It’s 10 a.m. when the attendant behind the thick plastic window presses the button releasing the lock on the entrance to the home. The morning had been brilliant in Pleasanton. The early rays from the late-fall sun seemed to have traveled for days to reach this town nestled in the Valley, and the bricks of the Retama Nursing Home glistened a bit, as though the dew had been heavy. The locked door was immediately inside the front entrance. It bore a sign reading “High Elopement Risk. Use Caution When Opening Door.”

As the door opens, muted silence gives way to chattering, speaking, squawking and laughing—the clap of clipboards on desktops and the mothering voices of nurses to patients. About the hall, elderly people in all states of posture move by while others sit at tables in a living area to the left. Some look over but most pay no attention.

Mabry at the nurses' station of the 
Retama Nursing Home

TAFP’s Physician of the Year, Leah Raye Mabry, M.D., sits at the nurses’ station, directly across from the living area. She pours over patient charts, asking questions of the nurses working in the area and giving direction to the two third-year medical residents from Christus Santa Rosa Family Practice Residency Program. Today is their first day on this rural rotation. When one of them alerts Mabry to my presence, she is startled. She has forgotten she is to be interviewed today. She leans back in her chair and a wide smile spreads across her face overtaking her usual stern demeanor. “Well, I’m glad you’re here today,” she says. “We’re going to be busy.”

 Her day began with a 6 a.m. trip into San Antonio, an hour’s drive north on Highway 281, for a meeting at Christus Santa Rosa where she holds the position of associate director of the family practice residency program. She then came back to Pleasanton to work at her clinic and meet the two residents before going two blocks over to the nursing home. She has a lunch meeting at another nursing home, Retama Manor in Jourdanton, not a half-hour’s drive out of town, and then it’s back to her clinic to see patients until 6 p.m., when a doctor who wants to meet with her is scheduled to drop by. A few days a week she follows an itinerary similar to today’s, and others she spends most of her time at the hospital in San Antonio. All Mabry’s days are busy.

“Jackie,” Mabry calls to one of the charge nurses, Jackie Ventura, “take him on the tour, please ma’am.” Mabry always uses ma’am and sir. Attention to professional and personal etiquette is not a question for her. 

Retama Nursing Home is considered a secure unit housing almost entirely late-stage Alzheimer’s patients. “Their families have given up because their needs are too great,” Ventura says. To the left and right of the nurses’ station are A Hall and B Hall, which consist of resident rooms for those patients who are free to walk around, use the living area and participate in group activities. Past another set of locked doors behind the nurses’ station is C Hall, a ward for patients considered “less functioning.”

Green and white tile floors the hall where several hunched Alzheimer’s patients shuffle past the doors of open rooms. Therein lie more people who stare with children’s eyes. “You can still relate to them,” Ventura says, “but their memory is zero.” For the people here, each simple task is an issue. “They need spoon-feeding,” she says. “Someone has to tell them to open their mouths, chew and swallow. They can at times become very aggressive—verbally and physically. By the time they get here, they are past the point of knowing something is wrong.”

A back exit at the end of C Hall opens to a quaint yard surrounded by a tall privacy fence. Two enormous live oaks stand in the middle, shading the concrete patio. Hand-made wind chimes hang from the branches of the oaks and by the fence grow several hot pepper plants the staff helped the residents plant last spring.

To the left of the patio, a fig tree has grown about 10 feet tall. “That’s Dr. Mabry’s fig tree,” says Scott Peacock, a staff member at the home. She planted it several years ago as a sapling, and it has flourished as she has done her work here.

Mabry grew up in Harlingen at the southernmost tip of Texas in a time and a place where women were considered to be second-class citizens. Her father was a strict disciplinarian, and according to her only child, Angie Mabry-Nauta, he gave Mabry “the fire in her eyes.”

According to a family tale Angie loves to tell, when Mabry was a girl, her father would punish her and her two sisters with a short, leather riding crop called a horse quirt. Being then as feisty as she is today, Mabry took it one day and buried it somewhere on their property. The quirt was never to be found, and Mabry’s father never learned what had happened to it. “That was quite a coup—that she got away with it,” Angie says, “because he was very strict.”

