Program Development

Neonatal Intensive Care Unit/NICU Transport

Dr. Robert Arrington described the start of neonatal transport, and the first NICU at ACH (Arrington interview here.) . “The federal government back in ’74 or ’75 solicited proposals from states for federal funding to improve the outcomes of pregnancy, IPO grants. With the help of Senators McClellan and Fulbright, Arkansas got one of the thirteen IPO grants. It was a fair amount of money, $4 million over 5 years or something like that. Well the problem was we did not have the facilities. Anywhere! The money came to the Arkansas Health Department and in the first year we got $65,000 of that earmarked to buy a newborn transport van. Children’s didn’t have one. In fact, Children’s didn’t have a nursery. So then I had to look for someone to accept the ambulance. This was like ’76 or ’77. I went over there and visited with Leland McGinnis, the administrator at Children’s. I explained the situation, and we had to do something about newborn care here in the state and that I had the money to get this ambulance but I couldn’t find someone to run it. So I talked to him 20 minutes or so. At the end of the time he leaned across his desk and he said emphatically, “We will do it!” So Children’s Hospital became the recipient of this van that we had bought with money through the Health Department. Then we began doing transports when we didn’t have a nursery at Children’s. We had gotten to a point at UAMS where we had to close the nursery because we didn’t have enough nurses. So David Pryor was the Governor and he formed a Blue Ribbon Committee to address the obstetric and newborn issues here in Arkansas. They developed a written proposal around a concept called “Regionalization” where you have levels of care from Level I, Level II and Level III which would include a Neonatologist and high risk Obstetricians. The report was given to Governor Bill Clinton as David Pryor had become Senator. The Clinton administration got legislation passed in their first session and appropriated money to build a nursery at Children’s. It went into what was called at that time a “boy’s ward” and a “girl’s ward” on the first floor. They took one of those wards and built a twelve bed nursery that opened in March, 1980. So finally our van had a place to bring babies back to. We began filling that nursery up very quickly and started doing more and more transports.” Steven Hanley documented in his History of Arkansas Children’s Hospital that the neonatal transport logged more than 9,000 miles in its first six months, transporting 55 newborns from hospitals across the state. Dr. Arrington went on to note, “Well first of all we ran out of room in the first 12 bed the nursery. We had to expand it in the girl’s ward and we went to a 30 bed nursery. Again we filled that up as we got more patients coming in with the transport system. So then we had to go upstairs and we added 17 beds; we had a 47 bed unit then. So we went from no nursery, to a 12 bed nursery, to a 30 bed nursery, to a 47 bed nursery, to a 52 bed nursery, to a 75 bed nursery, to a 100 bed nursery and all of that was driven by the capability of doing transports quickly. We have gone from the original 2 neonatologists; we now have 23 neonatologists. We have 9 pediatricians in our section who take care of the less sick babies so we have a pretty big operation now.”

 

Cardiology

Dr. J.B. Norton, the first major recruit by Dr. Robert Fiser, served as Chief of Cardiology from 1975 to 1996. Dr. Norton recalled his early days at ACH. (J.B. Norton interview here)   “There were a lot of major challenges. When I first arrived there was no facility at the little Children’s Hospital for subspecialists of any kind so I was based at the University Hospital, which had a very meager Pediatric facility. We didn’t have a real pediatric heart surgeon to work with. I needed to find a pediatric heart surgeon. I needed a facility to really care for the children with complex heart disease and I needed a cardiac catheterization lab. I explained what we needed at a board meeting at the Children’s Hospital. They were very supportive and said ‘Well gosh we can’t possibly put that kind of money’ – we needed about $400,000. At that time I became acquainted with a very wealthy man here in town through some committee work at our church. I knew Frank Lyon had the resources to help and I knew he had been very interested in philanthropy. I went to Frank Lyon one day at his office and I told him what I needed. He said, “Well Dr. Norton I am not going to give you $450,000, but I’ll give you $50,000 and I’ll help you raise the rest.” A week or so later his office called and said “Meet him at the airport, the private side of the airport, in the morning at 7:00.” I went to the airport and there was a private airplane of Worthen’s Bank President, George Worthen, who was on the board at Children’s and he and Frank knew each other. They brought along the Development Director from the Children’s Hospital and we flew to Tulsa. We went up to the Mabee Foundation in Tulsa and Frank Lyon told the guy there, he said “I want you to come across with some money for this gentleman. We are trying to build a Children’s Hospital and a first class Children’s Hospital in Little Rock and we need you to help get it started.” We came away with $400,000. With some of those early facilities that were really first class, we were able to recruit Dr. Steve Vandeventer, a pediatric heart surgeon from Harvard, who he brought a whole team with him. And then things just began to move very quickly and we were able to begin to do what Bob Fiser had originally asked us to do; to start training young people in general pediatrics, but letting them watch senior faculty take care of patients in the most sophisticated way. Working with the heart surgeon we became known, at least in my particular field, and I know other fields as well around the country as “Gee, Arkansas Children’s Hospital is doing first class work.” We began to get referrals from other states and other places. Patients who had been to Houston, for example, found out that they could get good care right here. We had terrific support from the Children’s Hospital board in terms of increasing our physical plant and Bob Fiser made that happen.”

