Texas Society of Anesthesiologists

Betty P. Stephenson Lectureship Inauguration

John M. Zerwas, MD, Speaker
September 8, 2007

What a distinct honor this is to stand before you today to really pay tribute to somebody that means very much to me.  As you can tell I may have a little trouble getting through some of this, I beg your apologies on that; I think it will get a little bit smoother as I move along here.  Betty was very, very special person to me, Cindy, and my entire family and to many, many of you.  This is just one of those distinct honors that I have.  I had the distinct honor to eulogize her about a year ago.  That was something that truly stands out, one of those difficult things that we all painfully do to honor those who leave from our mist here.  Certainly, one of the greatest things we can do to memorialize them is to institutionalize the things that they have done for us. You'll see up here a logo that is reflective of the Betty P. Stephenson Lectureship.  It came my way; I think it was the idea of Dr. Jim Arens, who was talking about the opportunity to allow me to speak at this inaugural lectureship.  I believe it was Jim. I heard it through the grapevine Jim. He said "Call Cindy Zerwas. She'll come up with something for a distinct logo that reflects this lectureship". Let me speak about that for a moment here.  What you see are a couple of things that I think Betty would be most proud of. One, the great state of Texas, standing before you there was no doubt very, very important to Betty.  And the way we saw Betty so many times, you rarely saw her without one of those medallions that she had earned. That she had just given her blood, sweat, and tears for.  All out of heart and soul, all out of passion, that she wore with great pride.  It may have been the ASA President's Medallion. It may have been her Distinguished Service Award from the Texas Medical Association. She almost always had that with her.  And so, we spent time putting these things together and trying to see if we could conceptualize that along with the Texas Society of Anesthesiologists. And we present to you today this logo for the Betty P. Stephenson Lectureship, which we're very proud of. It's distinct, and I think it really captures just a few of things that were so, so important to Betty.  But as I said this certainly marks one of the greatest honors in my journey in organized medicine and certainly as an anesthesiologist.  I thank the Society, I thank the Officers for granting me the opportunity to serve as your inaugural lecturer on her behalf and I certainly know-know it without a doubt, there are many others that could stand before you today and deliver this lecture with an equal passion, with an equal personal connection to Betty.  And so as I contemplated what this would be, I said let's call it "Carrying Dr. Betty's Bag" and that may sound like kind of a strange term for a lectureship but it is based on the story of "Driving Ms. Daisy".  You may recall that Morgan Freeman was the chauffer for Ms. Daisy and the essence of it was that there are certain lessons that we all learn as people because of a personal path.  It was an unstructured time, time just between me, time to go from one congressman's office to the next.  And as many of you know as Betty became a little more fragile in her health, sometimes even when she wasn't that fragile, you just kind of grabbed her bag. It was an excuse to be around her you know.  You had the opportunity to walk with a legend. Somebody who saw a future that many of us couldn't see.  Those opportunities to ride with her in a cab, helping her out of an elevator, and guiding her wheelchair to Tom Delays congressional office and getting her set and stable there.  Carrying Dr. Betty's bag was one of the greatest privileges that I will ever have. There are many others that have carried Dr. Betty's bag either figuratively or literally and have certainly learned a great, great deal from her.

Betty P. Stephenson was born and raised in Abilene, Texas.  All who met her knew her that her roots were Texas right from the beginning.  She was Texas to the core and she was very, very proud of it.  She graduated with a Bachelor of Arts Degree from Hardin-Simmons University in her hometown of Abilene. She went on pursue her post graduate studies at the University of Colorado in Bio-chemistry. In pursuit of her lifelong dream of becoming a physician, she attended Baylor University College of Medicine at that time.  It was there that she met, married her husband of 55 years, Charles T. Stephenson (she called him "Steve" affectionately, who became a highly respected orthopedic surgeon).  Betty graduated from Baylor in 1953 and completed her residency in anesthesiology at the Baylor affiliated hospitals in Houston from 1955 to 1957. Most of her practice/clinical practice was in Houston at Methodist Hospital and Memorial Hermann Southwest Hospital and she retired from clinical practice in 1996. 

