The Family Man

A family physician’s journey through history

By Kate McCann

Like other houses on Mockingbird Lane, the second home on the left does not impose on passersby, but quietly complements the serene neighborhood. The neat landscaping blends well with a white wood and brick exterior, and the lazy parabola driveway ushers visitors in and gently shoos them back onto the street. At sunset, birds sing from the waving branches of oak, pecan and palm trees native to the Texas Valley as the lengthening shadows stretch into the glow of the day’s last light. When standing before the front door flanked by stately columns, visitors knock softly as if any sound above a polite tap will disturb the picturesque scene.

Everything changes when you step inside the home of Texas’ Family Physician of the year, Cayetano E. Barrera III, M.D.

With his wife, three grown children and their three spouses, eight grandchildren and a vocal 30-year-old parrot, Barrera boasts a large, boisterous family. Screams of laughter from the grandkids whizzing by in a large game of tag add to the happy chaos. Each of Barrera’s children exchange hugs and greetings before splitting off to attend to the kitchen, resolve the youngsters’ short-lived disputes or relax on the back porch swing. With a slight breeze stirring the warm McAllen evening and lifting the grandchildren’s voices above the rooftops, the adults’ conversation ranges from medical issues to shopping to family stories, led by daughters Victoria and Melissa, and dotted with Barrera’s input.

He sees his grandkids everyday and calls himself fortunate that his family has stayed in the area.

“It’s a tremendous feeling to be together,” Barrera says. “Down here you have the support of your family; you bond with them, it’s a form of strength.”

Understanding this familial loyalty gives a good insight into the rest of his life; he has formed a large web of support within the patient base of his family medicine practice, the McAllen community and even around the state. Upon meeting him and sharing stories, anyone would feel as welcome in his company as if at his own monthly family backyard barbecue.

Barrera is one of four partners within the office of Family Physicians Clinic in McAllen, which he joined in 1968 with the late Carlos Godinez, M.D. Described as “diplomatic” and “a pillar of the practice,” Barrera is well respected by the staff and has numerous loyal patients. In their letter nominating Barrera for Physician of the Year, his partners talk about his view of life. It reads, “We can surely state that his most important qualities are his love of life, family, work and community service.”

The rough panels of exposed aggregate that form the outside of the clinic match the other neutral tones of South Broadway Street. Large black letters facing the sidewalk differentiate the clinic into its two roles, one set designating the name of Family Physicians Clinic and its four partners and the other stating the evening hours and name of the Valley Night Clinic. Travel through the glass door, emblazoned with the traditional AAFP family physician insignia, and you’ll stand inside a large two-room waiting area. Within these rooms, televisions spar noisily from opposing corners and a dozen patients sit in a row of chairs that runs along the perimeter. Above the chairs, colorful pictures of cactus flowers, historic landmarks and smiling children brighten the area, most of them reprinted from Barrera’s own photographs of the region.

Barrera shares the history of a watering trough at La Reforma ranch. The ranch originally belonged to his great-grandparents and is one of two ranches that have been passed down through the family for generations.

Passing by the enclosed-glass workspace where receptionists greet patients, another door leads down a narrow beige hallway and into a spacious nurses’ station. The large central desk acts as an axis from which the half-circle of examination rooms and doctors offices extend.

Barrera whips around the area between his office, the exam rooms and the nurses’ station with a white coat, stethoscope and patient file in hand. Here he is all business. He barely pauses to take a phone call at his desk before a green light above his office door signals that a patient is waiting. On his way out, Barrera says that he is one of the “six old guys” still practicing in the Valley, and with some families of patients spanning five generations, the clinic staff and patients really do make up a second family.

A sandy blond-haired boy, not older than 7, comes into the examination area with a cough and a tear-stained face. His father leads him onto the scale from which height and weight measurements are taken and then walks with him into a room to see Barrera. He squeezes his son’s shoulder and says, “My dad used to bring me here to the clinic when I was his age.”

