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JULIUS MALLETTE, M.D.
Clinical Associate Professor
Department of OB/GYN
Assistant Dean for Student Affairs
Brody School of Medicine
East Carolina University

September 6, 2000

Interviewer: Beth Nelson

Beth Nelson: Start with some pertinent aspects of your background beginning with your current title and then we will go back with your history.

Dr. Mallette: Right now I am a Clinical Associate Professor in OB/GYN in the Division of Maternal/Fetal Medicine and I am also the Assistant Dean for Students I have been here for almost twenty-three years on and off.

Beth Nelson: Now let's start with your growing up years.

Dr. Mallette: I was born in South Carolina. My father was teaching at Voorhees College which was Voorhees School at that time and I lived there for two years, the first two years of life. Great memories of that time! Then we moved to Wilmington, North Carolina where I lived until I was in the sixth grade and moved to Raleigh. Wilmington, as we were saying, was a very nice community to grow up in and it was much smaller than it is today but it was still a very nice place to get a lot of my traditional childhood values. There are people that I remember a lot in Wilmington. In Raleigh I spent my high school years and the same with that. Raleigh is quite different from the way it was when I was a child as it almost one quarter of a million people. Raleigh reminds me of Greenville when I was a child-about this size. It was a very nice community to spend my high school years in. It was an interesting time to be in high school during the latter sixties and early seventies. It was a different era in that time.

I then went to college at North Carolina State but prior to that I went to Washington University in St. Louis for two years and came back and I went to North Carolina State and majored in biochemistry, biological sciences and that's the ECU connection right there. My advisor at North Carolina State told me that they were developing a new medical school in Greenville and that I ought to apply. I had planned to attend medical school but after I pursued a Ph.D. in biochemistry my original plans were not to go into medicine right away. He told me no that I needed to apply to East Carolina as he thought it would be a good experience, at least applying. So, I applied and it was the only medical school I applied to and I was accepted.

What an interesting story-of course, it is hard to turn down an acceptance to medical school no matter what and I talked with the Dean at that time who was Dr. Hayek and he interviewed me and we had quite a good conversation, along with Dr. Volkman who was here in the Pathology Department. I applied to medical school and I have been here ever since on and off. I was away for training and things like that.

Beth Nelson: Tell me what medical school was like at that time. That would have been the first class of our medical school.

Dr. Mallette: It was the first entering class of a four-year program and it was a very small program. There were twenty-eight of us at that time and we had quite an experience. You know, Greenville was, of course, a college town with ECU but they were real excited about having a medical school-the entire community. We were interviewed by the newspaper and we had our picture taken and we were over at Dr. Jenkins' home on occasions to talk about his vision for the school and that was really quite an inspiration for us. But to me at the time it was where is the next book? I had to keep studying and not really pay a lot of attention to all the momentum that was occurring. It didn't come to me until much later that this was going to be the place that it is now.

Beth Nelson: I know that there was no Brody Building at that point. Did you hold your classes over in the Biology Building?

Dr. Mallette: There was the science complex where we took our classes. I think now they are developing that into the Howell Science Center but near that. We took anatomy in a double-wide trailer, not very big and that was really something because we would prepare bodies so we could study them and we did all that on our own. Now they have all these fancy devices for keeping the cadavers available for study. At that time, the trailer had windows up at the top so you could let some of the fumes out. So we would open them up even with the air conditioner running, as there was quite an odor to it. It was so funny, we were walking and all the other students and all the other people passing by knew that we were going into the lab where the bodies were. You would see them jumping up trying to look into the window while we were doing our dissections.

That was quite an experience. We had our classes there initially and then we had Friday classes at the hospital. This was an innovation for the school and for all medical schools to be involved with clinical studies in the first year. It was called clinical correlation, and that course exposed us to patients, to their clinical situation and to the relationship of the basic sciences to the patient. What a motivator this was to actually see someone that had severe rheumatoid arthritis while we were studying about collagen and the development of the collagen pathway. It just really made learning medicine much more of a challenge but it also was a tremendous motivating factor for you. You could see the patient and say you wanted to learn something so you could help that patient and do something to make their life a little bit easier, if possible.

