See also Vignette

EDWIN W. MONROE, M.D.
Chairman, Board of Trustees

April 17, 2000 and May 12, 2000

Interviewer: Beth Nelson

Also participating in this interview is Wayne Williams

Beth Nelson: You talked about having attended Davidson University of Louisville, and then going back and graduating from Davidson and then you attended the two-year program at UNC School of Medicine and got your medical degree in 1949 from the University of Pennsylvania.

Ed Monroe: I left Chapel Hill in 1949 and graduated from Medical School at Pennsylvania in 1951. Then I went on to Richmond for a year internship at the Medical College of Virginia Hospital. I then went back to Chapel Hill in 1952 when they opened the hospital and enrolled the first third-year class of medical students. During that year we had probably five or six doctors per session because the census was so low the first year or two.

Beth Nelson: Why was that, was it because it was a new hospital?

Ed Monroe: New hospital and not operating as a community hospital but as a referral hospital for the State. I did a residency in internal medicine there and by the time I finished in 1956, the average daily census was up over 200. I moved to Greenville in 1956.

Beth Nelson: Why Greenville?

Ed Monroe: I had two friends here who said they needed an internist. They were Earl Trevathan and Charlie Adams. Charlie is dead but he was a family doctor.

Beth Nelson: Where were you from originally?

Ed Monroe: Laurinburg, Scotland County, which is down near South Carolina. One of the reasons I came here is that they had a relatively new County hospital. It had been open about five to six years at that point. The other places I looked at in this part of the State, like New Bern, had three small hospitals, none of which were owned and operated by the County and they were all competing with each other. The doctors here seemed to want an internist.

Beth Nelson: Was that a relatively new specialty at that time?

Ed Monroe: In the rural areas of the State. It wasn't a new specialty in the urban areas, but I didn't want to live in an urban area. Nancy and I looked at places in relatively rural North Carolina and Virginia where she was from. The first year here I moved downtown into a converted automobile dealership building where Wachovia Bank downtown now sits. Frank Longino also moved into the same building and an ENT guy named Larkin, Ernie Larkin's father. So, the three doctors occupied most of that building. We stayed there until we developed the Medical Pavillion out here near the old hospital and moved out there about 1961.

Beth Nelson: Didn't you have partners over there later on?

Ed Monroe: In 1963 Eric Fearrington. Eric was the second internist to come to Greenville. A few months later Don Tucker came and things grew from there. The hospital was 110 beds back in those days, not integrated, small emergency room, two or three operating rooms, a couple of x-ray rooms, no complicated diagnostic procedures. It was interesting.

Beth Nelson: You were in practice for twelve years, is that right?

Ed Monroe: Yes, and the first seven were solo.

Beth Nelson: Then came the call for Allied Health?

Ed Monroe: No, not really. It wasn't known as allied health. It was starting in the early sixties and after it started a two-year medical school on the part of the University and several doctors getting involved in trying to help move that forward, not being aware of all the politics that were going on and the decision to detour into something called the Institute for Life Sciences and Community Health in 1967. Then they started recruiting a director and I signed on in the Fall of 1967 and worked part-time until the Summer of 1968 when Fearrington had recruited somebody to replace me so I left the practice completely at that point. We changed the name of the effort to the School of Allied Health Professions, developed the programs that are involved in those professions like physical therapy, occupational therapy, etc.

Beth Nelson: What drove you out of private practice? You must have found that very rewarding and very interesting?

Ed Monroe: Two things, one was the growing sense of awareness that the existing academic medical centers were not really going to do anything significant to improve the supply of that manpower in the State. They were going to continue doing what they had been doing, they did not see it as a real problem. I was getting impatient with them; particularly Chapel Hill, which was the state supported school. Feeling that through my experiences in trying to be helpful to the University, trying to improve working with other doctors to improve the level of self-care that we had available here, helping to recruit people like pathologists, neurosurgeons, cardiologists, etc., and recognizing that we had to start producing our own health manpower if we were ever going to really be of any help in expanding access to care in eastern North Carolina.

I thought if I could get things started, even though I didn't have a big background in academic medicine, that I could then recruit people who did have the right credentials and experience to move things along toward what we see today.

Beth Nelson: It must have seemed in some ways like a far-fetched dream at that point.

Ed Monroe: If you stop to think about it, it was but if you just take it a day at a time it did not seem so impossible. There were a lot of detours away from where you were trying to go.

Beth Nelson: Who appointed you?

Ed Monroe: A guy named Robert Williams who was, I guess, about the third in command at the University. He is dead now.

Beth Nelson: What do you think he saw in you then?

Ed Monroe: Stubborness, probably. I think Leo was interested in trying to get somebody with a reputation and I think Bob Williams was more interested in getting somebody that he felt comfortable with who he could work with in the University setting and that had some knowledge of this part of the State and what its needs were.

Beth Nelson: So it wasn't one of those competitive view type things.

Ed Monroe: No, it wasn't like that. A typical effort today to deal with the Office of Equal Opportunity Employment, those kinds of problems. If you wanted somebody, you just convinced them and signed them on. That is kind of the way we recruited the first faculty in Allied Health and the beginning of the two-year medical school faculty. You didn't have to do all the obstacle course in recruiting that you have to go through today. I'm not saying it's good, I'm just saying that's the way it was.

Beth Nelson: You were with ECU for a total of how many years?

Ed Monroe: From 1968 to the beginning of 1990, twenty-two plus years. Actually, it was February of 1990.

Beth Nelson: From there, I guess you had a number of different titles as I recall in the University administration.

Ed Monroe: Yes, you had to wear several hats so I was Dean of Allied Health and then I recruited Ron Thiele to take that on and I became the Vice Chancellor for Health Affairs. Then we changed chancellors in 1978, Leo retired and John Brewer came in and he reorganized his administration and did away with the Vice Chancellor for Health Affairs position, so I then became the Associate Dean in the Medical School and later head of Continuing Medical Education and head of Eastern Area Health Education Center.

Beth Nelson: When I came I think that is what you were doing. I think you were wearing both hats, I guess, Associate Dean and Director of AHEC at the same time. Looking back it seems at least like two people's jobs, I don't know how you managed to do two people's jobs.

Ed Monroe: When you are on site through the development of things it's easier to do more than one thing, you're more familiar with all the ins and outs of various jobs.

Beth Nelson: Since you left, that hasn't been possible.

Ed Monroe: No, things are a lot more complicated these days.

Beth Nelson: Then, it was in 1990 that you went to Kate B. Reynolds?

Ed Monroe: Yes, I was Executive Director of the Kate B. Reynolds Charitable Trust and I was in that for two and one-half years as a change agent, which is what they wanted. The year before in 1989 the R. J. Reynolds/Nabisco Tobacco Company had been taken over, a typical Wall Street hostile takeover, and all of the assets of the Kate B. Reynolds Trust were R. J. R. stock. After the takeover, the value of the stock appreciated enormously and that whole portfolio was able to be diversified by the Trustee of the Trust so that the income went from about $3 million a year to about $15 million a year, to be dispersed in the form of grants. They wanted somebody to come in and expand the operation, raise the visibility of the operation, relocate the office, hire additional staff, and get them started on the track that they are on today.

