A Heart to Serve

by Bill Frist

  I occasionally went along with Dad on his after-dinner house calls, and accompanying him was an education in itself. Dad always toted a black leather medical bag with him, in which he carried his stethoscope, a few thermometers, an assortment of medicines and bandages, syringes, and other basic medical paraphernalia. In those days, a doctor could carry just about everything he could use in that single doctor’s bag. Dad also carried a notebook in his shirt pocket to help him remember names and details about his patients. Before going in to see a patient, he would review his notes, which included tidbits of information about the patient’s family members, personal struggles, sometimes even photos of the children attached to the back of the notebook page. Dad wanted those he treated to know that he genuinely cared about them and their families as people, not simply as “patients.”

  Dad’s bedside manner in people’s homes was not much different than it was in the hospital. He always sat down in a chair, or next to the patient’s bed, laid his hand on the arm or shoulder of the patient, and looked the person in the eye as he or she talked. More than anything, Dad listened; he never gave the impression that he was in a hurry. Although he did not normally spend an inordinate amount of time with any one patient, they all felt that he had given them huge amounts of undivided attention. It was a lesson that would serve me well later in my life.

  Although Dad’s real interest always came back to his patients in Middle Tennessee, he also invested in initiatives that he felt could better the world community. In the late 1950s, he traveled to Mexico on a short-term medical mission trip on behalf of the Presbyterian Church—his first-ever international trip. I do remember going out to the airport as a seven-year-old to welcome Dad home. He’d brought back a stack of black-and-white Polaroid photographs depicting patients lying three people to a medical cot. Another photo showed a missionary surgeon gowned in white, holding lovingly in his arms a young child he had just operated on, a primitive medical clinic in the background. These images stuck with me.

  Dad was profoundly moved by his medical missionary experience. Within weeks, he helped found the Medical Benevolence Foundation (MBF) for medical missionaries, an organization associated with the Presbyterian Church. MBF grew in time to a huge global organization, today sending medical personnel on short-term mission trips, as well as providing medical supplies and equipment to needy people all over the globe, with more than one hundred hospitals and clinics serving hundreds of communities. The seeds Dad planted always seemed to grow magnificently.

  Dad always said he was not smart enough on his own, so he had to rely on others. Often when his patients brought him good ideas, good things happened. For example, there’s the story of Cumberland Heights, a 170-acre recovery and rehabilitation center for those with alcohol and chemical addictions, located about twelve miles from our home. It is worth sharing because it is a typical example of an individual’s single, simple idea blossoming into something larger than ever imagined, with a legacy that will affect thousands and thousands of people for generations to come.

  It all started in early 1964, when Nashville entrepreneur and our neighbor Bob Crichton sought Dad’s professional help in finding the best treatment possible for his alcoholism. After careful research, Dad said, “If you really want the best in the country, you need to go to the Hazelden Clinic in Center City, Minnesota.” Mr. Crichton, then a prominent and well-loved insurance executive in Nashville, thought it terrible that Tennessee, indeed the whole South, did not have an affordable, residential treatment facility the caliber of Hazelden. The need was huge. At the time there were an estimated 6.5 million alcoholics in the United States; the dark stigma attached to being an alcoholic in those days meant that only 10 percent were receiving treatment. Could Dr. Frist, who seemed to be able to fix everything else medical, help him start such a facility in Nashville?

  Dad, as was his manner, listened carefully when Bob came by to discuss the problem, but he told him that it would simply be impossible for him to take on this new project. “Bob, I cannot give it the attention it deserves,” Dad responded.

  That night, however, as he did every night, Dad reviewed the day in detail with Mother as they lay in bed. He told her of the dire need for a drug and alcohol treatment center in Tennessee and how effective the facility in Minnesota was. Mother’s natural sensitivities were affected; she asked a number of probing questions. Just before she and Dad drifted off to sleep, Mom said, “I really pray that someone will step up to make Bob’s vision happen. It could make a lot of people’s lives better.”