Since she had no job and no fiancé upon her high-school graduation, Mabry decided to go to college at the University of Texas. She had been told that as a woman, she had her choice of three professions—secretary, nurse or teacher. Of the three, nursing appealed to her the most, but she had no set plans when she enrolled, except that she would like to play in the Longhorn Band. Until this time, women were only allowed to be majorettes in the band. None played instruments.

Mabry became one of the first 10 female instrumentalists to join the tradition-rich ensemble, and playing marching snare, she became the group’s first female percussionist. At the governor’s inaugural parade in the first January of her membership, Mabry found herself in the public eye playing the role of pioneer she would grow so accustomed to through the coming years; she became the first woman to march with the Longhorn Band.

Early in her career at UT, Mabry befriended the band director, who sent her to meet with his close friend, the dean of the pharmacy school. Before long, she graduated UT with a bachelor’s degree in pharmacy. Eventually, she moved to Pleasanton and began to practice at Center Pharmacy.

"People were always asking me questions I didn’t have the answers to,” Mabry says. “One lady came in—she was the frosting on the cake—she said she’d been raped and wanted to know what to do.” Mabry says she didn’t know what to tell the woman. At that point, she started trying to get into medical school.

It was 1978, and by this time, Mabry was a good deal older than the usual medical school enrollee. Her daughter, Angie, was 7 years old by then, and Mabry had worked as a pharmacist for more than 10 years. She says the faculty of The University of Texas Health Science Center was reluctant to accept her.

Center Pharmacy shared space with the family practice office of Gerald Philips, M.D., one of the pillars of rural family medicine in South Texas. Philips agreed to help, and together Mabry and he convinced a respected member of the community to write his friend, a state senator influential in medical school funding. This senator wrote a letter to the medical school. The agreement Mabry sealed by handshake for the help she had received was to return to Pleasanton and practice medicine.

Angie remembers when the acceptance letter came. Mabry, her husband and she were living on 5 acres of land outside the Pleasanton city limits, a fact Angie now finds amusing. “My mother did all the work around the property because my dad didn’t like to get dirty and he didn’t know how to fix anything,” she says. “The gender roles in my family were reversed.” Angie and her father had an agreement that anything from the school was to be opened immediately, so when the letter came, they called some friends and threw a surprise party for Mabry.

Soon after, she and her mother moved to San Antonio to start school. Her father would join them there later. During her four years of medical school, Angie recalls her mother moonlighting at pharmacies to help pay the bills.

Mabry spent her three years of residency at Medical Center Hospital in San Antonio, but for her rural rotation, she returned to Pleasanton and studied under Dr. Philips. Mabry now considers him her greatest mentor, and when she finished her training, she opened shop in the same building as his office and became the first woman doctor in Atascosa County.

Initially, the going was difficult for Mabry, and in many ways, it still is. She estimates more than half the area population is Mexican American, much of the population is indigent, and beliefs held about a woman’s traditional role in society run deep here. But this shoot-from-the-hip, tell-it-like-it-is doctor is uniquely equipped for the job. She immediately became involved in the community. She joined the Rotary Club and she made herself available at all times. She joined the various medical organizations and began taking leadership positions in them. Now, her patients come from all factions of the population and she is well known in the community.

Back at the nurses’ station at Retama Nursing Home, it’s almost lunchtime and many of the residents are sitting in the living area around the director of activities. She is calling out the first halves of proverbial sayings while the residents try to say the rest back. “Nothing ventured, nothing …” she prompts. One or two voices reply, “gained,” then the others laugh as they realize they might have known that once.

The two medical residents, Premal Patel and Ana Trevino, stand behind Mabry and watch over her shoulder as she reviews patient charts filled out by the students after physical examinations they have performed. She shows them how to strike out mistakes and where to put CPT codes so the billing will come out right. “You’ll learn a whole heck-of-a-lot about CPT codes this next six weeks,” she assures them.

Mabry compliments the students on their legible handwriting, and pointing to a previous report she says, “Now this is Dr. Pena’s hen scratch. We’re working on her.”