Beth Nelson: I haven't had any dealings with the Kate B. but it seems like, as an outsider looking in, it seems that it has become more, I guess, more aggressive at looking at what the needs are and addressing them. Was that some of what you were called in to do?

Ed Monroe: I was supposed to start that effort. It had been very reactive prior to that. They had one staff person who had a part-time secretary and the office was in a little cubby hole about a block from Wachovia Bank in downtown Winston-Salem and it was hard to find.

Beth Nelson: Did you plan to be there any longer than you were?

Ed Monroe: No, it was understood that it would be no more than two to three years. It just seemed like an interesting way to finish off your career-your money making part of your career.

Beth Nelson: Was it difficult for you to leave eastern North Carolina at that time?

Ed Monroe: We didn't really leave, we didn't move out of the house, we just camped out up there. We thought we would get home about every other weekend but it ended up about once every two months for a weekend. We got a bit sidetracked because our daughter had to have a bone marrow transplant for her leukemia and she died a few months later. Things were very busy. We didn't see much of Greenville. I was also President of the State Medical Society that year and that made life more complicated. If we had just known we could have stayed here and gotten through it better. I was very tired and stressed.

Beth Nelson: You joined our Board pretty soon after coming back.

Ed Monroe: It was before I came back. It was the spring of 1992 and we came back here fulltime at the end of that year. The UNC Board of Governors appointed me because they thought my legal residence was Forsythe County, not Pitt County. I didn't disillusion them either. I had a couple of friends on the Committee that handles that and they said not to mention it, so I didn't.

Beth Nelson: I want to go back and pick up your perception of when you came here, what you saw in Pitt County and Greenville. I have had a number of people of your same timeframe talk about how the hospital here. Quite a bit of eastern North Carolina was taken care of by the hospital in Rocky Mount and number of hospitals that would have probably had a little bit more secure reputation than we had at that time. Kinston even was viewed as being at least good a hospital by many people, if not better.

Ed Monroe: I think it depended on what part of the county you lived in. I don't think most people in Greenville felt that they had to leave town, not to go to Rocky Mount, Wilson or Kinston. They left the county to go to places like Chapel Hill and Duke. People on the outer fringes of the county, like the Farmville area, for years had been going to the hospital in Wilson and continued for quite a while. People in the northern part of the county tended to go to either Tarboro or Rocky Mount. People in the Southern part of the county went to Kinston. A lot of it also depended on what your doctor's allegiance was and the doctors in Grifton tended to feel allegiance to Kinston, Farmville to Wilson, Bethel to Tarboro and Rocky Mount.

Beth Nelson: You saw a spark here through that maybe you didn't see in other communities, what was it?

Ed Monroe: It was a sense of feeling like your colleagues needed you. Frank Longino, for example, and Ray Minges, wanted somebody who had some knowledge and experience in dealing with electrolyte balance and cardiology problems, things of that nature. It wasn't that the doctors here were not okay, it was that they didn't have the training and experience required in handling some of the more complicated medical problems that go with surgery. The Lab was antiquated, it had to be upgraded, and the EKG machine was an old model that was not really portable and that had to be upgraded.

Beth Nelson: What about the staff in terms of the support staff that you needed?

Ed Monroe: The Lab staff were quite willing to learn once the head of the Lab and I worked out an understanding of the fact that he was to manage the Lab but not to interfere with the people working under him, the technicians, learning new techniques, and not to interfere with the need for acquiring new equipment. The nursing staff was great and they really took great care of patients and were quite willing to learn new procedures, new ways of handling patient care. So the younger doctors tended to try to improve hospital care through those sorts of mechanisms. The older doctors had not kept up with this by and large. They were comfortable doing what they knew how to do.

Wayne Williams: What about the facilities of the hospital itself, was it adequate at the beginning?

Ed Monroe: At that point in time, very adequate and really more adequate than the hospitals in surrounding counties, like New Bern. It was several years later that New Bern, Kinston, Goldsboro, Wilson, and Rocky Mount started developing new up-to-date hospitals. It got crowded in the late fifties so a 100-bed addition was made to move it up to 210 beds. Within about two years that was crowded. People were taken care of in the hallways, stacking people up on stretchers along the Emergency Room, twisting your colleagues' arms to move patients out more quickly so new patients could come in. When I came here it was not uncommon for a patient with sufficient resources to stay in the hospital several months if they required nursing care. There were no nursing homes; there was no home care. I can remember one family in particular, a retired banker and his wife, who were maintained in adjoining rooms on the fourth floor of what we now call the old hospital. They stayed there for about six months before they died. That was a lot cheaper than having fulltime nursing help at home. Room rates were only about $8.00 a day so times do change.

Beth Nelson: Talk a little bit about what you think the hospital has meant to Greenville, Pitt County and the region.

Ed Monroe: The first day I was in practice I think I saw three patients in the office and got called to the emergency room by a local doctor to see another patient. That patient was having trouble swallowing. It turned out that she had bulbar polio. We had no respirators, no way of handling that kind of problem. Back in those days we had no ambulance service and we called the funeral home and put her in a hearse, shipped her to Chapel Hill and she made it before she really stopped breathing. They got her on a respirator and over a period of time she almost completely recovered with no permanent paralysis. Today we don't have to send somebody like that out of town. We can handle it here.

Beth Nelson: Tell me again what type of problem she had.

Ed Monroe: Bulbar paralysis. That describes the kind of paralysis that can follow. Paralysis of breathing, swallowing, those kinds of functions as opposed to arms, legs, type paralysis. It was usually fatal, particularly if you were miles away from any kind of respirator.

Wayne Williams: You say this was on your very first day of practice?

Ed Monroe: This was in mid-July of 1956. Every year it is more comprehensive and more available than it was the year before. I see it over the last forty odd years as a step by step progressive improvement in available manpower, facilities, equipment, all the things you need to take care of people with problems.

Beth Nelson: What about what the hospital has meant to the region?

Ed Monroe: Well, I think initially it didn't mean a whole lot to the region because the region's physicians tended to refer patients who needed care that they couldn't provide to the medical centers rather than to Greenville. They didn't see Greenville as a medical center until we began developing the kind of specialized expertise and equipment that would allow us to take care of those kind of patients.

Beth Nelson: What was the turning point there? I know it is an evolutionary type thing,

Ed Monroe: It was a very evolutionary thing and I think it started in the mid-fifties on through the sixties as the doctors here steadily tried to recruit additional expertise to come here and by the time the decision was made to try to develop the new hospital in the late sixties because of crowding in the old one and the lack of space, to expand Radiology, to expand operating capabilities, expand the Lab, expand the patient care areas, by the time that need was clearly identified and understood we had doctors who were not available in some of the surrounding towns as far as what they were capable of doing. Like Ira Hardy for instance.

