Why would the chairman of the largest transplant program in the country join a brand-new, unproven medical school?
Alan Birtch, M.D., did just that in 1971, traveling halfway across the country to SIU School of Medicine from Harvard Medical School’s Peter Bent Brigham Hospital, where he was director of the transplant program.
He wasn’t interested in shifting his career, but he decided to give it a look based on the urging of his medical school classmate and friend Roland Folse, M.D., who had accepted a position at SIU School of Medicine as chairman of the Department of Surgery. Dr. Folse knew Dr. Birtch would be a good choice to build a transplant program and assist in the development of the Department of Surgery.
“Alan was the first person I saw when I walked up to medical school with satchel in hand,” Dr. Folse recalls. “He directed me to the anatomy lab, and we’ve been close friends ever since.”
Dr. Birtch was one of Dr. Folse’s first recruits at the new medical school. “Alan was the first person I called about general surgery and transplants. We were a good pair — Alan is thoughtful, meticulous, a thinker, a planner. I’m more of a ‘do it now’ person. We were a good team.”
“I wasn’t serious about coming,” insists Dr. Birtch. He had graduated from the prestigious Johns Hopkins University School of Medicine in 1958 and completed several surgical residencies at Peter Bent Brigham Hospital in Boston. He became chief resident in 1964. He completed research and teaching fellowships at Harvard Medical School then held staff appointments at Peter Bent Brigham Hospital, followed by surgical teaching appointments at Harvard. He became Board Certified with the American Board of Surgery in 1967. He assisted in the first long-term successful kidney transplant in the world.
“I had been at Harvard for 14 years,” says Dr. Birtch. “I knew I wasn’t going to make major impact there. I liked the idea of starting something from scratch — without 300 years of tradition.” On his 40th birthday, Feb. 3, he announced that he would join SIU School of Medicine. “I shocked all my friends!” Dr. Birtch became professor and assistant chairman, Department of Surgery, from 1972-96.
Joining a new school, Dr. Birtch wore many hats to keep the new medical school afloat. “Whether we were a medical school with a faculty of 10 or one that one has 300, the same number of things needed to be done.” Dr. Birtch was chairman of the general surgery residency program, assistant chair of the Department of Surgery, program director of general surgery, chief of general surgery at Memorial Medical Center, the first counselor and initiated the School of Medicine’s AOA chapter, and he was a member of the dean’s staff; he was director of Residency Affairs for 16 years, he started the Human Subject Committee, chaired the Student Progress Committee, and he headed the transplantation program at Memorial Medical Center.
In Boston, Dr. Birtch had assisted in four of the first twelve liver transplants ever done. In central Illinois, transplants were few and far between. “Local surgeons had done two transplants but didn’t want to do any more,” Dr. Birtch recalls.
The need was great, but Memorial could not begin its transplant program until Medicare approved it for payment. “It was frustrating, coming from directing a program that did the most transplants in the world — about 90 a year — to sitting on my hands until it was approved,” Dr. Birtch recalls. In August 1973, Dr. Birtch transplanted a kidney to a 40-year-old engineer at Memorial. “In those days, there were only two immunosuppressive drugs. Most patients had rejection problems, and many lost the kidney. This patient lived 10-12 years, dying of skin cancer.”.
Dr. Birtch created a transplant program that provided a personal, holistic approach with patient education, long-term care coordination, social work support, and financial counseling. “We treated our patients like family, not patients. We saw them often and got attached to them.”
Transplant recipient Cathy De Jong affirms that statement. She first met Dr. Birtch in 1982, when her kidneys had failed. “I thought he was straight-laced, but he was just shy. I started calling him ‘sweetheart’ to break his shyness. He blushed every time.” De Jong spent eight grueling months on dialysis before Dr. Birtch could transplant her sister’s kidney to her. “I had great confidence in Dr. Birtch. He and his team gave me excellent care. They were very professional, but caring, too. Dr. Birtch always explained my tests and answered any question, any time of the day or night. And he taught me to listen to my body and to call when something feels wrong. I’m alive today because of Dr. Birtch. He is my hero.”