Another patient, Nancy Dowell, smiles as she describes the doctor’s charm. “Dr. Barrera has been my doctor for 35 years and he’s wonderful,” she says. “He cares about me personally and that’s the important thing.”

In their nomination letter, Barrera’s three partners in practice write that the questions on the form are inadequate to encompass all of his virtues. Daniel Guerra, M.D., Leonel Moreno, M.D., and Homero Rivas, M.D., cite Barrera’s “genuine goodness.”

“[Barrera] is an excellent physician who is very caring, yet professional when it comes to our patients and our office as a whole,” they state. “He is the most impressive, most compassionate, most wonderful person you will ever meet.”

For Moreno, Barrera has been more than a role model and mentor. He says, “I have two fathers in medicine, Dr. Barrera is one of them.”

Much of Barrera’s inspiration to pursue medicine came from watching his own father, Cayetano E. Barrera, Jr., at work. His father maintained his own family practice office just down the street from where the younger Barrera’s stands today. Barrera remembers taking to the road with his father in the family’s Ford coupe when duty called outside of the clinic.

“I went on house calls with him to ranches that were 45 or 50 miles out and saw how much good he was doing,” Barrera says. “He was well respected in the community and people looked up to him.”

Barrera, Jr., was something of a Renaissance man, with a universal knowledge of ranching, farming, citrus tree and rose grafting, music, engineering and history that sparked his son’s interest in many subjects. But when his son was still young, Barrera, Jr., was struck with an illness that would force him into early retirement and eventually claim his life.

“After his father caught tuberculosis from one of his patients he knew he only had a few years left, so he taught him everything he could about history, ranching and genealogy,” says Barrera’s daughter, Victoria Cappadona. “That’s a lot to tell an 8-year-old, but he remembered it all.”

“I saw father everyday during that time that he was retired and he read to me and told me stories,” Barrera says. “The intensive lessons really helped stimulate my learning.”

Now the son has become the strong, compassionate, respected figure in the community that his father was, actively identifying the needs of his peers and pursuing solutions to problems that trouble the citizens. Among the list of his activities, he has served as the past president of countless citizens leagues, medical associations and museum boards, as the chairman of the board of Rio Bank and as an administrative board member for First United Methodist Church.

“He has always managed to find time to stay involved with the things he enjoys and being a physician gives him a unique perspective in the community,” says Guerra.

Almost 30 years ago, that perspective led Barrera and his staff to notice something about his community. The busy schedules of their patients prevented those who worked or were without transportation during the day to come in for treatment during normal business hours.

“[Before we had the night clinic] we’d finish up at 6 in the afternoon and would go to the hospital to do rounds,” Barrera says. “While at the hospital, we would start getting calls from the mothers who just got off of work wanting to bring their kids in to be treated. We’d tell them to come to the emergency room, but they wanted to go to the office.

“So they’d bring their child over to the office, the kid would vomit all over you, and there was no one to clean up. You’d have wrestle the kid to give him an injection and there was no nurse to help you. So we said, ‘well, let’s just start a night clinic.’”

In 1982 the Valley Night Clinic opened for business. “We started it and just never looked back,” Barrera says. It was the first extended-hours clinic in the area and has never closed, even though holidays and hurricanes, says Moreno. It is also one of the clinics in the area staffed solely by practicing physicians.

Barrera specifically remembers the first patient that the night clinic ever had, a “little old lady” who worked as a teacher. The teacher didn’t trust leaving her class in the hands of a substitute teacher for fear that “the sub would mess up the lesson plan,” so she came to the clinic in the evening and didn’t have to miss a day of school.

Many of the other night clinic patrons bring family members to the clinic once they have access to transportation or free time to spend in the doctor’s office.

above:In his office at Family Physicians Clinic, Barrera rarely has time to rest. Surrounded by shelves filled with his father’s medical books and scores of framed awards and family photos, he keeps a careful eye on a row of lights above his office doorway by which a nurse lets him know patients are waiting.

below: Barrera accepts the Texas Physician of the Year Award from then-TAFP President Erica Swegler, M.D., at last year’s Annual Session and Scientific Assembly in San Antonio.

