See also Vignette

DAVE MCRAE
President and Chief Executive Officer
University Health Systems of Eastern Carolina

April 4, 2000
April 5, 2000

Interviewer: Beth Nelson

Beth Nelson: Please tell me about your background, particularly as it relates to the hospital.

Dave McRae: I came from a medical missionary family who had gone to medical school at Bowman Gray and they went to the mission field in the Near East. I was born in Winston-Salem and was four years old when we moved overseas. Shortly after that I had polio as we moved from Beirut to Jordan. I spent a good many months equivalent to years, I guess, in and out of Warm Springs, Georgia, flying back and forth to the Near East. When the family came back to the states, when one of the wars broke out in the Mediterranean area, we came back to Winston-Salem and the family lived there a few years. We consider Elkin to be the family home where Dad practiced medicine for a number of years and went back to Bowman Gray and started the first academic emergency medicine program there. This was the twilight of his career as he was a surgeon by training. Mother was an educator and was a missionary in her own right before she met Dad. She was a home missionary in the Bayou country of Louisiana, having been to college and graduate school and the seminary, in a day when women didn't do that very much. They felt like they were a perfect match and had five children along the way. So, with those touches of family, Mother, Father, big family, polio myself, all of it I have always felt kind of destined for me to do something that would give me a feeling in life of having a sense of unique purpose. I love the saying "bloom where you are planted", finding a place. I don't think you wait as much for something to come to you as much as you create opportunity to do well or fulfill life wherever you are.

So with that background, I got interested in physical therapy. My Dad tried to get me to go to medical school. I was the one of the five kids who was supposed to go and I had no interest in being a doctor. The lifestyle of a solo practicing surgeon did not appeal to me back in the fifties and sixties as I saw it in my college days and high school days, but I very much wanted to be a physical therapist. After that gradually evolved to realizing that I felt I had some leadership talent and that I wanted to assert my interest in creating, developing, doing good in the sense of putting things together; managing, organizing, reading, encouraging, and all of those kinds of things.

I gradually moved through long-term care, even some public health experiences, acquiring first two Masters degrees, one in Public Health. I found myself looking at the opportunity to come to Greenville, North Carolina as the medical school was being created to establish a rehabilitation center, which in my mind, was about as ideal a job from my own history and background as I could think of and I thought of myself as spending the rest of my career running rehab services in an area that really needed it. That was my missionary zeal part.

Beth Nelson: How did you find out about the opportunity here?

Dave McRae: I was running a nursing home in Raleigh at that time while I went to graduate school, one class at a time. The Division of Vocational Rehabilitation, which was very instrumental in the establishment of this rehab center in Greenville, was working with me because I was trying to convert my nursing home into a rehab center. We had young people with quadriplegia and other long-term disabilities and DVR was coming to my nursing home and working with me. We had a big physical therapy staff and speech and occupational therapy, and we were doing some things that most nursing homes didn't do back in that day and age. There is much more of that now than there used to be.

One of the principles in DVR at that time was a fellow named Frank Ingram who told me about this job and that he was going to be on the search committee out here in Greenville helping Jack Richardson and some others pick the new director of the rehab center here and start the rehab center. The good part of the story is, I was not first choice, I was second choice. I have always enjoyed that. Jack had somebody from eastern North Carolina in mind. It was a fellow who was running a nursing home in eastern North Carolina. I do not know who it was, if I ever did. The fellow from Raleigh convinced Jack that they needed someone with a more maybe professional background and so I was hired but I told Jack once that I was imposed on him. I have never forgotten that. Jack always got a kick out of it. Buck Sitterson, of all people, reminds me to this day that I was second choice. Anytime I get too big for my britches he lets me know that.

So, I came to start the rehab center. I was actually offered the job in 1975. Had my first visit in the summer of 1975. I ate lunch in the cafeteria with Jack, at the old brick hospital, and met Dr. Gene Hamilton and Gene sat at lunch with me and Gene became a very good friend after that for many years. We found out that we both loved sailing and had a similar sailboat called the Flying Scot. We each had one and became good friends after that. I'll never forget that day. The first time I came here to interview I was to spend the night at the old Holiday Inn, long before it was renovated with that center courtyard area. It was a terrible rainy day and I remember driving into town. It was in the summer or fall and they were cutting wheat fields or tobacco fields or soybean fields, and tractors slowed you down even coming into Greenville from Raleigh on the old road. There were no four lanes. I don't think it even extended to Bailey at that time. Then it went to Bailey and then beyond from Raleigh. I was spending the night at the Holiday Inn and it was such a rainy, wet night and I was on my own as Jack had interviewed me during the day. Water was seeping in on the carpet at the door in my room and it made the room smell bad and I went home. I didn't spend the night and Jack Richardson called me three days later and said the Holiday Inn was still billing for the room and he wanted to know if I had checked out. I thought my days here were numbered! I hadn't been offered the job at that point. I remember that really well.

I came here to work starting in March of 1976 and we moved in May or April of 1977 so I moved into that old nursing dorm on the old hospital grounds, next door to Jack and I shared an office with my Secretary at that time who was Carolyn Smith. In fact, I had one telephone in that office and it was on my desk so I had to answer the phone and hand it to her. Jim Jones was upstairs above me, directly above me. He was starting Family Practice then and I worked with the then present Physical Therapy Department to get them beefed up. I mostly spent my time designing the rehab center and beginning to hire staff and develop policies.

Beth Nelson: Let's continue with your background. You came here as Director of the rehab center and your responsibilities broadened over the years. When I came here you were the Vice President for Professional Services.

Dave McRae: The first change in jobs, I'm not sure it was a promotion because they were all at the same level. By the way, I have every nametag I have ever had here. The first one was Associate Director, that's what we were called back then. I have a stack of all of the nametags. Actually the first one was Associate Director for Rehab. It was such a time of growth we did not have money to hire executives and so those of us who were here did whatever needed to be done. Buck, Craig, Warren McRoy, Rick Gilstrap, others of us who were here then, Jean Owens, everybody did whatever needed to be done and my talent or strength was in the fact that I was eager to help do anything. It wasn't that I knew or had great knowledge, or was the best at doing anything, it was that I had the most enthusiasm and virtually every problem, every crisis, everything that needed to be done, I offered to help or do it. I remember there was a nursing crisis in 1977, the first year I was here, and we decided that we needed someone to interview some of the nurses and find out what the problems were and make it separate from Jean herself. I volunteered to do that. I didn't have anything to do with the acute hospital at that time, in fact, the Administrative Staff didn't really think of me as a member of the administrative team. I ran the rehab center. It was almost like Mental Health, it was that separate and distinct. I didn't sit in on their administrative meetings in those earliest days very much and it was over the next year or two or three as I enjoyed the Administrative team and came to love the hospital, the new one and the old one, and would volunteer to do things that I became more integral to the Administrative Staff. That took several years and ultimately I think I had at least six or seven different titles and jobs over the years. Of course, even in the last year it has changed. I am CEO of University Health Systems now. I have given Jim the title of President of Pitt Memorial. I was President of Pitt Memorial; I was Senior Vice President and Chief Operating Officer of Pitt Memorial, Vice President of Professional Services.

