ADMINISTRATIVE STAFF
PITT COUNTY MEMORIAL HOSPITAL

PARTICIPANTS: James Ross, Gary White, Ralph Hall, Roger Robertson,
Diane Poole, Tom Irons, Ed McFall, Martha Dixon,
Jack Holsten, Tyree Walker, David Hughes, Scott Jones,
John Falcetano, Deborah Davis. Also participating:
Kathy Barger and Sally Lucido.

May 25, 2000

Interviewer: Beth Nelson

Beth Nelson: Who would like to begin?

Tom Irons: My perspective is not really a hospital perspective but I will give you just a little bit because I have to go to clinic in a few minutes. I grew up really in the old hospital on Fifth Street. I grew up in the daytime underneath my mother's feet in her office which was downtown and that's where I went after school every day. That's where I lived before I was old enough to go to school as that was the only choice she had. I believe in 1952 or 1953 there were only two female doctors in Greenville, I believe was a Dr. Ann Huizenga, who was an obstetrician. My mother was the only one with children and she had to take us with her. So we went over there in the evening. We parked in the emergency room lot, walked in through the emergency room and down to the doctors' lounge. That is where we stayed. Until we were twelve, we were not allowed on the patient units. We looked through the emergency room doors every night to see who was breathing and we were allowed to go from there down to the Pepsi machine which was down by where the elevators are in the County Office Building now. It was one of those machines that was horizontal and you slid the Pepsi out and pull up the latch and lift it out. Of course, we never had any money but if I stayed in the Lobby long enough somebody would come along and ask me if I needed a nickel. I remember when it went to six cents too because I had to put a nickel and one penny in that machine. Mr. Ward was known on occasion to actually buy me my Pepsi.

That doctors' lounge was just an old room with chairs and a table and up in the closet there were two jars. One of them had a heart in there from an infant, what was then called a blue baby. My mother would take the jar out and explain to me how the heart worked. The other was a great big jar of ascaris worms which had been removed from some poor child's intestines, which was very attractive to me as well. I saw coming and going up and down that hall every imaginable kind of patient, every imaginable kind of urgent emergency and minor issues. With my mother being the only woman around virtually other than the nurses who always wore starched uniforms and hats, particularly hearing her walk up and down those floors, it went clopity, clopity, clop and I could hear her coming for forever from way down from what was then called the colored wing, and then over into the other section and I could hear her coming down the hall and I would see what she had. Sometimes it was something terrible. I remember a little boy who Frankie Moye's husband's little brother who came in with bulbar polio in 1953. I was sitting there and I heard the gurney bed being rolled down the hall and that was always a call for me to go to the door so I could see what was going on. My mother was up on the gurney bed on her knees with great a great big bag trying to bag this child and I could see what was going on. There was no ambulance in Greenville in that day. The ambulance wasn't available as it was out. The ambulance and hearse were the same thing most of the time. The Wilkerson's ran the service. They got in the back of the family car and when she tried to give that child mouth to mouth respiration all the way to where they could find an iron lung in Raleigh. He died in Wilson. They stopped there and he died there. That was an incredibly powerful memory. The polio ward was up on the second floor and you couldn't go up there but you could stand outside and talk to your friends who were staying up there.

I also remember standing outside under the windows at the back of the hospital and talking to my friends who were isolated on the polio ward. This would have had to have been in 1952 to 1954. My mom was so incredibly busy then. When we came home from school, we often went straight to her office and hung out there. She always made sure we were welcome, sometimes to the point of playing under the exam table when we were very small. At about 5:30 p.m. or so she would put us all in the car and drive to the hospital and we would be deposited in the doctors' lounge for at least an hour and a half. When it was nice out, we could play outside the whole time in the field behind the nursing dorm. There was not much to do, but we became very good at finding the kildeer's nest in the spring, and watching the mother pretend to have a broken wing to attract us away from it. Sometimes it would get really late, when there was an emergency, and someone would come and get us and take us home. Dad was usually still working the hospital or on house calls, so he did not get home until just about our bedtime.

The hospital folks were always nice to us and seemed like family. I remember the warm relationships my mother had with the nurses, lab techs, and even the cleaning folks.

Beth Nelson: Do you remember there being a separate entrance for blacks?