Barrera joined the McAllen Economic Development Board 10 years ago, at a time when the area faced a dangerous 20 percent unemployment rate. Among other things, fewer people working meant fewer families had access to medical insurance and less money to dedicate to overall health care. His work in 2004 attracted more than 50 companies to the town, bringing good wages and better benefits to the people. Now unemployment has dropped to 5 percent.

“Before, many didn’t have medical insurance, so [the businesses] have helped tremendously providing health care,” Barrera says. “The patients didn’t have insurance, either because they were poor or there was none to be had. A lot of jobs just didn’t pay for medical insurance. Now [our patients] are more willing to come in and get treated.”

Barrera says that his community involvement stems from a long-standing habit of getting into everything, and office manager Marina Gonzales says it is because “he is always willing to help people.”

Although he maintains a strict dedication to conservative medicine, which he describes as a commitment to “tried and true” treatments and medications, Barrera was one of many doctors to be sued in the ‘90s when frivolous Fen-Phen lawsuits plagued medical practice. He had never prescribed the popular diet pill to any patients due to his own instincts and reservations about its effects, but 17 different patients brought lawsuits against him. As it turned out, further investigation caused the attorneys to non-suit Barrera with prejudice, meaning the cases could never be filed again. Unfortunately, since he didn’t go to trial, a court of law could not declare him innocent of the charges, and his once-spotless record reflected the cases. A year of frustrating legalities and a 150 percent spike in his malpractice insurance incited him to lobby the Capitol and tell his story to Texas Legislators.

Barrera had already spent years advocating against frivolous lawsuits as a member of Citizens Against Lawsuit Abuse, a local group in the Rio Grande Valley started by the Valley Chamber of Commerce, so he already knew what had to be done. To rally support for tort reform, he became part of the grassroots movement to cap non-economic damages in medical liability cases, leading to the passage of House Bill 3 and Proposition 12 during the 78th Texas Legislature.

These experiences led to more political work. In his most recent campaign, Barrera is working to place a monument to Spanish-Mexican Tejanos on the Texas Capitol grounds, an idea that came about when Barrera and his wife, Yolanda, were walking around the Capitol building. Noticing something strange, they took a second lap around and counted 31 statues and monuments, but not one with a Spanish or Mexican name. Reflecting on his love of history and respect of genealogy, Barrera knew that the Tejano contribution was too important in the formation of Texas culture to ignore.

So, he formed a committee of Texans that approved the design of Laredo sculptor Armando Hinojosa and set the resolution in motion. He now makes the five-hour trip north to Austin at least eight times a year to meet with sponsors, architects, engineers, historians, board members, legislators and all of the other necessary contacts to ensure the monument will be put in place. Although some funding roadblocks have slowed the process, the final product will be a grand tribute to the Tejano contribution. It will feature a life-size vaquero on horseback corralling two longhorns, a Tejano couple with a baby, a woman retrieving water by a stream, a little boy leading a goat and an explorer gazing over the whole scene.

Barrera has set up his own monument in his McAllen home to honor history and educate those who come after him. Mounted on the wall of one of his children’s old bedrooms hangs an immense family tree, a 3-feet by 4-feet Styrofoam hardboard whose branches document 14 generations of his lineage. It reaches all the way back to Spain, spans five generations of ancestors in northern Mexico and continues through the nine generations in the Valley. Barrera built upon the record inherited from his uncle, who had already spent years of weekends visiting distant relatives in the area and filling four huge branches of the family tree with the names of four generations.

Anytime you want to hear a good story about an “interesting fellow,” just ask Barrera about his ancestor’s interactions with the Spanish conquistador, Hernando Cortés. Otherwise, get him talking about his own life story; it is just as interesting and certainly one for the history books.