See also Vignette

JACK W. WILKERSON, M.D.

September 11, 2000

Interviewer: Marion Blackburn

Marion Blackburn: Tell me a little bit about how you became involved with the hospital.

Dr. Wilkerson: I came to Greenville on January 1, 1967 and I was the forty-fifth person on the Pitt County Memorial Hospital medical staff. There were forty-four doctors before me and how I became involved in it was that every doctor in Pitt County and in Greenville was an active member of the Pitt County Memorial Hospital Medical Staff, although you didn't have choice. You have to hospitalize your patients or else you referred them to some center like Duke or Chapel Hill or MCV in Richmond in those days in 1967. Shortly after I arrived, Dr. Billy Jones and Dr. Emmett Walsh came, one in dermatology and one with urology that year. I started in January and they started in July of 1967 so I am a little ahead of them. Everybody on the staff then had to do committee work. We did emergency room work on a rotation basis. There was no excuse. Every doctor except for the radiologists who would do emergency xrays, would do this almost once a month unless you were disabled by age or something of that sort. You did your turn from 7:00 p.m. to 7:00 a.m. in the emergency room taking care of whatever came in that place. Sometimes there were accidents and there were casualties and you would call in the colleagues and they would come in and help you out so you weren't exactly alone but at times you were alone and you would get up and go to work the next day.

The hospital bought a little trailer a couple of years after I was here and it was put out behind the old hospital and it had a bed in it and a shower and I guess it had a television but I think somebody stole the television. But at least you got some time you could walk out from the emergency room and stretch out on the bed and take a nap until the next patient came in or somebody called you.

Marion Blackburn: So there was no trauma?

Dr. Wilkerson: There was no organized emergency room or EMS at that time at all. We were just beginning to train rescue squads in Greenville and Pitt County and that was done on a volunteer basis and I was an instructor along with many other doctors in teaching the rescue squad CPR which helped to provide a little better care than we had.

Everything was volunteer on a small scale and today, you know, it is unheard of but until the medical school arrived the hospital grew very slowly and evolved and just a few doctors came to town, a few died. When I came to town my partner, Dr. Charles Adams, was Chief of Staff of the hospital in 1968 and, unfortunately, he died in 1970 due to heart disease. One of my other partners, Dr. Frederick Brooks, was Chief of Staff and organizer of the hospital in 1950. Dr. Fred Brooks died in January 1969. My other partner, Dr. Beasley Moore who I came to join, died in November 1970. So here I am two years in Greenville, a four-man partnership, and I am left the only one.

Marion Blackburn: Were you in Internal Medicine?

Jack Wilkerson: No, general practice. In 1970 the American Board of Family Practice was chartered, organized. By examination I am a diplomat myself of the American Board of Family Practice.

Marion Blackburn: Lets backtrack just a little bit when you said you had been in Greenville two years. Tell me where you came from and a little about your education.

Dr. Wilkerson: Well, let me see, I practiced in Stantonsburg, North Carolina for which the road out here is named-Stantonsburg-with a partner named Edgar T. Beddingfield, Jr. from 1965 until December 31, 1966 over there and came to work and live in Greenville since then.

Marion Blackburn: Are you an eastern North Carolina native?

Dr. Wilkerson: No, I am a native of nowhere. I was born in Washington, D.C. I grew up in Asheville, North Carolina and I went to the University of North Carolina at Chapel Hill and at undergraduate school I got a BA degree in chemistry; I served three and one half years in the U. S. Army during WW II and than I decided I wanted to be a doctor when I came back and I was going to become a Psychiatrist. So I went back to Chapel Hill and at that time we had a two-year medical school at Chapel Hill I was the last class in that two-year medical school before the four-year medical school opened. I started in 1949 and left there in 1951. Our fiftieth reunion is coming up next April.

Marion Blackburn: Were you a Medic in the War?

Dr. Wilkerson: No, no, I was a music major when I went to college. I played the bassoon, saxophone and clarinet and I was going to do all these wonderful things and when I got to Chapel Hill I thought well, I didn't have any talent, I was a country boy growing up in the mountains and played in this band and stuff, played dance music from those big bands and stuff and you got down there and there were some people from all over the world and they really were talented. I didn't have any talent other than maybe being a high school band director somewhere but I didn't much want to do that. When I got drafted I was probably saved from a fate worse than death.

Marion Blackburn: So, you took your BA in chemistry but you were at the same time thinking about doing something in music.

Dr. Wilkerson: Well, I started in college in 1942 in Chapel Hill, and I got drafted in February 1943 and I got discharged in April 1946 and started back in Chapel Hill in September and got my degree in chemistry in 1949 and started medical school in 1949. In 1951 I left Chapel Hill and went to McGill University in Montreal, Canada for my last two years of medicine. The reason I went there was because I wanted to go to Emory University in Atlanta but they didn't have any vacancies in their third-year class. My wife was from Mississippi and we were married in 1950 and she didn't want to go up North so we went to Southern Canada.