One of my jobs before that was we had Craig doing Business Office and Personnel and Community Relations, all wrapped in one in those earliest days. It was Personnel, not Human Resources and we all knew that we needed to get to the next level so I volunteered to Jack to be responsible for all of those services with Craig, not because I knew anything about them, and I remember saying I was no expert in Human Resources or any of that, but purely for the job of deciding how to create the next level of growth for Human Resources, particularly. We separated the Business Office and Buck and Warren had that, but I worked with Craig and he and I together went on trips, we visited other hospitals, we went to meetings, we may have been able to afford a consultant, I cannot remember.

Out of all of that we decided that it was time to separate those functions and we talked with Craig about what his skills were and what he was interested in doing and Craig actually chose what he would be doing. He loved doing this other kind of thing and he said he wasn't professionally trained in Human Resources either, maybe that should be where we should recruit. So, it was not done to Craig as much as it was an evolution. I recruited and hired Charles Fennessy, specifically, and what I said to Jack and what I said to Charles when I recruited him was that he would report to me, I was hiring him and I had a team interviewing and all of that. We put Craig in the new role and he started creating it and when I interviewed Charles finally after a big search process, I told him you will report to me for six months, but I promise you if you take this job at the end of six months I would get out of the way. I had no idea what I would be doing there and I don't know if they will need me but you will report directly to Rick Gilstrap at that time and he came with that understanding. He and I worked well together. I helped him blend into the community and then six months or a year later turned him over to Rick.

At that point, I can't remember if I went back to Rehab for awhile but I did something else for a little while. All the time I was keeping Rehab because by then I had Debbie Davis running Rehab for me. She ran it for me and then I moved to this broader Professional Services role. I took OR at one point and worked with the OR and then Radiology, Lab and the other professional services. After that I became Chief Operating Officer. By then, Rick had gone, Fred Brown had come and Fred was leaving and then I stepped up. To make it funny and anecdotal, not only was I second choice for the Rehab Center but when Rick left Jack hired Fred and didn't even interview me, didn't even ask me if I wanted the job and what was funny about that is, I was very eager and maybe worldly is an unfair word but came from a bigger city, and I am not sure that Jack at that point in time had warmed up to me at all. He saw me as meddling and saying that everything ought to change and at every meeting they kidded me that I came in with flip charts and boxes and squares and was trying to organize them. You had Rick and the Administrative Staff who came to work without coats and ties, rarely wore suits, often had short sleeve shirts on. Relaxed and easy going. There was not a lot of structure, not the kind of organization that you would expect a hospital to have. Everything I did had to be organized and looking to the future and planning ahead and I wore them out with that and it was just a natural instinct for me. I blame it on having polio partly and having well-organized parents and having to have a more structured life with therapies at scheduled times every day and all of that. So, it was second nature to me.

But I remember that at one point Jack invited me to sit down front at the Board meeting because he had Rick Gilstrap on his right hand side. He was inviting Rick to sit with him there. He told me to sit on the left side. I took that to be an acknowledgment that he thought of me as a major player on his administrative team. I turned him down. I told him that I had no need, I was not competing with Rick, I'm not trying to get his job, I want to help and contribute to this place and I can sit on the back row as comfortably as I can sit up front and I did not sit up front. Jack took that to mean that I didn't have ambition, I think, which was not true, I had a great deal of desire to do good but I didn't understand that I had an overt ambition at that time. I didn't feel it in myself. I don't remember feeling that. I had never had visions or dreams of being the hospital President. To that day it was not part of my growing up. Growing up as the Son of a medical missionary and a physician, a clinician, and a missionary Mother and educator, it was service. I was supposed to be on the mission field doing something, not eager driven Administrator of a hospital back in those days. It took me awhile to realize that in leadership in titles like administrator, boss, etc. you had the opportunity to serve in a different way. At that stage, I was in my early thirties, it was
not where I thought I wanted to go and needed to go and I said I liked what I was doing here and as long as you give me the opportunity to help, I am satisfied. So I remember sitting on the back row for several months just because I thought it was important to show that I wasn't competing. It was a fragile time. Jack was worried about getting things done and his job, could he do his job. Rick and the other Administrative Staff were really overwhelmed at times with everything that had to be done.

Beth Nelson: This would have been when we were in the new hospital, wasn't it?

Dave McRae: Just beginning. We were actually having Board meetings in the auditorium downstairs. When Jack invited me to sit with him he meant in front with him there. It was a time that I thought I needed to show I was not competing with anybody, that I was not trying to outshine Rick or Jack, or anybody else on the Administrative Staff. Pitt County-Eastern Carolina was a delicate place and I didn't think they needed someone with an ego coming in to prove I'm better, I'm bigger, I'm smarter and I can outmanage you. Any of that. It suited me because I didn't feel the need to do that anyway. I didn't have to try to do that, I didn't come out of an MHA program where I had to be the boss. I wanted to do good. I wanted to contribute and help. That worked well for me and it was really when Jack brought Fred in, didn't even ask me if I wanted the job, that I stopped to think that I wish that he had at least asked me. But he didn't and it made me think, maybe I am going to need to let people know that I want to do more and it was really at that time when Fred Brown came that I started thinking beyond just doing good and I have to think about my career.

I was thirty-five years old then and a member in good standing of the Administrative Staff. Fred Brown looked at me and said if I wanted to do all the work, great, you can do the work and he became a good friend and mentor and allowed me to do everything and I, in essence, became Fred's operating officer and when Fred left, Jack looked at me and said they would put me in the job.

When Jack retired, and I loved being COO, I had people like Deborah Davis running Rehab and other services; I enjoyed working with the crowd who had been here a long time and I really appreciated people like Bill Young and George Williams and folks in the OR and other areas around this building. I loved the people. I had moved every four years all of my life, at least or more often than that. To find a place where people were good, caring and warm and loved what they do, it made me feel like I was home. I very much wanted to be a part of that so I was very happy working with Jack and Fred Brown and the staff members, even with all the problems that we had. Doctor problems, private/academic issues.

Beth Nelson: I think about you being passed over the second time. I see you as being the kind of person who would have said to Jack, because you worked so closely with him over the years, hey, what about me? I wonder why you didn't do that?

