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Originally Processed With FOIA(s): FOIA Number: S S FOIA MARKER This is not a textual record. This is used as an administrative marker by the George Bush Presidential Library Staff. Record Group/Collection: Donated Historical Materials Collection/Office of Origin: Frieden, Lex, Collection Series: Disability Rights Organizations Subseries: OA/ID Number: 52218 Folder ID Number: 52218-004 Folder Title: TIRR [The Institute of Rehabilitation and Research] [1972-1996] Stack: Row: Section: Shelf: Position: V 8 6 3 6 Medical facility's 30th anniversary occasion for celebrating survival NE of the happiest parties ever staged in River Oaks Country Club's ballroom owed its life Thursday night to TIRR - The Institute of Re- habilitation and Research. Party-goers were there to celebrate the 30th anniver- sary of the internationally famous Houston medical fa- cility. Everybody, former patients and loyal supporters Betty Ewing Houston Chronicle alike, toasted survival. Bearded Don Slocomb, blowing a great sax How High the Moon solo with his quartet, remembers the early morning of June 21, 1986, when he almost got knocked to kingdom come by a drunken driver. Broke both legs, shattered a hip and worst of all, landed on his head and was out cold for 2½ weeks with a clot on the brain. "They (first Ben Taub, then TIRR) saved my life and then started me back to playing music," Don said. "My fingers were numb.' "He saw the accident," said Don, pointing to bass Monday, Nov. 6, 1989 player Dave Foster. Also providing the cool jazz for TIRR's 30th anniversary party were drummer Joe Ful- gham and guitarist Paul Chester. About this time in the conversation, Don spied a beauti- ful blonde and threw his arms around her. Turned out to be Dr. Catherine F. Bontke, director of TIRR's head in- jury program, which has been selected as a national Steve Campbell / Chronicle model. In fact, Bontke will be going to Hawaii soon to Seen chatting at TIRR's anniversary party were help a new rehab center there get rolling. Jerry Johnston Andrew, seated, and daughters, Beautiful Jerry Johnston Andrew, rolling around the from left, Cheryl Duff, Kathleen Andrew and Alli- room in a wheelchair, talked about the quicksilver mo- son Andrew. ment at high noon on July 20, 1974, when she was heading for a reunion with her four young daughters at Camp Ar- super in silver and black. rowhead in the Hill Country. A freak head-on collision - both vehicles were traveling at low speeds - hurled The brief but emotional program was opened by Dr. Jerry into the dashboard; and one snap of the neck turned William Spencer, founder and president of TIRR for 28 her into a quadriplegic. years. He was named "Physician of the Year" by Presi- Three of the girls (as youngsters, they were frequently dent Lyndon Johnson in 1965. Also applauded enthusiasti- referred to as Houston's Andrew Sisters) - Cheryl (Mrs. cally were TIRR's president and CEO Harold Taylor and J. Bradley) Duff, 30; Kathleen Andrew, 25; and Allison Lex Frieden, executive director of TIRR Foundation. Andrew, 27 - were buzzing around their mom like beau- Lex came to Houston after he broke his neck in an auto tiful butterflies. Karen (Mrs. David) Lawrence, 29, had to accident while an 18-year-old student at Oklahoma State miss the party. University in Stillwater back in 1968. "I couldn't have survived the change in my life without the help of family and friends and TIRR," said the still- After three months at TIRR he returned to Oklahoma active Jerry, a member of the TIRR board of trustees and received a degree in psychology from the University and co-chair of the party with Patricia "Pat" Luther. of Tulsa but opted to return to Houston for further study at UH. Kathleen DeSilva, who suffered a broken neck when she was a 16-year-old gymnast, also is a quadriplegic "I liked-the climate and the people," said Frieden, who who serves as TIRR's in-house lawyer. This courageous hails from northern Oklahoma where it snows a lot. "A woman (she has a respirator implant) put herself through wheelchair in the snow is not easy to handle." Rice University and law school at the University of Houston. TIRR board members spotted in the crowd: Charles C. Ever-glamorous Nita Weil, a polio victim from Hous- Beall Jr., Bonnie Brooks, Randall E. Evans, Paul Frison, ton's epidemic in the 1950s, has served as director of vol- William K. Lehner, Robert B. Sale Jr., Madeline Schnei- unteers (she has 225 actives and would welcome more) der, David D. Stock, Harold Taylor, Howard Wolf and since TIRR opened. She moves around via wheelchair Tom Tinsley, son of Houston City Councilwoman Eleanor too. So does staff member Linda Pickle, who was looking Tinsley, who also attended. REHABILITATION The Institute for Rehabilitation and Research Systems VOICE Fall, 1990 Chalemgers Hyston TIRR Sports Team Brings Home the Gold p.3 President Bush Signs ADA p.4 tiRR Systems Photo by Stephen McCarty BOARD OF TRUSTEES From the President TIRR SYSTEMS productive lifestyles. Howard Wolf, Chairman In the past few months, TIRR has been Charles C. Beall, Jr., President recognized for the outstanding contributions R. Edward Carter, M.D. Paul Frison, Vice Chairman made to rehabilitation. There are over 6,500 Richard Hardin, Sr. hospitals in the United States and TIRR has Pat Luther recently been named as one of the "Best Laurence E. Simmons, Secretary/Treasurer Hospitals" according to a survey conducted William A. Spencer, M.D. by U.S. News and World Report. Only 57 facilities were named to this prestigious list - TIRR FOUNDATION something for which we all take pride. William A Spencer, M.D., President Like the hospital's recent award, TIRR Jerry Johnston Andrew, Sec./Treasurer Sports athletes are also being recognized for Charles C. Beall, Jr. their outstanding accomplishments. This past Muffin Clark Charlie Beall President, TIRR Systems July, members of the Houston Challengers Lex Frieden, Executive Director competed in Colorado, France and Holland Richard Hardin, Sr. Pat Luther W hen I step back and look at each against the world's best athletes with physical Robert Sale, Jr., Vice President organization within the TIRR disabilities and brought home gold, silver and Allan Shivers, Jr. Systems structure, I see success stories. Every bronze medals - breaking world records and employee working in the four Systems setting personal bests. TIRR companies has made a commitment to be the A long-awaited project coming to fruition best and to provide the best care possible. All is at the corner of Lamar Fleming and Howard Wolf, Chairman of this hard work and dedication has paid off Moursund Avenue in the Texas Medical Louisa Adelung, Acting President Jerry Johnston Andrew in that our patients are returning to work and Center. Each day as you walk by the Charles C. Beall, Jr., Vice Chairman home, to lead more independent and construction site for the new six-story patient Bonnie Brooks tower, you are witnessing the successful Madeline Schneider-Bunch fundraising efforts of TIRR Foundation. A R. Edward Carter, M.D., Vice Chairman Rehabilitation Voice is a quarterly total of $4 million has been raised to fund part Randall Evans, Secretary William Lehner, Treasurer publication produced by TIRR Systems, a non- of this new building. Robert Sale, Jr. profit corporation that promotes and assists The Houston Back Injury Center, a the rehabilitation and independence of people Allan Shivers, Jr. member of TIRR Rehabilitation Centers has with disabilities through programs in the William A. Spencer, M.D. fields of health care and prevention; housing been demonstrating each day how hard work David Stock and home care; vocational preparation and pays off. It has been operating at capacity and placement; recreation; environmental returning injured workers back to their jobs TIRR SPORTS modification and adaptive engineering; professional training and public education; since its opening almost two years ago. This John Sparrow, Chairman product development and basic and applied fall, a second Back Center will open in the Charles C. Beall, Jr. research. Beaumont area. TIRR Systems includes The Institute for Bonnie Brooks, Secretary/Treasurer Rehabilitation and Research (TIRR), TIRR TIRR Systems is proud of the many Ron Pephens Foundation, TIRR Rehabilitation Centers, TIRR achievements found in each of the different Scott Schneider, Vice Chairman Sports and Rehabilitation Professional organizations. Every person affiliated with David Stephenson, President Services. the Hospital, Foundation, Rehabilitation Materials contained herein may be TIRR REHABILITATION reprinted only with the permission of TIRR Centers or TIRR Sports are doing their part to CENTERS Systems. Address all correspondence and any keep the name TIRR synonymous with address changes to Director of Public success! Charles C. Beall, Jr., Chairman Relations/Editor Melissa Sturgis, Rehabilita- tion Voice, TIRR Systems, 5100 Travis, Houston, Texas 77002, 713-528-0123, Clarlie Beall Bonnie Brooks, Secretary/Treasurer David Stock, President 713-528-4554 (fax) Tom Tinsley, Vice Chairman Photography by Johnny Airheart. 2 ON THE COVER TIRR Sports Team Brings Home the Gold By Kim Leo T he Houston Challengers, the competitive athletic team for TIRR Sports, were hot on the trail of success this past summer. Personal bests and medal honors were captured from continent to continent this past July. Ft. Collins, Colorado, was the site of the 1990 Junior National Wheelchair Games and athletes participating were Sara McLain, Anna Quartero, Pete Salazar, David Enderli and Chhay Mak. McLain, 14, achieved three personal records in addition to capturing seven medals - six gold, one silver - in swimming and track and field events. Anna Quartero, 16, swam to three personal bests and captured one silver TIRR Sports athletes, members of the Houston Challengers, gather for a team picture. Photo by and three bronze medals. David Enderli, 16, Lynn Trafton. set a personal best by swimming in three events, earning all silver medals. Seventeen year old Willie White took a silver medal in participated in the World Games for Disabled year old Chhay Mak qualified for the finals in the javelin with a hurl of 35.68 meters (117.74 Youth held July 3-10, in St. Etienne, France. the shotput and in the 200 meter dash. feet). This distance was only .12 centimeters Kaiser set personal records and won gold Pete Salazar, 15, participated in two short of a gold medal. medals in all of the events he was entered in - swimming events and six track and field Jaronnie Smith, 22, set the World Record the 60 Meter dash, 200 meter dash and the events, winning two bronze medals in the 50- for Powerlifters in the 56 k. weight class, long jump competition. yard freestyle and 50-yard backstroke. On the executing a gold medal lift of 254 pounds! Setting personal records and winning other side of the Atlantic, four more athletes Darrell Fontenot, 22, brought home a gold medals are tremendous victories for any took their talents to the World Champion- medal for the 4 X 100 relay and a silver in the athlete. The members of TIRR Sports are ships for the Disabled held in Assen, Holland. 