In addition to her outstanding clinical career, a part of Betty's legacy was her profound commitment to organized medicine. There are few organizations that have not recognized the tremendous vision and leadership that she exhibited.  She served as president of many organizations, including the Texas Gulf Coast Anesthesia Society, this Society, the Harris County Medical Society, the ASA from 1990 to 1991, the Texas Medical Association in 1994, and she was the recipient of the distinguished service award for the TSA, TMA, and ASA and I am convinced that any organization that she choose to be part of she would have been the distinguished service recipient. 

In just a moment I am going to key up something that the Wood Library Museums has done which is an absolute gem.  What they have done is taken some time to interview perhaps some of the greatest legends that our specialty knows. 

You're going to see perhaps five minutes of a one-hour segment with Betty one on one with another great legend who also has one of these videos, Dr. Jim Arens and Dr. Arthur Keats.  Nobody would deny.  But there is something that preceded this video, that only Jim can tell, and I think it is appropriate for him to tell that, what preceded the video before we cue that up.  Jim…

Introduction of Wood Library Museums Piece, James F. Arens, MD:

Thank you, John. I had arranged an interview with Betty and as you know she trained with Art Keats and so I arranged to have the video done at MD Anderson.  It is very sad, as you know Arthur passed away about ten days ago.  Arthur was always on time, so Arthur and I get to the interview and there's no Betty.  Betty was not the most punctual person in the world, so we waited a while, and I finally get on the telephone and call Betty and say, "Where in the hell are you?"  She says, "I am out buying my clothes to be interviewed in." So, I said "That's wonderful".   So, I say to Art, "She's late again".  Art says, "Damn, I'm going down to smoke", so he goes down, right outside the door of MD Anderson, and he's sitting there smoking cigarettes and so finally Betty arrives.  And as she walks in, I realize that she's in denim. She had just told me that she'd been out buying clothes, and so I walked up to her and almost out of my mouth came the words, "Where would you like to change clothes?" and then I realized these were her clothes.  And so, I can see Betty in this interview and that is what she wore.  That was so typical of Betty. She had gone out to buy denim to be interviewed for the Wood Library. 

(Wood Library Piece Plays (5 minutes))

Presentation, John M. Zerwas, MD, Continues:

This is a 54-minute interview. What a thrill this is. If you have the chance to view this in its entirety, do so.  I told Jim as I was looking at it and to capture the clip, that I wanted to bring to share with everybody here, I could have picked any part of that 54 minutes.  It is just tremendous, but I chose this one because of the comment she made right at the end.  That is out and out Betty, I tell you. She liked to see what happens now and I thought that was really where I wanted to end at that clip right there and really, to lead into what I really see the lessons that we have learned from carrying Dr. Betty's bag.  And as I contemplated on that, I was really taken back to an author, John P. Maxwell, an individual who has written numerous, numerous books on leadership. A renowned author, renowned lecturer, and consultant in the role of leadership.  And he had written a number of things along with what you see here.  "21 Indispensable Qualities of a Leader". A very tiny little book, to carry around with you, a bunch of short stories, put out in columns, twenty-one regarding leadership qualities and things.  And the very first thing he asks in that book is: "What makes people want to follow leaders?"  What made us want to follow Betty Stephenson?  What makes us want to follow Jim Arens?  What makes people want to follow each and every one of you that's sitting here? Of which I'd argue, for all people of our society.  The answer he says lies in the character of the individual and then he looks at that and breaks that down into twenty-one different things. You'll be comforted to know that I'm not going to walk through twenty-one different characteristics here today.  But what you can see is these things he's listed up here. All things that I think many of us are familiar with. But perhaps really have not ever taken the opportunity to sit and really digest them and sort of dissect them until we see what these things actually mean.  Betty Stephenson, I will tell you exhibited every one of those characteristics. 