Beth Nelson: What about the impact of the medical students we produced that are now out in the region in referring back?

Ed Monroe: You're jumping ahead. They do have an impact and it will be felt more and more as the years go by. You have to remember that those medical students really only began to go into practice in the mid-eighties. I think the first class graduated in 1981 and that was followed by three to five or six years of residency, so you are talking about doctors who started in the mid-eighties, some of them in eastern North Carolina in relatively small numbers, little classes of about 30 students. So if half of them practiced in eastern North Carolina, still only fifteen or sixteen doctors. So, it takes a long time for that sort of impact to really be noticeable.

Wayne Williams: Would you say that the hospital was beginning to become some sort of a center for the area than before the medical school came and before the new hospital was built. The hospital was a result of the medical manpower rather than a cause?

Ed Monroe: Yes, that's my impression.

Beth Nelson: What about the mindset of the physicians here? Things have been more open for specialists than in other communities. Wallace Wooles mentioned that one thing that worked to our advantage was the fact that Charlotte was so reluctant to have a medical school there they didn't want us to have one but they sure didn't want one there because they just wanted to protect their own and didn't want the competition that a medical school might create. I just wonder if somehow or other early on the physicians in Greenville were less reluctant to seek specialists even though they might have been competitive come to town from other areas. Would you see that as having been the case?

Ed Monroe: I think generally that has been the case. The physicians that had come to Greenville and particularly among those physicians, the leaders of the physicians, in Pitt County had been more open-minded, more focused on needs of people rather than dollars to be gained by their practices. I don't mean they all haven't done well. But they are less protective of their practices. Some of it is just the mindset that has been here since the late forties and early fifties when the doctors decided to develop the hospital. I don't think the doctors in Charlotte, as a group, the Mecklenburg County Medical Society, was opposed to a medical school in Charlotte when we were trying to develop one here. I think they felt that there was no particular need for one in Charlotte because they had full fledged residency in Charlotte Memorial Hospital and they had third and fourth year medical students from Chapel Hill who were receiving a lot of their clinical education at Charlotte Memorial and they didn't see where adding the basic sciences to that mix would do.

Beth Nelson: That's a different perspective. I guess they thought they had something of a medical school.

Ed Monroe: They had a medical center, they felt, and saw no need to complicate it by adding all the basic science resources to that complex.

Ed Monroe: Some of it was institutional loyalties, where they went to school, where they got their training. A lot of them were from Chapel Hill, a lot of them from Duke.

Beth Nelson: How about obstacles the hospital had to overcome over the years?

Ed Monroe: I think the major obstacle as far as getting the hospital started fifty years ago and again with the 100 bed addition in 1960 or 1961, and again with the bond issue in 1970, I think the major obstacle back in those days was always could the county afford to issue the bonds required to build the facilities and pay off the bonds as the need demanded. The county has never been a wealthy county compared to urban counties back in those days. But leadership always stepped forward and convinced the people that they ought to vote "yes" on borrowing money to build hospital facilities. It's fortunate that since 1970 no additional county-backed financing has been required for the hospital to continue to expand. As a little aside, back in the late sixties and early seventies, there was a National movement toward private funding for development of hospitals. Major corporations were started, like Hospital Corporation of American, to develop, own, and operate hospitals. Pitt County toyed with the idea of selling the 210-bed hospital to HCA with HCA agreeing to build a 300-bed replacement hospital, which it would own and operate. For a county that was not well off financially and looking at a $9 to $10 million bond issue to build a new hospital in 1970 and the passage of that bond issue was in some doubt. It was a very appealing offer but luckily the county leaders were able to resist that temptation and move ahead with the passing of the bond issue and the county building the start of the new hospital.

Beth Nelson: How long was that issue out there, six months?

Ed Monroe: About six months.

Wayne Williams: It may have been as long as a year as it had been going on for quite a long while with all the presentations from different groups coming in.

Beth Nelson: What was your impression at that time? You were fairly new in town at that time.

Ed Monroe: We are talking about 1968, 69 and 70. I had been here since 1956 and I had been over at the University for a couple of years and my impression was that would be a disaster for that to happen.

Beth Nelson: What did you do kind of behind the scenes to share that perspective with the powers that be?

Ed Monroe: Talked to the county commissioners, to the county attorney, who was a very sharp, influential person named Bill Speight, who the county commissioners listened to very closely and usually agreed with.

Beth Nelson: Was Reginald Gray the County Manager at that time?

Ed Monroe: Yes.

Beth Nelson: Where was he on that issue?

Ed Monroe: Privately, for the bond issue, publicly he was neutral. County Managers don't take unpopular public positions very often. They want to keep their jobs.

Beth Nelson: Who were some of the tough nuts to crack on that issue back then? Was Bob Martin a friend?

Ed Monroe: I don't remember anybody who was all that pushy about selling out, more willing to listen rather than push the idea forward.

Wayne Williams: I got the impression that the medical staff were as strongly for it as anybody was and they were more for selling than anybody.

Ed Monroe: I tried to bring into the discussion either with individual county commissioners or Bill Speight and I would try to get a group together, bring into their mindset any resource I could identify to convince them not to fall for that because that would have done us in.

Beth Nelson: Was there somebody else you were going to mention?

Wayne Williams: West and Gilbert, the pathologists.

Beth Nelson: They were in favor of the privatization?

Wayne Williams: They were in favor of anything that would block the development of a medical school.

Continuation of Interview with Edwin W. Monroe, M.D.
May 12, 2000

Beth Nelson: Talk about significant or little-known facts or events, things that are funny, things that are poignant, things that touched you over the years, whether they necessarily involved you or not. But things that you may have heard or known about that maybe other people might not have.

Ed Monroe: Well, it's kind of hard to separate the development of the medical school from the almost simultaneous development of the new Pitt County Memorial Hospital. So, some of what I have to say may be more pertinent to one institution than the other. As you mentioned earlier we are talking ultimately about the development of the medical center, not one part of the medical center. I have tried to recollect something that is little known that may or may not be humorous and that is hard to do because a lot of what I was involved in was a long time ago and you tend to forget things after they have happened. I guess in talking to my wife the things she reminded me of was the number of telephone calls from two or three individuals in the Legislature back in the early 1970s as we were trying to get the medical school approved as a two-year school by the Legislature. The telephone calls would come frequently at 1:00 a.m., 2:00 a.m. and 3:00 a.m. and I might have been asleep for an hour or two hours at that point, sound asleep, and trying to sound awake and alert and it was hard to do. Nancy would always wake up when the phone rang just like I did but I would answer the phone. Sometimes those calls were not very friendly, they were hostile. The people who were making them probably had been to a function which, back in the old days Legislators were known to go to in their headquarters, sort of motel, The Velvet Cloak on Hillsborough Street. There was a hospitality room sponsored by the North Carolina Truckers Association, with free flowing booze of all descriptions. After they had a few and got back they might get on the phone and call people and blast them out because they were not inhibited. So, I got a few of those.