Beth Nelson: You mentioned the name of that class, tell me that again.

Dr. Mallette: The Clinical Correlates for Basic Sciences. I think that was what it was. It was run by the Family Medicine Department and Dr. Jim Jones was the Chairman at that time and we have something like that even today with Family Medicine taking the forefront and teaching the students about clinical medicine very early I am very proud of that. That needs to continue and I am sure it will.

Beth Nelson: When you look back on it and think about those kinds of things you must now realize the risk that the hospital took on and the medical school took on by putting "greenhorns" in clinical experiences like that. Talk about that, how maybe you didn't perceive it at this time as was a milestone.

Dr. Mallette: Well, it was a milestone. Obviously we didn't perform clinical activities because we didn't examine the patients directly but the patients would give us their story so that we would have a better idea of what their situation was like. We did see the examination of some patients so we could get an idea of what to do but we weren't actually practicing at the time but we were learning a lot in a practice situation. But still that was risky though because medical schools were traditionally set up to have the basic sciences almost within a vacuum and then the clinical sciences within another. So that was very innovative for a school to make strides towards integrating the curriculum. To this day what we are talking about in medical education is the integrated curriculum as to how we can make this science real, how we can have students apply it to their clinical rotations.

Beth Nelson: When I think about there being twenty-eight of you, a faculty of how many, probably twelve or fourteen?

Dr. Mallette: Yes, maybe about fourteen, there was almost as many faculty as there was students. I think it was almost a 1:1 ratio so it was pretty close if you consider all the faculty that was there. You know you talk about living in a fishbowl because you would go downtown and they would say there is a medical student but it really was a good thing. I must tell you that initially my thought was that I finish medical school and I am gone. I really did not think in the first year or so that I would stay and if you would have asked me in 1977 or 1978 if I was going to be here in the year 2000, if you could have thought you were interviewing Dr. Julius Mallette on September 6 in the year 2000 with the ECU School of Medicine, I would have told you to forget it. I would have said that you were talking about some other Julius Mallette, not this guy because really my thought was to move on and go away and train at different sites. But I think it was God's will because this place has the potential to really be the model for health care centers throughout the country.

The reason why I say that is that we identified an area, a region that has a tremendous need. You have the structure within the school to develop individuals that are from that area to then supply the need and that just makes all the difference in the world. That is one of the reasons why our mission is so important to me. The mission of primary care because there is a tremendous need for primary care doctors. The mission of providing education for minority and underrepresented students, the mission of providing care for a region that didn't have care. I mentioned that I lived in Wilmington. My mother had to drive to Duke in order to see a specialist so I can imagine someone that lived in Bertie County or in Hyde County and how much of a struggle that would have been. So, here we are in Greenville now and I hear people say that they are going to Greenville to get our special care and that is just quite inspiring to me.

Beth Nelson: Talk about visiting in the home of Leo Jenkins. It just gives me chills to think about having been that close to the visionary person that he was. Talk about what he talked about, his plans for this place. Did you see him as sort of a pipe dreamer? Or did you think wow, look at all that is going on and we are going to make it happen.

Dr. Mallette: Well, I tell you, my thought initially was okay, he is a smart guy and there was no question about it and he knows what he is doing. But he was so approachable, he was such a human being. You could talk with him just like you and I are talking right now and he would tell me, young man, I want you to know that some day this is going to be quite a school and you will be very proud of it. It was things like that and, of course, I said I was with him but it didn't dawn on me that it would really happen until I remember walking in the hallway in his home and it had pictures of him with people like John F. Kennedy and people like that who were heroes especially during that time and still are today and I thought he really was going to make this happen and it would be great to be a part of it. Again, I was a student and the next thing I said was well it was a nice party, Dr. Jenkins but I had to go back and study and you learn to that pretty quickly. He was a real nice person.

