For more than a century, medical schools and academic campuses were largely separate in Texas. Though new medical technologies and drugs-conceivably, even a vaccine instrumental in the prevention of a pandemic-might be developed on an academic campus such as the University of Texas at Austin, there was no co-located medical school with which to collaborate. Faculty members were left to seek experts on distant campuses. That all changed on May 3, 2012, when the UT System Board of Regents voted to create the Dell Medical School in Austin. This book tells in detail and for the first time the story of how this change came about: how dedicated administrators, alumni, business leaders, community organizers, doctors, legislators, professors, and researchers joined forces, overcame considerable resistance, and raised the funds to build a new medical school without any direct state monies. Funding was secured in large part by the unique willingness of the local community to tax itself to pay for the financial operations of the school. Kenneth I. Shine and Amy Shaw Thomas, who witnessed this process from their unique vantages as past and present vice chancellors for health affairs in the University of Texas System, offer a working model that will enable other leaders to more effectively seek solutions, avoid pitfalls, and build for the future.