I also recall having to be more aggressive than is my nature and having to catch up with key Legislators at times that I am sure were inconvenient to them, like on Sunday mornings before I thought they might have gone to church. I remember calling Ramsey, who was Speaker of the House of Representatives and trying to get some insight from him in a quiet, peaceful moment in his life on a Sunday morning, as to what he thought was going to happen to some of the Bills that had been filed and were being considered by Committees. He was always very accommodating and polite. I tried not to abuse the privilege of calling him at home but sometimes I had to bother him whether I really felt it was appropriate or not. I remember calling the Governor in 1972 or 1971, Gov. Bob Scott.

Beth Nelson: How were you received by people like that, cordially? My memory was that he was a supporter and I think I saw an editorial where it was indicated that when he left office that it would be the end of support for the school of medicine.

Ed Monroe: That's what The News & Observer was hoping. No, he was very helpful. He was struggling in 1971 with the reorganization of higher education, the university system, and the dissolution of the State Board of Higher Education, trying to out maneuver the UNC/Chapel Hill crowd, led by Bill Friday, but ending up by being somewhat outmaneuvered himself. So, we ended up with a system that Bill Friday was the head of.

Beth Nelson: You talk it about it not being your the style to be so aggressive, particularly with people who were certainly at a different level in life than you were. When I think about that it kind of makes me wonder that you were so well received and well respected. You got in the door even though prior to all the hoopla with the school of medicine you were probably an unknown to most of these people although you were respected here locally and it was not a local well-known name up there, and yet people seemed, even though they might disagree with you, you got a lot of doors opened that a lot of people might not have. Why do you think that is?

Ed Monroe: I think part of it was I believed and came across as believing that what we were trying to do was the right thing to do. I was honest; I didn't try to mislead people that were in key decision-making positions. I think they could sense my sincerity and my truthfulness and some of the people on the other side did not follow that line of communication and sometimes their negative efforts were so obviously biased and false that it helped us. They were undone by their own arrogance to some degree. I think the other thing was that the evolution of events required that I act a certain part that was not my innate nature. I became to a degree what is known as a politician without being an elected official.

Beth Nelson: What did your wife think about all this?

Ed Monroe: She was very supportive of me and not at all fond of what I was having to do.

Beth Nelson: She was probably fearful for you being attacked.

Ed Monroe: It bothered her but I was somewhat of a public figure in a negative sense of the word in some of the state media.

Beth Nelson: But your public perceived you as a hero here.

Ed Monroe: I don't know. I don't know whether that is accurate or not. It doesn't matter anyway. I am not very pushy normally so I don't care whether I am perceived as a hero or not. I feel good about what's been done but I know we have a lot more to do. My only regret is that I am at an age where I cannot continue to be as involved as I have been and so I am going to be on the sidelines watching for the next few years rather than participating.

Beth Nelson: I don't know about that, I see you participating pretty heavily right now.

Ed Monroe: But that is just through this year and then that's over.

Beth Nelson: I would imagine there will be a lot of instances where your contacts, your perspective, your influence would be called upon to make some things happen.

Ed Monroe: Well, we will wait and see.

Beth Nelson: Does anything else come to your mind?

Ed Monroe: None of that sounds very humorous and it really wasn't very humorous. Except some of it was ridiculous. Like driving up here from Atlantic Beach when I was on vacation one week in the summer and meeting with the State Advisory Budget Commission who were here on a tour of university campuses and meeting with them over drinks and dinner, not knowing until I got here that the Dean of the Chapel Hill Medical School was also here and we were supposed to present positions for this body that recommended the state budget to the full Legislature. Dealing with that sort of social event in a way that convinced several members of the Advisory Budget Commission that Chapel Hill was wrong and we were right. Then driving back to the beach and getting stopped by a highway patrolman around Vanceboro because I was speeding and he asked me what I was doing out on the road at that hour of the night-it was about 1:00 a.m. and I told him where I had been and where I was going and he asked me if I worked for Leo Jenkins. I told him I did and he told me he would just give me a warning this time. He told me to keep up the good work.

Beth Nelson: Was that something that you were aware that you were going to be doing? When you came, were you prepared? Did you just think you were coming to a meeting and you ended up having to be the person who presented our perspective? Why do you think that was, how did that kind of thing happen? Was that just an oversight?

Ed Monroe: I had no earthly idea. I was astonished.

Beth Nelson: When was that?

Ed Monroe: That was about 1971 or 1972.

Beth Nelson: That would have been an opportunity to influence. I guess the ABC probably would have been ten or fifteen key people.

Ed Monroe: Ten or twelve.

Beth Nelson: This would have been something certainly you would have prepared for in advance had you been aware that you were going to be questioned.

Ed Monroe: I thought I was coming up here just to meet them and to socialize.

Beth Nelson: And those people, of the ten or twelve, you ended up convincing how many?

Ed Monroe: Two or three that were sitting on the fence.

Beth Nelson: Somehow or other word did not get back to the hinterland here that important things were about to be done. I remember Wally telling about an instance where he went up to Raleigh and you may have accompanied him, where he was asked to give a presentation and the UNC people were there with all their flipcharts and all their diagrams and eight or ten vice presidents Wally goes up there virtually by himself, maybe completely by himself, and stood up and told them that they could see that we just didn't have a lot of the resources to do these fine things that these fellows do but he just told them about the need and swayed some votes that day. It looks to me like there were a lot of instances where something happened inadvertently, we will think of it kindly. We were not notified about things to the extent we should've had. It may have also been because UNC had been through this ABC process several times and knew what to do and that it was a new hoop to jump through for us.

Ed Monroe: It was. I think the coincidence in a sense between the effort to get the medical school approved and funded and the efforts of Pitt County to build a new hospital. Those events kind of coincided fortuitously so that the development of the new hospital was one more little supporting beam in the structure that led to the medical school being authorized. The decision to locate a fifty-five bed regional physical rehabilitation center here as part of the new hospital development. That decision was made about the same time that the County approved the bond issue for the new hospital. The decision to locate the Alcoholic Rehab Center was made a year or two prior to that but it was again, one more little support for the development of the medical center.

Beth Nelson: Talk a little bit about Wally Wooles and your choice of him. When I think of all the people that you could have chosen for that position, you chose somebody from outside the state who certainly didn't know the politics here and you yourself were not familiar with all the ups and downs of politics in North Carolina and had never created a medical school before. When you think of things that he did over the years it looks like he touched all the right buttons somewhere along the way. I'm just curious about your selection of him for that role.

Ed Monroe: Well, back in those days you did not have to develop a race or gender balanced pool of applicants in order to meet Equal Opportunity Employment requirements. We started out looking for somebody who would be called a Director of Medical Education for what we hoped would be a two-year medical school. We did not feel we had to have a MD because most of the academic work was basic sciences in the first two years. We didn't know anybody in North Carolina who would have any earthly interest in that kind of position. We did not advertise either. We had two or three consultants come in. One was a professor of biochemistry at the University of Florida Medical School. Another one was a professor of microbiology at the same medical school. Neither of them was interested in moving. They were interested in what we were trying to do. They were very helpful in convincing some of the university's academic leadership that it needed to be a somewhat separate enterprise and not buried in a department like Biology or Chemistry.