I want to add one other thing because I did get to see him right before he died. He was in the hospital and he was on a stretcher and he was being cared for and I talked with him and I just wanted to remind him that I was one of the students that he had talked to over twenty years ago and I thanked him for having the vision that he had to help us reach our goal. I also told him that I was still here. He seemed to smile and that was also inspiring to me.

Beth Nelson: Something drew you back here. You talked about the fact that you saw yourself going other places, training in other places, and guess venturing out into the world. What drew you back here?

Dr. Mallette: It is hard to say. I really don't know exactly what it is as it is hard to put your finger on it but I would have to say it is the people more than anything. I lived in Raleigh, which was nice, and there are nice people there. But there is something about this community that you really feel that you can make a difference here if you try and I think you can.

I was here and I lived on South Greene Street, which was a part of Greenville that was probably and still is underdeveloped economically. It was amazing-cars would drive by and we would have to close the windows to keep the dust out. I will never forget that but the people there were so nice. You know how we have rain here with thunderstorms and it was the first time I had seen rain like that either. I remember being there and a lady was next door, I was new in the community and she didn't know me and I didn't know her or anyone. There was a bad thunderstorm and we lost all the power. In the rain she came out, had some candles and knocked on the door and told me I might need some of them and asked me if I had some matches and I told her no and she told me to take the matches too and then she walked back home. She didn't ask for anything. It was from her heart and I think it's the people that keep Greenville going the way it is.

It certainly has attracted me to come back and to try to help to serve the people and I see some of those same people that I remember in the community where I grew up while I was in medical school. You do grow up in medical school, believe me. But where I lived there and I get a chance to serve some of them and some of their children and that keeps me going. I delivered their grandbabies and some of their kids and they would say they remembered me when I was a student and that keeps me going and that is all I can say.

Beth Nelson: Let's quickly go back and finish the story of your history. After medical school here, you left.

Dr. Mallette: After medical school I did my internship and first year residency in Nashville, Tennessee at Hubbard Hospital. There I trained under Dr. Henry Foster who is a very controversial gentleman who was nominated for Surgeon General then. I learned a lot from Dr. Foster and he was quite a leader in obstetrics and quite a role model at that time. I had a family and I needed to stay with family and I think that was most important. There was another leader here in the Department of OB/GYN that I admired also and we talked and I decided to come back. Again, it was Greenville people bringing you back and I enjoyed being here. I finished my last two years of residency here at the medical school and the hospital.

The hospital connection was really so receptive to residents at the time and I hope that atmosphere is still here today. I think it is. As a resident at the hospital here you feel like you are here to serve but you also are here to learn and you are also a part of a community, part of a people that are trying to help other people in the East. At one point we had very few residents in the Department of OB/GYN so we served twenty-nine counties as a referral region along with about three faculty members all by ourselves for over a year so I kept pretty busy. I look at the residents who are on call who complain and I tell them that they should have been here when we were here. Everybody has war stories. It was quite an experience being a resident here and I enjoyed it. Of course, my daughter was born in Nashville but moved back here as a child so she enjoyed the early days of Greenville too.

Beth Nelson: The hospital had to have been new at the point you came here about in 1977 and it opened the end of April in 1977, is that when you started?

Dr. Mallette: I came in August of 1977. It was very young and my wife was nursing at the time and she worked on the Medical/Surgical Floor when the hospital first opened up. She worked as a nurse there. That was quite an experience to see, the hospital was really quite a contrast for the surroundings too. Friends would come and visit and say that the hospital looked like a Taj Mahal or something. You would drive in and Highway 264 was two-lane and you would go through several stops and by the time you get here you would think my goodness we are finally here and then you look and there is the hospital and would say goodness what a structure and I guess that is really almost a prediction of what the hospital could mean for the community. It was at that time seen as something that was really new on the forefront in the beginning of medicine and of treatment in an underserved area and we had the capacity of medical providers to do that.

