Joey Wahler (Host): He spent 47 years in practice here. So, we're discussing Jackson Hospital's rich history and bright future with our guest, Dr. Thomas Cawthon. He's a retired ear, nose, throat, and facial plastic surgeon. This is Vital Signs, candid conversations with providers who care. Thanks so much for joining us. I'm Joey Wahler. Hi there, Doc. Welcome.

Thomas Cawthon, MD: Hi there. Thank you for inviting me.

Joey Wahler (Host): Oh, great to have you aboard. What a life. What a career. Let's start with the fact that you spent your entire ENT career at Jackson. So, in a nutshell, what first brought you here and why did you stay for so long? Obviously, you loved it.

Thomas Cawthon, MD: Well, that is part of the reason I stayed so long. I did love it and still do. I first came to Montgomery in 1977 after completing a two-year stint in the military at Fort Gordon in Augusta, Georgia. During the time that I was there, my fellow colleague from residency, Dr. Richard Carroll, had already established a practice in Montgomery, and he invited me to join him.

So, I was entertained to come and consider joining him in practice. So that having been said, I signed on the dotted line, and I have been in Montgomery since then until most recently as I retired. I found Montgomery to be a very pleasant place. I have three children who were raised there. They went to school there. Two of them found their spouses there. I was surrounded at Jackson Hospital with great physicians and surgeons and nurses. They were warm, friendly. It made you feel like you were in their home as an invitee. And I tried to convey that to the patient load as it grew. We brought—I say we, Dr. Carroll and myself—we brought in other physicians with us.

We had as many as seven on some occasions through the tenure that I was there. And we brought a quality medical care for the ear, nose, and throat population that was new and introductory and innovative, and it made our practice grow by leaps and bounds. By the time I was completing my tenure, I was seeing third-generation patients. So, they were loyal, they were wonderful, and I still have many good friends, both from the standpoint of the physician pool and their wives and all the families, and certainly the nurses that attended my needs along with others in the paramedical world. So, I left Jackson Hospital after it's time to quit, and go do something else after 47 years.

Host: And three generations says it all, right? So, how would you say Jackson Hospital has changed most since the time you started there, whether we're talking clinically, culturally, or just involving its role in the community?

Thomas Cawthon, MD: Well, you have to look back to the time that I came. The professional office building that I practiced most of those years in was being enlarged, and it was five-storeys, six-storeys tall when I came. We were able to write our own diagram for what we wanted to build into our practice and build upon that.

By the time we left the practice area, 2018 was when we left that private office building. And we at that point in time had taken all the surrounding area. We almost had the entire floor to ourselves as we expanded our footprint. At that point in time, when we came, when I came, Jackson Hospital was kind of the new kid on the block. Baptist Hospital was there. Montgomery also had a Catholic hospital, which was thriving. They closed down as time progressed. Jackson Hospital was still the newcomer. They built a new campus, took all the land around them, expanded their footprint, brought in lots more physicians, lots of additional things that they didn't have to make Jackson Hospital a premier place to go if you're sick and certainly for me, a premier place to practice. I stayed there till I retired for all the reasons I just mentioned, and I still have a very fond place in my heart for Jackson Hospital and Clinic.

Host: It certainly sounds like it. So when you think, Doctor, about Jackson's growth and the challenges it's faced over the years, are there a couple of defining moments or turning points that stand out most?

Thomas Cawthon, MD: Yes, Jackson Hospital expanded its physical plant and built a new hospital as I was in attendance there as a physician. And it's still a beautiful facility. It's unfortunately, as we progress through time, fallen as many hospitals have on some harder times. At the present time, Jackson has filed for bankruptcy and is looking for new ways to manage its footprint, find some financial wherewithal to make it all happen, and to rekindle the fires and get it back running like it did so many years when I was there.

I sure in my heart hope that it happens. Jackson Hospital is needed by Montgomery and its surrounding population of patients. And Montgomery needs Jackson Hospital the same as Jackson needs Montgomery, Montgomery needs Jackson. Having said that, I don't know where the answers are going to come from, but I feel strongly that Jackson Hospital is going to be there for the duration in some form or fashion, because they can no longer give quality healthcare to the Montgomery population without Jackson's presence.

Host: Well said. Very well said. So, going to switch gears a little bit here, Doctor. Pont Rouge was a restaurant at Jackson Hospital during the '60s and '70s, which many people associate, of course, with its connection and history and their appetite naturally as well. What did it represent to you and to the hospital community?

Thomas Cawthon, MD: It was one of the premier restaurants in and about the Montgomery area, and I have very fond memories. My children grew up loving to go to the Pont Rouge. They would be treated to ice cream and things that I would never allow them to indulge in by the wonderful staff there. It was a wonderfully kept secret until it was no longer a secret.