4 X 400 relay. He also captured a bronze in the winners, not because they frequently bring Eric Owens, 27, brought home a gold medal 200 Meter dash. home the gold, silver or bronze medals, but in the discus with a career best of 21.76 meters Members of TIRR Sports were found because they are part of a team that is not (71.81 feet). In other competitions, 26-year old journeying all over Europe as Matt Kaiser, 12, afraid to try. TIRR Sports Offers Recreation Opportunities for the Physically Disabled T IRR Systems and the Greater want to compete, a lot of people, disabled or required, participants have the option to Houston Athletic Association for the not, are intimidated by competition," stated compete through the Houston Challengers Physically Disabled (GHAA-PD) have joined David Stephenson, President of TIRR Sports. program. TIRR Sports will train athletes who to form TIRR Sports, effective April 1, 1990. Stephenson, a sports and recreation choose to compete on the national and This new organization offers sports and professional with over ten years experience international level. recreation working with the physically disabled, stresses TIRR Sports works with over 50 different opportunities for that TIRR Sports was established to give physical disabilities and encourages people persons with physically disabled residents, age 6 and older, of all levels to participate. The program physical disabili- an opportunity to take part in a variety of operates out of the Metropolitan Multi- ties. sports and recreation. Service Center, a City of Houston facility at "There was Volunteer coaches help participants learn 1475 West Gray, that was designed specifi- such a need in the any of the activities offered, from beginning cally for the disabled community. Houston commu- through advanced levels. These currently TIRR Sports programs are conducted at nity for sports and include bowling, swimming, lawn bowling, ten different satellite locations around the TIRR Sports President recreation for team handball, weight training, soccer and Greater Houston area. For more information, David Stephenson people who don't track and field. While competition isn't call 521-3737. 3 President Bush Makes ADA a Reality T he Americans with Disabilities Act, or the ADA as it is commonly called, became a reality on July 26, 1990. It is the most important piece of civil rights legislation since 1964 and taking part in the historical bill signing on the south lawn of The White House were a number of Houstonians and former TIRR patients, all special invited guests of President Bush. Lex Frieden was one of 15 Houstonians invited by The White House to witness the signing of this important legislation. What makes this trip special to Lex is the fact that he helped draft the original bill in 1988 when he headed the National Council on Disabilities, a Former TIRR patient Justin Dart, Jr. (Chairman, President's Committee on Employment of 15-member commission appointed by People with Disabilities - seated right) and TIRR Foundation adviser Evan Kemp (Chairman, President Reagan. Equal Employment Opportunity Commission - seated left), look on as President Bush signs the In a Houston Post article by Barbara Linkin, Americans with Disabilities Act. Also pictured are Rev. Harold Wilkie and Sandy Parrino. Lex commented "the law which protects the Photo by Bob Burgess disabled from discrimination in employment, public accommodations, transportation and appeared that the ADA wasn't going to be reasonable modifications can be made at telecommunication signals more than changes signed into law, that it might be shelved little or no expense. in building codes and employment practices. forever. Concerns from some members of Final passage of the Act by Congress was It signals a changing attitude. We have a large the business community raised questions achieved on July 13 when the Senate passed population of people who are unable to work related to specific language and its potential the ADA bill by a vote of 91-6. One day simply because they're labeled as disabled." effect on the small business owner. How- earlier, the House voted passage by a margin More than 200,000 people with disabilities ever, most business people agree that people of 377-28. in Houston and over 43 million in the United with disabilities can be productive in the The Americans with Disabilities Act - a States will benefit from the ADA, yet it almost workplace and the community, and that giant first step in the quest for independence! Sports and Recreation Expo Coming to Clear Lake This Month W ater skiing. Quad Rugby. Sailing. 10 a.m.- 5 p.m. marks the date for this will be encouraged to participate in the Tennis. You don't have to be a star afternoon of free activities. various demonstrations. athlete to enjoy these and many more All members of the disabled community, Across the street from the Expo, visitors activities at the Texas Wheelchair Sports families and children are invited to attend. can enjoy the Fourth Annual Shrimporee Festival and Recreation Expo at NASA Clear Festival T-shirts with the official Expo logo will featuring a fish fry and shrimp boil, bluegrass Lake Park. Saturday, September 29, 1990 from be given out to the first 250 people to enter the music and a live auction. gate. The day's events will kick off The Wheelchair Sports Festival and with a 5K National Champi- Recreation Expo is sponsored by the RRTC in onship Wheelchair Race, Community-Oriented Services for Persons beginning at 8 a.m. with Spinal Cord Injury at TIRR, TIRR Sports, Expo attendees will the City of Pasadena Verne Cox Recreation Center, Southwest Wheelchair Athletic THE TEXAS AND WHEELCHAIR RECREATION SPORTS EXPO FESTIVAL have the opportu- nity to see the Association (SWAA) and Paraplegics on latest in adaptive Independent Nature Trips (POINT). recreational aids For more information, contact the and sports Department of Therapeutic Recreation at equipment and TIRR, 797-5945. 4 Construction Houston Corner Back Injury TIRR Systems President Charlie Beall (L), TIRR Foundation Executive Director Lex Frieden (seated), TIRR Medical Director Center William H. Donovan, M.D. (standing C) and TIRR Acting President Louisa Adelung Offers Work (R) are all smiles at the July topping off of the new six-story patient tower, scheduled to Hardening open in the spring of 1991. The first floor will consist of the Lillie and Program Roy Cullen Dining Pavilion which will open onto a patio at the corner of Lamar Fleming and Moursund Ave. The second floor will house a residents call room and Respiratory Care department. The remaining floors will O n any given day, you can drop in at be designated for patients in the spinal cord the Houston Back Injury Center injury program, the Dunn Foundation Brain (6601 Tarnef in Sharpstown) and see people Injury Rehabilitation Unit and the pediatric pounding nails, shoveling gravel or lifting program. Nick Guevera, a U.S. Postal carrier, was able various objects. These people are taking the to return to work and his gardening thanks "work as treatment" approach to help them to the work hardening program. return to their jobs they are participating in the Center's Work Hardening program. In today's competitive workforce, many growth since their opening in October of 1988 employers are realizing that it takes more and plans are underway to open up another than time off at home before an injured center in Beaumont. employee can return to their job. "Statistics The Houston Back Injury Center special- show that 60 percent of them will get izes in evaluating and maximizing the reinjured within the first year," said Sharon functional capacity of those suffering from Deshotel, Administrator of the Houston Back injuries to the back, neck and spine. T.O. Injury Center, a program of TIRR Rehabilita- Moore, M.D., a highly-respected orthopedic tion Centers. physician with years of experience in back Employers today are using Work injury and treatment, serves as the medical Hardening programs in order to prevent director of the program. further injuries among their employees. It's because of the Back Center's highly "They combine medical and vocational qualified staff and dedication to their clients rehabilitation and retraining, with an overall that keeps clients like George motivated goal of getting the employee back to work," throughout their therapy program, and more stated David Stock, President of TIRR importantly gets them back to work! Rehabilitation Centers. The Back Center has one of the best Work Hardening programs in the city and boasts a return to work rate of 61.01%. Programs like these can cut back on employers' costs. TIRR Named as Getting the injured worker back on the job One of the U.S.News faster - to help prevent rising costs - is the goal of the Back Center's Work Hardening Country's Best AMERICA'S BEST Program, and one that is obviously Hospitals successful. After trying numerous programs HOSPITALS and therapies, George Simmons, an TIRR has been named as one of the country's best EXCLUSIVE RATINGS electrician who injured his back on the job hospitals in the April 30 issue of U.S. News and World Anational guide came to the center. After completing the that helps Report. you choose work hardening program he exclaimed, "I don't know why I wasn't sent here Of the 6,500 hospitals in the United States, 57 were sooner why didn't I get treatment like this honored on the "Best Hospitals" list. U.S. News surveyed in the first place?" 400 doctors in varying specialities, naming TIRR as the The Center has experienced consistent "Best in Rehabilitation." 