American College of Oral and Maxillofacial Surgeons, Tampa, May 2009
R.V. Walker stood there humble as always, bigger and more athletic than an octogenarian should be. Now stoop-shouldered, his right shoulder a bit dropped as if to address a golf ball, he greeted his former residents and friends with his “high-octane Texas gasoline twang.”⁎ The circle surrounding him was impressive. Ray Fonseca, Doug Sinn, Tim Turvey, Bruce Epker, Ghali Ghali, Cesar Guerrero, and younger surgeons yet to make their mark, stood by like disciples. As he sat down with his wife, Emily, his shock of dense wiry gray hair seemed to bristle. Bruce Epker stepped to the podium to describe his mentor.
Near Waco, Texas, 1930s, the Great Depression
After his predawn chores with his dad's cows and mules, he threw a tennis ball against the house as hard as he could and fielded the rebound, over and over again, month after month, until nothing could get by him. “It takes ten thousand hours of work to get good at anything,” he would later recount. He developed the self-confidence only experience can provide: “I'm here to play shortstop,” he would later tell the manager at Texas A & M (and yet later in the Chicago Cubs farm system). “We have a boy with a scholarship to play shortstop. You are a walk-on,” said the manager. R.V.'s retort, “He can back me up in left field. I'm here to play shortstop.”
He must have spoken then as he does now, critical and to the point, terse, not judgmental, and not a hint of the anxious meanness or guile so common in today's surgical discourse. He would later use that honesty and self-confidence built by the dogged pursuit of excellence to help invent the specialty as it exists today at Parkland Hospital and across the world.
London, England, 1962, the Royal College of Surgeons First International Conference on Oral Surgery
Guildhall was filled with formality, dark wood, and academic regalia, as Fred Henny rose to eloquently toast the young specialty. Attendees from 32 nations met to determine that the specialty had worth, that it would last, and that it would grow. As R.V. recounted, “When Dr Henny spoke, and surrounded by elegance and the historical significance of Guildhall and the Royal College of Surgeons of England, all I could think was, by golly, we belong!”
Today, R.V. looks to the future by understanding the past. In his 2009 Tampa talk, “Early key happenings of a growing specialty,” he describes how these events intertwined to create contemporary oral and maxillofacial surgery. He believes these elements were put into place following the International Conference and they flourished in the midcentury years:
1.The development of a common curriculum to define the specialty.
2.An accreditation process through the Council on Dental Education and a review commission.
3.Moving ASOS and ABOS from Louisville and Dubuque to Chicago.
4.Hiring influential and effective ASOS executive directors.
5.Obwegeser's visit to the US in 1966. “It opened our eyes to major jaw surgery.”
6.Kurt Thoma's textbook, Oral Surgery: “I would take it out to show my colleagues, 369 pages on trauma, 95 pages on deformities, 59 pages on TMD, etc, to define our specialty at Parkland.”
7.JCAH standards to accommodate oral surgery and define its essential role in the hospital.
While these achievements are one way to look at our specialty's progress, another is to examine the personal characteristics of its leaders, since only with surgeons of R.V.'s caliber will future gains be made. This is what can be learned about R.V. from listening to him and Bruce Epker's presentation in Tampa.
•He has a memory that understands and uses our history to guide our actions today and “an office full of stuff” which are the treasures of his achievements.
•He understands the importance of ceremony: The First International Conference at the Royal College of Surgeons of England in London and its gala in Guildhall changed his outlook and his achievements.
•He loves teaching residents. As he stated, “Residents are the grit, the grind, and the glory of my life.”
•He is a surgical diplomat: building alliances, and making friends in England, from the receptionist who remembered him years later to leaders like Sir Arthur Porritt, President of the Royal College and Ambassadress Evangeline Bruce.
•He remains committed to his past—faithful alumnus of Texas A & M, veteran, and oral surgeon.
•He is devoted to his family by love and passion, not by a sense of obligation: in over 60 years of marriage to Emily, he lives in the same home, with a partner to shoulder responsibility and share the happiness of their lives together.
•He has developed traits only achieved with physical labor and consistent repetition.
•He recognizes that athletes often develop the temperament to be fine surgeons.
•He has the confidence to be a walk-on.
•He understands the meaning of service and leadership training.
•He fulfills his obligations: after being drafted by the Cubs, he completed his dental education.
•He put down roots: R.V.'s durability at Parkland is renowned. In 56 years he has 221 graduates, 29 chairmen and program directors, and 2 deans to his credit.
•He knows that life is a series of unremitting happenstance. “No person can claim credit for what he has become.” “I did not elect to be born into The Depression. I did not elect to milk cows.” When asked how he became an oral surgeon, he said, “Because I was a baseball player.” His assignment to Brooke Army Medical Center, ostensibly to play baseball, initiated his involvement with hospital-based oral surgery.
•He emulated his mentors: at Brooke, “Dr Boudreaux, Chief of Oral Surgery, played golf, so I played golf.”
•He has surrounded himself with great people, speaking of every hire at Parkland—Bruce Epker, William Bell, Rick Finn, Doug Sinn, Ed Ellis, John Zuniga, and others—as essential to his success.
•He is visible. His advice to Mark Kohn: “Do and be seen doing.”
•He has a sense of professional morality and obligation: “Do what's right even when you don't feel like it;” and an Olympian's persistence, “I am prepared. I have followed the rules. I will not quit.”
•He understands that the practice of oral and maxillofacial surgery is not a casual task: “You have to give self to become the best.”
And that only unwavering effort can achieve excellence: as R.V. put it, “I was always a better fielder than I was a hitter.”
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