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FORT WORTH, TX — Patients would show up at all hours. Sometimes with a broken arm, or a burst appendix, or a baby on the way.

They filled the wards of the 20-bed hospital that Dr. Riley Ransom Sr. opened in 1914, and they spilled into the large convalescent porch.

From early in the morning until late at night, Ransom treated patients in the first African-American hospital in Fort Worth, at 1200 E. First St. A highly trained surgeon, he spent much of his time in the hospital’s operating room equipped with the most modern instruments of the day.

After his patients recovered — and many of them did, despite the medical limitations of the times — they paid him for his dedication with gratitude and sometimes cash, eggs or vegetables from their gardens.

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Essie Ransom, 96, remembers how her father-in-law worked tirelessly, seeing patients at the hospital and sometimes at his home.

“He never turned anybody away,” she said. “He was so anxious to heal them all.”

Nearly six decades after his death, Ransom is being recognized for his hard work in the Texas Medical Association exhibit “Courage and Determination — A Portrait of Pioneering African American Physicians.” He is one of two Fort Worth physicians featured. The exhibit, which chronicles the challenges faced by black doctors from 1837 to 2009, is on display through June at the Texas Medical Association in Austin.

Dr. George Munchus, who is also in the exhibit, dealt with many of the same struggles that Ransom did in Fort Worth as the men tried to meet a huge and ever-growing need for medical care.

The physicians started their practices when the disparity between healthcare for blacks and whites was wide. In the early 1900s, when tuberculosis, diphtheria and other diseases were sweeping the state, there were only 16 black doctors in Texas. Blacks were dying from tuberculosis at a rate three times higher than whites.

White hospitals in Texas often refused to treat blacks, and if they did it was in the basement. At the same time, African-American physicians were not permitted to practice in white hospitals.

By the time Munchus came to Fort Worth in 1922, he had already seen his first hospital in Clarksville burnt to the ground by the Ku Klux Klan. He later established the Negro Community Hospital in Fort Worth.

Ruth Munchus Baker remembers her grandfather making house calls whenever someone needed medical care, even if it meant driving all the way to Dallas.

Through vintage images, maps and words, the exhibit unravels the story of more than 60 pioneer doctors who endured numerous setbacks as they tried to care for their patients.

What struck Dr. Carolyn Evans most about the exhibit was the courage that the physicians showed.

“I was not struck so much by the challenges they faced as what they were able to accomplish,” said Evans, a Plano pediatrician and the first African-American to lead the Texas Medical Association board. “The fact that they endured and overcame despite a lot of obstacles in their way was amazing.”

With no medical schools in Texas, African-Americans often had to travel far to get training, Evans said.

Ransom grew up in Kentucky and attended Pharmaceutical College in Indiana before graduating from Louisville National Medical College. Munchus earned a medical degree in 1909 from Meharry Medical College in Nashville.

Limited access to postgraduate education also hampered the doctors’ efforts to hone their skills. Ransom trained at hospitals in New York, Chicago and the Mayo Clinic in Minnesota before going into practice. Munchus went to Hubbard Hospital in Nashville before opening his medical practice in 1911 in Clarksville.

Texas laws made it difficult for black doctors to practice by forbidding access to their patients in segregated hospitals.

Parkland Hospital in Dallas experimented with allowing black doctors to practice there in the 1920s, said Peggy Hardman, who wrote her dissertation about tuberculosis among African-Americans in Texas. But the white doctors complained so much that the privileges were quickly withdrawn.

By 1954, Texas had at least 138 African-American physicians, but widespread segregation continued in hospitals. The Texas Medical Association denied membership to blacks until 1955.

It was not until 1964 that the National Hospital Association decided that “medical and hospital care must be made available to all without qualification of any kind.”

In Fort Worth, African-American physicians faced the same challenges as other black doctors across the South.

Before the black hospitals were built, African-Americans had to go to the basement of St. Joseph Hospital for care, said Reby Cary, a civil rights pioneer and author.

“By denying them the right to go to the hospital, they denied them the newest technology,” he said.

And that resulted in higher mortality among African-Americans, Cary said.

When Ransom established the Ethel Ransom Memorial Hospital on East First Street, he did his best to provide the most modern equipment, including a Shock Proof Diagnostic X-Ray, described as the best money could buy. The hospital, named for his wife, also boasted a state-of-the-art lab, where routine tests such as those for blood counts and syphilis were performed.

Although the hospital served mostly black patients, some whites did seek medical care there, Essie Ransom said.

In the Deep South, some white patients came to black doctors for treatment of venereal diseases because they did not want their own physician to know about it. Ransom said that was probably the case in Fort Worth too. Her father-in-law served on the State Committee for the Eradication of Syphilis.

For more than 25 years, Ransom tried diligently to make the hospital a success. Family documents show he performed more than 50,000 operations “with a fine average of cures and recoveries.”

When his son, Dr. Riley Ransom Jr., graduated from medical school, he joined his father at the hospital.

Ransom’s efforts were recognized in 1940 when Ethel Ransom Memorial became one of three black hospitals in the nation accredited by the American Medical Association. The facility closed in 1949. In 1959, Dr. Donald Brooks became the first African American physician credentialed at John Peter Smith Hospital.

Even as black doctors such as Ransom and Munchus faced a barrage of challenges, they were well-respected, successful men in the black community.

Munchus, who excelled in business, owned rental property in Tarrant County. When he hired a contractor to build his home at 1130 E. Terrell Ave., it caused quite a stir.

“Not that many blacks had custom-built homes then,” Baker said. “To have a two-story house with modern appliances in the ’40s was really something.”

Ransom accumulated property in Tarrant County. He also owned equity in about 30 oil wells in Cooke County.

“In the black community he was very affluent, well-to-do and respected,” said Lady Chance, who was delivered by her uncle, Riley Ransom Jr.

He always cared about his patients, Essie Ransom said.

“He was good and kind and always willing to go out of his way to help people,” she said. “Even if people weren’t sick, he helped them in other ways.”

Baker said that despite the difficulties brought on by segregation, her grandfather made significant contributions to society. “He might have struggled, but I didn’t see the struggle,” she said. “He had a very good life.”

What physicians such as Ransom and Munchus did for Fort Worth should not be forgotten, Cary said.

“If it weren’t for the black doctors, a lot of us would have died,” he said.

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