  Dad tossed and turned all night, troubled by Mother’s comment.

  By morning, he had totally reversed course.

  At 7:00 A.M., he called Bob Crichton to say he had changed his mind. Crichton was ecstatic. “Where do we start?”

  “We have to get good people who know what they are doing,” Dad replied, already thinking about some prospects. “If we do that, they can go out and hire the sort of people we need.”

  A week later, Crichton called Lon Jacobsen, chief counselor at none other than Hazelden itself. Crichton and Dad asked him to design the Nashville facility, and then to come down to run it. Jacobsen agreed.

  Dad helped lead a fundraising drive, and by the year’s end, more than $284,000 was raised; the groundbreaking ceremony took place on January 13, 1966—a mere six months after the foundation’s chartering paperwork was filed. The doors opened seven months later, and by the end of the year, the facility that Dad had at first said he simply didn’t have time to deal with had treated ninety-seven patients from sixteen states and one foreign country.

  The campus is still thriving today, more than forty-two years later, treating more than ten thousand patients annually and indirectly touching the lives of more than 127,000 family members and friends of the patients. Patients range from the indigent and unemployed, to small business owners and corporate managers, to nationally recognized personalities from the sports and entertainment fields. The initial one-hundred-thousand-dollar commitments that Dad and Mr. Crichton secured have grown today into an annual operating budget of over $26 million.

  The Robert Wood Johnson Foundation still characterizes chemical abuse as “the nation’s number-one health problem,” costing over $144 billion annually. But because of Dad’s willingness to listen to the “yes” of his heart (an epiphany precipitated by Mother), in spite of an initial “no” from his mind, more than two hundred thousand patients have benefited from remarkable rehabilitative programs at Cumberland Heights. In October 2007, the five Frist children and our spouses proudly participated at Cumberland Heights in the dedication of the Dorothy Cate and Thomas F. Frist Family Life Center, given in honor of our parents’ past contributions.

  Dad was part of many stories like that, all originating in the seed of an idea, the recognition of a need, and the follow-through to what it takes to make dreams come true. He had a passion to bring health, hope, and healing to others.

  AFTER GOING TO PUBLIC ELEMENTARY SCHOOL AT WOODMONT, I attended the same private boys’ school, Montgomery Bell Academy (MBA), to which both of my brothers had gone. I was a good student, but I had to work hard. Never the athlete that my brothers were, I lost myself in extracurricular activities, which I loved. My classmates voted me as their president three years in a row. Part of that, no doubt, was because I constantly sought to include people. Cliques rubbed me the wrong way; I reflected my dad’s belief that every individual had something good to offer, so everybody should be included. I couldn’t stand it if I saw someone ostracized because he wasn’t smart enough, wasn’t cool enough, or didn’t live in the “right” neighborhood. It was natural for me to befriend the unpopular guys, and I tried to look for the good in every person, just as I’d seen my mother do when she provided a refuge for our childhood friends when they had gotten into some kind of trouble.

  I loved to write. For a summer job, while still in high school, I worked at the afternoon newspaper, the Nashville Banner, and my senior year I was the edito
r of the yearbook. I followed in my brothers’ footsteps and played quarterback on the football team, though I was never very good.

  Looking back, life was going along well. I was having a good high school experience, my siblings had all gone to college, gotten married, and started their families, both of my older brothers were now on their way to becoming doctors, my sisters were thriving, and Mother and Dad were healthy.

  But for me, everything was about to change.

  I was coasting through my early teenage years, when one summer morning I came out of our house and spied my brother Bobby’s red motor scooter, parked in the garage behind our house. I knew Bobby wouldn’t mind if I borrowed it to take a spin.