Marion Blackburn: You still got to go to the South.

Dr. Wilkerson: So that is how we got to Canada. There were three of us from my class who went to Montreal and graduated from McGill in 1953.

Marion Blackburn: At that point you, I guess, would have begun your internship somewhere?

Dr. Wilkerson: When I graduated in 1953 I started my internship in Toledo, Ohio in St. Vincent's Hospital I was there from 1953 to 1954 and in 1954 I went up to Wyndott, Michigan, which is ten miles south of Detroit, and that was also the home of Wyndott Chemicals. Anyway there was the residency, I did a general practice residency there from July 1954 to June 1955 and then I did another year of residency. I needed money and I had two children, I had two little girls at that time, and I had been cold for four years so I wrote to the Dean of my medical school in Chapel Hill and asked him if he had any suggestions for a place to practice in North Carolina that I would like to come back home. He gave me a list of ten people, which started in the West and ended up in Plymouth. My wife and I took this trip; the little girls' grandparents were living in Asheville at the time and we spent about a week looking at these places.

Marion Blackburn: What did you do??

Dr. Wilkerson: I wanted to do obstetrics; I wanted to do pretty much primary care in medicine in a rural area. So, I did that and there were other objections besides the older men in various places I went I went to Asheville and came down to Gastonia and Hamlet, North Carolina, Stantonsburg. I didn't even do Plymouth as I decided I liked the man in Stantonsburg the best and we decided I ought to probably come back and join him.

Marion Blackburn: It sounds like you had a concern despite all your travels and all the places you had seen, you had a real concern with practicing some form of rural medicine.

Dr. Wilkerson: Yes, I worked for some clinics in Montreal in the slums and with the poor people as a volunteer. These people didn't come to private doctor's offices in those days. There were no means, no insurance or anything of that sort, any health insurance of any kind. It was a different life entirely. I remember my family doctor in Asheville said I could go out to Leicester and make a good living but it was mostly farming and in the mountains and I didn't want to be in that part of the country. I didn't know that tobacco crops were a little bit risky too.

Marion Blackburn: That's a whole different story, you mean in terms of your patients?

Dr. Wilkerson: Patients and living and that sort of thing. It was an economic loss. I called it my missionary work and that ended. My partner had started this before I went with him and he patterned it after the Kentucky Nurse-Midwife Program in doing home deliveries. Except for that, we delivered in our office. We had a delivery room and four beds, two white and two black. We would not do home deliveries. There were some old doctors around still doing home deliveries and there were a lot of old mid-wives we called "granny women" that did deliveries at home. These ladies, I guess they helped out before; they were black and they delivered mostly black babies but there was not much about sanitation or anything of that sort and we provided a place in the back of that office which was warm and was heated by stoves and which we later on put an air conditioner in, a central heating plan.

Marion Blackburn: When did you put in your air conditioning, I am curious?

Dr. Wilkerson: About 1957.

Marion Blackburn: That was quite early.

Dr. Wilkerson: Yes, my wife wouldn't let me put it in the house we built because she liked fresh air and after I got used to that cool place to work it was different. But to work with people it was like in a jungle. Everybody was perspiring and the odors in there and we were trying to stay clean. It was terrible. You don't realize it today as we live in a very sanitized world and in those days we just kind of accepted. If people had just used a little "Mum" it would have been better. That's an old underarm deodorant.

That was quite an experience. We delivered around two hundred fifty babies a year in our office and we gave them their prenatal care free. They would come in and have their checkups and we started when I started there we went up from $25 to $35 for a delivery. When I left there at the end of 1966 it was $100 for a delivery and $10 for the second twin and $10 for circumcision. People sometimes didn't even pay those prices but I delivered very few babies at home I did get caught once a lady had delivered her baby and I would go out and deliver the placenta and tie the cord and that sort of thing but that was rare. There were some old doctors around that were still alive that drove their cars out who would do that sort of thing. They would go in and attend the woman who was in labor but we said we were not going to do that and they should come to our place and bring one person with them, one female to be in attendance, and we would take care of the baby and we had everything except drugs. We had plasma. We lost one baby in that ten-year period of time. There was a mother who was a white farmer's lady from over in Wayne County and she was going to Goldsboro emergency room at night with heartburn and to make a long story short, she died of a heart attack before her baby was born. The baby died and that was the hardest day of my life to tell that man his wife was dead. There were three of us then, I had two partners, Dr. Milton Morgan in Washington was with us at that time, he had come back from Vietnam and he was working with us for a year or two before he went to Washington. We had known Milton as he had grown up around Black Creek in Wilson County.