Dave McRae: Good question. I remember thinking a lot about that later. Patti has told me that she thinks I have in all of my life had this balance of drive and ego but neutralized by family experiences and other things. My parents the way they were great people, good leaders in a natural way but not boss-type people. I think coming up in a big family, I was the second to the oldest of five children but was the leader of the kids. I think the polio had a great deal of influence on me because people with polio learn that you can't compete with other people in the same way. You can't outrun people; you can't pick people up. You have one or more of your limbs disabled and yet there is enough of you left that you can truly excel, and people with polio, as a group of people have done very well in life, very successful. Roosevelt is just one example but there are many people and so something about that experience taught me not to compete with people in the sense of football players learning to compete and yet I had a very strong drive to excel and succeed in my own way, but I muzzled it or I held it back and I do not remember ever going to Jack and asking him why he looked over me, and why didn't he think of coming to me. Jack was the type of Administrator back then; we didn't do that because he would have changed the subject. He wouldn't have confronted and dealt with that issue and he was feeling desperate. He wanted to get somebody in here quickly and he knew Fred, and I think that deal was done almost in an instant.

Beth Nelson: I guess to lose Rick after he had been here twelve or thirteen years was a big blow.

Dave McRae: I really think to this day, you will have to ask Jack this in an interview, that for many years Jack thought I might be too much for this place. Not that I was great or anything like that but that I might be too eager, not sensitive enough to politics, forcing too much organization and structure. The funny thing is I don't do much of that any more. I have other people who outshine me in doing that but at that time I was very organized and methodical and logical in the way I thought things should be done. It may well have been that there was a feeling that I wouldn't be able to balance Pitt County, regional, private, academic and all those other forces that were out there.

Beth Nelson: Maybe too you hadn't worked as closely with him because there had been people between you and him and it insulated you from him. I think he couldn't have until you sat shoulder to shoulder with him.

Dave McRae: I agree with that. I stepped into this job in my fourteenth or fifteenth year here and now I have been here ten, eleven, twelve more years. I remember a time or two the little bit Jack would say, he never sat down and really counseled me, but he would tell me I had a lot of potential but I had a lot to learn about eastern North Carolina and the people here. I have used that in speeches and other things and I think he really felt that. What was interesting to me with that history then, Jack was fifty-eight when he retired, and I was his key number two man. I was prepared to work with Jack for another five or ten years and at that point wasn't at all sure that I would have any chance of being Jack's replacement and I thought I would spend the next few years and when Jack retires I either stay here the rest of my career as one of the executives doing what I am doing or that I would go somewhere else, that it might be time to do something, mission work or something else.

Still, even at that point as COO here, I did not have this burning gut drive to say I had to be the CEO and if I can't get it here I would go somewhere else to get it. It was much softer than that, it was that I loved what we were doing here and it was a great challenge that could last the rest of my career. I liked working with the people. I actually enjoyed juggling and balancing private, academic, county, regional, no money versus better pay plan for employees, I really liked those kinds of challenges and instead of being beaten down by them I thrived on them. I think that helped me tremendously.

When Jack announced his retirement this time I didn't drop the ball Jack suddenly announced his retirement in November. He had some health problems and I think he was ready to travel and he and Lily wanted to do some other things in life. Almost overnight I wrote an eight or ten page dissertation, which I have in my drawer to this day, I have saved it, written on the best quality of paper we had in the place and I handed it to the Chairman of the Board. It was at that time that Bob Harrington was stepping in after Reid Hooper and I told him I wanted to apply for the job and so they made me the acting or interim President or Administrator-I cannot remember what title we used for Jack at that time. He said they would decide what to do about a search and I fully expected a search and that I would be one candidate. I thought they were going to bring in all these guys who have been running big health systems or hospitals at that time and that there was no way I had a chance at it. At least I wanted them to know that I was interested in the job and at this time I was going to stand up for myself more and not shy away from it. They interviewed me before they had a search and they offered me the job either at the interview or right after it.

Beth Nelson: Who interviewed you?

Dave McRae: Jim Hallock was there. Jim had been here about a year, Bob Harrington, Bob Spivey, he was Vice Chairman of the Board and I'll bet that Jim Hallock or Bob Spivey will remember, it seems like there was another person. I don't think Jack was involved. I think Jack was already stepping out of the way and they had me doing the interim and it seems like there were four people. I think the Chief of Staff was in the room but I just can't remember but somebody could figure that out and I would like to know that myself.

Beth Nelson: I would like to get a copy of that if you think it would be appropriate to put in the archives.

Dave McRae: Let me read it again. I think that would be kind of neat. I'll take it home and read it and I may let you read it and decide if it is worth having. I won't be insulted if you say that it really doesn't need to be here.

Beth Nelson: I think it would be interesting to see, looking back on it-looking eleven or twelve years down the pike-how on target some of that would have been. Lets talk a little bit about what you think the hospital has meant to Greenville, Pitt County and the region. Talk about the big picture types of things. The things that I think will carry a lot of weight would be vignettes, things that you remember, instances where without this medical center eastern North Carolina would have been. We could all think of things like this, tornadoes, flood and snow, some of those kinds of things. Tell me about this from your perspective.

Dave McRae: Well, there are two or three ways when I occasionally think about questions like that. First of all, I would not want to convey that we are so all-important and mean everything and that nothing would have happened in eastern North Carolina. As you know, I have grown to love this area and the people. I think your hometown is just one of those wonderful places where people who came here generations ago and dug the soil or whatever they did and many of them became successful people. You have as many bluebloods in that area as you can think of from the early Americas. Chowan County, Edenton, there is not a prettier small town in America, there can't be. Dare County, the Outer Banks, places like that. You look beyond beauty and culture and people and you say that they had a wonderful university here and that university was going to continue fulfilling a destiny and it has done so. It would be unfair to say that without the medical school and the hospital that ECU would have remained a teachers college. ECU would have found the Dick Eakins of the world and had, of course, the Leo Jenkins and others, and would have carved out a niche for itself that was special and unique.

There are other cities in the East, there are industries in the East, there are things that have happened independent of this hospital and medical school that I think you have to put at the base of this and acknowledge that despite great poverty, despite being in flood plain areas, there are many strengths in eastern North Carolina that need to be acknowledged and celebrated. It would be unfair of anyone or any institution to say that I am your Savior, I took care of you here. I think it would be wrong to convey that and I am cautious in giving community speeches and standing up in front of people who have given their heart and soul to this place and this area; the Vernon Whites of the world from Winterville, who was a legislator, in acting like that they were nothing until we came along. Start with that foundation-you could do a whole book, a whole series of interviews on the wonderful things that have happened in Greenville, Pitt County and eastern North Carolina.

I am convinced that the medical school and this hospital made a huge contribution. One of the top half a dozen contributions easily that could have made any portion of America and whatever else you add to what has happened to eastern North Carolina in the years leading up to the year 2000 you would have to list the growth of Pitt County Memorial Hospital and the School of Medicine as major, major life forces in eastern North Carolina. The university alone educated young people but then you brought in the medical school who educated young doctors who stayed here and along with that a fine hospital grew up and is providing tertiary care, high-risk care to OB patients, neonatal care, rehab care, surgery services, and you can go on and on in things that would have been much slower coming or wouldn't have been here at all and they are all under this one umbrella. How to measure that importance I am not sure I could do that. If it is the single most important thing to have happened here, I don't know. It couldn't have happened without the university being here in the first place. It couldn't have happened without some things happening in Greenville long before. Even the tobacco industry was important. It made Pitt County successful. So, people who say they don't want to talk about tobacco, they forget that something had to precede the medical system and the university in order to allow Greenville to become the place for the university and then the place for this hospital. It's all building blocks. There was no big bang. It was all an evolution of small decisions and things that happened with an occasional big burst of Leo Jenkins and others to get us where we are. Clearly, the present state of this hospital and its impact on the economy, its marriage with the university and medical school, is a very significant series of events to have a time-enduring impact on eastern North Carolina. It may be the single biggest impact of anything else that has happened.