  Just before I hopped on, Mattie Belle, a dear woman who lived with us for twenty years working as a housekeeper, saw me and gave me a reprimanding look. “If you’re gonna ride that dangerous thing, you better put a helmet on your head,” she said, nodding toward Bobby’s motor scooter. Mattie led the way down into the basement, where she found an old motorcycle helmet that cousin Johnny had left behind years before. To placate Mattie Belle, I put the dusty helmet on, fastened the chinstrap, and took off on the scooter.

  I was about a block from my house on Bowling Avenue when I spotted a good friend, Phil Brodnax, and his sister Shelly. Honking the horn with my left hand, I started waving enthusiastically—and maybe a bit too energetically—with my right. The last thing I remember was the crunching sound of metal and a heavy thump as the scooter slammed into the back of a stopped car. I don’t remember ducking my head, but luckily the brunt of the impact was absorbed first by my left leg ripping off the handlebars, and then my helmet as I smashed through the rear window. I fell off the back of the car into the ditch on the right side of the road.

  Lying limply in the gutter, I was still conscious, aware of the bright sun and the still-deafening whirring of the scooter’s engine with the throttle stuck wide open. I looked down at my left leg, and a deep twelve-inch flap of skin and flesh, muscle, and blood was my first clue that I was in trouble. I saw the bone protruding through my right ring finger, and when I tried to touch it, it was apparent that my left arm had been completely broken, with my wrist hanging at a right angle to my forearm. Man, I thought, I should have listened to the advice of my parents and never ridden a motorcycle.

  It took the ambulance awhile to get to the scene. An orthopedic trauma surgeon, Dr. Dewey Thomas, fortunately just happened to be driving by and came to my rescue, stopping the immediate hemorrhage. It was Dr. Thomas who spent all night putting me back together. Being just a block from home, Mother arrived on the scene before the ambulance. I recall her calm, reassuring voice telling me that everything would be okay.

  And it was, but before all was said and done, my list of injuries included a shattered right kneecap, multiple broken bones in my hand, arm, and nose, a concussion, and the leg laceration. I had glass embedded in my back that I was still picking out six months later. But I was alive.

  I spent two weeks in the hospital. The accident changed my life. It gave me at a relatively young age my first sense of mortality; I realized that had Mattie Belle not chided me into wearing that helmet, I would have died. Listen to wise counsel. The accident ignited a flame within me, a desire to live every day to the max, to make every day count. That sense of mortality has haunted me ever since. A day that passes is a day gone forever.

  For the next year, I worked on physical therapy, most of which centered on my right leg, since the right kneecap had to be totally removed. I resented having to waste so much time day after day doing leg lifts while sitting on the bathroom counter with weights strapped around my right ankle. Why me?

  During my junior year, I was sufficiently rehabilitated to play football with a knee brace as the second-string quarterback. I was slow and really couldn’t throw the ball very well, but since both of my brothers had been stellar quarterbacks, that seemed to be the natural position for me to play. I rarely got into a game my junior year, but we did go on to win the state championship under the legendary coach Tommy Owen (who claimed more state champions than any coach in Tennessee history). And during my senior year, I got to play behind the “greatest quarterback ever to play at MBA,” according to Coach Owen (though contested by my quarterback brothers). If I ever need to, I can always proudly boast to having played in the state championship game, even though I took only three snaps during the last two minutes, when the game was already well in hand.

  What do you do if you grow up loving sports but suddenly suffer a disabling injury? You find a sport in which the disability can be minimized, and that’s exactly what I did. My cousin Johnny, fourteen years my senior, had learned martial arts during his service in Vietnam. I was fascinated by karate, especially the mystical mind-body interplay. I drove my family members bonkers as I kicked my leg up to the top of the kitchen door archway and then stood in the doorway practicing my stretches, with one leg firmly against the doorway and my other leg stretched to the top of the woodwork. While my friends mastered the conventional sports, I earned a brown belt in karate.

  Another pursuit I came to love was flying.