Marion Blackburn: It sounds like you were in Stantonsburg from 1957 to 1967?

Dr. Wilkerson: 1955 to December 31, 1966.

Marion Blackburn: During that time you had already a real sense of the needs of a rural population and your responsibilities and you were already were beginning to understand that there was definitely a need for a personal commitment, that it wasn't about money or prestige.

Dr. Wilkerson: No, there wasn't any money to it. We didn't ever make much money. I never made any money roughly speaking. I am comfortable but I do some preceptor over work at the Family Practice Center with the residents and these residents when they leave here each year they are offered jobs starting salaries and work forty hours a week, none of this seven days and seven nights a week stuff that I was offered. If you are in group practice you can divide that and that is one thing. They can make $125,000 to $175,000 a year. As far as I am concerned these dollars just blow them up, and they complain about things and I ask them in the first year of medicine didn't they ask to be a doctor. I served on the Admissions Committee here for ten years so I know what the stories are. I asked them if they didn't tell somebody when they were interviewed that they wanted to be a doctor, probably even a family doctor, a primary care doctor and they would say it was different now. I told them there was no difference except they had got themselves a license to deliver health care to people and if they were going to be a "Robin Hood" and steal from them that somebody on the Admissions Committee had made a mistake. I don't say it to many of them but every once in a while you get one.

Marion Blackburn: Also, I have heard these words over and over again. Words like missionary, vision, passion, commitment, rural health care. These are things that thank goodness people like yourself have had on their minds and people like Dave McRae and Jack Richardson and I can go on and on and on, have said that this is what we are about, like it or leave it.

Dr. Wilkerson: In spite of all the grandiose schemes we got with the HMOs that were proposed a few years ago to solve all the problems now we are finding because the cost of medical care which is more sophisticated, the cost goes up. HMOs cannot compete and decide how to cut prices and stay in business and then all of a sudden we got to have a Patient's Bill of Rights which is a national issue because these people have stockholders who want a return on their money and they are not getting the returns they want and so they cut down some services. You hear about this lady who couldn't have a baby in this hospital because it was not on an approved list or there were no doctors on that staff that were approved to take care of her under the plan that she was in. She had to go to a hospital fifty miles away. Around here that just about blows your mind but we do have people at our Family Practice Center come to this medical center here regularly from Washington, Plymouth, Kinston and Goldsboro, all around, where is they used to go to their County or community hospital. We are a medical center now and that changes things very much because we are more sophisticated. We are on the cutting edge of medical developments and that's attractive to those people who can afford it. The sky is the limit.

Marion Blackburn: It is a whole different issue these days.

Dr. Wilkerson: In spite of all the wonderful, wonderful things that have been done in the days gone by, Johns Hopkins had lots of poor people. Back in Montreal, Montreal General Hospital was down on the St. Lawrence River in the slum section of town with the poor people down there and so forth, but it started to take care of those poor folks that had no health care. It was started by benevolent people that had monies to invest in a hospital.

Marion Blackburn: You were in Stantonsburg and then you came to Greenville. How did you come to Greenville? Were you invited to join another practice?

Dr. Wilkerson: No, it was a series of circumstances. When my oldest child was ready to start school, high school, there were things called school guidelines directed to keep people in school districts and in Stantonsburg we had a little high school that graduated about ten to fifteen children a year. You by law could not cross school district lines and send my children to Wilson. I had a lawyer. We went to the School Board, we tried everything in the world. They had three school systems in Wilson County, and they have one now. We tried and my wife went around trying to get things changed for consolidated schools and when this didn't work we just said that we were going to leave there. I went to the county commissioners; I talked to all of them about if they wanted a doctor in Stantonsburg if they would let my child go to a Wilson school I would stay in Stantonsburg. No, so I gave my six-month notice and I moved. I looked all over the state and ended up at Appalachian. The President of Appalachian State University at that time had been my high school principal and he wanted me to come and start a student health service. They had some doctors in town that were doing this but they were doing it on a part time basis. He wanted a full-time person. The salary was $17,000. I had made $27,000 last year in the country and I told him I couldn't put my family through this kind of sacrifice. He told me that he only made $18,500 himself. This was in 1966 now we are talking about. So we chose between Kinston and Greenville and we chose Greenville because of the university, the school system, and there seemed to be a little more liberal attitude than the conservative attitude of the people in Kinston. I'll let you know that John Birch grew up in Kinston, North Carolina before he went to Boston and became a millionaire. Anyway, Kinston has some awfully good people and it is a nice place and I had a good opportunity to go in there with a good person who wanted me to come there and join him. The man I joined here, Dr. Adams, would have been a year ahead of me at Chapel Hill in the two-year medical school so he would have been here practicing one or two years before I came to join him. His name is Charles P. Adams and his son is Charles Adams, Jr. who has an advertising agency. It used to be Adams & Longino.