As I prepared for this presentation, I re-read the book, and again, just like in the 54-minute interview, I was left with: "Wow!" I could talk about every one of these things, but I could put the entire audience to sleep doing that.  I said, "What are the things that I think really stand out to me?"  I think of those times of carrying Dr. Stephenson's bag in Washington, helping her prepare for the variety of meetings we had.  I picked out six of them. I said: "These are the things that I think about when I think of Betty." That personal time when I was around her. I can pull out, and say "these are the things, that really, really stand out".  So, what I want to do really is kind of just walk through those things.  For a minute, just kind of walk down, thinking about Betty and the things that she did. 

First of that being vision; and I have spoken in a number of different settings, and one of the first things that I always start out with is that if you are ever going to be successful, you've got to have a vision.  And that vision has got to be crystal clear.  You have to know where you're going. You have to see it and you have to be able to articulate it to those that are choosing to lead. Betty did this not because she wanted to be president of the Texas Gulf Coast Anesthesia Society, the Harris County Medical Society, or the Texas Society of Anesthesiologists. She didn't have the desire be president of the American Society of Anesthesiologists or the Texas Medical Association. Betty had a passion around the practice of medicine and led from the heart and soul.  She didn't lead from a desire to "lead" in a certain position.  Betty saw things that clearly, I could never see.  The power of vision, I think is incredible in the book called "Leading Change" by John Kotter, a Harvard professor in leadership. And he wrote in perspective, why do companies fail?  Why do initiatives fail?  Why do leaders fail?  When they have the greatest plan of what they want to do?  He lists the eight things that you see up here. I'm not going to go through all of those eight things.  But what I will focus is on the three that are highlighted.  Three of the eight things that are required for the success of a company or to at least avoid failure, require vision.

Underestimating the power of vision is the first. You have to know what it is.  Crystal clear, you have to be able to articulate it.  Under-communicating the vision: Betty was never guilty of under-communicating the vision much less under-communicating anything for that matter.  I certainly got an earful many a time, when she didn't think that I was hustling as much as I should have. And then removing those things which are our blocks to the vision.  If you can't think of anything better, than you are blocking that.  Carrying the football means Betty Stephenson's removing the obstacles out there to help the vision be realized.  I can think of no one that is more comforting to have on your team than somebody that had such a crystal-clear vision of what things she would do.  Betty saw things that I couldn't see.  And she saw those things because as I reflected on her, on her life, and part of the eulogy I gave was that Dr. Stephenson practiced medicine because she clearly cared about people-this was Betty's vision.  Your mission is your essence. I'm sure vision it's not that dream that you had out there. It's your absolute existence every day.  And her existence everyday was because she cared about people.  She committed herself at the highest level of organized medicine because she had a passion for the profession of medicine and because she really cared about people. She changed the world that we live in simply because she cared about people.
Perhaps the next thing that I really recognized in Betty, the second of these eight things, was her generosity.  A candle loses when it lights nothing.  I'm one of those candles that she lit, and I see in this audience a large number of other candles that have been lit out there because of her generosity.  Calvin Coolidge was a person that was never honored for what he received but honored for what he gave.   Betty is what I commonly refer to as one of us whose candle has been lit by day.  It takes a leader to bring up a leader.  Survey was done; John Maxwell cites that, not because there is any trick in the ability to lead.  A few of us get there because of some crisis in our lives but not that many of us.  Absolutely most of us. Those of us who have the opportunity to lead come from the influence of another leader.  And for I think Dr. Stephenson made one of the greatest contributions that can be made to our Society, to the profession of medicine, and to mankind in general.  It was that absolute passion of hers to light other candles. The greatest satisfaction that I saw Betty make wasn't going up and meeting Tom DeLay, Joe Barton and a number of the senators at that time. The greatest thing that lit her up when you talk about it was when she said: "I am going to interview a medical student who has an interest in doing a rotation in anesthesiology".  How simple is that? Simple as putting a match to a candle.  Her passion for advocacy was enormous and it is as simple as lighting a candle-taking that time out of your life to help another person succeed.