I was looking for faculty for the Allied Health School to develop those programs. We had to have a Ph.D. in Anatomy to teach physical therapy and occupational therapy students. We recruited one from the Medical College of Virginia who suggested that we might look at Wally who was a professor of pharmacology. He had been the coordinator for the second year curriculum for the medical students at MCV for several years. So, in early in 1970 we got him and Dorothy down here for a visit with Dorothy and we convinced him and he may recall this differently than I do. I never tried to tell him that a two-year school was a sure thing. I tried to tell him we had planning money for developing the curriculum but we had no guaranteed budget for a two-year school. I hope he thinks he came with his eyes wide open but I cannot swear to that.

Beth Nelson: Looking him as an applicant when you look back on him now, what did you see there?

Ed Monroe: Great choice, great choice. Calm, dedicated, perfectly willing to face challenges. He recruited a good corps faculty for what was to be a two-year medical school. Some of them were people he had worked with in years past like Bob Thurber in Physiology.

Beth Nelson: It has been said that the two of you in many ways sacrificed your career in some ways as a result of your unwillingness to let the school of medicine issue die.

Ed Monroe: Well, we knew we were skating on thin ice as far as any future grandiose positions. We weren't worried about being fired from the university because we both had tenure as faculty members but we expected some sort of retribution. We were hoping it would not be particularly punitive but it was. When Jenkins retired the new Chancellor came in, I think, with a already established program to try to get the medical school development back under the control of the authorities in the University System Administration. I think they viewed me as someone who was not particularly willing to follow orders and particularly willing to take whatever crumbs they were willing to cast this way.

Beth Nelson: Do you see yourself as not being particularly able to take criticism?

Ed Monroe: No, I have no problem with criticism, never have had. If I believe I'm right it's hard to convince me that I am wrong but constructive criticism I have no problem with at all.

Beth Nelson: Looking back on it, do you have any regrets?

Ed Monroe: No, none at all. The only thing I get a lingering thought about is if it had been possible to maintain some sort of involvement in clinical medicine during those first six or seven years that I was working over at the university I think I would have been more comfortable as the subsequent years went by. By the time the school had developed to the point that clinical faculty were involved in patient care, I was so out of touch with clinical medicine that it was impossible to try to do anything in a responsible way for somebody who was sick.

Beth Nelson: I would think it would be tough. When I see these clinical chairmen who still have some patient care responsibilities, I don't know how in the world they can do it. You would think that the Administration of their department would keep them absolutely stretched to the limit and then the thought of going into a clinic x number of hours a week-but I guess it really helps keep you in touch with your field and your colleagues and it makes them see you as something of a peer I guess as opposed to just someone in the ivory tower.

Beth Nelson: Let's talk a little bit about the reasons for the hospital's success. When you look back on it, I know there are some things that jump out at you as reasons for a lot of the good things that have happened here.

Ed Monroe: The major reason, I think, is the people who have been involved and their vision and their dedication. Some of them are no longer with us. People like Ray Minges. Ray was a local boy, general surgeon, his family was well to do, he didn't have to work but he was interested in taking care of people, whether they could pay or not. He was a good surgeon. He helped recruit Frank Longino from Duke to come here and start practice. There is just an endless series of names over the years that have been important to the hospital. Ray was not pushy about what he was trying to do. A lot of what he did he did anonymously.

Beth Nelson: Was he an early supporter of the medical school?

Ed Monroe: Very much so. He and Frank Longino both. John Wooten, Earl Trevathan, Allen Taylor, Bill McConnell, the only two radiologists here, Jack Wilkerson, who is a retired family doctor, Ira Hardy, the first neurosurgeon East of Raleigh. Then people on the hospital Board over the years like Kenneth Dews, Harry Leslie, Wilton Duke, people like Charles Gaskins, Ed Warren. Ed has been able to help more the last few years than he was able to do twenty or twenty-five years ago because of his position in the State Senate.

Beth Nelson: Talk a little about what Ed Warren has done more recently.

Ed Monroe: Well, he has been a strong supporter all along. I guess the most significant thing he has done was to get the funding for the new science building over at the medical school which was dedicated to Ed and Joan's honor last year sometime.

Beth Nelson: There is a story that I don't know if it is true. You probably would have a remembrance about this. It was said that when we were trying to get state appropriation for the MRI that an MRI was not even on our wish list and that there were a number of other things campus wide that were higher on the priority list and higher within the school of medicine than an MRI. It is said that Ed Warren got word that Chapel Hill was about to get an MRI and he held up l to give his support for Chapel Hill to get until they agreed for one to be given to ECU.

Ed Monroe: He may have been involved. My own recollection is that the person primarily responsible was Harold Hardison who was Chairman of the Senate Appropriations Committee. A friend of his named Walter Davis was on the Board of Trustees at Chapel Hill, before he was on the Board of Governors. He went to Harold and told him that somebody in his family had to go or he had to go somewhere else to get an MRI done, like maybe Texas where he had business interests anyway, and that North Carolina needed one, particularly at Chapel Hill. So Harold told him okay they would put one there if he would support us in putting one at East Carolina. So there were two approved and funded. One at Chapel Hill and one here. Ed may have been involved in that with Hardison, I don't know but it was kind of disturbing to the university administrative structure because it was not on anybody's priority list but it was either a question of accept or say no, we don't want it, which was unheard of.

Another thing that upset the university leadership had occurred several years before and it was called an Appropriation to build and equip a Radiation Therapy Center. This was not on the university's priority list but was moved up to number one position very rapidly when the Chancellor was told it was going to be approved and funded over their protestations whether they wanted it or not. So, to save face, they moved it up the priority list.

Beth Nelson: How did that happen? Who would have been the Chancellor then?

Ed Monroe: Tom Brewer, before John Howell took over, before Eakin came. Brewer did not have a very good relationship with any state authorities.

Beth Nelson: Do you remember how long he was here?

Ed Monroe: Three and one half years approximately. It is more like a Dean's tenure than like a Chancellor.

Beth Nelson: What was the deal about radiation oncology? How did that come about?

Ed Monroe: Well, we knew we had to have radiation oncology to become a tertiary care center. The university decision-makers, the Chancellor and several of the trustees did not view it as a high priority in the university's Capital Improvement Plan. The Brody Building was under construction and they thought that was enough money out this way for some time to come. We had to obtain the legislative authorization and funding without going through the typical university avenues that lead to capital appropriations. That's where people like Harold Hardison, Horton Rountree, Kenneth Royall, and a number of others were very helpful, again.

Beth Nelson: Did that require kind of going around the system, in a way?