Tom Irons: Absolutely. The emergency department took all comers. Yessiree there was a colored entrance. There was a whole separate unit which met near the coffee shop. The white and colored wings kind of came together there at the coffee shop of the hospital. It was just like at the bus station when you used to be you had a separate window. I think that was all gone by 1953 or so. I can't remember the exact date. I do remember that my mother's office was the first to integrate their waiting room in town. This was about a year before anybody else did. Of course, the waiting room was my living room and I used to play back in the colored waiting room. That was where I played with my friends. When that was obliterated then we all went to the other waiting room but I remember that.

The staff was so small the doctors would rotate call in the emergency department. Everybody took call, everybody took emergency call and you just took all comers. That parking lot was where we played and we played right there on Moye Boulevard, I'm sure, out there in those corn fields and of course, there was a nurses dorm and a lot of those nurses lived in it and you could go over there and most of them were single old ladies, gentle women where you could go there and sit and play with them and they would get things out for you.

Deborah Davis: I remember a couple of things in the old building. I can remember Hilda Norris feeding our first baby that was under two pounds. I think Dr. Shappley was the attending physicians and I can remember watching her actually feeding that baby. I should have been doing something else but I used to go up there and she would be feeding the baby with one of the baby doll plastic bottles and that was literally how they fed those babies. Hilda would sit in a rocking chair and rock the baby and feed her with the doll's bottle.

Tom Irons: If they needed to put a baby on a respirator they would have to use an Emerson tank respirator with a special adapter.

Deborah Davis: I can remember the first four-bed critical care unit was Neuro and it was down on the first floor and there wasn't any such thing as emergency power and I can remember us running drop cords from an Army Reserve generator to keep that unit functioning. I remember the mesh screens in the hallways.

Tom Irons: Oh yes, they were there. Places in the hall were not uncommon.

Ralph Hall: This morning I read Dave's speech that he gave on the CON presentation for the new bed tower and you could just go out and make the same speech today.

Beth Nelson: I wrote that speech and I remember it very well.

Ralph Hall: There were a lot of interesting things in that old hospital that were just amazing to me. I want to tell you that when I came to interview it was storming and the lights went off and the generator came on and Jack, Buck and Rick all took flashlights and went off and investigated. They went down to the generator room and I don't know what they were going to do when they got down there but that's where they went.

Deborah Davis: When the employees went to the cafeteria they had to walk by the Morgue.

Ralph Hall: If they had chicken on Wednesday, which was chicken day, the bones went down the sanitary sewer lines and then the sewage would back up in the cafeteria which was in the basement.

Tom Irons: I remember, for a child walking by that Morgue to get to the cafeteria was one strange experience. We often did that and we would be in the basement for hours.

Ralph Hall: I can remember one of the big issues was whether to put donuts in the cafeteria. I remember the dietician, Lorraine Nobles, she would not put donuts out in the cafeteria.

I remember since I have been here that Joel was getting a lot of complaints about bagels and that the prices were going up and he went out to negotiate and finally we went back to Boulevard Bagels and the guy raised the prices on us.

Diane Poole: I remember we had gypsies. We had the matriarch of the gypsy clan who was in and she ended up dying there. She had been there for a number of days, but they took over one whole waiting room; they went out in the atrium and washed their clothes. They brought in candles and lit them in the room.

Beth Nelson: I remember we had to get special dispensation from the Fire Marshall, I think somebody said, because it was against the fire regulations to have an open flame near oxygen and so I think somebody like Buck or somebody who had to stand by with a fire extinguisher the entire time that they burned the candles to make sure we didn't have any big problem. I think Fred Brown had to go out and tell them to cease and desist the washing of their clothes in the fountain.

Deborah Davis: I remember Rick Gilstrap having the bright idea that we should do an audit of everybody on the payroll and so he decided one payroll day that he was going to hold all the checks. He himself personally handed out every paycheck. He decided that he would never do that kind of an audit again.

Jack Holsten: Kathy, do you remember the story that the hospital couldn't meet the payroll.