Ronald A. Mackenzie, D.O., another past president of the ASA, upon recognition of the distinguished service award writes this: "Dr. Stephenson has touched the lives of countless individuals both inside and outside the realm of medicine. Her peers, associates and patients all are willing to laud her for her accomplishments in the field of anesthesiology. Yet, when talking about Dr. Stephenson, those closest to her speak not of the successes so clearly seen in her profiles and curriculum vitae, but rather mention her down-to-earth nature, her humor and her willingness to give".  Now in that same article there's another quote from one of my mentors, Dr. Arens. It actually had nothing to do with generosity, but I have to include it here, and he said: "As a politician, she may be even more effective 'behind the scene' as on the scene. As a driver of a 'souped up' blue Corvette, she also was effective at schmoozing Texas patrolmen. Betty was as comfortable being a role model for young women physicians as she was sitting around a Texas campfire being one of the boys. But her most precious moments were those she and 'Steve' shared on their ranch in the Hill Country".  Jim, thank you for that quote, thank you for that comment; you got it right.  I have sat around the campfire with Betty and when you're drinking firewater, be careful.  Never try to keep up with her. I've tried that before and I suffered for many days afterwards. 

Relationships. Betty was a master at relationships and you can see that President Theodore Roosevelt recognized that as one of the most important things to success is in knowing how to get along with people.  Now I am not standing here before you today to say Betty got along with everybody and even those she liked she sometimes may have made them feel a little bit roughed up afterwards and stuff, but Betty knew how to develop relationships and develop them into things that made a difference. Leonard Berry, Professor of Business at Texas A & M writes this: "The level of commitment to relationships depends on the extent of which the rise and dedication, rather than constraint.  Trust based relationships foster dedication."  Trust based relationships foster dedication. When you think about trust, you think about that deposition of trust, that intuited-ness, that confidence, that somebody or some organization that will be there without you having to think about it.  Think about that for a moment. Who do you trust?  Immediately people come to mind. Immediately organizations to mind.  The ASA comes to mind, the TSA comes to mind as an organization, my wife comes to mind, my parents come to mind, my children come to mind. Dr. Betty P. Stephenson would come to my mind as somebody that I knew I could trust to help me with a difficult problem and she would be candid about any advice that she would give me.  Whether it was legislative, whether it was professional, or whether it was even personal.  Albert Einstein's books similarly talked about relationships: "Strange as our situation right here upon earth each of us comes for a short visit not knowing why yet sometimes seeming of a divine purpose.  From the sampling of daily life, what we do day and day out, there is one thing we do know that man is here for the sake of other men". 

Ron Booker, one of those folks that toted Betty's book (or bag?) around, her satchel around (I asked a few folks if I could share some of their testimonials because its really more about others than myself) said the following: "I attended my first day at the legislative conference over 15 years ago and showed up at the opening session at the Marriott feeling very out of place being one of the only non-anesthesiologists in the room. I was equally uncomfortable when the Texas Delegation assigned me to make congressional visits with an old lady that I barely knew, Betty Stephenson.  Betty handed me her bag and told me "Let's go!" I helped her in and out of the cab, into the elevator, and as we made our way to the Capitol, I was surprised to walk into Tom DeLay's office and he planted a big kiss on Betty's cheek.  Betty exchanged pleasantries, told me what she wanted, and we left.  The same thing happened with other representatives and senators. I didn't realize how special this was until I heard other attendees complain about not getting to see their representatives and senators, instead having to visit with their aid.  Betty taught me to be confident, to know what you want and ask for it, and how important relationships are in politics." Ron thank you for that, I now see you out in the audience. I appreciate that. The last time I visited with Betty was when I was campaigning for the Texas House and even though she could barely speak she gave me a thumbs up and encouraged me to stay strong and enjoy it. 