Ed Monroe: Very much so. I was in the legislative building on a fairly regular basis, maybe once every couple of weeks, and I would bump into the university system administrators in the halls, going up and down back stairs that I didn't think they knew about and they didn't think I knew about, and we would bump into each other and exchange cordial greetings and I carefully watched to see which direction they were going to talk to whom and I would go in an opposite direction to talk to somebody else.

Beth Nelson: Through those kinds of channels, radiation oncology was approved over the objections of the university?

Ed Monroe: Well without the support of the East Carolina University Administration. I got blamed for it by the Chancellor at that point. He had already in essence relieved me of my position as Vice Chancellor for Health Affairs and I was working directly in the medical school so I wasn't concerned about what he would do anyway. He had already done it.

Beth Nelson: The Dean at that time would have been Dr. Laupus. You put him in a bit of an awkward position.

Ed Monroe: Oh, I don't think he felt that it was particularly threatening. I'm sure he felt it was kind of awkward. He also encouraged me to do what I could quietly and I will underscore the word quietly.

Beth Nelson: What about Dr. Laupus? Most everybody would say he was certainly a giant in the development of the school of medicine. You worked shoulder to shoulder with him for a number of years, talk a little bit about what he has meant to the development of the medical center.

Ed Monroe: A superb choice for the position of Dean. During the time the school was being put together, chairmen being recruited, faculty being recruited, relationships with the hospital worked out, a calm,super intelligent, quiet individual. He was a glutton for work. He referred himself as "Mr. Inside" and me as "Mr. Outside". That was his description of the relationship as the formative years of the school evolved. He was very effective in dealing with people like legislators and county commissioners but he was new to North Carolina. He took some time to get acclimated to the subtle differences between North Carolina and Virginia and Georgia where he had been in academic medicine before he came here. He was very good for us. He and Bill Friday had a mutually respectful relationship. Bill Laupus was well known in national medical education circles, a recognized leader in academic pediatrics. He was respected by the accrediting agency for medical schools.

Beth Nelson: Did you sit on the Committee that recruited him? Who else was on that Committee?

Ed Monroe: Yes, the Chairman was Wally, Jack Wilkerson, several of the faculty who are here still.

Beth Nelson: Was Jack Richardson on the Committee?

Ed Monroe: I don't think so. Irving Lawrence, I think, was on it. He is a retired microbiology man. He started out in the University Department of Biology and we persuaded him to move over after Wally got here. I can't recall what other local doctors were on it. It might have been Earl but I am not sure.

Beth Nelson: What about Jack Richardson? In the early days a lot of people have characterized him as not having been the first to jump on the bandwagon of the hospital and school of medicine teaming up for this kind of venture.

Ed Monroe: Jack was always careful not to get out in front as the point man on any issue. Jack was a very effective non-public, behind the scenes, hard working administrator who used his Board leadership to be the point people on issues that might be somewhat controversial, whatever they might be. Jack had some good leadership on his Board, some of whom I mentioned earlier. He had a good relationship with the Pitt County Board of Commissioners who respected him but he never challenged them. He and Bill Laupus had a very good relationship. In a non-public way they reached decisions and then went back to their respective constituencies and worked through them.

Beth Nelson: Were you on the Committee that drew up the Affiliation Agreement?

Ed Monroe: Yes. Wally and I had an Affiliation Agreement with the hospital before that. We had an Affiliation Agreement with the hospital in the spring and summer of 1970 because we had to have access to some clinical resources if we were going to have a two-year medical school. We had an Affiliation Agreement with Pitt and with Lenoir. When the four-year school was authorized and funding was being considered in the 1975 Legislative session, we started working with the hospital leadership on an Affiliation Agreement for the four-year school. The consultant who was here, Harold Wiggers, a retired Dean from Albany School of Medicine, and Wally and I drew up rough drafts which would be reviewed by the hospital medical staff leadership and the hospital board and Jack Richardson.

Beth Nelson: How long did that take?

Ed Monroe: This went on for three or four months. The final version evolved through the late spring and summer of 1975 with a lot of hands on input from Bill Laupus who was here full time starting in July but was here on frequent consultative visits prior to that for about two months. He was working closely with the Board of Governors Administration on getting an Affiliation Agreement that they would agree to and I would deal with the Pitt County Board of Commissioners who had to be party to any such document and Bill and I both would deal with the hospital Board of Trustees who were very supportive but also wanted to be sure that the rights of the individual private practitioners were protected and not usurped by the medical school taking control. Then we had to have preliminary drafts reviewed by the accrediting agency staff, accrediting agency for medical schools, known as the Liaison Committee on Medical Education, to be sure that they appeared to be okay with them so that when we were ready for an accreditation visit we would not have a big hang up about not having an Affiliation Agreement.

The negotiation and subsequent approval went on starting in late 1974 in a preliminary sense through the first few months of 1975 and then when the Dean came, on through the summer and the final document was signed, sealed and delivered in late 1975. It took roughly about a year. The accrediting agency was very positive about the final document and viewed it as somewhat of a model for other places to use. The medical school did not own and operate the hospital like they do at Chapel Hill and Duke, Bowman Gray.

Beth Nelson: Can you tell me some challenges for the future?

Ed Monroe: The immediate future is to continue to consolidate what has been developed over the last few years in our efforts to be more involved in eastern North Carolina. The relationships with the hospitals, not only with those that we own or manage, but those that we are affiliating with have to be nurtured, expanded. We have to have a closer working relationship with several hospitals in eastern North Carolina that up to now we have not been successful in developing what I consider the appropriate relationship, places like Craven County and Lenoir County.

I guess the longer-term challenge is to try to continue the evolution of a regional health care system. That is not just hospital focused. It involves the community practitioners across eastern North Carolina. Systems of care that if you were a health czar dictator you could envision creating from scratch where people had ready access to care whether they can afford it or not. That sounds unrealistic but it is a good goal to strive for. Appropriate levels of care so that primary, secondary care is rendered locally and the tertiary care comes to a well-equipped, well-operated facility like this one. More consolidation of resources so that unnecessary duplication of very expensive facilities and equipment doesn't occur. You can't do all that as a dictator. It would be so easy if you could. You cannot. You have to work with people and I think the challenge is to maintain that sense of community and working collaboratively rather than dictatorially on health problems in this part of the state.

September 14, 2000

Interviewer: Beth Nelson
(Second Interview)

Beth Nelson: Let's talk about the fight for the school of medicine something you are intimately familiar with, the significance of it, and for you to focus on the struggle from the University side.