Mabry points out a certain medication in an elderly woman’s chart and quizzes the students on possible reactions. Then she begins to tell them about things to watch for when evaluating nursing-home patients—things like weight loss, constipation and other symptoms of decreased activity. “And it’s very important to have somebody come in the nursing home and do the women’s nails and hair,” Mabry says, always professional kempt herself. “It makes them feel like a woman, and it truly makes them feel better,” she says.

Premal Patel has one of Mabry’s diabetic Alzheimer’s patients, whose tall husband says he’s never missed a day visiting his wife in the two years she’s been in the home. Customarily, he takes his wife to breakfast.

“The first thing he asked me was ‘How’s her blood sugar?’” Patel says.

“And you said?” Mabry prompts.

“I said, ‘It’s a little on the high side. Then I asked [the patient] what she liked to have for breakfast. She said pancakes.” They all shake their heads and smile.

Mabry reports that one of the patients she’d seen that morning was a rancher. “We bought and sold Angus cattle today,” she says, tapping her temple. “I go ahead and go along with the story. I asked him if he had bulls or heifers and he told me how much they cost by the pound. I’ve been on his ranch before, mentally, but this is the first time I’ve bought cattle,” she says.

Mabry’s accomplishments are too numerous to list. On the national level, Mabry is chair of the Commission on Public Health for the American Academy of Family Physicians. Currently, her goal is to develop a five-year plan for how the commission will address such issues as family violence, geriatric abuse and child abuse, gun safety, substance abuse and mental health. She has been a delegate to the AAFP Congress of Delegates and she’s held positions on national committees dealing with topics from vaccine awareness to the judicious use of antibiotics.

She is a past president of TAFP and she has held all the usual positions leading to that post. A keen interest in parliamentary procedure has led her to hold the parliamentarian office for several organizations including TAFP. Mabry says she almost always carries a copy of Sturgis’ parliamentary text in her purse.

Mabry has been on the TAFP Board of Directors since 1991, and she’s on the boards of the TAFP Political Action Committee and the TAFP Foundation as well. She’s held virtually every position of leadership in the Alamo Chapter of TAFP, and last year she won that chapter’s Physician of the Year Award. Meanwhile, she continues to sit on policy committees with the Texas Medical Association.

Mabry is a district examiner for the Texas State Board of Medical Examiners, and she’s been chief of staff at Tri City Community Hospital in Jourdanton. Along with her position at Christus Santa Rosa, her position on staff at the new South Texas Regional Hospital and her private practice, Mabry enjoys privileges at five other hospitals.

She has traveled to provide aid to Honduran citizens. She gives care at community sporting events like high school football and boxing. She’s even been a part of the Beautification for Pleasanton Community Advisory Committee.

Why does she do all this? Once, Mabry saw a phrase written on a statue—“Warrior of destiny.” This is what Mabry believes she is. “Her medicine is her ministry,” says her daughter, Angie.

“Now, I don’t mean for this to sound corny, but I think some people are just born to certain destinies,” Mabry says. “I was born to do this.” But at the end of the day, when her white coat is hung on the rack and she’s relaxed at her desk, she will admit that part of her wishes there had been women role models in medicine for her. When she accepted the TAFP Physician of the Year Award this past summer, she built her remarks around the title of a Kris Kristofferson tune, “Why me, Lord?” She talked about the mundane troubles of long days and missed social events, cold Friday nights on the football field sidelines and disrupted plans—“Why me, Lord?” she asked.

Then she told about how her house had flooded one morning when she had an out-of-town conference to attend, and how the community she had given herself to came to her rescue, and how they gave their hands, their talents and their time to solve her unexpected situation.

“Why me, Lord?” she asked one last time. “Me, because I believe I have a destiny to fulfill as a family physician,” she answered.

On the short walk back to Retama Nursing Home, the evening air is brisk and the people of Pleasanton have gone to their houses. A warm light comes through the windows of the home and the television flickers in the living area, and the place is not as forbidding as it had seemed. Out back, Mabry’s fig tree stands in the moonlight—a reminder that if something goes wrong in the night, Dr. Mabry will be right down the street.