Someone who proudly toted her bag more than anyone of us here was Linda Adkins.  Her testimony: "Wow!  I learned so much from that great lady.  From the time I began my job at the TSA, Betty Stephenson took me under her wing; I was under that wing with lots of others, but she always made me feel special.  Over the years she invited me to lectures that she thought I needed to hear, accompanied me to political fundraisers that she thought I could go to, introduced me to her friends she thought I would enjoy and nagged about making early reservations at medical meetings.  Out of this nurturing was born a friendship; the likes of which I had never experienced.  Caring for her was not an option it was a given.  In the last few years of her life when after Betty was no longer able to travel to meetings and see the friends that meant so much to her, I would take the program to her and regal her with all the trivia that I had picked up in Austin or Washington.  I brought her the printed material that Dr. Zerwas used in his campaign for the legislature.  She would read each one, word by word, with a magnifying glass. And when she could no longer read or speak audibly, she would dial my number, and I would bring her up to date on the latest news.  She would just listen.  With her friends she easily gave more than she took; if she chose you for a friend it was a lifetime deal.  For me it was a friendship of a lifetime". 

Strongly put another one of those great characteristics of Betty's, was that to get ahead you have to put others first.  This author reflects on that truly observant people, serves their best interest and in so doing will not always be popular and may not always impress.  But because true leaders are motivated by loving, concern, and their desire for personal glory they are willing to pay the price.  Albert Schweitzer, 1950 Noble Prize winner said: "The one thing I know is that the only ones among you who will be really happy are those who will have sought and found how to serve." 

About four years ago I became somewhat incapacitated with a very bizarre, unusual, I call it number sixteen on the Mayo Clinic list of a clinical illness. A condition I call it; I didn't feel sick, I just couldn't feel or walk.  I couldn't walk so I had a condition, I just didn't feel sick.  It's not like I spent a few days in the ICU, but Betty called me often and she was one of the first people that called me when Cindy was by my side. We spent about a week in the hospital. I had to recover at the hospital with a wheelchair and a walker, just to get back home because the weekend was coming, and I knew bad things happened at hospitals and I wanted to get out of there.  "Get me out of here." So, we did and we sort of crawled our way home. And there low and behold, with I'd say within the first forty-eight hours of being home, I got a call from Betty, "John how are you doing?" "Not doing a whole lot today. I can't walk. I can't feel." "Well, we're coming by to see you." "Okay that'd be great Betty, come on by.  It's kind of lonely here" (Well not lonely, Cindy and I are together, she just didn't walk off and leave me there). I said, "Come on by" and she comes by and she brings a pot of stew and chocolate chip cookies…a pot of stew and chocolate chip cookies. I don't know if Betty made that or not. Betty was pretty slowed down at that point, but she took the time to come and we chuckled.  Charlie had some disabilities also and they came by and they spent probably three hours with us that afternoon.  Roger Litwiller happened to call during that time and we talked with Roger Litwiller for a time.  But we remember, and I remember Cindy saying now here is somebody that really has accomplished all that there is to be accomplished and that much more.  She took the simple act to say "I'm going to go visit my friend.  He can't walk, can't feel a thing both ways, going make him something to eat, make him some cookies and we're going to sit and have a conversation".  That was her; that was Betty Stephenson. 