Ed Monroe: The struggle to establish the school of medicine is an interesting anecdotal kind of story in the sense that the first Bill to establish the school was introduced in 1965 in the General Assembly and was approved with a condition attached to it that was impossible to meet. That was that the school had to be accredited within fifteen months after the Bill was enacted. That was impossible to accomplish but during the struggle to change the status of East Carolina College to East Carolina University in 1967 coincident with that effort the Bill authorizing a two-year school was in essence renewed without any money attached to it. It was just an authorization Bill. When the effort was made to go ahead with development of the school money was appropriated for planning in 1969 with the efforts of Governor Bob Scott. We decided at that point to start trying to recruit the core faculty for a two-year school. That effort began to bear fruit in 1970 with the arrival of Dr. Wally Wooles from the Medical College of Virginia as the first Dean of what was to be at that point a two-year school. He recruited several additional basic science faculty, almost all of whom he knew personall, to serve as chairmen of the key basic science departments. Than we got sidetracked into a one-year program where students would come here for one year and transfer to UNC Chapel Hill School for their last three years. That was a compromise worked out by the educational and political leaders of the State without the endorsement or approval of anybody in eastern North Carolina that I can recall.

The one-year program operated for three years during which time we went through a horrendous struggle to move ahead with further development of the medical school. Wally Wooles and I spent many days in Raleigh meeting with Legislators individually and in committees. It is difficult to recall all of the specific happenings of that period but I had more hair when that started than I did when it was over. It was tough. We finally got authorization to move ahead with a four-year school from the education establishment, the UNC Board of Governors in the fall of 1974 and got generous funding for operating expenses and capital expenses in the 1975 Legislature.

During that timeframe from 1969 on through the beginning of 1975 the increasing numbers of people in eastern North Carolina who became strong advocates of the development of the school was an amazing thing to watch. Civic clubs from all across the Eastern part of the State passed resolutions in favor of the school, local Government units, City Councils, County Commissioner bodies, all across the Eastern part of the State. It began to infiltrate to some degree into the Piedmont section of the State. We began to pick up some support from the Central areas of the State who felt that number one, there were not enough doctors in the State and the three schools were not doing enough to increase that production. Number two, they identified with the underdog which was us and number three, they were somewhat disenchanted by the insensitive and to some degree arrogant behavior on the part of the three existing medical schools and their universities.

The four-year school was authorized, funded, and a Dean was recruited from MCV, Dr. William Laupus, a great calming influence throwing peaceful, meaningful waters on a hot political potato. He had just the ideal personality to come in and seize the momentum and move ahead. The hospital during that timeframe, roughly a seven to eight year timeframe, had begun plans to expand. The original 110 beds had been expanded by 100 beds somewhere around 1960 and it rapidly became overcrowded. People were lying on stretchers and beds in the halls of all floors in what we now call the old hospital. So finally the County agreed with the Hospital Board to allow a bond issue vote to occur. That passed I think in 1970 and the plan at that point was to either expand the then existing hospital on site or to move to a new site and build a new one. A consultant from Richmond who had kept up with things in this part of the state and had attachments to eastern North Carolina advocated starting over with a building. The bond issue plus a loan from the Federal Government through the Hill Burton Act provided enough money to begin. I think that about 1973 ground was broken on our new location just West of what we now call the old hospital. The County purchased ninety-seven acres to build the new hospital. The people in the County supported that bond issue remarkably strongly and the decision to become a part of the medical school evolved after construction of the new hospital began. There had been discussions between the school and the hospital when the school was seen as a two-year school, which would not have had much impact on hospital business because the students wouldn't be spending much time in the hospital in their first two years. When the four-year school was authorized then the hospital had make a decision-did it want to be the major teaching facility for a four-year medical school or did it want to be only an affiliated institution similar to the affiliations being developed with surrounding hospitals like Wilson, Kinston, Goldsboro, Rocky Mount. Luckily the leadership of the Hospital Board, the leadership of the Board of County Commissioners all foresaw the advantages of the hospital becoming the major teaching hospital for a new four-year medical school.

Most of the medical staff agreed with that decision, a few did not. A few were concerned about the impact of this on their own practices and the increased competition that they dreaded which incidentally never came to pass. So the hospital agreed and then the argument moved up to the State level, the University Authority, the President of the University System and his Board of Governors, most of whom pushed very hard with his nudging for the school to build a separate hospital. It was foreseen as a 200-bed teaching hospital, which would be in direct competition with the County hospital. We quickly squelched that idea with the help of some key Legislative leaders who we convinced it would be cheaper to add on to the County hospital that was already under construction than to build a separate hospital.

I figured we saved the State roughly $7 or $8 million with that approach. The opponents on the Board of Governors caved in and then they began giving us a hard time about an Affiliation Agreement. We spent several months writing, rewording, sending copies of a proposed Affiliation Agreement to the university headquarters in Chapel Hill, to the accrediting agency for medical schools, to local authorities which to approve any agreement and through that drawn out process we ended up with an agreement for the hospital to be the major teaching hospital with all kinds of safeguards built in to insure that the medical school nor the university had any control over the hospital as such and that the hospital no direct control over the academic component of the medical school. Everybody saw it as a win-win situation and the education authorities in Chapel Hill again gave up and approved that document which at the time it was written in 1975 was viewed as a model Affiliation Agreement by the National Medical Education circles around the Country. It has turned out to be a very worthwhile agreement; it functions well, everybody seems satisfied with it, it has required no major changes over the years except a reduction in the number of Board members of the hospital, through attrition, down to a manageable number of twenty. Eight of whom were appointed by the UNC System and twelve of whom were appointed by the County. That lasted for over twenty years up to now.

Beth Nelson: What do you remember about the mood in eastern North Carolina from 1969 to 1975? The support of county commissioners, city government and county government and medical societies. Talk a little bit about the culture in eastern North Carolina; the fact that the East is made up of "pull yourself up by your bootstraps" kind of people. We were a medically underserved area and had limited transportation capabilities. You probably couldn't go anywhere back in that era without people stopping you and saying to keep up the good work we are right behind you, and those are the kinds of things I want to capture. I don't want to put words in your mouth but you must have this somewhere in your memory.

Ed Monroe: The people's support was truly astounding and educational for me. Leo Jenkins was rather unique. He presented himself as a carpet bagging Yankee from New Jersey, brash, irrepressible as far as taking any kind of insult to heart. His belief was that people in eastern North Carolina had not had a fair shake since the Civil War and he was absolutely determined to see the people of eastern North Carolina get more of what he thought was needed in this part of the State and he started out building East Carolina College toward university status; got people excited about the development of an athletic program, particularly football; didn't understand why people in eastern North Carolina would drive three to four hours to go to a football game up in the Triangle when they could drive an hour and come to Greenville and see a scrappy football team play; worked very hard to get on the schedule of some of the big name schools in the State; started a summer theater and the people up in the middle part of the State just laughed at him saying you can't expect eastern North Carolina people to take advantage of any kind of cultural opportunity. He worked hard to develop the School of Music, the School of Art, and it was only after all of that got underway that Leo turned his attention to the health care needs for the State.

When I joined the university in January 1968 some of the initial steps had already been taken but they were kind of faltering because of the unfair and unachievable condition that had been attached to the original Bill authorizing a two-year medical school. We detoured into the development of the School of Allied Health Sciences which became the second health-related school with the School of Nursing that was set up in 1960 and I think we lulled some of the opposition into a state of lethargy for a little while because they thought we were satisfied with programs to educate physical therapists and occupational therapists and medical technicians, those kinds of disciplines and that we had just decided not to pursue the medical school. We fooled them and kept working quietly on building Legislative support and Legislators listened to their constituents so Leo, Wally Wooles, several of the other faculty and I went to innumerable civic gatherings around the Eastern part of the State talking to people.

