Wildford Hall-Only Ghosts Left
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- Location: San Antonio, Tx
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At ‘Big Willie,’ all that’s left are the ghosts
By Sig ChristensonAugust 24, 2017 Updated: August 26, 2017 1:17pm
The flagship hospital of the Air Force has been cleared out.
Wilford Hall Medical Center, a 60-year defining presence on the West Side skyline, is empty and its nine-story atrium now has the feel of a giant chamber in Carlsbad Caverns.
Doctors, nurses, technicians and patients affectionately called it “Big Willie.” But the tests, examinations, X-rays and cafeteria meals are over — a final surgery was performed last week — and a ceremony this morning at Joint Base San Antonio-Lackland will start a new era.
Hospital operations have moved across the street to the Wilford Hall Ambulatory Surgical Center, a futuristic $420 million glass-and-steel structure that’s roughly half the size of the vacated hospital’s 1.2 million square feet.
All that remains at the old Wilford Hall are the ghosts.
One of them lurked in the mind of Maj. Gen. Bart Iddins as he walked along its now shadowy sixth floor. He stepped into a room where his first patient, who was fighting pancreatic cancer, died in 1991 after a sudden hemorrhage.
“That was my first rotation as an intern out of medical school,” said Iddins, commander of Wilford Hall’s 59th Medical Wing. “I was on my oncology surgery service and she was really my first patient to be directly responsible for, and I associated it with this floor.
“My wife received chemotherapy for breast cancer in this room,” he added, in a different hallway on the same floor. “People who have had a long association with Wilford Hall, every single person can tell you a story about this place.”
Twenty years later, Iddins’ wife, Sarah, is a cancer survivor. His civilian director of staff, Candido Ramirez, an Air Force enlistee who became an officer, had a son born in Wilford Hall, one of 103,482 babies delivered there.
The hospital off U.S. 90 was dedicated on Nov. 16, 1957, as the Air Force rapidly built a massive Cold War infrastructure in the wake of the Korean War.
Generations of troops, retirees and civilians were treated there. It held as many as 1,000 beds, scores of offices and examination rooms along 12 miles of hallways.
Famous people came through — NASA’s Mercury astronauts, American POWs after their return from Vietnam, the freshly exiled Shah of Iran.
Presidents Jimmy Carter and George H.W Bush dropped in. Carter met with patients to show his support for Air Force medical services, and Bush and his wife, Barbara, talked with troops wounded in the 1989 Panama invasion.
Maj. Gen. Bart Iddins and Brig. Gen. John Degoes, commander and vice commander of the 59th Medical Wing at Joint Base San Antonio-Lackland, respectively,
Like Brooke Army Medical Center across town, Wilford Hall treated the wounded from wars that now include Iraq and Afghanistan. Its Level 1 trauma center treated civilian accident and crime victims, too.
And it was a birthplace for innovations that transformed health care in and out of the military.
One of them was a device called ECMO — extracorporeal membrane oxygenator, a type of portable heart-lung bypass machine for newborns that Wilford Hall pioneered in 1972, saving a baby dying of respiratory failure. ECMO now is used for adults as well.
“This place was wall-to-wall people,” Robert Weston, a 30-year veteran of the old hospital who’s chief of operations and maintenance, said while standing in its subbasement, now home to idled stainless steel carts.
Getting people into the new surgical center, which performs outpatient procedures, was something of a squeeze and not everybody fit.
It has a vastly different look. At three stories, its waiting rooms face a glass wall and open-air atrium that allows sunlight to pour in. Staff, patients and visitors can sit in a long, open commons area, for lunch and conversation, the smell of hot food wafting through the air.
Upstairs, on the second floor, in a room called the Gateway Innovation Center, hospital workers sat in overstuffed chairs for a nine-day class to introduce them to a new way of caring for their patients.
The concept is modeled after ideas used by Intermountain Healthcare, a Utah-based medical network, and the Toyota Production System, which Iddins credits with saving an estimated $25.4 million for the wing and improving care.
If smaller, the center is different and perhaps better. The cost per patient visit has fallen from $339 to $275 over the past three years, said Ramirez, the center’s director of staff.
How “Big Willie” changed the world
Wilford Hall Medical Center and its 59th Medical Wing have helped transform the way troops and civilians receive care on the battlefield and at home. Here’s a look at three major innovations.
Critical Care Air Transport Team
CCATT, as they’re called, are essentially flying critical care specialists. Comprised of a critical care physician, nurse and respiratory therapist, they’ve been around since 1997 and fly to far-flung parts of the globe, caring for up to three severely injured patients, acting as a mobile ICU. Col. Mark Ervin, a physician who has flown 25 CCAT missions to places like Bosnia, Kosovo and Africa, calls them a “classic example” of how the wing has made innovations in health care. Four CCATT units are always on call, and can be ordered into action as Hurricane Harvey closes on the Texas coast.