5 VOICE TRACKS Catherine Bontke, M.D., Director of the Rebecca Clearman, M.D., director of the Thorkild Engen, C.O., director of Brain Injury Program has been selected to Sports Arts Injury Program at TIRR has been Orthotics for TIRR, was recently honored serve on the Center for Disease Control, invited to share her expertise in sports with the 1990 "N-EMMY Award" for Division of Injury Control's Rehabilitation medicine with her foreign counterparts in the Excellence in Medical Rehabilitation. Panel. The panel prepares the national agenda Citizen Ambassador Program of "People to Presented to him by the Dallas Rehabilitation for injury control and meets several times a People International." "People to People" is a Institute, a member of National Medical year. Dr. Bontke will be helping set our non-political organization dedicated to Enterprises Inc., the award honors Engen's national priorities in the planning, funding promoting international understanding. The significant contributions to the field over the and implementation of injury research, Citizen Ambassador Program primarily past thirty years. Additionally, Engen training and control programs. focuses on the desires of professionals to received the "Research Achievement Award" share their expertise among colleagues of for his research contributions to the field of various cultures. Their primary goal is to physical medicine and rehabilitation from R. Edward Carter, M.D., Director of the bring North American practices in sports Baylor College of Medicine - Department of Spinal Cord Injury Program has been re- medicine to the Eastern European countries as Physical Medicine and Rehabilitation. Engen elected for a second term of two years as well as the Soviet Union. is an associate professor in the departments of President of the International Medical Society orthotics and physical medicine and of Paraplegia. This society is composed of TIRR staff will be presenting a "hands- rehabilitation at Baylor and has been with over 1000 physicians in 70 different countries. on" workshop in inhibitory casting September TIRR since 1954. Dr. Carter is the second President to be 21-23 for rehabilitation professionals. The elected from the United States in the 30 year focus of the three-day workshop is the use of history of the society. inhibitory casting as one modality in the Tom O. Moore, M.D. medical director management of spasticity for brain-injured of the Houston Back Injury Center and Sharon patients. The workshop is a joint effort of the Deshotel, L.P.T., administrative director, will Two members of TIRR's Occupational Education, Occupational and Physical be featured speakers at the Texas Association Therapy department are serving on the Therapy departments and the Brain Injury of Rehabilitation Professionals in the Private conference committee for the Texas Occupa- Program. Sector (TARPS) workshop, to be held in tional Therapy Association Annual State October. Conference to be held in Galveston, October 11-14, 1990. Pam Lathem, director of L. Don Lehmkuhl, Ph.D., FAPTA, Occupational Therapy is co-chairing the director of Brain Injury Research at TIRR was exhibits for the conference and Susan Garber, recently honored at the American Physical assistant director of research is co-chair for Therapy Association's annual conference. publicity. Named as the "Mary McMillan Lecturer" Lehmkuhl was honored for his distinguishing contributions to the field of physical therapy. 6 Variety Club of Houston Forms Limb Bank at TIRR S ometimes, 9-year old Amanda Crow and her twin sister Megan trade places and try to fool their mother by switching pajamas. It usually works until one of them starts giggling. At a glance, it would have been difficult to tell the identical twins apart. Although Amanda has an artificial limb, she does not believe that it makes her any different from her sister, much less any other child. Amanda has a congenital birth defect. She was born without the portion of her right arm below the elbow. When she was 9 months old Amanda was fitted with her first hook-type prosthesis. "The main advantage of the limb she has now is its appearance. The limb makes her look like the other kids at school," said her mother, Jamie, who along with her husband, Richard, and 4-year old son Ricky, live in Hunter's Glen in Missouri City. "Of course, she was raised no differently from other children." There are other benefits of Amanda's artificial limb, her mother said. For instance, The Variety Club of Houston presented 10-year-old Amanda Crow with a myoelectric hand. Her the limb makes it easier for her to participate in new friends include Darrell Duggan, commander of VFW Post 6010 (L); Diane Atkins, director two-handed activities at school. Also, Amanda of the Amputee Program (C) and John Nau, president of Silver Eagle Distributors, Inc. (R). can use her hand during games at recess. When Amanda was 9 she received a artificial limbs. be held on Thursday, September 27 will get the myoelectric hand which is more technically Children between the ages of 1 and 10 bank going strong, said Atkins. "We need at advanced than the hook-type prosthesis. outgrow their prosthesis every 18 months to least $100,000 to get the program off the "I can hold things better now," Amanda two years. Non-electric components are ground." The $100,000 would cover all costs of said. "I like the way it looks better and it is generally not used again. The electric compo- componentry, prosthetic fabrication, training more comfortable." Amanda can wear more nents however may benefit up to three or four in physical and occupational therapy, types of clothing and the hand requires less children, said Atkins. maintenance, repair and eventually, replace- maintenance, her mother added. The cost for Amanda's myoelectric hand ment when the child outgrows it. Amanda received the myoelectric arm from was more than $7,000 in 1989, but the cost for The major sponsors of the event will be the the Veterans of Foreign Wars, Post 6010 and myoelectric elbows -- if the arm is missing Westin Galleria Hotel, American Airlines and the Variety Club of Houston, which is in the above the elbow or at the shoulder -- if often Anheuser Busch, Inc. process of forming a Limb Bank at TIRR. over three times that amount. "Because of the Houston's own Dr. Red Duke is scheduled "Instead of holding money, this bank will nature of the expense, many insurance to be the introductory speaker of the cocktail hold limbs," said Diane Atkins, director of the companies won't sponsor electric parts. Also, party and variety show. Entertainment will be Amputee Program at TIRR. "When a child Chronically Ill and Disabled Children (CIDC), a provided by Larry Gatlin and the Gatlin outgrows an artificial limb, the bank will be state-supported agency for families in financial Brothers with others to be named at a later able to provide the child with a larger limb at need, doesn't have the funding for so many date. little or no cost." families," said Atkins. Tables for 10 will be $1,000, $1,500 or The Limb Bank would be managed by the Because of the cost, recycling these parts is a $2,500. Atkins said the goal for table sales was Amputee Team at TIRR. Limbs would be cause that the Variety Clubs International, a 80. For more information on the fundraiser, available based on psychological, emotional, worldwide service organization for children, contact Laura Rowe, chairperson at 525-2288. medical and financial needs of children supports. between 1 and 19 years of age. Children would Sponsored by the Variety Clubs of Houston, * Reprinted with permission from Elizabeth L. be evaluated and followed after they receive the "Have a Heart, Lend a Hand," fundraiser to McDavid, The Houston Chronicle, "This Week." 7 PATIENT PROFILE Beating the Odds: The John Scarborough Story J ohn scorched the beans last night - Realizing something was wrong, Pat took his first attempt at cooking in six John to the hospital on Saturday morning, months. "I'm not used to an electric stove," he February 3. It was here that he had his second explains. But the fact that the beans were stuck stroke, an extremely violent one. Despite being to the bottom doesn't matter to John and Pat strapped to the gurney, six people couldn't Scarborough. It's a memorable moment that hold him down. almost was taken away from them. They were "The initial thought was that John was high school sweethearts and like many others, drunk. As soon as they drew blood they they married soon after graduation. Life has realized this was not the case. A CT scan held been good to Pat and John. They've been the answer," remembers Pat. "According to his married for 28 years and are blessed with two doctors, John's condition was deteriorating beautiful girls - Jill, 21, an aspiring photogra- almost hourly." pher and DiAnna, 27, the mother of twin 17 On Thursday, February 8, John was month old boys - Pat and John's first grandchil- LifeFlighted to a hospital in the Texas Medical dren. They share a beach house in Galveston Center where his initial assessment was John leads fellow Challenge Program with Pat's uncle where they partake in "R&R" critical. "I was told John would probably have clients in the newspaper group where they write, design and layout a every other weekend. another stroke - and the next one would be quarterly newspaper. Ironically, it was in Galveston, their "get-a- fatal," said Pat. When arteries rupture in the way place," where John and Pat's life took a brain like John's did, they usually don't make sudden turn for the worse. John was a senior it to the hospital. Once he had stabilized, a consultant for C.W. Systems Inc. and had just shunt was put into his skull to relieve the accepted a new position in Freeport for Dow cerebrospinal fluid building up and pressing Chemical Co., a client of his. John designed a on his brain. After the vasospasms stopped, computer system for them and was preparing (the brain violently reacting to the hemor- to take on another project when his life was put rhage), he started to come out of coma. on hold. He was beating the odds. Surgery was "It was Tuesday evening, January 30 when scheduled for March 2. Initially, Pat was told John called me from Galveston, to thank me for John wouldn't make it to surgery and that if he making the long trip to see him. He seemed to survived, he'd have the mentality of a 4-6 year be talking nonsense and kept on thanking me old and would need years of therapy. for meeting him but I never left Houston that Again, he beat the odds. Pat kept a vigil at day," recalls Pat. "During the conversation, John's bedside, occasionally leaving the room John began to complain of a strained neck and so as not to cry in front of him. It had been a mentioned that he was up all night vomiting long, exhausting ordeal but no one was ready and his back hurt - he thought he had the flu." to give up hope. With his doctor in the room, It wasn't the flu - it was a stroke. An Pat asked John, "Do you know who your aneurysm to be exact. Incredibly, John went to doctor is?" work Wednesday and Thursday, not realizing "Yeah. Medium height, reddish brown that his "flu" was actually a life-threatening hair, black glasses," John replied. situation. That Friday, February 2, John drove With this, all mouths in the room dropped home from Galveston to Houston in the to the floor. "Get this man into therapy as soon pouring rain. He was going to Baton Rouge on as possible," his doctor demanded. Monday and had to stop at the bank and the Now came the time to find a rehabilitation cleaners, running the last minute errands one program for John. Because John was a good does before leaving on a trip. candidate to return to work after his rehabilita- Finally at home in Houston, John went to tion, the Texas Rehabilitation Commission bed in hopes of getting rid of the flu. "It was accepted him into their program. the middle of the night and John couldn't stay After an extensive search for rehabilitation in bed. He was in SO much pain. Then the programs, they