We would drive into town and we had been told where the meeting was to occur, we would get out of the car and people would just surround us and tell us to keep going guys and not to give up and that we could beat those blankety blanks. It was encouraging and we needed all the encouragement we could get because we were catching only hell from all of the major newspapers in the State, from the educational establishment of the State, who had contacts with medical school accrediting bodies who were also giving us a hard time. When you build up the people momentum not just in the Eastern part of the State, plain ordinary people in the Western part of the State, union leaders in North Carolina, a minority to be sure, but still an important segment. The Christian Action League which was set up to try to stop liquor by the drink in North Carolina, some very ardent servant members of that organization who for some reason decided they ought to get behind this struggle to start another medical school, the Grange which was a grassroots farm organization, the State Farm Bureau. In other words, any avenue of voice that would allow the real people to be heard we pursued. We talked to Lions clubs, JC clubs, Rotary clubs, you name it. We talked to church circles, book clubs, all of them producing resolutions favoring the progressive development of the school. Incidentally, those resolutions were presented to the Board of Governors in 1973 and 1974 and they just sort of tossed them on the table and said that anybody could generate that sort of stuff and that it didn't mean anything. That infuriated people even more. So we were counter punching not mounting a major offensive but more of guerrilla warfare sort of approach.

The other interesting thing was that with the decision to relocate and build a new hospital all of a sudden the hospital is about to lose its accreditation by the National Commission for Accrediting Hospitals. That came at a very key point in the medical school debate. When the university authorities in Chapel Hill got wind of that they saw that it was splashed over every newspaper in the Piedmont, particularly the News & Observer in Raleigh, which was totally anti anything in eastern North Carolina where its major subscription base existed outside of Raleigh. So, they made big stuff out of "medical school jeopardized by hospital loss of accreditation". The only reason the hospital stood to lose accreditation was because it was in a totally inadequate antiquated facility and the dumb inspector who came didn't realize that a new one was already under construction. So, some hurry up trips to Chicago were made and that decision was delayed, accreditation renewed for another year and once again the opponents lost their major argument against the medical school. Things sailed smoothly thereafter.

A number of people around the State still remember a lot of this which started thirty odd years ago; some of them are still living, some of them were very key players in the effort to develop the school. We owe them a deep debt of gratitude and I hope somehow that they will eventually get recognized for what they did.

Beth Nelson: I do want to talk about the founding chairmen. The facility that they found themselves in when them when they came here. The status of the helicopter

Ed Monroe: Using the planning money that was appropriated in 1969 and recruiting Dr. Wooles and we in turn recruiting the key basic science chairmen. All of them came with a clear notion that they were in on the ground floor of what was to become a two-year medical school. They saw that as a unique opportunity. What they did not know was that the planning money did not include an operating budget beyond 1971. It was not a closely held secret, they were just so busy getting organized and recruiting a few more faculty members for their departments and never stopped to think what a chance they were taking, professionally and personally. When we received operating money for a one-year program in the 1971 Legislature everybody breathed a sigh of relief. The only facilities available were in a new science building called the Biology/Physics Building and most of it was in the Biology Section of that building. It is now known as the Howell Science Building on campus. The Biology Department somewhat reluctantly with some arm-twisting agreed to house those first few faculty members. Things were crowded, there wasn't a lot of equipment but there was a lot of "make do" arranging going on that was remarkable to watch. Enthusiasm, high morale, a sense of excitement, it lasted until 1973 when we got lambasted by the University System leadership and by the Medical School Accrediting Agency. We were running a one-year program under the auspices of Chapel Hill's accreditation and we got very unfairly criticized for the state of development. We were being scrutinized as if we were an authorized funded four-year medical school. So, the faculty got very discouraged at that point and Wally Wooles, Dean Hayek, and a couple of other key faculty members did a super job of keeping the group together and working and teaching the one-year medical students. Simultaneously in that time was an effort to develop a Health Sciences Library. JoAnn Bell, the first Director of that Library existing in closets, the old cafeteria basement on campus, getting books and journals from every conceivable resource with no money to subscribe to anything, everything was donated. She just kept plugging away and when we finally got funding for the one-year program we began to get a beginning budget for a library. When we got funding for the four-year medical school, we got a very generous budget for a library and as far as I know the budget has been secure ever since.

Beth Nelson: Talk about the other chairmen and the sense of camaraderie. I want you to talk about the respect that you must have for those people. I would like that to come through because they were, if you hadn't had the right people that would have derailed the whole process. We would like this to also come out of this.

Ed Monroe: Starting with the arrival of the first key chairpeople-the basic science chairmen. Working under Wally Wooles was Dean Hayek running Admissions and JoAnn Bell developing a library, and a small group of very dedicated people keeping their eye on the prize but working like dogs to do their teaching, to do some research and incidentally most of them were also involved in teaching some of the allied health students, particularly those in physical therapy and occupational therapy. These were
heavy teaching loads for medical school faculty some of who hadn't done that much teaching since their days as instructors in their early thirties or late twenties. That was a nucleus of faculty that we were very lucky to have. That nucleus was expanded when the four-year school was authorized and Bill Laupus was recruited as Dean by proceeding with strengthening those basic science departments under the leadership of the chairmen who were already here. While clinical chairmen for the major clinical departments were being recruited and the initial group of those chairmen arriving in Greenville kind of laughing to themselves in a self-amusement kind of way about what their wives were going to say when they saw where their husbands were taking them-down here in the boondocks of eastern North Carolina was a little old tobacco town. These people were coming from metropolitan settings, well established medical schools across the country, places like California, upper New York State, New York City, unbelievable of sense of excitement on their part about being part of a new endeavor. They were well educated during their recruitment trips about the needs of this part of the State, the needs of rural North Carolina, the need for the development of a major medical center to serve this part of the State, the excitement of teaching a brand of students that they would never run into in the big city, the excitement of developing the clinical services in the hospital, working out the understandings they had to have with the private practice members of their services, molding them into a cohesive group along with the fulltime clinical faculty of the medical school. They were truly a remarkable group of people that we owe a great deal to. Most of them are still around, several of them are retired. One of them in particular who was a good friend of mine seems to move every four or five years and has been on the faculty of every medical school in Virginia and North Carolina, including an affiliated program in South Carolina. We tease him about that all the time, that he just can't still a minute and he is Bob Brame, the first Chairman of OB/GYN.

The family sense that occurred starting back in the 1970s carrying on in through the 1980s and hopefully still here, everybody pulling together. Sure, there were some disagreements among the departments about who ought to get what in the way of resources, but still a sense of we are a team and we are doing something unique, we are in a unique situation and lets show people what can be done. They have just done a remarkable job.