Kathy Barger: We were down to $5 million, actually we might have been just a little bit below that. There were a couple of payrolls and Debbie kept all the capital requests on her desk and I told Dave, this was when I was a consultant, you are going to have to go to the bank to get a lot of credit. I went home for Thanksgiving and Dave probably started talking to some banks and stuff and Bill Watson, the county attorney, came to Dave and said he couldn't get a line of credit because we were a public hospital and this wasn't allowed. They never got a line of credit. I guess we just borrowed money from the county.

Ralph Hall: They got a $450,000 loan some place and that is when Bill Watson came and said that we couldn't do that.

Deborah Davis: Also a couple of years after we moved in I had to go to Mr. Leslie's office once or twice a week for him to sign checks and we had to verify that we had the money in the bank. He was then Chairman of the Board. This went on for at least the first year and a half, do you remember, Sally?

Sally Lucido: It went on for at least that long.

Kathy Barger: We were in cash flow problems in the late eighties, in late 1987 and early 1988 and we didn't pay all our bills and we would pick which ones needed to be paid right away.

Beth Nelson: Dave had the idea of getting Betty Bailey, George Williams, John Stallings, Sandra Harrison and Bill Young and Betty Bailey-a group of those kinds of people together similar to this and they could talk and feed off of each other. That is kind of the beauty of doing it like this instead of individually because hopefully you will spur each other's thinking.

Deborah Davis: I remember when we didn't have any money to buy equipment and I think the radiologists actually bought the first piece of xray equipment.

Ralph Hall: I remember when I was on call that Dr. Bowman would call me at 3:00 a.m. and tell me he wanted me to know that they didn't have a certain piece of equipment that he needed in Materials Services.

Jack Holsten: I remember Buck telling me that during this time period you guys were being really tight on supply costs and he used to use a roll of adding machine tape and when it was finished he turned it over and used it again.

Beth Nelson: Was that in the old hospital or the new hospital?

Deborah Davis: No, that was in the old hospital.

Beth Nelson: I have also been told the story that apparently Jack's office had a closet in the back of it and after a while they decided to bust through the closet to allow Buck's office access to Jack's office and he would be in a meeting with a Board member on whatever and Jack would say lets see what Buck thinks about that and he would call for Buck and Buck would out of what everybody thought was a closet and he told everybody that he just kept Buck in the closet for when he needed him. Buck and Jack have each told me that story.

Ralph Hall: I can tell you one big issue was that Sidney Carraway here in Greenvile always sold the hospital typewriters and the typewriters cost around $200 or $300. They came out with new electric typewriters and those jokers cost $800 and when that went to the Board of Trustees everybody knew what a typewriter was going to cost and we were going to pay $800 for a typewriter. That was a big issue.

Sally Lucido: Talking about things like that, I was the first to get a word processor which was a Lanier and at the time it cost somewhere around $12,000 - $14,000 and that had to be taken to the Board for approval. Can you imagine-that was when they first came out.

Kathy Barger: Speaking of Jack, my first experience of being around here we would go into his office where there was a big leather couch and its still around the hospital somewhere and everybody would just sit there and that's where we had our meetings and when Jack was ready for the meeting to get over with, he would just stand up and walk out of the room and we would say we guessed the meeting was over with.

Jack Holsten: It's kind of neat with the culture in this hospital and when we would have the annual retirement party you would see people who had not met in maybe five or ten years they would come down the hall and greet each other and talk. I'll bet there are some good stories. There will be another one on June 8.

Beth Nelson: I will try to attend as I'll bet I could get some good stories there.

Beth Nelson: We plan to kick off the book that is being written with a short vignette about the tornadoes and the night they came through. For those of you who have not been around as long, this was in 1984 and we had roughly 150 people through the ED in a span of about three hours and the ED was under construction at that time with expansion and renovation it looked liked a MASH unit under the best of circumstances. It was really bad that night. Nine people from Pitt County died that night as a result of the tornadoes.

Deborah Davis: We had them in Rehab and the Cafeteria and we had a communications center and we had people that were being transported to hospitals all over the place. We actually had to set up a temporary morgue and we had family members everywhere and were asking family members to come and identify bodies. It was just awful. You couldn't get through on the highways. I lived in Winterville at the time and I had to get a police escort to take me to the hospital. I don't think we have ever had any situation where we had to deal with that many family members. We had social workers working with them.