Beth Nelson: When you think about the impact we certainly see it immediately in Greenville, but when we step out a little further to the areas that are so hard hit by the economic problems, talk a little bit about the impact out there. For instance, the thing that I am thinking about are when we first stuck our big toe into the idea of satellite clinics, that was just sort of a fledgling effort to reach out to eastern North Carolina. Things like what we have done at Bertie, things like that. Look at Dare County. Look at what we are doing with Seaborn Blair, granted he would have kept going whether we had teamed up with him or not, but those kinds of things. We are pretty much guaranteed that with or without Seaborn Blair health care is needed out there. Those are some of the kinds of things I would like you to talk about.

Dave McRae: You touched on two of my favorite stories. I think the Seaborn Blair story and his broader family really is one of he finest stories about why the medical school and why this hospital grew. You can't practice medicine like Seaborn does in isolation without support. It was hard to do years ago and it will be impossible in the future. For him to have telemedicine support, clinic support, a hospital that we are building in Dare County and a tertiary hospital in Greenville with transportation to get his patients back and forth makes him much more as a physician then he could be without. This is a great, great story and on top of that he is one of the best educators that the university has for residents and medical students. One of the finest teachers we have got lives in Hatteras and its Seaborn and his practice and other docs he has worked with. What a great training experience we are trying to give young doctors and residents to work with him and see how he lives and how he loves his land and how he takes care of his neighbors.

The other favorite story, not on your topic yet, is Bertie. People harassed us about Bertie and said it couldn't be done. It couldn't be saved, and it shouldn't be saved. I am as pleased about Bertie as I am Pitt Memorial. To have been able to go into one of the larger geographic areas of North Carolina and take a hospital that was on the verge of closing, but changing it to the kind of health facility that can survive, now having recruited good doctors who will stay there and bring others and having the leadership of Steve Lawler and Bob Spivey and other people in that area makes me feel like we have done something that is very, very important. Steve is running the hospital now. It's just a great story. I don't think that could have happened without us because there was no incentive for a for-profit company to come in and do that. They would have let it shut down. That community had the courage to stick with it and thank goodness we had the courage to go offer to help them. It is a great story and I love all of what we have done from Heritage to Roanoke-Chowan to Chowan and Dare, but Bertie, I think, is an extra special story. Back to a broader theme, to me the delicate balance is that Pitt Memorial didn't grow in order to take care of all the patients of eastern North Carolina, it grew to take care of its community of patients Pitt County, Greene County and immediate adjacent people who could easily drive here to deliver their babies and have their children taken care of primary services.

The real contribution of Pitt Memorial was twofold. One is to be the training site for the school of medicine. To give the best experience we could for medical students and residents and equally as important to nurses and allied health students and respiratory techs, and plumbers even to work in the hospitals. We have done that very well and therefore created a foundation for folks in training to get good experience and to have the encouragement to stay in eastern North Carolina. It was very, very important and we succeeded in doing that in a tremendous way.

Equally as important, the growth of the medical center has allowed us to serve what is really a small segment of eastern North Carolina because we provide tertiary services for eastern North Carolina. In any community there are one out of a thousand people who need tertiary services. There are very few people who need it but the fact is that we are here and we provide that. The local communities are providing community care, general hospital care, but for that one in a thousand people who would be transported by helicopter or need trauma service or high risk OB or to lose that baby, or heart surgery, or cancer, or rehab after being physically disabled, we are here. Although we shouldn't be touching everybody for tertiary care, we are touching those who need it and they do not have to leave the region for it and they are getting quality care. In my own experience here, some of my favorite anecdotes, stories, come out of rehab because that's my background. I remember when we opened the Rehab Center, the first patient was a young man, I think his name was Alligood from Washington, N.C., who had been in a tractor accident, the tractor rolled over him and he was sixteen years old at the time and he had a head injury and he was virtually hemoplegic. I remember and he came to that Rehab Center for care and left here able to take care of himself and do better. I remember clinics that the rehab doctors ran and remember I had an old physical therapy background at that time, but I remember seeing a young man walk in, a young black man, I think with sickle cell, who had other severe medical problems and disabilities, and he didn't have the equipment, had not been through proper medical care and he walked in on a walker that was made from taking the legs off a chair, a wooden chair, and it was flipped upside down and he was walking with that. He did not have braces, did not have medical care, did not have crutches, all of the things that I had as a youngster that allowed me to have legs that remained straight even though they were not strong, and grew up on braces and crutches, etc. He didn't have any of that and it nearly brought tears to my eyes to see a youngster like that come into our Rehab Center. Those two stories you can duplicate all over the Country. To this day, people continue to come out of the woodwork, just like that. That's our contribution.

Beth Nelson: Tell me about Frank Ingram, the person who recommended that you pursue the job here. Is he still alive?

Dave McRae: Yes. This is more focused on me than it needs to be. I thought I had told you yesterday too much about me and my history here. Frank was with the Division of Vocational Rehabilitation in the Raleigh office and was one of their top two or three leaders statewide. He had some special responsibility for professional services, development across the State in DVR and apparently had some realm of control or authority over the piece of money from the Federal Government given to DVR that would build our Rehab Center. That's why he was on the Search Committee or whatever they had at that time. I don't think he is with them any longer but it seems like somebody knows him and could track him down if we needed him. That was twenty seven years ago. He became a good friend and a helper and knew a lot about rehab that I didn't know. I was a physical therapist but had been running a nursing home so I needed a lot of help from people who had run rehab centers or we know where they have and helped me put that rehab center together. I leaned on him a lot. He was down here every week or two it seems like that first year I was here.

Beth Nelson: Do you know how I could reach him? Do you know of anybody who would have a phone number or an address for him?

Dave McRae: In Greenville there is a DVR office and the man who heads it is Carlton Hardee. Carlton might know him and know how to reach him. Carlton Hardee is a member of the Hardee family. Of course the Hardees out at Lake Glenwood developed that area out there and Ervin Hardee was a Board member and Lyman Hardee, I think he is a cousin in that family.

Beth Nelson: Was he the kind of person who had stuck his neck out somewhat to get funding for us for the rehab center then? Would he have been instrumental from that point?