The Austere Surgical Team
This team, created in the mid-1990s at Wilford Hall, isn’t known to everyone, but a variation of the unit called the Tactical Critical Care Evacuation Team-Enhanced - TCCET-E - quietly shadowed President Barack Obama when he traveled to Kenya, Ethiopia and Cuba. Unlike the Austere Surgical Team, TCCET-E specialists do two weeks of extra training to be qualified to perform surgery aboard a plane. Five specialists serve in either team, one of them either a general or trauma surgeon. They take everything needed in an OR - all of it packed in five large rolling suitcases. The Air Force has trained 11 Austere Surgical Teams, which can do surgeries in a shelter of opportunity - even a one-car garage of a hotel lobby. The Air Force will 60 of these teams on duty in two years.
59th Medical Wing Acute Lung Rescue Team
Wilford Hall developed the Acute Lung Rescue Team in 2012, borrowing from a concept initially tried at Landstuhl Regional Medical Center in Germany. The team uses ECMO - an extracorporeal membrane oxygenator, a type of portable heart-lung bypass machine that was developed at Wilford Hall decades ago for newborns. Now it’s also used to help adult patients with severe pulmonary or cardiac illness. The idea is to bypass the heart or lungs, buying time for the body to heal itself. The Acute Lung Rescue Team flies all over the world but also helps civilians living within a 185-mile radius of San Antonio and out of state. The team so far has cared for 41 people, one from Afghanistan, Honduras, Colombia and Japan, with the rest from the United States. Six or seven in every 10 patients cared for by the ALRT have survived. Fewer than 15 to 25 percent would have otherwise lived.
The center was born in the nation’s 2005 base-closure round, which created the San Antonio Military Health System run by the Air Force and Army, with Iddins as the current commander. The new outpatient facility has fewer missions than Wilford Hall, while Brooke Army dramatically expanded at a total cost of $777.5 million.
BAMC was to be known as San Antonio Military Medical Center-North while Wilford Hall would be called San Antonio Military Medical Center-South, but the idea didn’t survive first contact with Lt. Gen. Eric Schoomaker, the Army’s surgeon general at the time who had served in various Army Medical Command roles on Fort Sam in the mid-1990s.
The changes “did not create a unified command or single chain of command for Army and Air Force medicine, as in the national capital region,” he recalled, so the Pentagon decided to “retain the historical names and separations of the two institutions brought together” by Congress under the SAMMC medical consortium.
Most of the transfer of offices, staffs and equipment to the surgical center have been going on over the summer. Some of the old hospital’s best known services ended long ago. The last of the babies born at Wilford Hall was delivered Aug. 28, 2011. The emergency room, which shuttered in 2010, will be revived — perhaps this year — but it will not handle the most complex medical cases, as BAMC’s does.
The surgical center is in line with an ongoing nationwide trend toward more day-side procedures with stays of only hours.
“If you increase quality, you can make the system more efficient because you are making fewer mistakes,” said Iddins, who noted that Pentagon health care costs top $50 billion a year, a figure he called unsustainable. “We are also becoming more efficient by teaching people how to solve their problems, how to improve their processes in a methodical, organized way.
“And by understanding where all of our costs are, we can decrease the amount we’re having to spend.”
On a recent day, retired Army National Guard field artillery officer Jim Cunningham was at the center to be treated for precancerous cells on his face, a by-product of spending years in the field with no skin protection. At 69, he spent the morning doing a “blue-light special” in the center’s dermatology department, his face cleaned with acetone followed by a cream that looked like suntan lotion.
A technician then trained an ultraviolet light on Cunningham’s face to remove the precancerous cells.
“Right now my face is red and a little bit painful, but it’s all for the good,” he said.
The new center is OK, Cunningham said, but he’s still trying to find his way around.
In time, after the old hospital is imploded or demolished next year, the land it sits on will become a park designed to help patients relax. The ghosts of Wilford Hall will fade, replaced by a new way of practicing medicine.
Iddins, a dermatologist who sees patients every week in addition to his wing commander duties, said he’s emphasizing a culture that “should be more enabling than coercive,” one that gives the lowest-ranking enlistee a chance to suggest changes.
A Toyota plant worker, he said, can stop the assembly line if there’s a problem.
“We must have airmen who have enough confidence in their chain of command that the most junior person in the organization can raise their hand and say, ‘There is a problem with this. We must stop,’” Iddins said. “That is how we avoid making medical mistakes, is having every single member of that team fully empowered to point out a mistake ideally before that mistake is made.”
sigc@express-news.net
At ‘Big Willie,’ all that’s left are the ghosts
By Sig ChristensonAugust 24, 2017 Updated: August 26, 2017 1:17pm
The flagship hospital of the Air Force has been cleared out.