Ralph Hall: I'll tell you who can tell you a lot about that is Lyman Hardee who lived out in the area where the thing went through. The ED has been expanded about three times now. We also had to build a plywood tunnel.

Diane Poole: The other thing to remember was the EastCare crash. I remember, Buck has probably told you about that as he and Charles Mayo had to go to the site, this was in the middle of a forest. The tragedy of that with the Chief Flight Nurse, Mike McGinnis and the nurse. It was really a very difficult time for the hospital.

Beth Nelson: I remember that Jack Richardson said it was a very controversial issue about whether we would continue EastCare. Many Board members felt like this was a sign that we needed to get out of that business and Jack said if one wing of the hospital burned down we would replace it and EastCare was just like that. It was a big gutsy decision for this hospital to make at that time.

Deborah Davis: There was a major outcry in the community and I do remember there was discussion by our Board about shutting it down.

Diane Poole: There was a Board member named Joyner from Farmville and he was head of the Transportation Committee and he was one of the ones to help push through replacing the helicopter.

Jack Holsten: There are a lot of humorous little things that occurred about Bertie and that would be great stuff to have ten or twelve years from now.

Beth Nelson: We have all of that. There is a fourteen page article that Dave gave me a copy of and several pages were missing from it. I just went through it recently and it did have some good information but I need to get a complete version of it.

Jack Holsten: I remember one story that went around and it had to do with Craig Quick was working and some church group sent over twelve chickens because they wanted to help us and heard we were out of food. They also sent over twenty-five or thirty gallons of water. You will have to ask him about that.

Ralph Hall: I want to tell you all the issues of this hospital up until about ten years ago was that there was never enough money and it was truly a non-profit hospital. They cut everything so close. I remember one time where we were raising room rates and we were going to make a little bit of money and Mr. Richardson said we were not going to do this. I even argued for raising rates since our liability insurance was going up and we at least had to cover our our liability insurance.

Beth Nelson: I remember too when DRGs were getting ready to come we were really fearful of the impact. We had a lot of managers meetings and that kind of thing which were focused on ways to save money and we stopped putting a top sheet on the beds in order to save money and I will never forget that Wayne Kendrick came in my office and asked me to go around with him. He said he wanted me to see what we were doing in this hospital. One of the things that he showed me is that we were no longer putting a top sheet on the patient's bed and it was a shocking thing. I think when we found out we could survive with DRGs we spent $100,000 buying up sheets so the whole hospital could have two sheets for the beds.

Ralph Hall: But we really solved that, we took the top sheet and put it on the bottom.

Kathy Barger: I know when we were having so much of a cash drain and we were afraid we were not going to meet the payroll, we started looking at our market rates and we were so below margin.. We hadn't had a rate increase in three years when hospitals everywhere around us had increases. That was back in the days when you could raise to whatever you needed. We were so far behind margin. I think the Board then got so afraid because we did and we had gotten to be a big place by then and they were ready to increase rates so we did that several years in a row. I can remember one year taking in a budget where we recommended a rate increase and the Board told us that it wasn't enough. They really got scared there, everybody did.

Ralph Hall: I'll tell you another thing about not having the money the Board would not give the Administrative Staff any raises and so Jack went to them and pleaded for an increase for the staff and they gave him a lump sum of $4,000 or $5,000 or something like that and told them he would not take a raise and he took the money and divided it among the administrative staff.

James Ross: We need too to talk about some of the growth of services over the years what really distinguishes us. The early history is that the hospitals in Rocky Mount and Wilson were bigger than Pitt County and now look at how things have turned. When you look at the School of Medicine and when it went from 2 years to 4 years and look at the heart surgery startup under Chitwood and that was not an easy course and there was a lot of fighting about whether to start heart surgery and there was a lot of fighting.