Marion Blackburn: I don't know if you know Chris Bremmer. They are good friends of mine.

Dr. Wilkerson: I do very well. Chris Bremmer went to work with the man in Kinston that wanted me to come to join him.

Marion Blackburn: I figured there would be a tie there.

Dr. Wilkerson: We tried to get Dr. Angston to come and join our group when Dr. Bremmer got into Kinston. I tried to get Dr. Bremmer to come from Kinston and join me when I was by myself. We knew the medical school was a glimmer and that the medical school was coming as it was developing with possibilities, but in the late sixties or early seventies there were a lot of things that had to be done before it became a reality which some people don't understand. If you read Wayne Williams' book it will give you a tremendous appreciation. I would like to give a copy of that book to each person that is involved in medical education around here and staff members of the hospital and people of that sort. In another twenty years, it will all gone. That book will be the answer and when I read it, it brought all kinds of things to mind I had forgotten about.

Marion Blackburn: I remember the story though, I was in Junior High and High School and my family subscribed to the News & Observer and so you know what kind of perspective I got.

Dr. Wilkerson: Did you grow up in Kinston?

Marion Blackburn: I grew up in Rocky Mount and attended the City schools, oddly enough.

Dr. Wilkerson: What is interesting in talking about the school systems, as soon as I moved to Greenville people outside of the Greenville School District, Winterville, could come to Greenville and send their children to school by paying $50 tuition supplement. They would never let me do that in Wilson because it was an integration thing keeping blacks where they were supposed to be and whites where they were supposed to be and that is what it was all about. It was scrubbed later but that was in the middle sixties and that was what was going on.

Marion Blackburn: It later became a real hot issue with lawsuits and everything.

Dr. Wilkerson: The year after I left Stantonsburg my partner closed the shop and went to work in Wilson and worked there until he died in 1980.

Marion Blackburn: You came to Greenville and you had a practice with some people that you believed were contemporaries and within two years you were practicing alone.

Dr. Wilkerson: Actually so, they all died. The oldest man, Dr. Brooks, was Chief of Staff in the hospital in 1950 and started that brick structure on the hill. He was sixty-nine when he died and Dr. Moore was sixty-seven, he died of heart disease and had expected to retire but he stayed on and Dr. Adams was only forty-five when he died.

Marion Blackburn: What did you do with all those patients?

Dr. Wilkerson: I saw all those I could and suggested to others that they go and see someone else and in those days there were three or four internists in town, half a dozen or maybe a dozen general practitioners scattered around and we just see people who lived outside of the city limits or outside of Pitt County. Today over at the Family Practice Center there will be people there from all over eastern North Carolina coming there for their primary care. I personally think that is not good. I think that you should be able to do what the old adage was, if you can't go from the county seat to your home from sunrise to sunset, the county is too big. That was to ride a horse or a buggy or something. That's how the counties were set up - the county seats. I think that is right but we do have transportation, we have communications and so distance is not so important and I suppose eventually we will have a conglomerate thing of four or five counties banding together and call it a multi-county facility in some places.

Marion Blackburn: That is almost what is happening now certainly in health care with the University Health Systems and a lot of them, say Ahoskie, Chowan, Tarboro and Bertie. These are hospitals that were their community hospitals and they are still community hospitals but now they are part of one system.

Dr. Wilkerson: It is too expensive to maintain the level of services at those hospitals and at the same time with communications and the helicopter service and everything else we have got you can go sixty miles in sixty minutes without much trouble.

Marion Blackburn: You brought up, of course, a real interesting subject which is the difference between now and then and you are talking about situations where the tradition is can you ride a horse there and back in a day. Now the tradition is well, we have helicopters, we have ambulances, we have telemedicine, lets talk a little bit about things that have changed that you would not have expected in the terms of the hospital and the hospital system. I can imagine that there are tremendous changes. When you came in 1967 like you say the medical school was a glimmer. I doubt there was helicopter service in those days and the EMS service was not yet created.

Jack Wilkerson: In Pitt County Memorial Hospital in the first Intensive Care Unit we had four beds in the old hospital on the first floor at the end of the surgical hall. Dr. Fearrington and Dr. Rand, I don't know if Dr. Rose was here at that time or not, but that is where they had all of their intensive care. That was the first Intensive Care Unit that we had in this hospital.

Marion Blackburn: Could you describe it for me?