"Courage is rightly esteemed as the first of human qualities", as Winston Churchill says, "because it is the quality which guarantees all others".  Eleanor Roosevelt also said: "You gain strength, courage and confidence by every experience in which you really stop to look fear in the face." Do you think that she stopped and looked at fear in the face when she was stricken with Parkinson's Disease and knew very well what the consequences of that would be?  She saw her husband of 55 years progressively struggle with Alzheimer's Disease. But you know she looked fear in the face.  Yet she was able to say to herself: "If I live through this horror I can take the next thing that comes along.  You must do the thing you think you cannot do."  Patrick Giam, Secretary of the Society (Patrick thank you for this), he writes: "Words mean different things to different people. To me courage means having the strength and fortitude to do the right thing despite a challenging obstacle.  Betty Stephenson was the epitome of courage.  Betty's public life exemplified the grit and substance that most people only read about.  Her professional accomplishments have been well chronicled by everyone.   She was a trailblazer in many areas of medicine going where no Texas lady and few Texas men had ever gone before.  Her life of service to her patients, fellow physicians, and organized medicine leave a legacy that we honor today with this lectureship.  However, what really impressed me about her courage was the way she continued to participate and contribute at the highest level, even during the advanced stages of Parkinson's disease.  She could have easily chosen to withdraw from public life and to enjoy the peaceful tranquility of Southeast Texas but instead having a wealth of deep personal courage, she chose to persevere in spite of the nearly overwhelming physical obstacles that must of made it exhausting to even travel to meetings must less participate actively and richly.  She must have known her time with Parkinson's, I was amazed at her spirit though it was not. For her lifelong demonstration of public and professional courage to go where few had gone before and for the personal courage that she showed me during her time with great physical limitations, I'll always remember and be inspired by her".  Thank you, Patrick.

And finally, character, "being a piece of the rock".  Probably one of my favorite quotes and it comes from the time that I discovered an early unknown British author. He says, "Leadership is the capacity and the will to rally men and women around a common purpose and the character which inspires confidence." That's Betty Stephenson.  "Character" is actually the first chapter in John Maxwell's' book because it is in fact perhaps the most important aspect of leadership.  Scott Kercheville submitted this to me: "My first encounter with Betty was when I passed the local arrangements for the TSA Annual Meeting in San Antonio (first time it was at the Hyatt Hill Country).  I went to the TSA March Board of Directors meeting in Austin to give a report to Monk; one of the many agenda items that day was the redecorating of the TSA office after fifteen to twenty folks weighed in with all kinds of ideas and suggestions, Betty spoke up and said: "Call so and so and have them take care of it!".  A while later, I asked: 'Who was that gravely voiced lady from Houston and why did her opinion matter so much?' It was then and there I learned Betty for want of a better word, had "presence".  My next encounter was my first trip to Washington for the ASA Legislative Conference. Same thing-all week people gathered and spoke of things but once she spoke everyone listened.

She pulled me aside on Wednesday morning and in Phil Green's office, she said, "Kercheville change your name tag to the other side of your coat!  How do you expect any of these guys to believe anything you say if they don't even know your name?"  I called her the "burning bush" in my speech at the TSA Annual Meeting when I became President. I still believe that today.  All I can say is that for someone who didn't talk a lot her words spoke volumes. She was not what anyone would call refined, but you never doubted she cared about people and issues-she was loyal to a fault.  The same thing for her causes-heaven help those who openly crossed her.  She was the only person I ever saw make an ASA President squirm on stage with a simple question, "How much money was spent and who authorized it?"  She was truly a singular person who was cut from a bolt of cloth that is in very short supply these days.  Betty was Betty no matter who she was with. Her influence was profound and broad touching even the most powerful.  Being apart from the crowd was one of the things that made her most proud and most happy. The opportunity to influence some of our highest elected officials.  She also loved being around some of us that were less powerful (no offense) and she liked to hang around with the least powerful people out there, at which I take no offense to that at all. My favorite comment is one that Betty shared with me and one that she shared with many of you, many times over and that is: "I am proud to be a physician first and foremost and an anesthesiologist second." This was one of the things that Betty constantly reminded us of." Thank you, Scott.

Dr. Stephenson did so much in such a profound way and she did it all just by being "Betty".  And so today I say thanks to Betty, just as Dr. Joe Annis shared with us on Thursday in his acceptance speech upon receiving the TSA Distinguished Service Award where he expressed: "How do we say thanks to those who have gone before us and made such a profound impact on who we are and what we do?"  First of all, we reflect on that and say: "Thanks for that".  But I pledge, and I know that many of you have pledged also, as Joe said to continue her legacy through membership, service to our fellow man, and to light that next candle.  To the Board of Directors and the Officers of this Society, thank you for what has been one of the greatest honors I have had in my career. Thank you.

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