  When Tommy was gallivanting across the country in his Stinson plane the year he took off from college, he would fly back to Nashville for weekends. He loved flying, and always looked for excuses just to soar through the air for a few hours. It was (and still is, last year flying a single-engine plane from Nashville to Italy) an addiction for him. One Saturday when I was about six, he took me out to the general aviation side of Nashville’s airport (then-called) Berry Field and proudly showed me his cloth-covered plane. The next thing I knew, Tommy was hand-cranking the wooden propeller, and minutes later we were taking off, his excuse this time being that he wanted to try out a new roadside barbecue pit for lunch over in tiny Bolivar, Tennessee. Within minutes, I was hooked. I felt the sense of freedom in being aloft for the first time, the opportunities of being able to fly for just thirty minutes and then be so far away, landing in a tiny town I’d never heard of, borrowing someone’s car at the rural airport, eating a freshly smoked pulled-pork barbecue sandwich for lunch. I dreamed that flying could open worlds for me. Going to bed at night, I’d look up at the pennants from schools all over the country and think to myself, “Now I know how he does it—flying!”

  During the summer before my sixteenth birthday, Tommy and Trisha invited me to come visit them during his military service, when Tommy served as a flight surgeon at Warner Robbins Air Force Base in Macon, Georgia. He and I agreed that my visit would be the perfect opportunity to begin my flying lessons—a detail we didn’t mention at home, so as not to needlessly worry Mother and Dad. It was our secret. I soloed in Piper Cherokee 1969Z a few weeks later, cutting off my shirttail as a memento, as most student pilots do to celebrate their first major milestone in flying. That white shirttail, now framed, has accompanied me everywhere I have moved since. At that young age, flying instilled in me a sense of freedom. I loved the sense of adventure, and I loved that edge of danger. It was skill-driven and it was knowledge-based. Flying also fit my personality. It put me squarely in control of my destiny. It taught me to trust my instruments, a lesson with broad applications, since sometimes in life you need to rely on more than your own instincts. It meant making no mistakes—mistakes meant death, literally. It meant judgment…misjudging the weather had devastating consequences. Most of all, flying gave me a tool that I would use, and enjoy, for the next forty years.

  Like Tommy, I looked for every excuse to fly. While others were playing team sports at MBA, I was running out to the airfield every afternoon to earn my multiengine rating, my commercial license, and my instrument rating.

  Flying has come in handy over the years. I went on during my years at Princeton to run the “country’s oldest collegiate flying club” (which entitled me to a substantial discount of being able to fly for twelve dollars an hour), flew throughout medical school in Boston to go to board meetings as a young alumni trustee at Princeton, boug
ht old and very inexpensive airplanes and then refurbished them to sell, and in my medical years, used general aviation to pick up hearts and lungs to transplant back at Vanderbilt. When I entered politics, flying allowed me to cover the state and meet with people in ways that would have otherwise been impossible. In a single day, I could fly myself across our five-hundred-mile-long state, being with constituents in as many as six events in all three Grand Divisions of the state. Tennesseans want to see and talk directly to their senator in their hometown. Flying made that possible for me. Visiting all ninety-five counties during a session of Congress was made a lot easier by flying. And it all started with an older brother taking his kid brother to get a barbecue sandwich on a serendipitous journey one Saturday afternoon.

  IN THE FRIST FAMILY, PROBABLY BECAUSE I WAS THE LAST OF FIVE, I was always the adventurer, seeking to do things in a different way. All my brothers and sisters had gone to college in Nashville, but I wanted to get away from home, to spread my wings, and to see what life was like where no one knew I was one of the Frist kids, or cared.

  Few students from MBA had gone to Ivy League schools—almost all stayed in the South—but the year before graduation, a good friend of mine in high school whom I looked up to, Gordon Peerman, had toured Princeton and the University of Virginia. He told me how enthralled he was with the gothic structures on the Princeton campus and the teaching strategy of very small classes called “precepts.” Gordon ultimately got a scholarship to the University of Virginia, but his magical description of the faraway campus up north remained vivid in my naïve mind. I’d never known anyone who’d gone north to school.