chose TIRR and John began his bizarre behavior began. John started putting therapy in March. His goals were set and socks on his feet - but there were no socks. updated every two weeks by the brain injury He'd light a cigarette and smoke it - but there program team led by Catherine Bontke, M.D., wasn't a cigarette." and Robert Sawicki, Ph.D. Immediately, John 8 Jill, John and Pat Scarborough treasure their daily walks around the apartment complex. began his daily regimen of physical, occupa- and his associate at C.W. Systems, John tional, and cognitive therapy. He believes his Raitano, are donating their time and expertise positive attitude helped him in his recovery. to designing a computer system for TIRR's "I'm still young and have more years ahead of Speech-Language Department. The new me. I couldn't sit around in my wheelchair in system will determine the cognitive compe- self-pity I had to keep myself motivated and tency level of patients when entering TIRR. It hopefully set a good example for the other will also reduce the amount of time spent on patients," says John. He did set good testing patients. examples for other TIRR patients. When a After spending 139 days in hospitals, John patient had difficulty using his foot to and Pat were ready to get on with their lives. maneuver himself in his wheelchair, at the Because of the amount of time Pat was away therapist's request, John gave the patient a from work, in addition to the industry's quick lesson and the two men began "cruising decline, she lost her job. Today she is working the halls." part-time for a company that is "emotionally All of TIRR's programs stress family supportive and has a positive atmosphere." participation, as this is critical to the rehabili- Pat and John reflect on the past six months tation effort and Pat Scarborough didn't miss and manage to keep things in a positive light. a day. John worked hard throughout his "We feel very lucky. John's aneurysm was rehabilitation. He was determined to walk out congenital. This could have happened ten "With the excellent of TIRR on his discharge day and he did. On years ago when we had two young children programs at TIRR we've June 22, two days before Pat's birthday, John to care for or it could have happened ten Scarborough walked out of TIRR amidst years from now when John was older and not learned to problem-solve. applause, balloons and plenty of smiles. A a good candidate for TRC's program," reflects It's a challenge. We talk video camera captured this important Pat. "With the excellent programs at TIRR about the barriers and moment. "It was the best birthday present I we've learned to problem-solve. It's a could ever receive," said Pat. challenge. We talk about the barriers and figure out what to do from The next step in his rehabilitation was figure out what to do from there." there." TIRR's Challenge Program, an outpatient day Pat makes a point to mention her source of treatment program for adults with brain strength John's mother. "She is the most injuries. What makes this program unique is inspirational woman I've ever met a role that it uses everyday experiences as a means model I'll reach for as long as I live. Her faith of therapy. The community is a classroom, and Christianity is not a coat she puts on-it's a giving clients access to restaurants, banks, part of who she is. She kept me going. She grocery stores and the METRO bus. kept me positive." John spends three days a week at the When John asked Pat if she was happy Challenge Program, preparing for his return with "what she's brought home," she replied to C.W. Systems, Inc. and Dow Chemical Co. with a smile- "I'm very happy with what I've In between his busy schedule of therapy, John taken home scorched beans and all." 9 Brain Injury Prevention THANKS! Campaign Proves to be a Hit Many thanks to the following individuals T his past July and August, TIRR and at select Kroger stores and imprinted Kroger and companies who generously gave of their the Texas Head Injury Association grocery bags. time and talents to the Brain Injury Preven- embarked on a Brain Injury Prevention Public Shortly after the bags were printed, tion Public Awareness Campaign: Awareness Campaign. The purpose of the Kroger received this response from a effort was to educate the public in the comment card in one of their San Antonio Stephanie Babb methods of preventing serious injury. The stores. Baylor College of Medicine - Public Affairs summer months were chosen as the period "I received a plastic bag to carry my Bob Green Productions for the campaign because the incidences of grocery purchases in that said seat belts and Mary Ann Board brain injuries increase during this time. car seats prevent brain injuries. That bag rode Catherine F. Bontke, M.D. and the Brain Using the theme - "The Brain, the part you home with me in my car. I looked at the Injury Team can't replace," the campaign stressed the use message and thought - what the heck - and Challenge Program Clients and Staff of seat belts, car seats and safety helmets as a put my seat belt on - my wife did the same. Elizabeth Earhart means of preventing serious injuries. After about a mile later we got run off the Karen Fiffick During the two month timeframe, the road in our Volkswagon and the car flipped Anna May Heser message was sent out to the public via over into a ditch. The car was totaled. We Peggy Kannellos outdoor advertising (billboards), a 30-second walked away with a bruised knee and a sore KPRC Radio television public service announcement, a 30- elbow. That public service advertisement KPRC-TV second radio spot, staffed information tables saved my life." Kroger Stores Pat Maurer Patrick Media Group Pearlman Productions D. Peterson and Associates Nancy Pumphrey Mitch Rappaport Linda Rock Ann St. John Rennie Swift Texas Head Injury Association Wright Advertising and Public Relations The July Brain Injury Prevention Public Awareness Campaign was a success thanks to TIRR staff volunteers: Karen Fiffick, RN, CRRN (L), Mary Ann Board, MSW, CSW- ACP (C) and Pat Maurer, RN, (R). Mary Ann Board and Pat Maurer visit with a Kroger customer. WOW Can Use If only your brain was this easy to replace. r Change DOUBI Make Change! Institute Seat belts, car seats and safety helmets prevent brain injuries. A public service message brought to you by The Institute for Rehabilitation and Research, the Texas Head Injury Association and Patrick Media Group. The tongue-in-cheek billboard was one of 25 posted around the Houston area. 10 Dr. Stelly-Seitz Directs TIRR's Pediatric Program By: Kim Leo S ince her 1989 debut at TIRR, disabilities are now living longer, more Charlotte Stelly-Seitz, M.D., has productive lives. Dr. Stelly-Seitz stresses this proven time after time how important her to the parents of her patients and encourages patients are to her. As Director of the them to plan for the future. She encourages Pediatric Rehabilitation Program at TIRR, she her patients to take steps to embrace not only sees a multitude of children with disabilities today, but tomorrow as well. "I try to make due to injury or illness. Her unique combina- my patients think ahead and often times this tion of expertise - she is board certified in involves the idea of vocational planning at an pediatrics and has a dual specialty in physical early age. When these children turn 18, they medicine and rehabilitation - allows her to should be prepared to enter the most meet the special needs of the children. The independent, productive life possible," she Pediatric Program Director Dr. program was developed to meet these explains. Stelly-Seitz believes in educating her growing needs and includes individualized Dr. Stelly-Seitz stresses that "children young patients in all aspects of their treatment programs to help each child need to receive specific pediatric treatment, rehabilitation as seen here with throughout the rehabilitation process. not adult treatment that has been altered for Krystal Stockton. There are many services of the Pediatric children." In treating children, she empha- Program that are unique because of the young sizes that each child is different and should be patients in the program. Since an injury or treated according to their particular develop- illness often disrupts a child's education, mental age. "It is important to keep in mind certified special education teachers from the that pediatric rehabilitation is much different Houston Independent School District work than adult rehabilitation. Children are still with each child. This allows the young gaining skills, whereas adults have lost skills patients to continue their studies even though and have to re-learn," she said. they are in the hospital. Her patients' needs aren't forgotten after Other specialized services TIRR provides they are discharged from TIRR. She says that for its young patients include medication consistent follow-up care and funding are the supervision, nutritional assessments, two biggest challenges facing her today. It occupational therapy, speech-language isn't uncommon to find Dr. Stelly-Seitz therapy, physical therapy and therapeutic meeting with the Texas Board of Health or recreation to name a few. Clinics which advocating for Chronically Ill and Disabled address a child's particular disability are also Children (CIDC). In addition to these an integral part of the program. measures, she also finds time to talk with The rehabilitation process may seem a bit support groups. confusing and upsetting to a young child. Dr. Each child that visits TIRR is unique to Dr. Stelly-Seitz feels that this fear is the main Stelly-Seitz. The patients and their families reason behind educating the patient and know they can trust her and feel confident in family on every aspect of a child's injury or putting their child in her care. By listening to illness. "The family is very important when it and caring for both the patient and family, Dr. comes to bringing the child to his or her Stelly-Seitz has proven the importance of fullest potential following an injury or family involvement in comprehensive IN THE NEXT ISSUE: illness," she said. rehabilitative care. Each child's hopes and Because of the recent developments in dreams are considered when Dr. Stelly-Seitz research and technology, children with prescribes treatment. Spinal Cord Injury and Modern Technology The Sports Arts Center Celebrates its Second Year 11 IN GRATEFUL ACKNOWLEDGEMENT The TIRR Systems family our board, Dr. and Mrs. Michael A. Petitt Jay Medical, Ltd. Charter Bancshares staff and patients, wish to express our Pharmacia LKB Biotechnology, Inc. Mr. and Mrs. Don F. McMillian Clear Creek Golf Course gratitude to the following individuals, Rockwell Fund, Inc. Motion Design Congregation of St. James the Fisherman foundations and companies whose Mr. Alex Segall Neiman Marcus Mr. and Mrs. Allen B. Craig contributions or pledges of money or Shell Oil Company Foundation Omni