Dr. Wilkerson: It was just four beds, I guess the walls were taken down and there were curtains that went between them at the end of this hall. That was the Intensive Care Unit and you had oxygen and monitors and stuff like that in each room. They had cardiac monitors installed where you could see traces of the heartbeats and the nurse would sit back in the nurses' station and watch them and monitor their rhythms and so forth It was very primitive but it was better than what it had been. When I first came here we put them in their own room and would put in an oxygen machine, didn't have any heart monitors so you would look out for them and they might have a private duty nurse who would kind of stay for eight hours and they would monitor the patient and check their vital signs and start their intravenous fluids. There wasn't a whole lot of heart medicine that was reliable remember one night Dr. Longino was walking through the hospital and they called him to see a patient of mine and I believe the man had cardiac arrest and Dr. Longino resuscitated him and started him back. He went on to live. He had been a retired Dupont person and he lived maybe ten years, his wife still lives, yet he had gone to Mexico City and because of that altitude down there had chest pains and they had to hospitalize him.

Marion Blackburn: How long would you stay in the hospital when you had a heart attack back then?

Jack Wilkerson: Oh, most of the people would be kept in there from anywhere from three weeks, some even six weeks.

Marion Blackburn: That was another thing that Dr. Rose and I were talking about is how when you had a heart attack in those days it was bed rest, it was take easy, it was don't do anything and in the hospital and where as it is now maybe you might be even treated as an outpatient depending on the severity and then you are going to go home and you are going to be in some kind of Rehab or you are going to actually begin working on getting better.

Dr. Wilkerson: Today we have what is called clotbusters which basically dissolve the clot and if you can get in there within less than six hours from onset you can dissolve that clot and it opens up the artery and the damage to the heart muscle can be minimized and, therefore, you don't have all this stuff to go through. Then the clot was formed and boom you have had it. There was the question of if you didn't die of it, twenty percent or more died, and people dropped dead on the street. One in five people who do not survive heart attacks if you happen to be in the hospital you have a good chance of getting out. If you are on the street you are probably going to be dead. You read about this in the paper all the time. You have these chemicals which will dissolve the clot then you put them on Cumaden later for preventing clots developing next year or ten years from now. That goes up and down because it is pretty good but it also causes hemorrhages and various things and it waxes and wanes in its popularity. There are also other types of things that will prevent clot formations in certain people. There is aspirin which works and they have been experimenting with that for many years and I was in a placebo group in a Harvard Physicians' Study that went on from about 1976 to 1984 for fourteen or fifteen years and I was in a placebo group. They broke the code because twenty percent of the people that were on the placebo were having heart attacks and that was bad because a lot of them died. I had nosebleeds and I had to stop the aspirin. When you get old there is one thing after the other.

Marion Blackburn: Well, I think that you have just a tremendous ability to reflect on these things and to reflect on the perspective of someone who has seen it progress and you are still involved with the medical school it sounds like.

Dr. Wilkerson: This is my best hobby. You see I didn't fish or hunt or chase roulette wheels, anything of that sort. Then I got into medicine and it became my life in all ways. My wife used to tell me I was at the hospital more with the patients than I was with the family and I said it might be true in some ways but not entirely.

Marion Blackburn: It sounds like you have a real love for it.

Dr. Wilkerson: Yes, I really do and you have to like people and when I was on the Admissions Committee I would ask the student if he liked people and tell him we had some brilliant people who want to go to medical school but the East Carolina University School of Medicine was not started to be a research institution. It was started to be an institution to take care of the people of North Carolina. Particularly they needed family doctors and the minorities that needed help in health care and that has been law and you can read that pretty truly in Wayne's book. That has been said over and over and that is just proof. When I was on the Admissions Committee I reminded a lot of the candidates that the only reason we have this school here and why we want you is that you are from the State of North Carolina and you can provide health care for these people. I will have to admit that once the person gets that M.D. degree they are a free agent, the State has nothing to hold them and there is no way to do it unless they had borrowed money from the State and many people will borrow money from the bank and pay the State back and not go into service for three years in a rural area. Many of them do but there are all kinds of schemes trying to get people to go to rural areas to provide health care but at the same time that person has an M.D. degree and it opens all doors anywhere. Not saying that you can't be just as important in Atlanta, Georgia as you are out here in Pactolous, but you have a whole lot more bright lights in Atlanta Georgia than you do in Pactolous and if you come from there or your spouse comes from there it is not likely that you are going to relocate there and that was the idea of the whole philosophy behind it.

There was a study called the Bible Study done back in the sixties, Dr. Bible did the study, it showed where the doctor's spouse came from and where that doctor came from and not what determine where that person was going to end up in practice, not where they did their internship or where they went to medical school. Those things were important but the biggest thing was where were the families, where were the family ties. I am not sure that will hold up today but that was one of the things that was used and spoken about when we were talking about relocating people.

