Memorial Hermann Healthcare System president and CEO Dan Wolterman has dealt with a number of challenging media events in his 11 years since he first joined the system. But none has compared to the notoriety that fell on his doorstep in January when Rep. Gabrielle Giffords and her family selected TIRR Memorial Hermann as her place for rehabilitation from a gunshot wound to the head.

While reforming the healthcare system in America is paramount among Wolterman's concerns, he took a break from focusing on that issue and an hour out of his daily responsibilities of overseeing the largest not-for-profit healthcare system in the state to discuss the ramifications of Giffords' move to TIRR. (The system has 20,000 employees working in 11 hospitals, three of which are in the Texas Medical Center.)

From his office on the 27th floor of the new Memorial Hermann Tower in the Memorial City Medical Center, Wolterman reflected on the attention that Giffords has brought to TIRR.

CultureMap: The shooting of Rep. Gabrielle Giffords in Tucson, Ariz., and her subsequent move to TIRR Memorial Hermann placed the rehabilitation hospital in the national spotlight, didn't it?

Dan Wolterman: Yes, under unfortunate and tragic circumstances. And we were very honored to have the Giffords family reach out to us and inquire about our system and its care capabilities and then actually coming here. And most of that early introduction was done through her husband, Mark Kelly. Mark called very early in the process to me personally. Working with Capt. Kelly and also with the Navy medical team, who assisted him in evaluating facilities around the country, the ultimate decision was to come to Houston.

The flight surgeons, they call them, because the Walter Reed Hospital has a very sophisticated trauma facility, they were out there helping Mark understand her situation and medical care needs . . . With Mark's NASA flight coming up they wanted to make sure that the care would be appropriate. We spent a lot of time not only with the family including Capt. Kelly, but also the Navy flight surgeons.

CM: The flood of publicity and press that landed on your doorstep as a result of that must have been overwhelming.

DW: It wouldn't be overwhelming but it was quite intense, particularly on the day that she arrived in Houston . . . By the time she got here there were media throughout the Medical Center, both print and electronic news media and others, the tabloids, you name it. It was very interesting to manage that situation. That's the biggest media horde that we've had to deal with in my history here. It far exceeded what we had to deal with in Hurricane Ike or even Tropical Storm Allison, the shutting down of the facility. This was intense.

Everybody wanted a piece of the (Giffords) story. Everybody wanted a picture. And the family was adamant about the utmost privacy. They didn't want any pictures to be released. So that was a challenge. To be honest, the mainstream media was wonderful to deal with. They respected the patient's privacy and the family's and the hospital issues that we had to deal with. But there were some that were on the outskirts of mainstream media that tried to push the limits and that tested us at some times.

CM: Has Giffords' presence at TIRR Memorial Hermann enhanced the institutions reputation and could you feel a change?

DW: TIRR for 20-plus years was rated as one of the top two to four comprehensive rehabilitation hospitals in the country by U.S. News & World Report. So it's consistently had a very stellar reputation.

I think at times we Houstonians take for granted just the outstanding health care in general in the community and in this case specifically that we have one of the world's best comprehensive rehabilitation hospitals.

So, yes, in today's media world with instant news and PDAs in your hand, the exposure was phenomenal. It did elevate the status. We received numerous patient referrals from all over the United States and outside the United States. You could sense it immediately. It spiked.

CM: What did that mean for TIRR?

DW: Our problem is that we run full almost all the time, trying to cover this region. It's not just Houston. We're the only comprehensive rehab hospital for many miles outside of Houston. You want to look at the best in the U.S. — Denver has a good one, Chicago, Washington D.C. So they're quite spread out and so we get a quite large referral base.

Since we took over TIRR in 2005, we've added 25 beds to the facility. We were able to do that and that's helped. We will soon be opening an additional 10 more beds with a little bit more of a capital infusion. And we've been able to upgrade some of the rehabilitation equipment and other things that we need for our patients.

CM: We know that TIRR has served a number of high-profile patients over the years including Buffalo Bills tight end Kevin Everett. Are there others you can discuss?

DW: The Texas Attorney General Greg Abbott is a former patient and has done well. The newspapers covered a prominent surgeon in town, Dr. Gene Alford, (injured by a falling tree) and his tragic case. And that was one where we could build him a wheelchair, get him to stand up in the wheelchair and let him go to the operating room. We actually took him to the operating room for months until he got it down.

Most people don't understand that it's not just the rehabilitation. But when you have these either paraplegic or quadriplegic patients, they need special wheelchairs. We design and build the special wheelchairs at TIRR. And so depending on their needs, we can, like for Dr Alfrod, we could build a chair that actually stood him up and supported him and allowed him to use his hands and the gift that God gave him as a gifted surgeon. At the end of the day he would go back to being in the wheelchair and moving on with his life.

It's a real blessing when you go down there. And I think the community could become more aware of what we have here.

CM: How did TIRR and Memorial Hermann come to join forces?

DW: TIRR had a very rich history as a stand-alone member of the Texas Medical Center, focused on comprehensive rehabilitation care. TIRR was able to do fine until the environment of health care changed and they were having a difficult time attracting reasonable managed care contracts from the insurance companies as a single hospital. And they had some other issues of an aging physical plant and some capital needs.

So their board approached our organization about the possibility if we could preserve TIRR in its current state and enhance its capabilities by bringing it under the Memorial Hermann System. And we were able to do that.

We brought it in as a separate and distinct corporation. So TIRR has its own board of directors. About half of the board are original members of the TIRR board and the other half are Memorial Hermann appointees. Today, it's just TIRR Memorial Hermann and it's just become one of us.

That was probably one of the best and easiest transitions we've had of bringing in stand-alone entities into our system.