Dave McRae: Well, the rehab center was almost a different story but it evolved. I was at Carolina in the mid 1960s when the rehab center concept came about through a statewide planning group, School of Public Health, DVR people, and UNC, and it was a statewide plan. There were to be five or six rehab centers across the State. One was to be in eastern North Carolina. Their plan was a State plan to deal with people who were disabled or who had chronic diseases and as they looked at where to place one in the East, they heard about the medical school here and decided they would attach it to the new hospital and medical school. So, his role and their role was more getting Federal money for the whole State out of which they probably got $10 million and they gave each community $2 million for their rehab center, which was almost enough to build one at that time. I think we spent $3 million on ours. $1 or $2 million came from the DVR. He controlled that money and that's what made him powerful and influential.

Beth Nelson: I was just wondering if maybe he was somebody I should at least talk with on the phone about the development here.

Dave McRae: It wouldn't hurt and it be wonderful to have a little piece on rehab because you think about fifty years of Pitt Memorial and a major piece of that was the development of a rehab center starting in 1975 and its contribution to this hospital and the region. I avoid that because it sounds so self-serving to say let's talk about what we did with rehab to bring physical therapy and occupational therapy and rehab services here when this hospital never had it. We really took it a giant step forward in some ways equal to creating heart centers and those other more glitzy services. I don't go that way just because it sounds self-serving and it's a world that I am so close to, emotional about, that I try not to act like I'm doing this job in order to promote things that were important to me from the past. It could easily be woven in, at least as a piece, a chapter or subsection to talk about how among other things, the establishment of the Regional Rehab Center was one of many things to help Pitt County Memorial Hospital become a major force in eastern North Carolina. He would be a good one in that context.

Beth Nelson: I would be curious to hear what he saw in you, why he would have seen you as being a good fit in this situation as you were in the nursing home business. This would have been a jump for you a different focus of your career.

Dave McRae: It was. My career track, in fact you may have heard this story, that before I came here I was on track to move to Jacksonville, Florida to be the Regional Vice President for a nursing home chain for the state of Florida. Something like thirty percent of their business was in that one state and they were based in Tacoma, Washington. When I left they said they wanted me back and I said that I needed to go and see what this med school world is like and that I would be more valuable to them when I come back. I had really intended to go back and after being here and starting the Rehab Center, I think that it was the fourth year that I was here, they called me and said they wanted me to come to the corporate office in Tacoma, Washington, and move out there and be the Vice President for Professional Services for the whole nursing home chain and they would give me stock options. It was a for-profit company and I would have been an officer of the corporation. I actually bought a lot and was building a house out there. I didn't go eventually. The company had a leveraged buyout and it was called Hillhaven and the company that bought them out was Manor Care, which is still in business, and they bought a controlling share of stock and there were two new people being brought on as officers of the corporation, a new CFO and me.

The President of the corporation called me, actually I had resigned here. I was building the house, I had told Jack I was leaving. Jack had picked my replacement already here and the President had called me, he was my age and had become a good friend, he told me they had been bought out and they control the Board votes now and they have canceled the two senior officers that he had just hired and told me I didn't have a job. I went back to Jack Richardson and told him I had lost my job I was moving to and asked him if he had anything I could do. He had not actually made the offer but had picked the person to run the Rehab Center and he hired me back. I had never gone off the payroll.

Beth Nelson: I had never heard that before.

Dave McRae: I don't tell many people that and now it is for the world to know. My point is that I loved long-term care and geriatrics and really thought my future was in that area. I thought that they needed me and I didn't think hospitals needed me and I didn't think that was where I belonged. That was where big shots were and that's not what I felt like I needed to be doing. Once I came here and saw the need in eastern North Carolina and the need for this hospital to have a different set of talents added to it, it really gave me a boost in thinking this may be where I need to plan to do my thing.

Beth Nelson: I also made a note to kind of focus on the image of rehab and I guess the development of that. I know you were not solely involved in that but I think your influence, Debbie's influence, and a number of other people, a lot of staff involvement, rehab has gotten to be a far bigger player, from my perspective, then it was when I first came here. Yesterday we talked about the issue that physicians wouldn't refer to rehab and a lot of their services were underutilized. I also wanted you to talk a little about the post polio clinic. I see in the paper that it is still involved. I remember when I was working in Information and Publications when that clinic got started. I did an article on it and the thing that I remember particularly was that it was the only one in the Southeast. The nearest one was in Atlanta and I want to say Baltimore, so people were being drawn here from a number of states and there are not many things that we do that are so esoteric that they are that rare.

Dave McRae: Now they are everywhere. There are at least three or four in this state and I am sure every state with a major hospital and/or rehab program has it. Let me give you my thumbnail on that. Rehab has really come a long way, as they say, in the last few years and in more rural areas, like eastern North Carolina, there was very little true rehab even very little individual service like physical therapy, speech, occupational, and some of the other related services. That was back in the sixties. The first thing you do is you build a hospital and you create an emergency department, and you do surgery and take care of the medical problems. Only gradually do you get into these other things that contribute to the health of the population.

We were lucky that DVR in this State was one of the leaders nationally and foresaw the need for a statewide rehab system and that it shouldn't be just based in one big place like Chapel Hill and there was some momentum for that to happen, one big rehab center in Chapel Hill, like the burn center. With rehab you had to be closer to where people lived for lots of different reasons so this decentralized approach was created. Chapel Hill had been trying for years back then to start a residency in physical medicine but couldn't put it together because it takes a real cooperative approach from orthopedists, neurosurgeons, rheumatologists and neurologists because these docs, called physical medicine docs, sort of invade everybody's turf and you can get into some real battles.

We had our share of those but thank goodness there was some foresight to get us over that. Rehab's coming here was a real jewel for us in that it was built right at the beginning of the new hospital being built on this campus. Really the only true rehab center in this state was in Charlotte next to Carolinas and the rehab center in Asheville. Then there was one added in Fayetteville, one in Winston-Salem and one here and now this was part of the plan too, that those five are still there, the one in Chapel Hill makes six, I guess.

There are many rehab centers in many small communities and that was part of the plan. There were about six more identified in eastern North Carolina. Heritage has one now. Many hospitals have stroke units and small rehab units so that has come to fruition and it is a very, very important part of healthcare. In the next twenty-five to fifty years now that we have conquered infectious diseases and we have made surgery less traumatic and all. But the real challenges of the future will be chronic diseases. It will be controlling diabetes and juvenile asthma. It will be helping people learn to live with a whole host of disabilities. Osteoporosis, all the problems of aging, these are not primarily acute episodes. They are learning to live with chronic disease and disability so rehab, as a general field, will be more necessary than ever and that is why it is so important that we have the base we have here in Greenville.

We have great staff, great facilities, and maybe now the real crowning touch here is Dr. Phillip Bryant and his residency program which we are convinced is, and will be even more so, one of the best in the Country.

Beth Nelson: Who is Dr. Phillip Bryant?