Dr. Birtch directed the transplant program until his retirement in 1996, performing more than 350 transplants, as well as contributing to advancements of the procedure. He helped found the New England Organ Bank and the Illinois Organ Transplant Society, which later became the Regional Organ Bank of Illinois (ROBI), now known as Gift of Hope. He helped raise awareness of the need not just for kidney donors, but livers, hearts, corneas, and pancreases. For 24 years, he made monthly trips to Chicago to meet with transplant teams to grow the statewide donor procurement effort.
Under Dr. Birtch’s direction, Memorial Medical Center was on the Honor Roll for organ procurement every year, transplanting as few as 10 or 12 kidneys to as many as 30 a year. In 2002, the Illinois Secretary of State honored Dr. Birtch with the Lifetime Achievement Award for organ and tissue procurement.
“He is a remarkably gifted surgeon and educator,” notes Edgar J. Curtis, president and chief executive officer of Memorial Health System. Curtis first met Dr. Birtch in 1975 when Curtis was a nurse on floor 5B: the transplant ward. “I thought Dr. Birtch was bigger than life. What struck me as a young nurse was the meticulous care he gave to patients, always doing his own exam and giving detailed reports. He always put patients first.” Curtis recalls going on rounds with Dr. Birtch, where he noticed how Dr. Birtch took time with patients, how he cared for those patients and families. “The thing that impressed me most about Alan Birtch was as a surgeon, as a physician. He was an incredible doctor with his knowledge and skills in the operating room, and follow-up outpatient care. He also respected everybody equally, which I admired. He led by example, teaching medical students, residents, attendings, and even the nurses. No matter how little you knew, he always treated everybody with respect. I always admired Dr. Birtch for that. Whatever time of the day or night, he always came in when we needed him. I would consider him the single most significant mentor in my life.”
Although an esteemed transplant surgeon, it was his devotion to education and his dedication to teaching students and residents that drew him to the medical school. “If I’d wanted to devote my career to transplants, I would have stayed where I was — Brigham was the first and largest transplant program in the country,” he says. “What made me interested in coming to Springfield was starting the medical school and residency program with a clean slate.” The first two residents began work in July 1973. Eventually the program grew to 10 residents for the five-year program.
Dr. Birtch recalls his own training days of residency. “We worked 36 hours on, 12 off, 36 on, 12 off, 68 on, 12 off. We worked every other weekend and every other night I slept at the hospital.” His residency salary? $250 a year.
Says his wife, Elaine, “I remember him eating dinner with the family, fork frozen — he had fallen asleep at the dinner table! But when he was home, he gave our four children all his attention.”
Dr. Birtch’s aim was not to change these residency training methods. “But I could see in the system here that it was unnecessary to have them work the 120 hours a week that I worked. Many of those hours I worked were spent starting IVs, drawing blood, all things done here by excellent nursing staff. This gave our residents time to study and more time off. It was a natural evolution.”
William Tyree Finch, M.D., was the third member of the general surgery faculty and joined Memorial’s Renal Transplant Team. Dr. Finch assisted in getting the local chapter of the AOA Honor Society approved by SIU Carbondale. Dr. Birtch, an AOA member himself, recalls, “At the time it was unique — we set up qualifications for election to AOA; we gave faculty in Carbondale an opportunity to nominate outstanding students.” Drs. Birtch and Finch became very close. “Alan and Elaine have been there either in person or in spirit for the high points as well as the low points of my post-Springfield path. Alan most assuredly is my big brother.”
Dr. Folse remembers how Dr. Birtch quickly got the residency program started. “He is extremely organized and can handle a lot of different things. He is an excellent teacher who had a lot of good ideas about how to develop the clerkship, write curriculum, develop the residency program, and recruit for the seven surgical divisions.”