Dr. Richard Readinger was the first Cardiologist hired by Dr. Norton who joined Drs. Tom Dungan and Florence Char. By the time of his retirement in 1996, Dr. Norton had added 8 new pediatric cardiologists, including Drs. Sylvia Angtuaco, Renee Bornemeier, Chris Erickson, Elizabeth Frazier, Ernest Keil, Michele Moss, Richard Readinger, and Paul Seib.

 

Radiology

Dr. Joanna Siebert, who served as Chief of Radiology at Arkansas Children’s Hospital from 1976 to 2002 recalled the early days of Radiology. (Joana Seibert interview here) “For us it was exciting to start a department of Pediatric Radiology at Children’s. When I got there they had one x-ray room where you would do regular x-rays, just film, lamps, things like that. Then they had a fluoroscopy room where you did fluoroscopy looking into a mirror. I had done that maybe once or twice in my residency; it was kind of an ancient art. And we also just read films. There was no reading room where you could really do rounds very well but the hospital was very supportive. Very soon they were able to get another x-ray unit that was modern and the Cardiologists, Drs. Norton and Dungan, needed a kind of special room. And so together we did it jointly where Pediatrics and Cardiology used that room. We had these big multi-film viewers where we would put the films, instead of into stacks, where we would read films and also clinicians would come in and look at their films on these big multi-film viewers. Each of our teams would have a special place on there so all of the films would be right there. It made rounds a lot easier. Radiology was being adapted to the needs of the clinicians instead of Radiology being adapted to the needs of the Radiologists.” Dr. Arrington recalls “The growth of Radiology played a giant role in what we were able to do in Neonatology. I remember the first time Dr. Siebert ever rounded with us in the nursery back before digitization of x-rays. We had all these x-rays just all over the place and she couldn’t stand it. We would have to dig through them to find the comparative x-rays. So the first thing she did is get this thing called a “panorama scope” which is kind of like a scroll, a motorized scroll, and it had plastic that would go from one spool to the other so that you could put x-rays in it. So we went from having these piles of x-rays to having the x-rays in sequence, day-to-day, patient-to-patient. We could sift through their x-rays and compare them to previous days. This was her first innovation for us that made life so much easier in the nursery. And she built a tremendous radiology group. We started having daily rounds and we would go downstairs physically every day and look at every x-ray with a Radiologist.”

 

Other Programs

Several other important clinical programs at ACH had their start in the later 1970s. Dr. Daisilee Berry began treating patients in the Hematology/Oncology Clinic in 1976. Dr. Betty Lowe started the Rheumatology Clinic to assist in the treatment of children Rheumatoid Arthritis and other connective tissue diseases. Dr. Watson Arnold, who served as Chief of Nephrology from 1978 to 1990, performed the first renal dialysis treatment in 1978, and the Children’s Renal Dialysis Center opened in 1979. The Arkansas Children’s Developmental Center opened in 1979 under the leadership of Dr. Pat Casey. The center’s multidisciplinary team provided diagnosis, evaluation, and recommendations for follow-up treatment for children with a broad array of developmental disabilities.