Some people were opposed to both of those programs because they were afraid they were going to lose their OR time. They still are. You think about the fact that we have now got three different types of robots in the hospital-between the Pharmacy, Central and heart surgery going. All those programatic jumps, investment in the service array. It is a phenomenal story and faster than any place I have ever seen about the growth of the services. The Cancer Center Bone Marrow Transplant, the Neurosurgery Program, the Trauma Program. You have more accredited programs in Rehab than any place else in the state, in the Southeast. The investment in services is the coolest story to me

The trials and tribulations from those convinced people to go to the technologies that are in place. The really sophisticated HLA labs on transplantations and that sort of stuff really led to the growth and development. The Children's Hospital, what with Tingelstad's retirement. There are 95 beds in the Children's Hospital. We do the Telethon once a year and raised more than a half a million or three quarters of a million, whatever it was. That has happened in modern times and when you cross that money threshold what we did with it was so cool.

Kathy Barger: The foundations for the projects really were established back when there was not that much money and I think that is more phenomenal.

Beth Nelson: Also in persuading the state to provide funds for some of these things I thought was really interesting. I don't know if this is true or folklore, but they always said that back in the days when we were supporting an MRI in ECU you had a long laundry list of equipment and buildings and one thing and another it wanted . An MRI had been on that list but Ed Warren was in the General Assembly and he got wind that Chapel Hill was going to be getting an MRI and he wouldn't let it go through Appropriations without ECU getting one so we ended up getting an MRI.

Diane Poole: Well that's how we got a birthing center. Jack Richardson came back and said we were getting a birthing center.

Ralph Hall: But they called me and said they wanted to see drawings and I drew out on a piece of paper.

When you realize how many people whose lives were impacted when you went from serving Pitt and Greene counties to serving four or five counties to maybe twenty now, you really really changed the complexion of our part of the state.

Ralph Hall: Let me add on to what Jim said because of I have done 240 projects for this hospital in my lifetime and of those 240 projects in every program put in here at Pitt County Memorial Hospital has far exceeded even our expectations. When Chitwood came here we really projected and hoped that we could do 125 cases the first year. We did 225 cases. It was like that with every program. I remember Dr. Scarantino came to the Cancer Center. He said they would probably be doing 20 patients a day. It wasn't six or eight months that he was doing 40 patients per day. Almost every service that we have put has just really gone over expectations.

Kathy Barger: I'll tell you though, the fact that Pitt was even able to get those 143 beds was phenomenal. It was almost amazing, nobody then was adding beds when we were. I can remember some of the discussions we had. We talked about maybe we were crazy doing this and Ralph said no, we should be. Nobody was adding beds and here we got it though the teaching exemption.

Beth Nelson: People said that Jim Hunt used his influence. I am sure that is the reason that CON got approved.

Ralph Hall: Let me tell you when Hunt came. We built two bed towers and then we affiliated with the medical school and then in the agreement with the medical school was they were going to bring in patients from outside the county, that they would do a replacement bed tower which was the west bed tower. So when we put that before the CON, the CON people turned it down. They said to us there was no more need for beds in eastern North Carolina and then Jim Hunt stepped in and gave an executive approval for that west bed tower.

About service development, the number of employees in our system that have greater than ten years of service is about 30%. That is huge. When you think that there are 6,500 employees in the system, that kind of tenure can stack up with any hospital I know. I'll bet they are not close to 30% with ten years or greater. When you look at that kind of history, it's not the long-term stuff. It is quite a distinction, I think.

Beth Nelson: You said 30% of all employees, are you talking about our hospital or all hospitals in our system?

Ralph Hall: In the system.

Jack Holsten: Is the book about the system also or is that just part of recent history?

Beth Nelson: That would be included but it is not the biggest focus of it only because that's a big part recently.

Debbie Davis: Kathy was talking about the amazement of building the 143 beds. The bigger amazement was that we could staff it. When we look at the employee base when I came I think in 1975 there were about 450 employees and about 70 physicians. So you go from that, basically in 20 years for a tenfold increase in eastern North Carolina. We started recruiting in areas like Nuclear (Medicine). I remember when had to recruit out in Florida and on the west coast there was nobody trained in those areas that we could recruit for eastern North Carolina. We had to create training programs to meet the growing needs. I think the greatest challenge we all faced was how the heck are we going to staff it and continue to recruit to Greenville from eastern North Carolina. We had to create training programs to meet the growing needs

I think the greatest challenge we all faced was how the heck are we going to staff and continue to recruit to Greenville from eastern North Carolina in areas that traditionally they did not want to come.