Wilford Hall Medical Center, a 60-year defining presence on the West Side skyline, is empty and its nine-story atrium now has the feel of a giant chamber in Carlsbad Caverns.
Doctors, nurses, technicians and patients affectionately called it “Big Willie.” But the tests, examinations, X-rays and cafeteria meals are over — a final surgery was performed last week — and a ceremony this morning at Joint Base San Antonio-Lackland will start a new era.
Hospital operations have moved across the street to the Wilford Hall Ambulatory Surgical Center, a futuristic $420 million glass-and-steel structure that’s roughly half the size of the vacated hospital’s 1.2 million square feet.
All that remains at the old Wilford Hall are the ghosts.
One of them lurked in the mind of Maj. Gen. Bart Iddins as he walked along its now shadowy sixth floor. He stepped into a room where his first patient, who was fighting pancreatic cancer, died in 1991 after a sudden hemorrhage.
“That was my first rotation as an intern out of medical school,” said Iddins, commander of Wilford Hall’s 59th Medical Wing. “I was on my oncology surgery service and she was really my first patient to be directly responsible for, and I associated it with this floor.
“My wife received chemotherapy for breast cancer in this room,” he added, in a different hallway on the same floor. “People who have had a long association with Wilford Hall, every single person can tell you a story about this place.”
Twenty years later, Iddins’ wife, Sarah, is a cancer survivor. His civilian director of staff, Candido Ramirez, an Air Force enlistee who became an officer, had a son born in Wilford Hall, one of 103,482 babies delivered there.
The hospital off U.S. 90 was dedicated on Nov. 16, 1957, as the Air Force rapidly built a massive Cold War infrastructure in the wake of the Korean War.
Generations of troops, retirees and civilians were treated there. It held as many as 1,000 beds, scores of offices and examination rooms along 12 miles of hallways.
Famous people came through — NASA’s Mercury astronauts, American POWs after their return from Vietnam, the freshly exiled Shah of Iran.
Presidents Jimmy Carter and George H.W Bush dropped in. Carter met with patients to show his support for Air Force medical services, and Bush and his wife, Barbara, talked with troops wounded in the 1989 Panama invasion.
Maj. Gen. Bart Iddins and Brig. Gen. John Degoes, commander and vice commander of the 59th Medical Wing at Joint Base San Antonio-Lackland, respectively,
Like Brooke Army Medical Center across town, Wilford Hall treated the wounded from wars that now include Iraq and Afghanistan. Its Level 1 trauma center treated civilian accident and crime victims, too.
And it was a birthplace for innovations that transformed health care in and out of the military.
One of them was a device called ECMO — extracorporeal membrane oxygenator, a type of portable heart-lung bypass machine for newborns that Wilford Hall pioneered in 1972, saving a baby dying of respiratory failure. ECMO now is used for adults as well.
“This place was wall-to-wall people,” Robert Weston, a 30-year veteran of the old hospital who’s chief of operations and maintenance, said while standing in its subbasement, now home to idled stainless steel carts.
Getting people into the new surgical center, which performs outpatient procedures, was something of a squeeze and not everybody fit.
It has a vastly different look. At three stories, its waiting rooms face a glass wall and open-air atrium that allows sunlight to pour in. Staff, patients and visitors can sit in a long, open commons area, for lunch and conversation, the smell of hot food wafting through the air.
Upstairs, on the second floor, in a room called the Gateway Innovation Center, hospital workers sat in overstuffed chairs for a nine-day class to introduce them to a new way of caring for their patients.
The concept is modeled after ideas used by Intermountain Healthcare, a Utah-based medical network, and the Toyota Production System, which Iddins credits with saving an estimated $25.4 million for the wing and improving care.
If smaller, the center is different and perhaps better. The cost per patient visit has fallen from $339 to $275 over the past three years, said Ramirez, the center’s director of staff.
How “Big Willie” changed the world
Wilford Hall Medical Center and its 59th Medical Wing have helped transform the way troops and civilians receive care on the battlefield and at home. Here’s a look at three major innovations.
Critical Care Air Transport Team
CCATT, as they’re called, are essentially flying critical care specialists. Comprised of a critical care physician, nurse and respiratory therapist, they’ve been around since 1997 and fly to far-flung parts of the globe, caring for up to three severely injured patients, acting as a mobile ICU. Col. Mark Ervin, a physician who has flown 25 CCAT missions to places like Bosnia, Kosovo and Africa, calls them a “classic example” of how the wing has made innovations in health care. Four CCATT units are always on call, and can be ordered into action as Hurricane Harvey closes on the Texas coast.