Foundation Mr. and Mrs. Jim Crowther equipment have supported our efforts. Such Dr. and Mrs. William A. Spencer The Powell Foundation Ms. Carolyn M. Davidson donations enable us to provide services or Texas Commerce Bank Quickie Wheelchair Manufacturer Ms. Myrna L. Davidson to undertake research and educational Union Texas Petroleum The Rienzi Foundation, Inc. Mr. Doug Dwelle projects that otherwise may not be possible. Variety Club of Houston, Tent 34 Mr. Stephen W. Schneider The Endowment Fund of the Jewish J. M. West Texas Corporation Mr. and Mrs. O. M. Schoenemann Community List includes pledges and contributions St. Luke's United Methodist Church Mr. Randall E. Evans received January 1, 1989 June 30, 1990. SPONSORS Mr. and Mrs. David Stock Ms. Susan Fronek $5,000 $9,999 Richard Stodder Charitable Foundation Ms. Susan Garber FOUNDERS The Gordon and Mary Cain Foundation Sysco Corporation Ms. Clare A. Glassell $100,000 + Dr. Denton Cooley Mr. Robert Wilhite Mr. Lloyd Green M. D. Anderson Foundation Mr. Hartley Hampton Mr. Howard Wolf Mr. J. E. Harrell The Clayton Fund, Inc. Panhandle Eastern Corporation Zapata Corporation Mrs. Leota Meyer Hess The Cullen Foundation Al Parker Buick Mr. and Mrs. Thomas J. Holmes The Cullen Trust for Health Care River Oaks Garden Club of Houston BOOSTERS Mr. and Mrs. Seth Houck John S. Dunn Research Foundation Skandinaviska Enskilda Banken $500 $999 Mr. and Mrs. Charles Kaiser The Fondren Foundation Corporation Allen Park Inn Mr. and Mrs. Leonard R. Kallop Strake Foundation Tenneco Gas Mrs. Jerry Johnston Andrew Mr. and Mrs. Albert B. Kimball TIRR Auxiliary Battle Mountain Gold Company Dr. John F. Lancaster PARTNERS Compass Bank Mills, Shirley, Eckel, and Bassett BENEFACTORS $1,000 $4,999 Mr. and Mrs. Joe Hardilek Mr. and Mrs. Grover B. Nielson $10,000 $99,999 Amco Medical Services Mr. and Mrs. Irwin L. Levy and Ms. Janice Oshensky R.C. Baker Foundation Baroid Corporation Mrs. Gerson Scheps Pro Form Botwinick-Wolfensohn Foundation Ms. Harriet Bath Muilenburg Prosthetics, Inc. Raymo Products, Inc. Mr. Branard Brochstein Mrs. Billie Bath Perlman Ms. Phyllis P. Rathbun Mrs. Mable Rettig The Galen T. Brown Foundation Mr. and Mrs. Charles C. Beall, Jr. SCI Consensus Conference Fund Roho, Inc. Compaq Computer Foundation Ms. Bonnie Brooks Mr. Allan Shivers, Jr. Dr. Donald C. Ruthven Enron Foundation The George and Anne Butler Foundation Texas Gas Transmission Corporation Mr. and Mrs. M. M. Schwartz The William Stamps Farish Fund CRS Sirrine, Inc. Mr. and Mrs. Melvin Simon Gillson Longenbaugh Foundation Everest and Jennings, Inc. PATRONS SmithKline Beckman Invacare Corporation ExtendaCare Health Systems $100 $499 Mr. and Mrs. George A. Speer The Ralph A. Johnston Foundation, Inc. First City, Texas Adlib, Inc. Mr. and Mrs. David Stein and Family Kappa Kappa Gamma Charitable Fluor Daniel, Inc. Mr. Issac Arnold, Jr. Mr. and Mrs. Dallas J. Stephens Foundation Mr. and Mrs. Lex Frieden Mr. and Mrs. Elliot Axel Texas State Optical Little York Mr. and Mrs. Homer L. Luther, Jr. The Garden Club of Houston Mr. and Mrs. Mike Baker Dr. and Mrs. Sellers J. Thomas, Jr. The Meadows Foundation Hobby Foundation Banyon Townhouse Association Weatherford International Inc. Mitchell Energy and Development Ms. Lauri Hunter Ms. Sylvia J. Bartay Mr. Lionel Wayne White Corporation Mary Lou Canter Trust Non-Profit tiRR 5100 Travis Organization Houston, TX 77002-9742 U.S. Postage PAID Systems 713/528-0123 Houston, Texas Permit No. 3687 RETURN POSTAGE GUARANTEED ADDRESS CORRECTION REQUESTED Change name or address as shown on address label. I received a duplicate copy. Please make the necessary correction. Please add my name to the mailing list. Please remove my name from your mailing list. Please return your address label in an envelope to the TIRR Systems address above. The Quality of Life Dear Friend: A major Southwestern firm recently asked one of its executives to review the activities of the Texas Institute for Rehabilitation and Research to ascertain (1.) the contribution the Institute was making to this community and (2.) what support, if any, the company should give the Institute. We were privileged to see the final report. Believing it accurately presents the picture of the Institute, we asked and received permission to publish it in this small pamphlet. We have taken the liberty of adding photographs. TIRR is a vital regional medical institution deeply involved in the welfare of mankind. I sincerely hope that you will take these few minutes to become better acquainted with it. Sincerely, R. Rarhan Charles R. Rathbun, President Board of Trustees The product of the Texas Institute for Rehabilitation and Research is rare indeed. The doctors and nurses are not debating the questions of life or death, but rather the quality of the life of their patients. It is this desire for the quality of life that impressed me most about the Institute when first I discovered it located at the geographical heart of the Texas Medical Center. I had heard much about its work and accomplishments and decided to learn more through visits with patients, volunteers, members of the Institute staff and administration. My initial concrete finding was that the Texas Institute for Rehabilitation and Research is no ordinary medical institution. While I expected to feel sorry for patients suffering injuries and illnesses crippling them for life, I soon learned that no one at TIRR wants or needs sympathy. Patients have individ- ually and collectively conquered what fate handed them, each in his own way. They are living proof that a handicap need not be a liability. These aren't handicapped people. .even though they use a battery-powered respirator for breathing, ride in a wheelchair, or spend hours and days in special- ized therapy. They are individuals rebuilding a body that has been impaired, and there is not one of them who does not believe he or she will soon be back again meeting and succeeding in the day to day chores of life. The Institute's Director, Dr. William A. Spencer, stated it this way during one of our conversations: "Many of our patients are young with a long life ahead. Are they going to spend the rest of their lives in a nursing home or return to a productive life with the dignity of an individual and the economic freedom to earn a living in a free society?" With respect to the staff, 1 have never met people in industry, government, or private life who are more dedicated in their work or have more faith that the tasks they are undertaking daily will bring about favorable results. 2 FORMER PATIENT, Nita Weil, Director of TIRR Volunteers. one of the battery-powered generation. F No.: 1 W De BACKGROUND The Texas Institute for Rehabilitation and Research is located in the heart of the famed Texas Medical Center in Houston, Texas. It was created in 1959 as a voluntary, nonprofit, regional health facility serving patients throughout the Southwest suffering from: Extensive paralysis-resulting from spinal cord injury (largely due to auto accidents and athletic injuries), brain injury or damage from poor circulation or vascular disease causing a stroke, or diseases of nerves and muscles as with multiple sclerosis or muscular dystrophy. Multiple handicapping conditions-due to birth defects, diseases of the circulatory system, skeletal system deformities, amputations, inflammatory conditions such as severe arthritis, and diseases affecting the general chemis- try of the body. Breathing impairments-due to cystic fibrosis, childhood illnesses affecting the lungs and circulatory system, or where there is nerve and muscle damage causing weakness or paralysis of the breathing muscles. Compared to the other Texas Medical Center facilities, the Institute is housed in a small building (84,000 square feet). It has 59 beds for inpatient care and operates fifteen individual outpatient clinics. 575 inpatients are cared for per year and 1,500 outpatients and day care patients. Late in 1970, TIRR acquired an additional new 40-bed facility, near the downtown area, having a basic design compatible with wheelchair level mobility. It is ideally suited to the paralyzed patient, those in need of re-evaluation and followup, and those in need of interim extended nursing and medical services as a part of the total hospitalization. The facility will provide the Institute the opportunity to extend and expand its present pro- grams so that an additional 200 people per year may be served on an A NEW BREATH OF LIFE - 4 as a technician inserts aerosol medication in nebulizer vial of inhalation therapy machine. the inpatient basis and 250 on an outpatient and day care basis. The new Annex will also afford a group of quadriplegic young people, who are former patients of TIRR, the initial opportunity to develop management experience of a cooperative self-support residence. They will also be respon- sible for planning and defining the operating requirements of multi-residence apartment units for both elderly people and the physically handicapped, like themselves, who are of college or working age. The full-time staff at TIRR, headed by Dr. William A. Spencer, totals 400 doctors, nurses, other allied health professionals and supporting personnel. The Institute is closely affiliated with the Baylor College of Medicine. Exten- sive research is conducted in the prevention and control of disability and on ways to restore bodily function and achieve life adjustment. Nearly 900 physicians and medical students participate annu- ally in this combined care, research and training program. A total of 4,300 allied health professionals and physicians were trained in 1970 alone. The TIRR/Baylor College of Medicine joint program is making an invaluable contribution to the service afforded by the Institute. Baylor's participation is underwritten by a special grant from the Social and Rehabilitation Service of the U.S. Department of Health, Education and Welfare for a regional Re- search and Training Center in Rehabilitation Medicine. The Institute's finan- cing is entirely separate and must be derived from patient fees (66%), federal and state grants (22%), and foundation, industry, and private contributions (12%). The Institute's annual budget for services to all in need, for research and educational activities in the early 1970's was approximately $3,500,000. Since its founding, the Institute has served a total of 8,242 inpatients and outpatients. 