They also had a corridor to the hospital where patients could be wheeled down in their wheelchairs, if applicable, and have a quality five-star meal right at the table with white tablecloths and excellent service. It was open to the public, so it wasn't just a Jackson's thing. Quality food from top to bottom and all those many days and many meals I ate there, I cherish even today. It was a wonderful addition to the hospital.

Host: What was your go-to meal after a long day of work?

Thomas Cawthon, MD: Well, I didn't eat every day there, of course. But when I did go, it was anything from steak to a hamburger to a lobster. You name it, they had it on the menu. So, you could have a quality five-star meal.

Host: That's awesome. Wow. So now, that you've stepped away from practice, how do you view Jackson's current position, which you alluded to a moment ago after its recent restructuring? And what do you think it needs most to move forward here being such a vital, crucial part of the community?

Thomas Cawthon, MD: Well, it's very obvious that money is required to make a hospital run. It doesn't run without that in its boiler, if you will. Where the money's going to come from to rekindle the fire that needs to be getting that boiler up and hot again, I'm not sure at this point. But let's face it, the physical plant is there. The patient load is just waiting for Jackson to rekindle and get back where it can accept the patient load. I hope that it happens. I don't have the answers before me. It may come from federal funding, private monies. Mr. Jackson, who's a distant family member of the founding fathers for whom this facility was named, has infused some monies.

But either the city, county, or the state, or some other source is going to have to come to the rescue of Jackson Hospital. Then, and only then, can they start to adopt a new hiring plan for physicians, nurses, facility needs, new equipment, and things that make a hospital modern and ready for today's future.

Host: Definitely sounds like a plan. Couple of other questions for you. First, you talked a little bit earlier, Doc, about the fact that it's been a family affair for you and your family in the area in terms of a bunch of you growing up here and raising families here, et cetera. What would you say to a provider looking at employment in Montgomery as to why they should consider it, and specifically joining Jackson Hospital? What's the one defining thing that you want them most to be aware of?

Thomas Cawthon, MD: Well, oftentimes I'll have a communiqué with one of the nurses or one of the fellow physicians that are asking me a question about a medical issue. And to the person, they still have a fond, fond memory of what we all did together back in the day. I think that can be reinforced by new physician mode, also nursing hires, and making it all happen yet again. It won't happen overnight, I recognize that. But the footprint's there. All it needs is that influx of physicians and nurses and monies and things to make it all run like it needs to run.

Host: And then, in summary here, you've done such a great job as you just did there laying out what's needed going forward. If and when that occurs, looking ahead, what's your vision for Jackson Hospital's future? What would that success look like for healthcare in Central Alabama with the right support?

Thomas Cawthon, MD: Okay. Having said that, I would tell you that I would go to Jackson Hospital tomorrow for the specific needs of an ear, nose, and throat physician. They're down to two now, mind you, from the seven that we had years ago. So, you're going to have to have more manpower, more operating room time, more operating room staff. Operating room facilities are there. They just need the physicians and the patients to come through there, and that's driven by the physician force and the outlyings which feed the physical plant with the physicians being the ones that take the patient to surgery or do what they need to do in the clinic setting.

So, that all needs to be congealed, and it can be done. I would tell someone who's wishing to look to come to Montgomery, it's centrally located. It has that advantage. It's right on the expressway, I-85 corridor, so you can easily get there in an emergency. And you can go south to the beaches, beautiful beaches of Alabama or Florida. You can go westward to New Orleans, where I trained at Tulane, or you can go to eastward to Atlanta if you want to go to Atlanta to catch a plane, or you have a good airport in Montgomery. You can leave from there and go anywhere in the world. So by and large, it's kind of the middle ground where you can go north, south, east, and west and come home and have a good time and a good life

Host: Absolutely. And you're living proof of that. And speaking of which, finally, Doctor, what are you spending your retirement days doing most right now?

Thomas Cawthon, MD: Well, I have vacated Montgomery and I have a small home down in Fairhope, Alabama, which is near Mobile. It's fairly close to the Gulf of Mexico. I enjoy the water and I enjoy fishing, and I'm right now doing what my wife tells me to do, to stay out of trouble, and I'm being successful most days, but that's what keeps you busy. And she had the statement once said, "If you don't have a project, you're going to die." So, she said, "I'm not going to let you die." She's always gotten me a project to go forward with. So, I don't think I'll be idle in most of my days to come.

Host: I hear you. I hear you. And I think that's probably the best thing for both of you. Well, folks, we trust you're now more familiar with Jackson Hospital's historic past and hopefully bright future. Dr. Cawthon, a pleasure. Congrats again on your long, wonderful career. Great luck in retirement, and thanks so much again for sharing your story.

Thomas Cawthon, MD: Well, you're very welcome. I hope you, when you retire, can enjoy some of the same pleasures that I currently enjoy.

Host: From your mouth to God's ears, I will take it. Folks, for more information, please visit jackson.org. If you found this podcast helpful, please do share it on your social media. I'm Joey Wahler, and thanks again for being part of Vital Signs, candid conversations With providers who care.