The Austere Surgical Team
This team, created in the mid-1990s at Wilford Hall, isn’t known to everyone, but a variation of the unit called the Tactical Critical Care Evacuation Team-Enhanced - TCCET-E - quietly shadowed President Barack Obama when he traveled to Kenya, Ethiopia and Cuba. Unlike the Austere Surgical Team, TCCET-E specialists do two weeks of extra training to be qualified to perform surgery aboard a plane. Five specialists serve in either team, one of them either a general or trauma surgeon. They take everything needed in an OR - all of it packed in five large rolling suitcases. The Air Force has trained 11 Austere Surgical Teams, which can do surgeries in a shelter of opportunity - even a one-car garage of a hotel lobby. The Air Force will 60 of these teams on duty in two years.
59th Medical Wing Acute Lung Rescue Team
Wilford Hall developed the Acute Lung Rescue Team in 2012, borrowing from a concept initially tried at Landstuhl Regional Medical Center in Germany. The team uses ECMO - an extracorporeal membrane oxygenator, a type of portable heart-lung bypass machine that was developed at Wilford Hall decades ago for newborns. Now it’s also used to help adult patients with severe pulmonary or cardiac illness. The idea is to bypass the heart or lungs, buying time for the body to heal itself. The Acute Lung Rescue Team flies all over the world but also helps civilians living within a 185-mile radius of San Antonio and out of state. The team so far has cared for 41 people, one from Afghanistan, Honduras, Colombia and Japan, with the rest from the United States. Six or seven in every 10 patients cared for by the ALRT have survived. Fewer than 15 to 25 percent would have otherwise lived.
The center was born in the nation’s 2005 base-closure round, which created the San Antonio Military Health System run by the Air Force and Army, with Iddins as the current commander. The new outpatient facility has fewer missions than Wilford Hall, while Brooke Army dramatically expanded at a total cost of $777.5 million.
BAMC was to be known as San Antonio Military Medical Center-North while Wilford Hall would be called San Antonio Military Medical Center-South, but the idea didn’t survive first contact with Lt. Gen. Eric Schoomaker, the Army’s surgeon general at the time who had served in various Army Medical Command roles on Fort Sam in the mid-1990s.
The changes “did not create a unified command or single chain of command for Army and Air Force medicine, as in the national capital region,” he recalled, so the Pentagon decided to “retain the historical names and separations of the two institutions brought together” by Congress under the SAMMC medical consortium.
Most of the transfer of offices, staffs and equipment to the surgical center have been going on over the summer. Some of the old hospital’s best known services ended long ago. The last of the babies born at Wilford Hall was delivered Aug. 28, 2011. The emergency room, which shuttered in 2010, will be revived — perhaps this year — but it will not handle the most complex medical cases, as BAMC’s does.
The surgical center is in line with an ongoing nationwide trend toward more day-side procedures with stays of only hours.
“If you increase quality, you can make the system more efficient because you are making fewer mistakes,” said Iddins, who noted that Pentagon health care costs top $50 billion a year, a figure he called unsustainable. “We are also becoming more efficient by teaching people how to solve their problems, how to improve their processes in a methodical, organized way.
“And by understanding where all of our costs are, we can decrease the amount we’re having to spend.”
On a recent day, retired Army National Guard field artillery officer Jim Cunningham was at the center to be treated for precancerous cells on his face, a by-product of spending years in the field with no skin protection. At 69, he spent the morning doing a “blue-light special” in the center’s dermatology department, his face cleaned with acetone followed by a cream that looked like suntan lotion.
A technician then trained an ultraviolet light on Cunningham’s face to remove the precancerous cells.
“Right now my face is red and a little bit painful, but it’s all for the good,” he said.
The new center is OK, Cunningham said, but he’s still trying to find his way around.
In time, after the old hospital is imploded or demolished next year, the land it sits on will become a park designed to help patients relax. The ghosts of Wilford Hall will fade, replaced by a new way of practicing medicine.
Iddins, a dermatologist who sees patients every week in addition to his wing commander duties, said he’s emphasizing a culture that “should be more enabling than coercive,” one that gives the lowest-ranking enlistee a chance to suggest changes.
A Toyota plant worker, he said, can stop the assembly line if there’s a problem.
“We must have airmen who have enough confidence in their chain of command that the most junior person in the organization can raise their hand and say, ‘There is a problem with this. We must stop,’” Iddins said. “That is how we avoid making medical mistakes, is having every single member of that team fully empowered to point out a mistake ideally before that mistake is made.”
sigc@express-news.net
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