Marion Blackburn: It's a good thing too that people like yourself on the Admissions Committee had such a strong commitment to making sure they understood the mission and making sure that you knew about things like where they were from and where they wanted to go.

Dr. Wilkerson: I served ten years on it and then we got some new members and I had to remind them periodically why this school was created, and Dean Hayek was the Chairman of the Admissions Committee, he was Vice Chancellor for Admissions, and just retired here a couple of years ago, Dean would reiterate this.

Marion Blackburn: I would have to say that I think it has been a remarkable success, I mean just coming in now and doing interviews and talking to people. I personally have a family doctor with ECU Physicians and the Bremers are very good friends of mine and when I talk to people over and over be it somebody in Oncology or somebody in Family Medicine, Cardiology, I hear it over and over again that we have been committed to improving rural health care in the East.

Dr. Wilkerson: You know, there are a million and a half people down here and what has the impact been, well it has been good, there are more doctors now doing more things and we have sophistication here in the center and I think the school is still trying to maintain its role as a provider of primary care physicians and that would be good for a while and how long it will last is after a generation or two go by things change. You have to keep up with time. There is something sentimental that you just don't wipe under the table or sweep off the porch, it is there and that is you have people with needs, you have people to help solve those needs in some way or another to make them better, you put them together you will be able to make everything better for everybody. That is a lot of philosophy but I am willing to preach it still.

Marion Blackburn: I always have a real hard time getting people to talk about themselves in the sense of their leadership but I did want to ask you about your time as Chief of Staff at the hospital. I wanted to find out when you were Chief of Staff.

Dr. Wilkerson: Well, I was Vice Chief of Staff twice back in the old days and that was when my partners died and I didn't have the time for that. I became Chief of Staff in the new hospital and I served from January 1983 until December 1984. It used to be the term of Chief of Staff was two years originally and that is what it was for my partner Dr. Brooks, who was the first Chief of Staff, Dr. Irons was Chief of Staff, Dr. Trevathan for two years. After my term, it became a one-year term of office and we were alternating at that time, one year the person was from the medical school and the next year the person was from the private practice in the community, a community doctors and a medical school doctor. That was to try to prevent the separation of "town" and "gown" it was called. The biggest thing I wanted to do in the hospital was keep an open staff hospital so that any doctor that came to Greenville who did not want to be a medical school doctor, did not want to work for the medical school, wanted to have a practice, could take his patients to Pitt County Memorial Hospital in those days and admit them. Having been in Chapel Hill in those days, it was a closed hospital. Only medical school doctors. Doctors in Chapel Hill in private practice could not admit their patients. They took them to Durham County Hospital and they would drive that ten miles back and forth to care for their patients in Durham.

Marion Blackburn: Is it still that way in Chapel Hill?

Dr. Wilkerson: No, they finally changed it about fifteen or twenty years ago. When I came back to practice in 1955 that is the way it was and people asked why I supported the medical school. I had four friends who were family doctors out there that practiced in the shadow of Memorial Hospital and were fine doctors and had big practices caring for patients. Half of them were family and children of medical school employees and yet they had to take their people over to Durham back and forth.

Marion Blackburn: That is one thing I am working on the transcript of an interview with Dave McRae and it is one of the things that he mentions over and again is the open staff and parity like you say between "town" and "gown".

Dr. Wilkerson: This is the whole thing and you know this is what people who were against us, you can read all about it in Wayne's book, they would say that we will be just like Chapel Hill and in ten years you won't be able to get your patient in, you won't be a staff member of the hospital and they will kick you out. There was talk here that we were going to build a separate hospital, private practice hospital. That's the worse thing we could have done would have been that but there were lots of doctors around and I won't name them that believed that and they didn't want to have anything to do with the medical school developing. I was kind of involved in it at that time and I was appointed by Dr. John Wooten. He was Chief of Staff and this was in the mid-seventies somewhere. I was Chairman of the Medical School's Committee on the Affiliation Agreement. That was a big agreement; that was a landmark thing, I was cussed and damned and carried on and we stuck with it and we ended up with the best. I know Dr. Fearrington got it done when he was Chief of Staff and he was Chief of staff one or two terms before me and did he had to go to Chicago with the Liaison Committee on Graduate Medical Education and help line this thing up. The medical school has responsibility to its patients and its teaching role. Private practice had the responsibility only to its patients to their care and this was how to get them together and the Affiliation Agreement was how it worked out. I am kind of proud of that thing and I enjoyed it after it was all over and said and done but my colleagues from Chapel Hill treated me like Benedict Arnold. I went to a Medical Society Meeting in Pinehurst and they would stick their nose up in the air and go the other room and didn't say hello or kiss my foot or anything.