Dave McRae: He is the Chairman of Physical Medicine and Rehabilitation. He has been here only a year or two now. He is a medical school physician but medical director in essence of the rehab center. He works with Martha Dixon. He is just a superb individual and leader and knows that field well. He has developed programs in the rehab center in all of the specialty areas of physical medicine. I am very proud. What I did was give it a start and hired the first people and got us through those first early years when we really didn't have much. We didn't have money. The hospital was struggling to survive so it couldn't very well give all its money to rehab back then. We had some political, delicate issues with physicians who were fearful of intruding into their areas of specialty, so there was a lot to overcome to get us to where we are now.

Beth Nelson: Who was the first Chairman?

Dave McRae: To start with we used a Committee and Dr. Bob Timmons chaired it and he was really my best mentor at that time and Dr. Ron Thiele, who was the Dean of the School of Allied Health, was my other mentor. Both of them helped me in those earliest days. Then we hired a doctor named Don Weir and he was here for two or three years. He was a physical medicine doc. We had a doctor, an orthopedist and really good guy from Charlottesville, who went back to Davenport, Iowa and then we had Ulrich Alsentzer who started the post polio clinic and he is still on the faculty at ECU. Then after that we recruited Dr. Phil Bryant. Each one was a step forward in taking us to the next generation and brought something new and important.

Beth Nelson: Are we at ninety beds there?

Dave McRae: We have seventy-two. We had fifty-five to start and then we added on twice. It really is a great service. The first polio piece Ulrich started. Most old polios came out of the forties and fifties, at least in the United States. Although I happened to be living in the Near East when I had polio, it was at the same time that the epidemics were occurring in the States. We had polio hospitals in Hickory, North Carolina, Raleigh, Greensboro, areas of the state where polio kids were taken to try to isolate them, separate them, because there was fear the infection spread at that time. They didn't understand the disease. Those of us who survived and most did with disabilities; most of us have lived reasonably well adult lives. After thirty-four years those muscle fibers that have compensated for the weaker fibers wear out and you get a firing of the anterior horn cell, which is almost like a signal of pain because those other fibers have been overloaded for all of your life and that's where post polio syndrome comes from. It is a whole host of problems. For some people it is like a chronic fatigue syndrome; for others it is just muscle soreness and aching and for others it can be more serious problems.

Beth Nelson: It seems like I also remember that there was a lot of misunderstanding about it and it was overlooked as a diagnosis for many years because physicians just were not trained about it.

Dave McRae: Right. The old docs who dealt with polio had died off or retired. The new generation didn't even know about polio much less post polio syndrome so gradually there has been a new field created and there are web sites now that I occasionally check to see what the latest research is. Ulrich was one of the doctors who said we can and should do something about this and he had some special interest and expertise, did some research and training, and created one of the first post polio clinics in the Southeast. He did a very good job of getting it up and running. Then I think he helped others start clinics across this state at least. Now, as I understand it, there are clinics-several in North Carolina and there are a number across the Country. In those clinics they can't cure people. What they do is help them learn to live with and manage whatever level of post polio syndrome that they get. It has been a nice service to have that here and of course, it is personal to me because it is something that I may need more of in the future and it is something I would like for us to have as part of our rehab service.

Beth Nelson: You mentioned the Dr. John Wooten story and I made a note about that, what about that?

Dave McRae: Well, John was Chief of Staff a year or two before I came to Greenville in 1975 and soon after I came he was put on our Board. John was an orthopedist trained in what back then, I guess, was contemporary orthopedics. Therefore, he understood and knew the need for rehab and services like that but had his own opinions about what the rehab center should be and how it should be developed and what services it should have. I learned pretty quickly when I got here that I needed to deal with, get along with and work with John, especially since as I developed the rehab center, although I had money from VR, it had to be matched by Pitt Memorial Hospital by some percentage.

So, every time I added staffI had to come through Jack Richardson's Board and the budgeting process to get it staffed and yet Jack didn't have enough money to build and move forward with Pitt Memorial. I had to be very careful in those early days not to act like they had to give me all the money I needed to do rehab because it was a new service when they were just trying to get beds open and keep them open with old equipment from the old hospital. I tried to be sensitive in balancing and blending and being a part of the hospital as well as running my rehab center.

I'll never forget having to go to the Board for an additional five or six staff. We had fifteen or twenty and it was time for some growth, next round of patients, and I went to ask for staff and John Wooten was against me. I had to get John convinced that we needed that rehab staff and he said we need equipment in the orthopedics department and the surgery suite and asked why they should give me money for rehab. I remember how startled I was that here is somebody who knew and understood rehabilitation and that he was challenging me. As it turned out, he supported the motion of the Board that night and he spoke in favor of it but it really caught me off guard that he was the one asking me the hard negative questions at the beginning of my presentation. After that I learned to always talk to John and be sure he was in the loop and I think we even had him on the committee in rehab. He became a very good friend and he and his wife and Gene Hamilton and his wife and others of us sailed together, sailed to Ocracoke and back and did other things together. I always remembered that John really thought about where to spend money when he was on this Board and I had to make sure I dealt with him.

Beth Nelson: His father was the one who created the old hospital.

Dave McRae: That's right. Talk about history and now Lamont is here and is just a superb surgeon and just a wonderful family legacy.

Beth Nelson: I wanted to be able to do a vignette about the three of them. You had mentioned wanting to do the multigenerational type thing. That kind of goes to a different level when you think of somebody like them that they not only were a multigenerational family involved but they were in leadership roles.

Dave McRae: Dr. Bartlett and now his son is an orthopedist and his other son is a dentist. I don't know his father or grandfather but there are some great stories like that.

Beth Nelson: What about Lamont? Does he do anything from a leadership standpoint?

Dave McRae: He is very active in the hospital and in the medical community and has been, either is or has been, section head of orthopedics for awhile so he has been in a leadership role. What would be fun would be to check with families like that and see if the next generation of kids, most of who now are teenagers or college students, are choosing pre-med. That would be neat to have a third and a fourth generation coming along.

Beth Nelson: That is interesting because they have a son who is the age of my son and they have a daughter who is a little older. I tell you, based on what I have seen of John Wooten, he has every potential to be anything he wants to be. He is twelve now and he is a crackerjack. Let's talk about the private docs. You have always been such a champion of how important they have been in the success of this place. Please talk in general about the importance of private docs but particularly from the standpoint of the leadership role. I just want to make sure we give them their due. It is so easy to focus on the school of medicine, but I think the private docs could be overlooked if we are not careful.

Dave McRae: Well, first of all, I came here with no understanding of private/academic issues not having actually worked with or led an academic center. My Dad, as a surgeon, trained at Bowman Gray and worked both in private practice for a number of years and with the Bowman Gray School of Medicine. He started their first academic emergency medicine program later in his life as he got closer to retirement and being close to him in high school, of course, and then as an adult living halfway across the state, I got some sense of what his life was like as a private physician getting access to the ORs and scheduling and working with nurses and administrators as they were called back then. I also got a real appreciation for his love of Bowman Gray and academia in that sense.

