James 'Red' Duke, iconic surgeon who started Life Flight, dies at 86

Dr. Red Duke, on the Life Flight Helipad at Memorial Hermann - Texas Medical Center on June 2, 2008. Dr. Red Duke, on the Life Flight Helipad at Memorial Hermann - Texas Medical Center on June 2, 2008. Photo: Robert Seale, Robert Seale Photography Photo: Robert Seale, Robert Seale Photography Image 1 of / 26 Caption Close James 'Red' Duke, iconic surgeon who started Life Flight, dies at 86 1 / 26 Back to Gallery

Dr. James "Red" Duke Jr., Houston's iconic, cowboy-style doctor who delivered homespun health advice on nationally syndicated television and founded the Life Flight helicopter ambulance system, died Tuesday. He was 86.

Duke, a trauma surgeon who attended to Gov. John Connally on the day of President John F. Kennedy's assassination, succumbed to natural causes at Memorial Hermann Hospital in the Texas Medical Center. He had been in declining health the past year.

"Red was a true pioneer in medicine for our community - a visionary in trauma care, a dedicated doctor, a superb educator, the larger-than-life figure that everyone knew," said Dan Wolterman, president of Memorial Hermann Health System, where Duke practiced for four decades. "His personality was so contagious. You couldn't help but like Red and want to engage him in conversation. He was everyone's friend."

His passing was announced Tuesday evening in a statement from his family issued by Geo. H. Lewis & Sons funeral directors.

"To countless colleagues, friends and patients, he was a skilled physician, innovative healthcare provider, exceptional communicator and dedicated conservationist," the statement said. "We, however, mourn him as a caring father, grandfather and devoted brother who will be deeply missed by his family.

It was Duke's colorful, country-boy style that captured the public imagination - the trademark bushy mustache, chewing tobacco habit and Texas twang. He dressed in faded jeans, bolo ties and cowboy hats, called most everyone Bud or Babe and spoke in a vernacular known as Dukeisms. "It ain't the fall that's so bad," he'd say, crusading against preventable injuries. "It's the sudden stop that hurts."

The images were so rich, prime-time television exploited them. Duke was the model for the 1987 television show Buck James, which starred Dennis Weaver as a country doctor at a Houston academic hospital. Weaver shadowed Duke for two weeks to create the character.

Duke had already gained a national following from his non-fiction doctoring on television. He first came to the public eye when Life Flight was featured in a 1979 prime-time documentary. He was such a natural that the University of Texas Medical School at Houston, where he was a professor of surgery, choose him to give its Texas Health Reports. These were short, folksy but no-nonsense segments on everything from proper nutrition to preventing skin cancer that ran on local newscasts in 30 states. He also hosted the PBS series "Bodywatch."

By the late 1980s, his profile was so high he was talked about as a candidate to succeed Surgeon General C. Everett Koop. In a 2012 tribute, U.S. Rep. Ted Poe, R-Houston, summed up Duke's appeal as "John Wayne in scrubs."

"Dr. Duke has the personality of an old-fashioned country doctor that makes house calls but knows people and medicine like no one I have ever met," Poe wrote. "(He) is somewhat of a phenomenon to foreigners (who don't live in Texas) because of his simple, straight-shootin' style. People are drawn to him because he has the rare ability to put a complicated subject into simple terms everyone can understand. But don't let him fool you. He is a world-class surgeon trapped in a Texan's body."

Duke, who acquired the nickname Red because of his curly red locks, was born Nov. 16, 1928, in Ennis, a southeastern suburb of Dallas. Shortly thereafter his family moved to Hillsboro in central Texas, where he picked cotton, dug ditches and delivered the Dallas Morning News and the Saturday Evening Post. Hunting and fishing in the surrounding countryside, he became lifelong friends with another redhead, Willie Nelson. Later, as a doctor, he was given to bursting into Nelson songs without warning.

Duke, a Southern Baptist, originally intended to go into the ministry. As a boy, he had asked his mother whether a preacher or a doctor made more money, and even though she said a doctor earned more, he decided to become a preacher. He went on to earn a divinity degree at Southwestern Baptist Theological Seminary in Fort Worth before he decided medicine was his real calling, motivated by a book he'd read on Albert Schweitzer.

He attended medical school at UT Southwestern in Dallas, then did his surgical training at Dallas Parkland Hospital, where he was on duty on Nov. 22, 1963, when Kennedy and Connally arrived after being shot by Lee Harvey Oswald. Accompanying the chief of surgical services, Duke arrived at a trauma room where Kennedy lay when he was told a patient across the hall needed help, too. There, Duke saw a man lying on the table, dressed in a dark suit and a bloodied dress shirt.

"I don't know when I finally realized it was the governor of Texas," Duke recalled in 2013.

Duke found a serious gunshot wound that needed immediate treatment. He quickly closed the wound and inserted a chest tube, and the governor was rushed into an operating room, where surgery proved successful.

After a stint as an academic surgeon in Afghanistan, Duke came to Houston in 1972, joining UT's new medical school, then just two years old. The school had no buildings, and its surgery department had just three members at the time. Duke would help build a program that culminated in the establishment of Memorial Hermann's Level 1 trauma center, now the nation's busiest.

During that time, he also quickly realized the potential of the helicopter landing pad that had been built at Hermann Hospital and began pushing for it to be used for emergency patients. In 1976, the idea became Life Flight, considered one of the premier air ambulance services in the country.

"He was the Life Flight champion," said Dr. Kenneth Mattox, a trauma surgeon and longtime chief of staff at Ben Taub General Hospital, which operates the city's other Level 1 trauma center. "He was a gee-whiz character who had a practical approach to the medical system and medical problems. He knew how to make things work."

Read more about Duke's legacy on HoustonChronicle.com.