Minutes after the March 22 crash of USAir Flight 405 at New York's LaGuardia Airport, Dr. James A. Block had torn his way out of the sinking airliner and waded the icy waters of Flushing Bay to safety.
Dr. Block -- then president of University Hospitals in Cleveland and soon to become president of Johns Hopkins Hospital and Health System -- found himself in an ambulance beside another, more seriously injured crash victim, racing to Elmhurst Hospital in Queens.
Unaware of his own injuries, he pitched in to help treat the other man, at one point helping to resuscitate him when he stopped breathing.
It wasn't until he got to the hospital and was handed a mirror that Dr. Block, 51, became aware of his own lacerated head and hands, broken nose and hypothermia. He was hospitalized for 10 days.
Three and a half months later, safely settled into the comfortable ground-floor office of Hopkins' former president, Dr. Robert M. Heyssel, Dr. Block still marvels at it all.
"I didn't have any sense of being injured at all," he said. "In that kind of a situation, you just function on a different level."
To former associates in Cleveland and in Rochester, N.Y., Dr. Block has always seemed to function on a different level, breathing new life intohealth-care institutions.
Dr. Block is a "visionary," said Dr. Paul F. Griner, chief executive officer at Strong Memorial Hospital in Rochester. At the same time, "he is politically astute and very diplomatic. He understands the politics of change and he's able to . . . bring people to consensus very effectively."
But he is more than a skilled institutional mechanic, they say.
"He is dedicated to the care of the less fortunate. He sees health care as a mission as well as a business," said Dr. Donna I. Regenstreif of the Hartford Foundation in New York, who worked with Dr. Block in Rochester.
Tall, slim and soft-spoken, Dr. Block might pass for a Kennedy. His thick crown of white hair makes him easy to spot at crowded functions.
He says he enjoyed wading into a crowd of Hopkins employees at a recent welcoming party. But he strikes some as cool and aloof.
"I knew of his accomplishments from Rochester, but I thought he was a little standoffish," said Dr. Edgar B. Jackson Jr., associate chief of staff at University Hospitals in Cleveland.
"I learned later it was shyness. The only people who dislike him do not know him," he said. "The deeper you go, the better he looks."
He looked good to the trustees at Hopkins, who picked him in January to take over July 1 as president of an institution twice ranked by doctors in a U.S. News and World Report survey as the nation's best.
Dr. Block's domain -- the Johns Hopkins Hospital, Francis Scott Key Medical Center and Johns Hopkins Medical Services Corp. -- also constitutes one of Maryland's biggest private employers, with 14,000 full-or part-time employees and gross revenues of $612 million in 1991.
He'll work beside Dr. Michael Johns, dean of the Johns Hopkins School of Medicine, who oversees Hopkins' teaching and research.
"The opportunity to work with the quality of people here, and with Michael Johns in particular, was very difficult to turn down," Dr. Block said.
"I also have a certain sense that these are extremely difficult and challenging times in America, and health care is not immune from the stresses of a society facing very fundamental change," he said.
HTC "Dr. Johns and I are keenly aware that we have to re-evaluate what we're doing, adapt and lead" in addressing issues of health-care affordability and access, biomedical science financing, AIDS, drug abuse and violence in children, he said. "This [Hopkins] is an institution that has to thrive."
Taming the giants
Although he was trained in pediatrics, Dr. Block is fascinated by large, complex organizations and has spent most of his medical career trying to make them work better.
"To the extent that you can help them unleash their remarkable talent and energy, it's very exciting and very rewarding," he said.
L Institutions do seem to thrive under Dr. Block's leadership.
While head of ambulatory services at the 400-bed Genesee Hospital in Rochester from 1971 to 1979, he transformed the hospital's ailing outpatient clinics into a thriving physicians' group practice, adding middle-class patients to what had been mostly Medicaid and charity clientele.
In 1979, Dr. Block tackled rising health-care costs and stifling state regulation as president of the nine-hospital Rochester Area Hospitals Corp. (RAHC).
Inspired in part by Maryland's Health Services Cost Review Commission, RAHC won government approvals for a cooperative regional rate structure that controlled hospital cost inflation while allowing hospitals to profit from more innovative and efficient operations.
Costs at Rochester hospitals remain below the national averages.