Dr. Birtch was an asset in recruiting faculty and working to gain the favor of the community surgeons. “A commitment to a community medical school meant we were going to do everything the hard way.” Dr. Birtch recalls. “We had to find people with skills not already in the community so we wouldn’t be duplicating and alienating the community.” He helped make peace with the orthopaedists to persuade them that ortho could flourish as part of surgery. He helped recruit Elvin Zook, M.D., the first plastic surgeon in central Illinois. He also helped to build vascular surgery division, recruiting his former classmate and good friend, David Sumner, M.D. Dr. Birtch, Dr. Sumner, and Dr. Folse — all classmates at Johns Hopkins — became affectionately known as the ‘Hopkins Mafia.’ SIU School of Medicine holds an annual lectureship named for Drs. Folse, Birtch, and Sumner.
“Alan was one of the more intelligent members of the class – a serious student,” recalls Dr. Sumner. “At Hopkins, no grades were disclosed, but at the end of each year a medical book was given to the top students in consideration of their academic status. It was widely known that Alan was a recipient of these books.”
Dr. Birtch recruited surgeons who weren’t just skilled clinicians, but were devoted to teaching, per the vision of Dean Richard Moy, M.D. “Alan is a serious person, compulsive, and decisive — good surgeons are — and very friendly,” Dr. Moy notes. “He also is a superb athlete. I always wanted to make sure Alan was on my team for the Lung Association golf tournament. And he was a great shortstop at our softball games.”
Dr. Birtch’s serious, yet affable nature helped persuade the cautious community surgeons that the medical school would be an asset — not a threat — to their practices.
“We had to beg, borrow, cajole, and do everything possible to calm feathers,” Dr. Birtch says. “We laid a plan that had the surgeons doing what they do best, without loading them down with administrative duties they abhorred. We newcomers wanted to be reasonable and pleasant parts of community.”
Dr. Birtch’s wife, Elaine, explains how the wives of the early faculty helped reach out to the community. “We felt very strongly that we needed to get to know wives of local physicians. They got to know us personally and realized that we were not a threat.” Early supporters were Jim Graham, M.D., Bob Patton, M.D., Jack Allen, M.D., and John Denby, M.D., and numerous others.
Still, the initial negative reaction from some physicians took its toll. “It was very difficult at times,” Mrs. Birtch says. “Some didn’t see the big picture of what the medical school could do for them. It was so painful because our husbands were putting their careers on the line.”
Dr. Birtch embraced the challenges. “There was a close feeling at SIU that we’re all pulling together, bringing a large barge gradually up river,” he says. “It would have been easier to do it the way it had always been done, but we all were enthralled with the idea that there might be a new way to teach medical students. The students were enthusiastic and fun to teach.”
Mrs. Birtch recalls these exciting times. “There was a spirit of camaraderie. This is an adventure, and we were all in it. There was a feeling of esprit de corps.”
Dr. Birtch brought that esprit to the department and helped instill the camaraderie in the Department of Surgery. “We wanted to make the department very family-oriented. That was high on the agenda,” Dr. Folse says. “Together we planned Christmas activities, parties, and family picnics.” The Birtches, married 56 years, have four children, Grant, Jane, Eric, and Mark, and 10 grandchildren.
In 1996, Dr. Birtch retired as professor emeritus. Still active today, Dr. Birtch remains an emeritus member of the Memorial Health System Board of Directors’ Quality and Safety Committee, which Curtis considers the most important committee. “Dr. Birtch has an analytical mind and a passion for doing the right thing for patients,” Curtis says. “He still wants to improve care for patients. He was a tremendous role model and helped me shape the way I treat people. I owe a lot to Alan Birtch.” Memorial recently renamed the transplant program The Alan G. Birtch, M.D. Center for Transplant Services at Memorial. It has nearly 800 kidney and pancreas transplants on record.
“Coming to SIU was a risk for all of us, and certainly for Alan,” Dr. Folse says. “He had to start the transplant program and the residency program from scratch at a brand-new school. He was a great mentor and leader for all of the students and residents.”
As his friend and colleague, Sergio Rabinovich, M.D., professor and chair emeritus in the SIU Department of Internal Medicine, put it, “We need more Alan Birtches in the world.”