Beth Nelson: One funny thing, the story Jack Richardson told us the other day was that at the point that the funding came through for the Rehab Center the state also appropriated money for the North Carolina Zoo in Asheboro and maybe it was Ralph or somebody who made some comment that Asheboro got the zoo and we got Dave McRae.

Ralph Hall: That was really a struggle. Dave did a good job on the Rehab Center. They built five of them in the State of North Carolina and rehab was new. I kept telling Dave we should sell that for a Holiday Inn since there were no hotels there then.

Kathy Barger: Talking about the staffing of the bed tower like for a year and a half or maybe two years before we opened up that bed tower, we took big financial hits for bringing on nurses. We brought those nurses on way before that bed tower opened up.

Ralph Hall: Diane will remember the only people available were the new graduates that were coming available. We rented the Holiday Inn for beds.

Debbie Davis: The state loved that. They really liked it the first time. The second time around they thought we were out of our minds.

Ralph Hall: The first time was before we built the West Bed Tower. The second time was before we built the North Bed Tower.

Debbie Davis: Actually, it looks like we will have to rent it again before we build the next bed tower.

Ed McFall: That bed tower addition brings to mind a couple of things from my perspective. We had only twenty-four to thirty-six hours left and we had a problem with the brand new switching software that provided network access to every workstation in the entire bed tower. It was over a weekend and we could not get the vendor. We were totally dependent on ourselves to solve it. We had to physically move/rewire every workstation connection in the new bed tower, and we needed thirty switching devices (belden connections) to make the rewiring change work-and all we had was ten. We called all the electronic supply places in the eastern part of the state and finally located some in Raleigh. We dispatched a staff member to pick up the connectors-after having to take up a collection from other IS employees of about $360.00. Then, the entire IS staff complement was called in to work at 10:00 p.m. and the rewire job was completed by the next morning-thirty minutes ahead of the deadline to abort the bed tower opening. The bed tower opened on schedule.

Kathy Barger: One day I was in Raleigh at an NCHA meeting and we had already gotten designated and I was driving back and I was sitting there kind of looking at the mileage and thinking something is wrong. We are further away from Wake County than what I thought we were. The test was that your hospital had to be a certain distance away from the MSA, which was Wake County. What we had done, we had measured the distance from the Wake County line to the Pitt County line. And here we were getting all this money and we had announced it to the Board and we were whatever they called it, a rural referral center and that is when I went back and talked to Amelia and pulled out all the paperwork. Ernst & Whinney had helped us with it. We said we didn't meet the requirements and so that is when Amelia and I got out and said maybe if you would take these back roads it would work. So, we took the map and unfortunately there are roads that looked like they were there and never connect and we were like on all these dirt roads and we were counting the miliage but we came back and wrote up this document and told HCFA that we didn't meet it and we were sorry that is why you shouldn't pull our designation and back then there were hundreds, probably thousands, of hospitals going through these new designations and they had a special board to look at it. We sent them our letter and they came back a couple of months later and said okay you can be one and we never met the rules.

Ralph Hall: Remember when you coerced Dave into buying that first PC?

Debbie Davis: I did do that. Ed set me up for that. What happened was that Ed and I had been having these discussions about we really needed to move that way and Dave just was not for doing this.

Ralph Hall: Well, I had the first computer.

Debbie Davis: Not what we're talking about. I remember when we were working on a Saturday, several of us. Dave even at that time was really pushing us hard to do things more visual whether it be flip charts or whatever. At that point you sat down and hand drew out everything. He was working on something with a map of the region and he was trying to put in referral numbers.. He was in his office sketching this stuff out, spending hours doing it, and so I thought this was the perfect opportunity .I told him to let me see if I couldn't get something for him that might be a little better for you to take to the Board. I went and saw Ed and asked him if there was a way to do this on the computer. Ed worked like an hour and they had these beautiful maps with the numbers all displayed and I remember that Saturday taking it back to Dave and he just about fell out of his seat and I think from that day forward he was committed to buying PCs and finally figured out what they could do for us.

Ralph Hall: When I went to the computer for the facility it was a Dell and this was back in 1974 or 1975. Jack told me that I would never get approval to purchase it. So what we did was we just called it the environmental machine. This thing was six feet long.