Without much more than those tools, as a young man coming out of physical therapy and nursing home administration, it was a real hard lesson for me to come to understand. It would have been easier for any executive to go to a hospital that was all private staff or to a hospital that was all academic staff. But to come to one that was growing with the coming of the medical school and come to understand either side of that street, and then to blend the two and ultimately have to lead that blending may be the greatest challenge, and I hope the greatest success that I had here in twenty-five years.

I think out of a love and appreciation of my Dad and his roots and a strong desire to balance those forces here in Greenville, I took it on as a personal challenge to make this place one in which the med school could thrive and flourish and private docs could too. I'll admit I probably felt like I was talking out of both sides of my mouth over and over because I would meet with private doctors and try to persuade them that I cared about them and that I wouldn't let them get closed out of practice here and wouldn't make decisions to hurt them.

Having a clinical background I appreciated the world they came from and at the same time I was meeting with whichever Dean was in control then and academic docs trying to reassure them that we understood the Affiliation Agreement required that we make this a place for this medical school and that meant they had to have influence and control. All of my career I have had doctors in both academia and the private side saying they need to be in charge, one or the other in order to get their fair share, their due and to be sure things were done for them. I think that having been able to straddle that fence and I think move it forward as you can straddle a fence and end up in quagmire or you can really move forward. I think we made this place a wonderful place to practice for private doctors to this day and yet we fulfilled more than the med school ever dreamed it could get out of its marriage with this hospital.

I feel very gratified that we have done that. I didn't do it by myself, of course, but to have been able to weave the balance of that and then as I stepped into the CEO role to be able to manage that so we could move forward was one of my greatest challenges.

Beth Nelson: It was interesting to me as I interviewed Wally Wooles for the second time. He was fascinating and I could have listened to him all day. He talked quite a bit about some of the physicians who were early supporters and one person he mentioned was Don Tucker. Do you have any memory of that?

Dave McRae: Well, of course I came in 1975 and 1976 so I didn't see the earlier part. In the years after I came at that point it was the first year Bill Laupus was here, doctors who may have been literally against the med school, I think at that point made peace with the fact that it was here and it was coming and so Don may have been in that camp, I am not as knowledgeable about that. I feel like in my years of dealing with Don directly and seeing him on the campus, his was more an issue of making sure that you don't run private docs out of practice. There was a genuine fear and I think it was legitimate at times, that we would be overwhelmed and dominated by academia and it wouldn't be a good place for private docs to practice. I felt then and feel to this day that it is not fair to a doctor who came here and established his trade, his practice of medicine, for him to end up being run out of town by the hospital or the med school. That doesn't mean you have to give them a free ride. They have to do their part to support the medical staff and if they are going to live here to support the school in some way. I felt his was more like saying be sure you don't do things that could do damage to us.

In that sense, I thought of him as not negative but very cautious about the dominance of the med school. Wally may know things I don't know about other ways that he contributed which I am not sensitive to. In the years that I am aware of his role, it was more his asking us not to let the med school dominate private doctors or run us out of town. Don became a friend of mine.

Beth Nelson: One of the things Wally gave me was a video of a meeting or gathering that he pulled together of people who got the medical school started. He did it like four years ago when Horton Rountree was still alive. He did it primarily to give credit to Horton Rountree and I got it this morning and am dying to go home and watch it. I will keep this copy for our archives. To me it would be neat to be able to incorporate some piece of that into CD ROM videotape that we will put together. I told him it was a shame that Tom Fortner didn't know about it because it would have been a neat thing to do a story for the newspaper or for some of our publications. I think there were thirty or forty of the key people across the state. It sounded like the kind of thing where people from the early days were included.

Dave McRae: You need to do some checking about what doctors were supportive and not supportive in those early days.

Beth Nelson: I feel like if Wally doesn't remember that he was opposed since he remembers him as a supporter, then that is kind of the way I would see him then. My memory of Don's perception of the whole may be tempered by the fact that when he fought us on the endoscopy lab and some of those kinds of things.

Dave McRae: Ed Monroe might know because he was shepherding it then. There will be some others who would know. I think if you could sit down and talk with Don it would be a neat interview and you could tell him exactly what we are doing and ask him to sit and talk with you and tell you about what his issues were and where he was on some of that. We would like to know. I think you would get a neat story out of him.
That would be a great interview. I would like to hear his perspective on some of that and how he perceives himself before and after the med school was here.

Beth Nelson: Major obstacles the hospital has had to overcome.

Dave McRae: Money and the lack of.

Beth Nelson: Buck had story after story about when he packed up all of the accounts in a briefcase and drove to Durham and begged and told them the hard times we were experiencing and left there with a check. To think about that today just seems unreal. It was like two weeks worth of payroll and that was what was needed to meet payroll.

Dave McRae: Of course I had that twelve years ago. Amelia Bryant is still here and you ought to get her quote on that. My first year as CEO she came to me, startled, and told me we didn't have the money to meet payroll because up until that time it was never thought of as appropriate for a public not-for-profit hospital to have reserves, to have money in the bank. You had the County bail you out and so forth. We paid cash. Charles Gaskins will still tell you that he doesn't believe in borrowing money and that a public entity shouldn't have extra money sitting around like that. We didn't and she literally came in my office and told me we couldn't meet payroll and I said lets go borrow it from the bank or something and she checked and the lawyer said we couldn't do that. A public entity has to sell bonds in order to borrow money and I promised myself then we would never get in that situation again. We then started working hard to build some reserves and educating the Board of the need for a growing place like this to have money in reserves and so forth.

Beth Nelson: I remember talking with Kathy because I think she was instrumental in helping us survive the process but I remember it had to do with the computer problem related to Blue Cross. Because of some computer problem, apparently on our end, they told us in November that we probably wouldn't get paid until February or March being such a big piece of business, it was not the kind of thing we could swallow and keep on going.

Beth Nelson: Do you remember any of the stories from Buck's era about money being tight?

Dave McRae: Well, you've heard the stories about moving over here from the old hospital, having to paint equipment as we moved the patients. We would take the patient out of the bed, paint the equipment, then put the patient back in the bed by the time we got here. That was absolutely true. We did that with many pieces of equipment and we created the Gifts Committee. Harry Leslie chaired it, and we started trying to make a little gift money so we could replace old beds, bedside tables, and chairs in the rooms. It took us several years to do that.

When you think back on those times it's amazing to me that this hospital was able to survive because it was growing. Every year then we had more patients coming and we didn't have any money. How we were able to keep up with equipment and build the rehab center and work with the med school as they hired more doctors, it is just amazing to me to think that we did that.

Beth Nelson: Why were we so financially strapped? I have heard different people say different things. I was talking to Kenneth Dews and he said that nobody had any money back then. We were in an environment where money was short for everybody. I was in Ahoskie at that time and that was a very well financed hospital back then. When John Blanton retired they were sitting on quite a bankroll.

Dave McRae: You're right, it was a very wealthy hospital. I remember that from back in those days. They had money set aside. Remember that this was a public not-for-profit. In Ahoskie it was a private not-for-profit and it was created, I think, with people who helped establish that hospital and they were able to run it a little more like a business back in that day. County owned, city owned hospitals were treated differently back in the fifties and sixties and even seventies. It was different. They were not embarrassed by having amenities in their hospital that others of us wouldn't of thought of having.

