The founding dean of The University of Texas Medical School at Houston, Cheves Smythe, M.D., came to the school in 1970 and established its faculty, overseeing the curriculum, building its infrastructure, and shaping its future. He served as dean from 1970–75 and as dean pro tem from 1995–96. He has continued to serve on the faculty since that time, with three leaves of absences, including one during which he served as the dean and later chair of the department of medicine at the Aga Khan University of Health Sciences in Karachi, Pakistan. He has had continued to have an influential role on the educational program and in the field of geriatrics at the Medical School. He is retiring after 41 years of service to the Medical School.

How has the Medical School changed since you were first named dean?
It’s bigger; it’s increased logarithmically in size, so it’s not as personal, less warm. But it’s more productive. It’s a tradeoff.

What are your favorite memories of the Medical School?
Friendships—everyone on the staff, the students, faculty, and supporters in the community. First and foremost it’s the people. There’s not a particular episode I can think of now.

What are you most proud of in your career?
I might surprise you that it’s not a memory from here. In 1966, I was involved in changing the leadership of the South Carolina Medical College from being run by the state medical society to broader representation. And in 1982 I became dean of the Aga Khan Medical School, which went from being 89 acres of sand to a successful school—it has really taken off.

What was your biggest failure—and what did you learn?
I couldn’t hold a job. I’m an impatient man, and I want to change too much too fast. It makes people restless, although the changes eventually get made.

What has inspired you?
I got into Harvard Medical School without an interview. The associate dean said he wanted to meet me because I had written an honest letter about why I wanted to go to medical school. I wrote that I didn’t want to be a lawyer and being a doctor seemed like a good way to make a living. I’m not inspired to care for the world.

That seems at odds for a medical school dean who must inspire students who enter medical school starry-eyed, wanting to care for the world.
The role of a dean is not to inspire students. The role of the dean is to provide resources to give to the faculty so they can set the values for students. The dean’s role is a background, not a forefront, position.

What will you miss most about the Medical School?
I don’t have sense enough to lead an unstructured day. The residents and students keep you mentally sharp.

What do you think the future holds for the Medical School and the practice of medicine?
The United States is slow to adapt to the change that Europe and others have already undertaken. This country is wasteful, and we can’t have everything we want. Rationing is a dirty word, but we must have more testing and a more stringent definition of benefit. To do away with waste is imperative. In addition, the molecular biology revolution will change care.

What advice would you give to students starting out in our medical school today?
I tell students and residents to assume the world in which they move around today will be different in the future and to maintain an open mind about health care.

What challenges do faculty have today that they didn’t have 40 years ago?
Forty years ago was a great time to be in the medical school business. The federal government was funding us; the NIH was providing startup funding. Nowadays, the competition for grants can only grow, and clinical faculty are expected to earn their way.

What has kept you here at the Medical School?
I’ve always written myself a letter when other opportunities came along—listing the pros and cons. And I have moved—the university let me go to Pakistan, and I took a sabbatical at UCLA. But things were always working here with more reasons to stay than move.

What else would you like to add?
People often ask me why I came here. I came here for opportunity and growth. And just because Houston and the Medical School have grown, that doesn’t mean that opportunity and growth are no longer around. The future remains very bright, even though it is a tough economic climate for health care.

-Darla Brown, Office of Communications