Marion Blackburn: Was this because you were a private physician who supported a medical school?

Dr. Wilkerson: Absolutely and even my Dean of the Medical School told me that I sold them down the river. He said that Duke and Bowman Gray have all sorts of foundations with money and there is only so much money the State has got and the State cannot afford two medical schools. The AHEC Program is done by the people in Chapel Hill as a means of taking the money so we wouldn't get it so the Legislature in its wisdom gave us the money to have the AHEC and East Carolina simultaneously and it has been the best ever done.

Marion Blackburn: I didn't realize about that because I also interviewed Ed Monroe and he is very proud of AHEC but he was also instrumental in getting the medical school.
How ironic.

Dr. Wilkerson: Oh, he was, very much so. Ed was a UNC graduate when it was a two-year school. He was a couple of years ahead of me. Anyway the powers that be in the Legislature were responsive to their constituency and the folks at UNC Medical School were absolutely opposed to this thing being developed. They put all sorts of stuff out and rumors and the Chairman of the Board Trustees from UNC was adamant and they used the papers in various ways. I found that the papers could use you too because I got misquoted a few times but that was all right. The AHEC Program they came down here and Dr. Fordham was Dean and so forth and he came and talked to us and Earl Trevathan and a group of us. We were still in the old hospital at that time, and we said we were not ready to commit and he said we had to do it in a week's time, seven or eight days or we would get nothing. To make a long story short, East Carolina with Ed Monroe and some other incorporated AHEC in nineteen counties, different governmental structure and organization and that was when everything was forgiven.

Marion Blackburn: That is why there is region this and region that and we are Eastern AHEC. I did not know that. You talked a little about the medical school and how you were involved with the Affiliation Agreement. Now you continue to be a private physician and did you ever actually join the medical school staff. Of course, now you are a preceptor.

Dr. Wilkerson: I was what is called a clinical professor and you get that from delivering health care but you do not have academic credibility, how's that? So I was a clinical professor of family medicine and have been since we opened the Family Practice door over there.

Marion Blackburn: When was that, in 1978?

Dr. Wilkerson: I think it was 1976 or 1977. Jim Jones was the first person. James G. Jones, came here from Jacksonville where he left his practice and was Director of Medical Education for Pitt Memorial Hospital and there was some money and he had a little office over there in the nursing residence and one secretary to develop a program. The American Board of Family Practice was chartered in 1970 and with that blessing the need to develop residencies in Family Medicine that is of course the old general practice residencies. They were two-year residencies plus internship, three years training. There was a program called two years of medicine and two years of pediatrics. We still have that going on here and it is optional to do family medicine and it eliminates gynecology complete and obstetrics is out of it. Family doctors deliver babies and take care of babies from cradle to grave. So that could have not been earlier than 1970 that the American Board of Family Practice was chartered and then they began developing a residency program around the country. I think 1976 was our first year. The Family Practice Center over here was built with AHEC money. I have been on the Board of Eastern AHEC since it was chartered, as long as Dr. Monroe was and I am still the Secretary of that thing. I represent University Health Systems Hospital and I represent Dave McRae on that Board of Directors.

Marion Blackburn: So, you were a private physician. You courted the medical school. You helped with the Affiliation Agreement, and then you were a clinical professor, I imagine that you had a very difficult time at times with your private physician colleagues. Was that ever an issue here?

Dr. Wilkerson: Oh yes, once it became established that we were going to have this medical school here, once that was okay then things changed. I mean there are still a few of them opposed, but most of them have gone to work with the medical school except for the ENTs and the Orthopedic Surgeons and they are separate. It used to be the obstetricians and they joined Physicians East, a multispecialty group, which is partly to do with HMOs and has nothing to do with local stuff that went on.

My two years as Chief of Staff were enjoyable with the Board of Trustees every month and I interviewed people and talked with new Trustees of the hospital and what it was like coming on the Board and where the medical staff was and these people were from all walks of life. I went for two years to the annual Hospital Association meeting with Jack Richardson and Dave McRae. McRae came here as a physical therapist and opened the Rehab Center and that is where I first got acquainted with him and he was a very talented and bright young man. His father had been a missionary doctor.

Marion Blackburn: I know they were in the Middle East or it was called the Near East then. I know when he came on for him to serve was just a second nature. It was not a question of if he served others or not and I think his personal leadership has been real critical.

Dr. Wilkerson: He has been the finest thing in the world for this center. He is very talented. Jack Richardson did a good job but Jack was part of the old school. I think Jack did a good job as the Administrator of the hospital.