6 LEARN AND TRAIN, a constant program for thousands of professionals and physicians visiting and working annually at the Institute. Q: CC Я To help in evaluating the Texas Institute for Rehabilitation and Research, one should review four areas of activity - administration, operations, re- habilitation and research. ADMINISTRATION TIRR is governed by the basic philosophy centered on the "quality of life"- making man productive, while preserving his dignity and usefulness in spite of physical handicap. Under the direction of Dr. William A. Spencer, the Insti- tute operates toward three goals: I. Service Goal-makes provision for comprehensive rehabilitation to a maximum number of persons through efficient usage of available resources. The staff strives to provide a multi-disciplinary program to assist the disabled patient in adjusting to life-physiologically, psychologically and socially. Earlier care costs less and achieves more beneficial outcomes. II. Research Goal-finds the staff of the Institute striving to understand the causes and the mechanisms of disability which destroy the health of the indi- vidual, his capacity to function and to adapt and cope with daily life- physically, emotionally and economically. Extensive and ongoing research is conducted on methods to improve the effectiveness and efficiency of all Institute services. III. Educational Goal-The Texas Institute for Rehabi- litation and Research, under the Baylor College of Medicine program and with Baylor or Institutional research grant support, strives to develop new rehabilitation teaching techniques for physicians, medical students, and allied health professionals. The results are then, in turn, implemented for the benefit of as many disabled individuals as possible. 8 THE DELICATE QUALITY OF LIFE is administered by a professional staff of 400. The Institute is structured into four primary areas of operation: Care, Research, Teaching and Supportive Services. TIRR is run like a business should be run. Operational expenses per square foot are the lowest of any institution in the Texas Medical Center. Free care ranks well above all Houston area medical facilities, other than those sponsored by the tax supported charity hospitals. OPERATIONS Twenty-three individual departments and programs stand ready to assist in patient care. For inpatient care, they include specialized centers for patients with spinal cord injuries and chronic respiratory conditions, nursing, physical therapy, occupational therapy, medical social service, orthotics, surgery, clinical labs, radiology, pharmacy, inhalation therapy, vocational services, psychological services and educational programs. Ongoing clinical programs are offered in the specialty areas of neuromuscular disabilities, scoliosis, spina bifida, stroke, cardiac rehabilitation, arthritis, and for the amputee. On an average, each patient is served by no less than six employees. The Institute utilizes advanced electronic data processing (EDP) for the daily 24-hour programming and scheduling of each patient's care according to individualized objectives and needs. Daily medical conferences and EDP scheduling insures a highly satisfactory form of quality control over individual patient care and utilization of services which benefit the patient. Two hundred volunteers contribute their time and energy assisting the Institute's permanent staff. REHABILITATION In the rehabilitation of a patient, the totality of man is viewed as the problem. A team consisting of a doctor, nurse, highly trained attendants, medical social worker, occupational and physical therapists cares for the patient. 10 THE EXCITEMENT OF TAKING THAT FIRST STEP AGAIN is but one phase of the physical therapy program. Until visiting the Institute, I had never thought of the miracle connected with a man touching his nose once he had lost use of both arms, or the fine tuning required to re-educate and strengthen muscles which cannot be volitionally moved because of nervous system disease and injury. The Rehabilitation teams face these challenges daily in support of the Institute's motto: "In our society every disabled person deserves the chance to live as a man." Once a patient is admitted, upon physician referral, the medical, physical, and psychological rebuilding program begins. To this end, a patient is afforded highly personalized attention. It has been found that rehabilitation is a slow process, but the results in any number of cases have been exceptional. A few examples of the work done by the Institute might prove beneficial: A young teenager riding in the backseat of a foreign sportscar was involved in a head-on collision in March of 1969. She fractured her spine and laid unconscious for nearly two weeks before being admitted to the Institute, with very little hope for survival. In August, 1969, she walked out of the Institute wearing specially designed braces and crutches. By early 1970, she needed only the support of a cane. One year and four months after the accident she was functionally independent, riding horseback, and continuing her college education. A twelve year old boy, just two weeks before Christmas, was accidentally shot by a neighbor while playing with a new gun. The bullet hit the boy's liver, spleen, one vertebra, destroyed one kidney and damaged the other. After many months in a hospital recuperating from two operations, with very little hope for survival, he was admitted to TIRR. Through combined efforts of the Institute's team and the boy's parents, the boy survived and, though in a wheelchair, has gained back most of his original weight, is attending school and following the routine of an almost normal life. BUILDING SOMETHING, ANYTHING 12 with the aid of hands powered by artificial muscles in a well rounded occupational therapy program. A young gymnast, captain of her high school team, slipped while doing a handstand and fell, breaking her neck and becoming paralyzed. After months of rehabilitation efforts (physical and occupational therapy), she has learned to write again, breathe normally, and graduated with her high school class, as her classmates insisted she move her wheelchair to the stage for diploma presentations. She is now attending college. The doctors, nurses, and patients have told me that rehabilitation is slow. But when I see and hear of some of the apparent miracles that have been accom- plished-rebuilding a practically useless body in less than four months to a point where a person can function on his own with supportive equipment and some personal care-1 am truly impressed. The facilities and equipment are, for the most part, modern. New items are needed and added when monies become available. From a very practical point, I found it cost less to rehabilitate a person than to leave him for life in a nursing home. A recent study of 1,000 patients provided comprehensive services at the Institute, showed that the average cost for the initial complete program was $4,376 (excluding physicians' services, which were donated). Individual care costs vary with the severity of the condition, e.g., cost of comprehensive rehabilitation of the spinal cord injured averages $9,500 with another $1,200 for equip- ment. If these patients had been relegated to custodial care in a nursing home for the average life expectancy (25 years) of a spinal cord injured person, it would have cost someone (probably the taxpayer) at least $5,000 a year or a total of $125,000, not counting innumerable hospital admissions for acute complications. In simple terms, the finished product of the Institute revolves around a human being and the ability to preserve as many options as possible for his or her future life. In 1970 more than twenty patients of the RESEARCH requires time, money and dedicated professionals to 14 discover new, more effective approaches to combating disability and hastening the rehabilitation process. 9 800 700 Institute attended college in wheelchairs. Hundreds of others have been returned to productive life, to being a taxpayer and to realizing the dignity of man. And absolutely to my amazement, I tested the Institute's special driver train- ing equipment upon which one hundred patients-some with little use of their arms or legs-have learned to drive and pass their State tests during the past twenty-four months. The driver training program is a facet of a well- planned, thoroughly integrated Vocational Unit dedicated to providing the atmosphere and training required to make a client (patient) capable of employment, and then DRIVER EDUCATION me INSTUTE FOR SUBTORY AND RESEARCH to help him find a job. There are seven primary programs and activities in the Vocational Unit-comprehensive vocational evaluation, work adjustment training, selective placement and follow-up, client self-support programs, computer programmer training, driver training program and work evaluation research. The success of the Vocational Unit is a man or woman utilizing a different set of skills to successfully gain employment, earn an income and resume a contributing role in society. More than 40% of the most severely handicapped adults imaginable have been able to achieve competitive employment. Rehabilitation is more then just the goal for the patient. It involves the entire family-and society. As an integral element of the rehabilitation program, the Institute initiated in January, 1968, an extensive educational program directed toward members of the injured patient's family. This program has done much to reduce the anxieties of both family and patient when the family unit is brought together again in a home atmosphere. 16 AT TIRR, some people learn to drive autos with the limited use of arms or legs plus ingenuity and desire. FOR DRIVER EDUCATION RESEARCH The scientific and medical world has for many years looked to the Institute and its personnel for major technical breakthroughs. One of the most signifi- cant developments in the area of spinal surgery can be credited to Dr. Paul R. Harrington, who has successfully perfected internationally acclaimed spinal instrumentation and fusion techniques for curvature of the spine (scoliosis). It is amazing to view photographs showing first a person humped over with a badly twisted spine and then to see the same person standing erect following Dr. Harrington's surgery in which his technique and instru- mentation was employed. Additional laboratory tests are currently underway to further perfect advanced instrumentation in this area. Dr. Spencer and Danish-born Mr. Thorkild J. Engen have recorded exciting advances in the development of externally powered upper extremity anthoses. These devices are, in fact, mechanical carbon dioxide powered artificial muscles to power paralyzed arms. Their utilization has allowed over 100 quadriplegic (totally paralyzed) and other patients to achieve con- siderable functional independence. Mr. Engen is presently attacking the problem of weakened lower extremities. His efforts should eliminate the need for heavy leather or metal riggings for paralyzed or weakened legs by the use of modern plastics and ingenious fabrication techniques. By virtue of a Social and Rehabilitation Service Research Grant, his accom- plishments at building a lightweight limb that functions like the skeletal and ligamentous elements of a human limb, a normal walking gait is possible for a person with a drop foot after a stroke. Scientific investigation into the care and rehabilitation of the stroke patient