 years of the Ochsner institutions:
The future security and stability of the clinic (and foundation) depend upon having full, whole-hearted interest and cooperation of the staff and key personnel…. This I believe can only be realized by real participation, both in policymaking and profit sharing. This would require a very large partnership with a very complicated formula for voting and sharing….With a tight, small controlling group we will never be able to recruit the top-flight men required to do the kind of work we wish to have done….The staff thinking and attitude is what really controls our services to patients and our income & unless the staff is satisfied & have a feeling of real participation, the future of the Clinic is not secure not sound (3).
Cohesion
Guy Alvin Caldwell's role in the creation and planning of the vibrant institution that Ochsner Clinic Foundation patients and employees and the surrounding community enjoy today cannot be challenged. Dr. Caldwell made many more contributions than those above; I have chosen what I considered some of the most important and most telling. He was one the most fervent advocates for the building of the Brent House Hotel to give patients and families a sense of comfort and security during their visit to the Hospital and Clinic. He was a pioneer in the field of orthopedics and an accomplished physician and administrator. Perhaps the best compliment to Guy Caldwell's importance to the Ochsner legacy came from his fellow founder, Dr. Curtis Tyrone: He was “the glue that held us together” (3).
Acknowledgments
The author would like to acknowledge the recollections of Drs. Frank Riddick and John Ray in addition to the generous contributions of Guy Alexander Caldwell, PhD.
- Ochsner Clinic and Alton Ochsner Medical Foundation