Marion Blackburn: I guess the last question I would like to ask you would be, and we have already touched on it a little bit, which would be, we have seen ICU go from four beds and four curtains to today where we have non-invasive procedures, can you talk a little bit about the future of health care in eastern North Carolina, the future of the hospital, where it should head, where it is heading?

Dr. Wilkerson: Well, I was asked by a man whose son is one of our surgeons and he is from New Hampshire and he is a member with the Golden K Club who are members who are fifty-five plus and we meet once a week and this man is the upcoming President. He asked me what was the future of robotic surgery and I told him I thought it was fabulous because of the things that you learn with computerization and electronics and fiberoptics, you bring it all together and robotic surgery is just the thing. It is like Detroit has all these robotic machines putting the cars together and they are not falling apart and they are good stuff and I told him when you can operate on people with robotics your chance for that body to recover is a whole lot better than if you had to open it up and weave around in there for three or four hours trying to figure out what the heck is going on and putting them back together. The technology is going to be the guiding thing for the next twenty-five to fifty-years and the imagination. To me the people that understand computers and what they do, I don't understand them that much and they talk this "computerese" and this kind of mental ability is going to drive us where we need to go but we still have to have our feet on the ground. If you don't wear your shoes your feet hurt.

Marion Blackburn: Maybe you could speak a little bit about the about the human genone project and cloning and bioethics.You know, people are talking about invitro testing and if someone has a gene for Parkinsons do you abort or do you do genetic surgery on that person. We have so many issues now that were just not even a question when you first began to practice medicine. How should we approach some of those ethical issues?

Dr. Wilkerson: With a great deal of fear and trembling. I heard Bill Moyers' first thing last night on living and dying. He is doing a four-part study, two hours each, and he has been working on this for a couple of years on how do we take care of the terminally ill which is a cost in our health care system more than anything else in dollars for the last thirty days of your life which is mores expensive than all of the rest of it. This is with technology where you have to decide whether you are going to ration or not to ration and what the people want and what they do not want. My wife and I have living wills, we have durable powers of attorney and we have a directory of medical things we want done and not done to us and the only thing I haven't done is to buy a medical bracelet that says do not resuscitate or have do not resuscitate tattooed on my chest because once you get into the arms of the EMS people you are going to be resuscitated no matter whether you are brain dead or not. We are not going to extinguish people and we are going to let nature take its course. We are going to provide comfort care but at the same time if you provide fluids, a feeding tube, such as a hole in your stomach which can go forever, you are going to be as brainless as can be and you can go on like that poor Kathleen Quinlan did before they shut off the resuscitation efforts years ago. So you have a whole psychological thing to acquaint with when we talk about aborting things or you can take tissue from the fetus baby and use it. A lot of people including the Pope say this is not to be done. You can look at all kinds of good things and I am not Catholic and say this we won't do. It is just like playing God and we don't think much of what happened to people in concentration camps in WW II and the Bataan March and at the same time life is important and it needs to be respected and if we are in the healing profession we do all we can to alleviate suffering and help folks out and how we do it and how we get there, there are a lot of jags in the road.

I remember telling some of my people that talk about cardiac bypasses-when I was a senior medical student there was a man in Montreal named Arthur Vining who is dead now but he did thirty-eight what is called coronary artery bypass grafts on people in 1954 and he had this medical meeting in Montreal General Hospital and the Royal Victoria Hospital and he had a number of these patients then that were living several years after he had done this and he would take this artery and stuck it into the heart muscle and they
survived and they grew without doing a suture and he didn't have to do any big procedure. He lived another fifteen or twenty years but Arthur Vining was the first coronary artery bypass man in the world. I was a medical student and saw some of these patients and talked to some of them and asked them how they felt and if they had pain. In various parts of the world things are going on that we don't know about so communication will make it a whole lot better and that is a good thing about the Internet, I guess.

Marion Blackburn: I could impose on your time for several more hours. There are a lot more questions I could ask you. Is there anything that I haven't asked you about that you would like to share with me, any particular memory.

Dr. Wilkerson: Let me tell you what I am doing. We are getting ready to move. We are building a place over at Cypress Glen and hopefully it will be done in about four months. Anyway, when you are downsizing a house this size to 1,300 square feet, we have stuff we are trying to clear out. I have two file cabinets up there with all my medical stuff and I went through part of it one time and I will send you a copy of a bill from Representative Sam Bundy - he had sent me a copy of a bill after the appropriation of the medical school. I have a bunch of stuff up there and I am going to be going through that, shredding it and burning it and throwing it away and if I run across things I will call you.

Marion Blackburn: Please do, as a matter of fact even anything that we can take a picture of on invoices, an invoice that might have your fee for delivering a baby which might be $25.00 or $100.00, something like that. Anything you come across would be great.