continues. Current research is being conducted into the feasibility of an elec- 18 BIOMEDICAL INGENUITY - combined with Physiological Knowledge creates the devices to let them walk, move, run, play and live. trical stimulation device designed to activate nerves and allow a stroke patient to walk and move more normally. A small cigarette case size electronic de- vice is carried in his pocket. Early in our nation's effort to place man in orbit, the Institute conducted ex- tensive human immobility tests for NASA. The research team was headed by Dr. Carlos Vallbona (now Chairman of Baylor's Department of Community Medicine) and Dr. David Cardus, cardiologist and physiologist. Today, Dr. Cardus has turned his attention to evaluating the capacity for physical work of those persons having heart disease so that they may re-enter an active life as soon as possible after a coronary occlusion. In TIRR's new Work Toler- ance Evaluation Laboratory, the cardiac patient is placed under controlled exercise. Through scientific testing, using an on-line computer and specialized instrumentation and evaluation, the patient's ability for work is established and an individual activity schedule developed, reducing both the physical and mental anxieties of post-cardiac recovery. Future research in this area calls for a carefully controlled exercise program involving physical therapists for the rehabilitation of people with coronary heart disease. Many of the extensive research activities are supported by a large rehabili- tation-engineering program which provides new instruments and blends engineering technology with medical research. In nearly every field of re- habilitation, including the physical, psychological, social, and vocational, new techniques are being tested for the person with spinal cord injury, stroke, amputation, spine deformities, and the child with cystic fibrosis, muscular dystrophy, and birth defects. I have heard for such a long time that results from research take time, money, and dedication. The dedicated men and women at TIRR need only 20 WORK TOLERANCE TESTS, developed at TIRR, to test man's capacity for work following heart disease. time and money before making yet more significant contributions to this multifaceted field. FUTURE Dr. Spencer daily faces the problem of the future of the Institute. In many ways the future will be decided by the financial support forthcoming. I sense that they are trying to define an optimal operational size that will meet the demand, while allowing the best utilization of source manpower. Plans call for: Doubling the bed capacity and adding research and education space in the medical center unit within the next three to four years from 63 beds at present to approximately 100. If done, this will require a major capital investment in expanded facilities. The recently acquired Annex is envisioned as the medical hub of a major residential facility for handi- capped young people of working and college age, and elderly handicapped persons, capable of independent living. This will require financing principally for land acquisition. A major commitment to research. This appears mandatory both by the professional nature of the Institute's personnel and the realization that techniques and treatment can be perfected. It is only through research applied to the problems and needs of handicapped people that the benefits of science and technology can improve their outcome. Optimum use of resources. The Institute has achieved better results each year in its time requirements for patient care. Improved techniques are work- ing toward the reduction in time spent by a patient in the Institute and reduced cost to sponsors, and to allow more people to be helped. Current programs under study should still show more improvement in this area. 22 TO DR. WILLIAM A. SPENCER, Director of the Texas Institute for Rehabilitation and Research, "Our goal for each patient is a productive life with economic freedom and, above all, dignity." Major developments planned or anticipated through 1976: Development of "care centers" similar to those already established to provide programs for those having other impairments such as the multi-handcapped child, the hemiplegic stroke patient, scoliotic child, and other problem groups, especially the multiple amputee. A coordinated multi-institutional stroke program is expected to be in oper- ation in the next year to afford higher quality services and better access to the stroke patient. Expansion of vocational services to provide automated vocational perform- ance testing and preliminary work to achieve job matching of physically or educationally handicapped people, as well as, better training and placement services. Expand the usage of the computer based hospital information system into evaluation of the care process to improve its efficiency of delivery and effectiveness and the definition of requirements for transfer to other institutions. CONCLUSION If one takes pride in a well researched and manufactured product, favorably praises a well managed and staffed organization with high morale, supports those projects that reflect well on the community in which one works and lives; and above all, if one truly believes in the dignity of man and the economic system that encourages the individual to earn his own way as a substitute for welfare dependence, then philosophically, morally, and practically one must be in agreement with the work being done by TIRR and should consider the extent of its support in this light. 24 BOARD OF TRUSTEES EXECUTIVE STAFF Charles R. Rathbun, William A. Spencer, M. D., President Director Mrs. S. M. McAshan, R.E. Carter, M. D., Vice President Director of Patient Care William A. Spencer, M. D., C. G. Breckenridge, M. D., Vice President Director of Education Chester M. Fulton, M. J. Fuhrer, Ph. D., Secretary Director of Research Charles C. Beall, Jr., J. M. Lias, Treasurer Assistant Director for Administrative Affairs Harry I. Battelstein R.P. Bushman, Jr. N. C. Hott, Business Manager Richard Colt Peder Monsen Henry J. N. Taub James M. Walsh Texas Institute for Rehabilitation and Research 1333 Moursund Avenue Texas Medical Center Houston, Texas 77025 Dedicated to the Quality of Life Prometheus Unbound Symbolic of the goal of the Texas Institute for Rehabilitation and Re- search - that every man, regardless of his disability, deserves the chance to live as a man and to enjoy the quality of life. your ourfirst TIRR Benefit Wednesday, November 8, 1972 Texas Institute for Rehabilitation and Co-Chairmen, Ticket Sales Committee Research Mrs. Curtiss Brown Featuring: Mrs. Franklin Fisher Mrs. Aron Gordon Tony Bennett Bill Cosby TIRR Board of Trustees The Golddiggers Charles R. Rathbun, president Music by Ed Gerlach and his Mrs. S. M. McAshan, vice president Orchestra William A. Spencer, M.D., vice president Sets by Robert Howery Studios of Chester M. Fulton, secretary Houston Charles C. Beall, Jr., treasurer The Board of Trustees and Executive Harry I. Battelstein R.P. Bushman, Jr. Staff of TIRR express their appreciation Richard Colt to the many individuals and organiza- Peder Monsen tions who have worked SO diligently to Henry J. Taub make the TIRR Benefit possible. James M. Walsh DeBakey and Dr. William A. Spencer met to discuss the idea of establishing a rehabilitation and research facility in the Texas Medical Center. Within six weeks, architectural sketches were prepared and construction began soon thereafter. Funds for the Texas Institute for Rehabilitation and The Institute serves those who can ben- Research came from private founda- efit from early comprehensive care tions and a federal grant. and rehabilitation required to restore From that small beginning, TIRR has them to a healthier physical and psy- grown to become one of the nation's chological condition with the ability to largest research and training centers be productive and care for them- for rehabilitation medicine. Extensive selves as independently as possible. research into the prevention and con- The doctors and nurses at TIRR do trol of disability and ways to restore not debate the questions of life and bodily function and life adjustment is death but rather the QUALITY of life of conducted at the Institute. There has their patients. The patients are not been no restriction of eligibility due to handicapped people - even though income level, place of residence, they may use a battery-powered res- Tonight, a great entertainment event age, race or source of sponsorship. pirator for breathing, ride in a wheel- for your enjoyment. The TIRR Benefit is The only limitations have been the ex- chair or spend many hours each day also an important fund-raising effort tent of donations and the capacity of in specialized therapy. They are indi- on behalf of a unique medical facility, the resources. viduals who are in the process of re- world-renowned for its pioneering ef- Its concept is to be a voluntary, non- building lives that have been inter- forts in the areas of research and reha- profit, regional health facility to assist rupted by a physical impairment. bilitation. The Institute had its begin- the disabled. Its purpose is to provide The full-time staff of 400 at TIRR, ning in 1959 in a small meeting of care for people of all ages, SO af- headed by Dr. William A. Spencer, well-known Houstonians. Houston fected by disease or injury that their includes doctors, nurses, other allied financier-philanthropist Ben Taub, the survival is threatened or who have lost health professionals and supporting late Lamar Fleming, Dr. Michael the ability to take care of themselves. personnel. The Institute is closely affil- medical services. The new facility pro- vides the Institute the opportunity to ex- tend and expand its present programs SO that an additional 200 people per year may be served on an inpatient basis and 250 on an outpatient and iated with the Baylor College of Medi- day care basis. cine. Nearly 900 physicians and medi- Major developments planned or cal students participate annually in anticipated through 1976 include: the combined care, research and Development of additional "care training programs. centers" to provide programs for The Institute serves patients suffering those having particular impair- from: ments - the multi-handicapped Extensive paralysis child, the hemiplegic stroke pa- Multiple handicapping conditions tient, the scoliotic child, and other Breathing impairments problem groups, especially the Compared to other Texas Medical multiple amputee. Center facilities, the Institute is housed A coordinated multi-institutional in a small building - 84,000 square stroke program is expected to be feet It has 59 beds for inpatient clinic. in operation in the next year to Expansion of the usage of the com- More than 575 inpatients, 1,500 outpa- afford more specialized services puter-based hospital information tients and day care patients are and better access for the stroke system