Kathy Barger: I remember when I first came here, now we have or did have those elaborate retreats ,but remember those retreats we used to have on Saturday mornings with the Board members and our medical staff and we would get up there and do these terrible presentations. We did these in the GLC.

Beth Nelson: This is now the annual planning retreat.

Sally Lucido: Those sessions that were held in the GLC that is when the staff first started rehearsing for the presentations.

Diane Poole: I thought you were going to talk about the Administrative Staff Retreat where we went through classifying people as animals.

Beth Nelson: Gary, tell us some stories about how we were perceived from the region. Can you think of some vignettes there about some faux pas that we committed over the years?

Gary White: Well, I can tell you this that when you were going to build the last bed tower, Don Logan and I sat down in a room and we thought about when we got the letter from Dave how we were going to respond to that. We checked around with all the other CEOs and there was a coalition being formed to go against it from all the hospitals . Some were Sun Health and some we now own. We sat down and talked about how we were going to handle this and I told him that I had known Dave from prior years and we were going to make a lot of enemies but I was going to say we award them as long as they were intensive care beds. We wrote back that letter. I talked to other CEOs in this region and we (Craven Regional Mediacal Center) were the first hospital to support it.

Beth Nelson: There was one public hearing you came to and you spoke against one of our projects. I was thinking it was that project but it may have been another one. Anyway, Dave had to stand up afterward and I guess try to rebut what you said. I remember it was over at the County Office Building. Do you remember that, Kathy?

Kathy Barger: I wasn't here for the public hearing of the bed tower. That may have been rehab-that was something else. I think I remember that but I wasn't here for the bed tower hearing.

Beth Nelson: I think it was you all and Rocky Mount that opposed it.

Kathy Barger: It may have been rehab.

Gary White: Frankly, I don't remember us opposing anything. I just remember we supported the bed tower and I will never forget. We got a lot of calls about that.

Beth Nelson: I remember that. Jim was there and I think it was the first one he ever went to.

I think that was probably rehab. There was more than 20 beds available and we negotiated a split with Rocky Mount and Craven.

Kathy Barger: Yes, and we did the teaching exemption.

That's what I remember. It was a right fair amount and we wanted so many and how it got divvied with the others I don't recall.

Martha Dixon: Actually there were several years of CONs for Rehab and the initial split was between Lenoir and Tarboro and the next go around was Craven and Nash.

I don't remember exactly how it played out but I do remember some opposition and stuff and we negotiated the split.

Kathy Barger: The CON office was the one who told us to do the teaching exemption. We had to take it to Raleigh and we were driving around the Beltline 80 miles per hour and I was freaking out thinking we were not going to get it there on time.

Beth Nelson: I remember when we used to do CONS and we would be so frantic and we would have to take them to Raleigh at the very last minute. We even took two cars of people in case one broke down, one a few minutes after the other, to make sure that somebody got through.

Kathy Barger: I remember we had the car waiting ready to go and we were looking through the appendices and we had somehow put something in there that was wrong and we were already like a half an hour late and I was ripping stuff out and everybody was standing around throwing papers out everywhere. If you look at that CON there are hand-written page numbers on there because we were pulling it together and we didn't have time enough to paginate it and we just had to write the numbers on every page.

Debbie Davis: Ralph, you can tell the story about Jack Richardson's car and the fact that he made us change it around.

Ralph Hall: Jack was very conservative so when he wanted a new car and it had an AM/FM radio in it, he had that thing changed out. Had the whitewall tires removed.

Kathy Barger: Back to talking about the CON office, the Albemarle people had something happen to them with the Dare County CON. They got up there that day and it was before 5:00 p.m. and there are a few things they check like to make sure you have the check and they found some critical thing in their CON that they were missing, and they told them that they had until 5:00 p.m. to get it in. They had the information faxed in and where they faxed it, it wasn't really right and we jumped on that. I felt sorry for them. Nash lost a CON one time because they left out the financials. They had them but somehow when they put the thing together it didn't get in there.