People would ask me if I worked at the hospital and would say I must be excited about that and I would tell them of course I was. They would ask if there was any way they could work there too. I would tell them they could apply and they would tell me I was a doctor and I would tell them I was a doctor in training. They told me they wanted me to talk to their cousin about going into medicine, that he was a smart guy or she was a smart young lady and they thought they could do it. So I started feeling very connected to the community in that way, especially being an African American in a community in which there was about forty percent or so of African Americans. As an African American in Greenville there is a responsibility but it is also an honor to be involved with developing institutions that will help the community.

Then I left again. I said I was through with the OB training and that was okay and I started working in the community but this time it was for a different reason. I left this time because I really had intentions of coming back, I really did. I left to do my training in Maternal/Fetal Medicine and Human Genetics because I knew that in order to really make a difference in the lives of the people in the area I needed to have that extra special training in order to be a part of the faculty, in order to have some authority in what I would say and try to implement for the people. I needed to have that extra training so I went to Baltimore and did training at the University of Maryland in Maternal/Fetal Medicine and Human Genetics. There is a tremendous need for that.

I had one experience in which I worked as a student during my basic science years and I worked with the medical examiner and one of my first cases was a maternal death. That experience will always be in my mind and the individual died from a condition that is very common in eastern North Carolina and that is eclampsia . That was a tremendous motivator for me and I said if I could do anything to help the people in this part of the state that I was going to work with patients who had eclampsia, preeclampsia, maternal conditions like that. Someone said it is not the size of your bank account or the car you drive, you can make a difference in the life of a child then you have accomplished something. That is what I wanted to do. The mother and the child died in that case. It is pretty rare but that was in 1978 or 1979. I was in second year of medical school but I was working with the medical examiner and so I remember that very vividly in my mind. I wondered what I could do to try to keep this from happening.

Beth Nelson: Was that Paige Hudson?

Dr. Mallette: No, Paige was there but it was Stan Harris. What a mentor he was too. He almost convinced me to go into Pathology but I couldn't do that but I learned a lot of medicine. I remember him quite well and how you could sense all the knowledge that he had about patients and we would do quite a bit of detective work. We would drive around the East too in different places and it was like working with Quincy. That situation motivated me to get more training in OB so that I could try to make a difference and some of my research is involved in preeclampsia and eclampsia and I am now working with the telemedicine program in which we are using telemedicine to help prevent severe preeclampsia in patients that are home. Through the hospital we have been able to do that too. The Home Health Program is also involved.

Beth Nelson: You use telemedicine through the home health nurses?

Dr. Mallette: Yes, and they will take the telemedicine device along with the monitoring system into the patient's home and then at a central station we can monitor the patient's vital signs, blood pressure, fetal activity, and we can look at the fetal heart strip and we can look at the mother and examine her through the telemedicine. We can examine the essential features of the mother like her eyes. In one of my areas of research I looked at the flow of blood in the back of the eye during an eclamptic seizure so I know that the eye can give you a lot of information to help you in managing the patient. One of the first features of preeclampsia is swelling around the eye, so we can use the telemedicine to actually see that in the patient while she is at home. We hope to expand into other areas as well to look at the eye so we can see the blood vessels also. Most important is that the patient can be at home, she can rest at home and the doctors can be available and they can rest at home too knowing that the patient is being monitored with all the vital signs and things that are important to make sure that she is safe. With preeclampsia sometimes the condition requires strict bed rest and that may make a patient stay in the hospital sometimes for months and with this project that the hospital helps to fund and support we have been able to keep patients from needing to stay in the hospital and they can stay at home. That is very important especially if you have young children. Other family members depend on just seeing them if nothing else. I guess that is sort of an interesting story of being a part of the hospital. I remember that patient very well, the one that lost her life although I don't remember her name, I just remember it was almost my first day or so on the job and I saw her and she had lost the baby and her own life and it was from eclampsia and I was going to have to try do to something about that.