into evaluation of the care cared for each year. patient. process, thereby improving its effi- Late in 1970, TIRR acquired an addi- Expansion of vocational services to ciency of delivery and effective- tional 40-bed facility near the down- provide automated vocational ness and the definition of require- town area having a basic design performance testing and prelimi- ments for transfer to other insti- compatible with wheelchair level mo- nary work to achieve job matching tutions. bility. It is ideally suited to the para- for physically or educationally These goals will be accomplished lyzed patient, those in need of re- handicapped people, as well as, through the continuing efforts of the evaluation and follow-up and those in increased training and placement TIRR staff and the continued financial need of interim extended nursing and services. support from the community. song. Tony Bennett's I Left My Heart In San Francisco is just one of this super- star's many hits. Bennett's career got off the ground in 1950 when his first hit record Rags to Riches was released. During childhood, Tony began sing- ing at church functions, school plays and operettas. After displaying an un- usual talent for painting, he enrolled in New York City's High School of Indus- trial Arts, commuting each weekend to nearby Paterson, New Jersey, to sing in local restaurants for $10 a week. Following three years of service in World War II, Bennett made the deci- sion that singing - not painting - was to be his career. Then, in 1950 it hap- pened. Bennett was singing at the Greenwich Village Inn, in a show star- ing Pearl Bailey. She heard Bennett and told the Inn's manager to "Keep that boy on. I like the way he sings." Bob Hope, attending one of Miss The Golddiggers Bailey's shows, discovered Bennett As versatile and talented as they are and signed him on to tour with the Bob beautiful, the Golddiggers have re- Hope Show. Mitch Miller heard Ben- created a unique form of entertain- nett's demonstration record of ment. As an eight-girl song and Boulevard of Broken Dreams and his dance troupe, they started their rise to recording career took off. stardom on the "Dean Martin Show." Tony Bennett Hit followed hit. Because of You, One of the show's main attractions, the Even if you have never been to San Cold, Cold Heart and Rags to Golddiggers' popularity increased Francisco, you probably feel you've Riches catapulted Bennett to phenomenally. They are currently stars been there largely due to one man's stardom. of their own syndicated weekly series. Bill Cosby It's only coincidence that "Comedy" and "Cosby" both begin with the same letter. Bill Cosby, whose hilarious ventures into reminiscence have con- vulsed millions of people for years, revealed his unique gift for laughter at an early age. In the simplest manner possible, he has become the spokesman of many people all over America. He's the street level philosopher who gives the twist of the ridiculous to everyday faults, foibles and successes, and makes them a recognizable slice of He has also signed to star in "The happy unhappy life. His appeal, how- Electric Company", newest experi- ever, is not restricted to any specific ment in educational television from group, as his Chaplinesque qualities the Children's Television Workshop, have endeared him to people in all creators of "Sesame Street". He has walks of life. also filmed two half-hour shows for ed- The versatile Cosby made the transi- ucational TV networks, "Concern" tion from standup comic to actor in which deals with his concern for the NBC-TV series, "I Spy" and power- school children, and "Prejudice" in ful dramatic role in the film, "Man and which he does an irreverent spoof of Boy." He has since teamed with his the hangups of prejudice. Both shows "I Spy" partner, Robert Culp, for their were written, directed and produced first motion picture together, "Hickey by the star. and Boggs". He recently left NBC to Cosby, who has moved with his sign with CBS for a new weekly come- family to Massachusetts, is continuing dy variety show and will star in a studies toward his doctoral degree in number of films for that network in the education at the University of "CBS Friday Night Movies". Massachusetts. If ever it could be said that one man embodies the spirit and determination of an institution, that man is Dr. William A. Spencer, TIRR Director and Chair- man of the Department of Rehabili- tation of the Baylor College of Medicine. Named "Physician of the Year" in 1965 by the President's Committee on Employment of the Handicapped, Dr. Spencer was one of the founding fa- thers of TIRR in 1959. Dr. Spencer's philosophy centers around the premise that many of the patients can spend the rest of their lives incapacitated in a wheelchair or nursing home or they can return to a productive life with dignity, usefulness and economic freedom despite a physical handicap. A Phi Beta Kappa graduate of Johns Hopkins Medical School, Dr. Spencer was elected one of the Ten Outstanding Young Men in the United States in 1954 in recognition of his work in the field of poliomyelitis. programs at the Institute. Under the di- rection of Mrs. Nita Weil, Director of Volunteers, activities of the Auxiliary Members fall under three areas of service: 0 Service to Patients and Staff Fund Raising Public Relations Their responsibilities include feeding the patients, personal shopping, mak- ing beds, reading to patients, assisting staff in clinics and the pharmacy, helping with the recreation program, providing clothing for the clothes bank, operating the beauty shop pro- gram and many other activities which tional fund of TIRR. prove invaluable to the Staff. Public relations activities include Their fund raising activities include production of the quarterly Volun-TIRR the day-to-day operation of the Korner newsletter distributed to TIRR volun- TIRR Volunteers Store, the Short Stop, the Coffee Cart teers and donors, audio-visual presen- More than 200 active, associate and and conducting periodic bake sales, tations to clubs and organizations and life TIRR Auxiliary Members donate raffles and flea markets. All proceeds preparation of public service copy for their time and energy to the volunteer from these activities go to the opera- radio and television stations. We also wish to express our appreciation to the follow- Chester Fulton ing individuals and organizations including those Mrs. Bobbie Goggan W.H. Vaughan, Jr. Wm. H. Lane Morris Glesby whom we were unable to acknowledge here. Dr. Shalom Vineburg Tom Leervig Ed Gerlach Mrs. Willard Walbridge Frank Mancuso Barry Galloway Jim Walker Frank Mann Dick Gottlieb Bernard Wolf SPONSORS GOLD PATRONS Peder Monsen Johnny Goyen Wallace S. Wilson Mr. & Mrs. Leland Anderson K. S. "Bud" Adams Mrs. Carroll Masterson Mrs. Pat Haggerton Nita Weill Automated Business Forms Stanford Alexander John J. Moran Wm. E. Holke Mr. Dale Wrenick Isaac Arnold Reuben Askanase Joe Moss Dick Hulbert Frank Waters John A. Beck Mrs. I. Alexander Mrs. John Martin Houston Host Hotel R. W. Wood, Jr. Brawner Paper Co. Maurice Aresty Bob Mathis Frank Horlock Jack Wells Borden Dairy & Services Harry Battelstein Richard Mace Ms. Norma Howard Joe Weiser Mr. & Mrs. Cecil N. Cook Mr. & Mrs. Whitfield Marshall Leon Jaworski A. R. Busse & Associates Louie Welch Mr. & Mrs. Ben A. Calhoun Mr. I. S. Brochstein 1. L. Miller John Jamail Leilabeth Crispin Ray Miller J. Johnson, Jr. H. Merlyn Christie Mrs. W. L. (Jane) Barfield Mrs. S. M. McAshan Dick John R. P. Bushman Public Service Directors of: Caniff Engraving Co. Dr. Alice McPherson Bernard Johnson Coca Cola Bottling Co. Lloyd Bentsen III Larry McKaskle Mrs. Gaylord Johnson KHOU TV Jim Brock Dunham & Hunter, Inc. James McConn Irvin Kaplan KHTV TV Mrs. M. M. Feld Battelstein's, Inc. James McRae Leo Kern KPRC TV Mr. & Mrs. Hebert J. Frensley Mr. & Mrs. Thomas Blake Jim McDonald Carmen Knebel KTRH TV V.W. Frost Paul Boesch Ed Noret Mrs. Jake Kamin KURL TV Fulbright, Crooker, Jaworski Norman Bock Gus Nelson Miss Natalie Loehr Houston Disposal Service Mr. & Mrs. Ralph Balasco Jim Olivarri Nancy Landau KCOH AM Mr. & Mrs. L. G. Hubele Charles Barker Ms. Dee Osborne J. Edwardo Lloret KENR AM Murrell Johnston Abe Battelstein E. Weber Ogden Jim Lias KIKK AM John Jamail Properties Mrs. J. Curtiss Brown Linda Pickel Bubby Levy KILE AM The Nathan J. Klein Fund O. Dean Couch, Jr. David Pasternack J. Hugh Liedtke KILT AM Louis Kaplan Richard Colt Louis Pearce, Jr. H. L. Lively KNUZ AM Mrs. Henry S. Meyer W. S. Cochran III Billie Perlman James E. Lyon KODA AM M & M Ambulance Co. Joe Cassady S. W. Pearson Jerry Lamberbeck KPRC AM Elizabeth Alexander Price Mrs. Edward Rotan Hermon Lloyd KTRH AM Elaine Cargill Mr. & Mrs. C. W. Pierson Louis Deutser Ben Rogers George W. Strake, Jr. KULF AM Rice Hotel Laundry Chas. Rathbun S. J. Shelby KXYZ AM SAM Office Furniture Renee Danziger Don Rossi Jon Schumway KYOK AM Leon Davis Sterling Electronics Ranger Insurance Carl B. Sherman KAUM FM Stanley Supply Co. Mylie Durham, Jr. Judson Robinson, Jr. Dr. William Spencer KLOL FM Schuler & Wohlt Michael DeBakey David Read Joycelene Sawyer KLYX FM L. L. D. Tuttle, M.D. E. C. Dorrah Virginia Ribb J. Swann Jay Traylor John Dunn Homer Ford Texas Commerce Bank The Houston Chronicle Tel Tex Mr. & Mrs. J. M. Edward Ed Farrell David J. Turrell The Houston Post Mr. & Mrs. David Winterman Mrs. Fletcher Emerson Mr. & Mrs. Aron S. Gordon Robt. F. Tyler The Houston Tribune Waldman & Co. Interiors Mrs. Franklin C. Fisher, Jr. H. B. Gordon David M. Underwood The Westside Reporter Wilson Fire Equipment W.S. Farish III Larry Groce M.R. Underwood FUN Magazine Wilson Stationery J.R. Frankel John Gehbauer Randy Villasana The Pasadena News TIRR this is what it's all about On behalf of the TIRR Benefit Cam- paign Committee, | wish to express our appreciation to those of you who have worked SO diligently to make this first TIRR Benefit possible. Proceeds from this evening's show will enable TIRR to continue their pio- neering efforts and to expand their re- search and rehabilitation programs. Thank you again for your interest in the Institute and your efforts. Hang d Batulatun Harry 1. Battelstein Chairman "JOUF ourfirst Texas Institute for Rehabilitation and Research 1333 Moursund Avenue Texas Medical Center Houston, Texas 77025 GEORGE BUSH October 18, 1996 Dear Lex, BUSH LIBRARY PHOTOCOPY - GEORGE BUSH HANDWRITING For your information, enclosed are copies of letters I fired off to Bengt Lindqvist, Marca Bristo, and Susan Parker. I loved yesterday's luncheon. Well done, my friend! Warm regards, G Bl Mr. Lex Frieden Senior Vice President The Institute for Rehabilitation and Research 1333 Moursund Houston, Texas 77030-3405 10000 MEMORIAL DRIVE HOUSTON, TEXAS 77024 P.O. Box 79798 Houston, Texas 77279-9798 ay Bush Postage and Fees Paid Mr. Lex Frieden Senior Vice President The Institute for Rehabilitation and Research 1333 Moursund Houston, Texas 77030-3405