Beth Nelson: I can tell you, I serve on the SHCC (State Health Coordinating Council) and seven years in serving on that Board we really have a reputation, it is obvious, of being a maverick in North Carolina. I mean it's like we have this reputation of doing things that nobody else is doing and trying things that are questionable and doubtful and that nobody says will work and somehow or other we always manage to do it. It seems like there are a lot of comments that are made about our hospital that it is amazing to me. Other hospitals are not discussed to the extent that we are. I'll give an example-when the big story came about robotics and Ranny Chitwood, an announcement was made during the SHCC meeting calling attention to that but I don't care what type of esoteric stuff that's going on at Duke and how they might be setting all kinds of records, I have never known any recognition to be given to anything like that on that day.

Kathy Barger: You know what they were talking about-they were talking about whatever committee that made the open heart decision and Ranny Chitwood was on that and Tom Elkins said remember that committee and how well they did and you know who was on that committee, Ranny Chitwood. They were proud. We did our teaching exemption Home Health CON application. What I remember about that was that we were trying to do this negotiated settlement with Home Health & Hospice and all that sort of stuff. It was hell. All these parties were getting ready to sign all these documents and stuff and the day before the deal was to close, the FBI, the SBI and everybody else raided Home Health & Hospice offices and they carted half of their computers out and all their papers and stuff and we were within hours of signing with them.

Kathy Barger: At first we had gone through all of that appeal and then we settled where we didn't have to actually go to court and the settlement was because we were going to buy Home Health & Hospice and then right before we were going to buy them.

Diane Poole: Actually what we had done after we had signed the settlement which because of all the discovery process that still needed to occur. I'll never forget Mary Beth Johnston calling in that afternoon and there was so much I couldn't keep score of what she was telling me. That was close.

Ralph Hall: I'm sure Debbie remembers too when Charter Medical wanted to come and we were halfway through that progressive care unit and they literally came into our office and took all of our documents, a whole truckload of them, to Raleigh and this lawyer, Rene Montgomery from Charter Medical, she grilled me for eight hours. She wanted to know everything on activities and drawings and everything related to that progressive care unit.

Beth Nelson: Remember when that progressive care unit was under construction you hung a sign out and its working title which said "Minimum Care Unit"! I remember telling you or somebody that we can't call it the Minimum Care Unit. It would indicate perhaps that people don't care much at all over there. I told you that we cannot call it that.

Ralph Hall: That was like the sign at the ED that said "The Walking Wounded" or something like that. That was Jack Richardson's idea that we put these big signs up meaning that this one entrance was for the walking sick and wounded. It was a common terminology that we used.

Debbie Davis: I can remember when we put in paid parking and we charged a quarter a day and we had a steady stream of people lining up to complain about it. They were not complaining in a low tone of voice, they were yelling. This went on for about a year after we did that every day.

Ralph Hall: People would literally park across the street up on the curb so they wouldn't have to pay that twenty-five cents. One day I saw this old guy coming across and he had parked up on the curb and he was struggling his way across to come to the building and I really felt sorry for him and told him I would give him the coin to pay for the parking. Somebody told me that that guy was one of the richest guys in Pitt County and the reason that he was one of the richest guys in Pitt County was that he wouldn't spend that twenty-five cents to park in that parking lot.

Debbie Davis: I think it was the first paid parking lot in eastern North Carolina. One of the real reasons we did it was because we needed the money to put the lights in the parking lot. We didn't have the money for lights.

Kathy Barger: I also remember when you bought the Moye property over there.

Ralph Hall: I tell this story about this old lady, Mrs. Hadley Moye. We went and sat down with her and talked to her about them about the property. Jack offered her a price for that lot and she said it didn't look like they had anything to discuss further and that was it. One day out in the Beef Barn and she said to me see this big pocketbook I have, I had to get this big pocketbook to carry all that money you paid me.

Kathy Barger: It was important property though and it was worth what we paid for it.

Beth Nelson: People used to say that, remember when we were short of space and we started bringing in the mobile units, and that was one of the things that Dave was so embarassed about, and the big joke was that PCMH stands for Pitt County Mobile Homes. Remember when we started buying property and we had never bought property until Dave became the CEO or very close to that and the big joke was that gosh Dave is buying so much property the next thing you know you will be buying the Fuel Doc. There was such a change in philosophy.

Ralph Hall: I can remember the times when I went downtown those people would ask when we were going to stop spending all that money out there and now they are interested in us spending money.