I always thought of Ahoskie, even in those days, as having things others of us didn't have. Jack and I used to stop and see John Blanton as we drove up that way to Williamsburg occasionally. There are other hospitals that were like that. Rex Hospital I always thought of as one with an endowment and business people who helped start it and run it; whereas, Wake Med struggled for years and years when it was created because it was the County hospital. I think of it mostly as there wasn't much money-Kenneth is right. Nobody had much money and hospitals were not thought of as businesses. They were not intended to have money set aside for a rainy day. They just didn't do that and so there was no money and as the old red brick building went downhill, there was no money to rebuild it and the struggle to decide whether to move over here was difficult enough and I am sure you have interviews that there were people against the bonds to move us here. I think you told me that Joe Pou helped lead that fund raising effort and it just barely passed.

Beth Nelson: I hear it only passed by about twelve votes. I have heard Jack Richardson say he was shouted down at public hearings and that he was accused of everything in the world for having pushed so hard to see it survive.

Dave McRae: As you put that story together as a section, chapter or vignette or interview, always trying to relate the history and our appreciation for where we came from to today and the future, I think you have to talk with people like Jack Holsten and look at the way money is managed today when you are in the kind of big business we are and how you manage money, you efficiently use borrowing in this day and age. Appropriately so, so that you're financing some of your growth instead of just spending your cash. It allows you to set aside cash and we have over $200 million in the bank and we are one of the few hospitals in the United States of America with a AA bond rating.

Beth Nelson: At one time we were one of only sixty.

Dave McRae: It was one of sixty in the Country but you have to qualify it. Standard & Poors had been asked to inspect it that year so it is still a very low number. Of the 5,057 hospitals in the Country at that time, there were probably less than several hundred that were AA rated but in that year we were one of sixty that had gotten AA ratings by the rating agencies. To think that we came from the history we just talked about to that level in the last four to five years, we were blessed with a few good years of making money. We had a lot of business, we good reimbursement from Medicare, teaching costs were reimbursed, there were things that we don't have even now.

Things changed and money has been taken away from teaching hospitals. We had one year where the Federal Government set aside money and then paid you a year or two later to confirm that you owed that money. There was one year that we had accrued and were paid some huge amount of money and it allowed our bottom line to go to $42 million in one year. People thought we made that off the backs of patients in that year but it was really set aside money from Medicare adjustments over several years that was allowed to be booked in that year. It didn't take many years like that of those four or five years to give us the kind of reserves that we have today. So, we are going into the new millenium feeling in very good shape with a goal to continue improving and developing service in the region. But as we grow we will need to build our reserves so we won't ever get back in that same shape we were.

Jack can give you some of that information.He has projections for the next five or ten years about what our reserves need to go to and how do we balance spending $350 million on construction in the next five years and building reserves and making salary increases and all the other things we need to do.

Beth Nelson: That reminds me in looking at the Administrative Staff, some of those people are real important that I would want to interview. In doing so, it would be helpful to me if you would steer me in the direction of who would be the six, seven or eight most important to include. I have already done Ralph and Buck.

Dave McRae: This isn't necessarily for the book is it, because Wayne is doing the book?

Beth Nelson: Yes, but this would be incorporated in the book but I would like to get everyone necessary.

Dave McRae: There are other places some of this can be used when you relate. You can almost do one of the People magazine things where you have one page that shows the old and the next the new. What we didn't have and what we have now. Our information systems and Buck's story about our most advanced technology in the Business Office was that we had one manual calculator and he had it on his desk. It is a true story and he had the only calculator in the earliest days. Sandra Peaden has been here all of those years in the patient finance area and now you could talk to Ed McFall and hear what we are spending each year on information technology and what the future is. He can tell you about the patient medical record integration and all of that

October 9, 2000

Interviewer: Beth Nelson
(Second Interview)

Dave McRae: Fifty years of history is so important to remember to acknowledge and to recognize. There are people and events that have been instrumental to this place in its formation. Yes, there is the flood but there were snowstorms and tornadoes before that. There were construction projects; there were people we had to recruit and there were very, very important decisions that had to be made by County Commissioners, by the Board itself and even by Governmental leaders at the State level. All of these events are part of our history. It is important in this fiftieth year to remember them and to recognize them. That's what this fifty year recognition is about; that's why all these people have been interviewed; that's why we are having this period of several months to recognize and remember those events.

Every organization has events that take place in its life but it is the people that give meaning to those events. The core decisions that have to be made, the focus on mission and purpose of an organization is what these events are about. We have a wonderful history of people and decisions that they have made for fifty years that have led us to the point that we face now.

Beth Nelson: Let's talk about the tendency of the people of this place to take on risk and step out and do something with a little bit of innovation and a little bit of flair and set the stage.

Dave McRae: We would not have been prepared for the floods that we have had in the last year had there not been people, leaders and workers, who made important decisions and took risks; people who stepped out and made decisions that were difficult to make that were hard for the community and the region and the public to understand. It was the willingness of leaders to take those risks that have set the stage for this place to be what it is today. That focus that we have today and have had for fifty years is our mission. Yes, the mission has changed and it has been interpreted differently over time which is appropriate. But it has always been about a mission of health care for the people of Pitt County and for the citizens of eastern North Carolina. A mission of service, a mission of education and ultimately a mission of improving health and quality of life for the people who live in this area.

Beth Nelson: Talk about how over the next few years you will see some minor changes in our County but the thing that would stay the same would be the mission.

Dave McRae: This place has moved from one of being a community hospital to a teaching hospital and in recent years to a regional health care system. Throughout that transition there has been an abiding focus on mission, on service to people. Over the next twenty or thirty or fifty years there will be huge transformations to this campus alone in Greenville. Construction projects ranging from $300 to $400 million to make this place what it needs to be to serve the people of this community and this region. As we go through that bricks and mortar and structural change, it will be the goal of the leaders of this organization, as it always has been, to focus on mission of service. Regardless of the brick and mortar and the structure, service to people is what this place has been about. The willingness to take risks to meet that challenge and the willingness to use people to help achieve the goals of this organization is what has brought us to this day. We will do everything we can to not only recognize that history in the past that has been here but now we must challenge those who come after us to fulfill that mission in the future as well.

Beth Nelson: Focus on the local leaders who brought us where we are today.

Dave McRae: Part of the history of Pitt County Memorial Hospital has to do with the leadership that Governmental leaders have provided, County Commissioners particularly. There have been leaders throughout the fifty years who were willing and able to help make the really difficult decisions to allow this hospital to serve this community and the region and to be the teaching hospital that it committed to be some twenty-five years ago for the school of medicine and the State of North Carolina. Those leaders are honored and recognized as we go through this period of time recognizing the history of this hospital. These leaders are part of the legacy of this place.