[This text is machine generated and may contain errors.]

Collection Number: Date: July 17, 2001

Narrator: Harriet Wooten, MD Interviewer: Jack W. Wilkerson, MD Transcriber: Janipat Worthington

Copyright 2001 by East Carolina University. All rights reserved. No part of this document may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system. without permission in writing from East Carolina University.

JW: This is July 17,2001, and this is Jack W. Wilkerson, MD, interviewing Harriet Wooten, MD, in her home at 1807 Circle Drive in Greenville, North Carolina. The purpose of the interview is to learn something of her experience as a physician in Pitt County, North Carolina, and other aspects of her career. This recording will be transcribed and kept at the Health Sciences Library at East Carolina University and will be available as an oral history resource for people interested in the history of healthcare. Dr. Wooten, do I have your permission to record our conversion?

HW: Indeed you do. It's my pleasure.

JW: Thank you. Would you begin by telling us where you grew up?

HW: Well I was born in northern New Jersey, which is a metropolitan area right across from New York City, so I was really a city girl in the wintertime and went to public schools there, but my heart was in the country. My mother was from upstate New York, so we spent our summers in upstate, and I learned how to milk a cow and do all those wonderful things and I still have a deep love for that part of the country.

JW: Great.

HW: ...although I'm a converted southerner.

JW: But you've had plenty of country in Pitt County, haven't you?

HW: Yes, and I've enjoyed it.

JW: Great. How many brothers and sisters did you have?

HW: I only had one older sister. She was six years older, so that's quite a difference, and our interests were different, but I was fortunate to have one older sister who still lives in the family home in upstate New York.

JW: Great. You told me your father was a dentist?

HW: Yes, he was, and I worked for him in his dental office during the summer vacations in college. I guess that's why I decided I never wanted to be a dentist.

JW: Did you learn anything else while you were there?

HW: Well, I liked the patient contact. I liked the feeling that the patients were really very fond of daddy, and he was very proud of his profession.

JW: So you got a good grounding in patient relations.

HW: Yeah, I think that may have had something to do with it. It might have.

JW: Was your mother a career lady?

HW: No, not really. Well, she taught school but then when she married and had a family, she did not teach anymore. She was what they call a-I went to an elder hostel recently, and we had a professor talk about the family, the different terms of the family, and she called that kind of a family a republican family no political connotations but it was a family that was headed by a husband and wife, and they centered around their children. And I guess that was the kind of family I was in fortunately.

JW: Great. Yes. Very fortunately. Well now, did you go to private school or public school?

HW: No, we went to public school-a great big, multinational public school in the city, and it was a good school. I mean we had to take four years of Latin, and we had, you know, the usual curriculum.

JW: And that stood you in good stead in your medical career.

HW: Oh, I think so. Most definitely. It just concerns me that we have so much freedom in picking courses now, and so we... Well, that's a concern of mine. In fact, at this same elder hostel, we had a... You want to hear about this?

JW: Sure.

HW: Well, we had a professor who talked about education, and he was from Hamilton College, which is also in upstate New York, and he talked about the fact that even the selective universities or colleges don't require a core curriculum anymore. So, I said, 'Well, how does the incoming student know what to take?. And he said, 'Well, it's up to the faculty adviser.' So, if they have a faculty adviser who is very laissez faire and they want to major in art and ballet for four years, they don't ever have to learn the scientific method. So I said it all boils down to the faculty you choose. Well that's beside the point I guess in a way, but I think the future doctors really should have more of a liberal arts education than they do.

JW: Where did you go to undergraduate school?

HW: Well, upstate New York...

JW: Upstate New York.

HW: ...at Wells College, which is small-it's still a small school for all women, although they do allow a few men in. I think it's a great college because it's relatively inexpensive-good professors-and they have the freedom now of going to Cornell, which is only 20 miles down the lake, and they can leave in the morning and take any course they-Advanced Russian Literature or something. They can take that at Cornell if they want to, so they have the advantage of the university plus the intimate association with professors that they have at Wells.

JW: Very good.

HW: So, I'm trying to boost that at the local high school but have had very few takers because they hear all-girls school and they turn it off-even my own granddaughters.

JW: That's not a religious school is it?

HW: No.

JW: No, private. Where did you go to medical school?

HW: University of Maryland.

JW: University of Maryland?

HW: In Baltimore.

JW: How did you happen to decide on the University of Maryland?

HW: Well, I had been in the Navy...

JW: You had been in the Navy?

HW: Yeah, well, see I was a sophomore in college when the war broke out-THE war-you know...

JW: WWII?

HW: Yeah. Pearl Harbor was bombed, and we were already isolated because at that time the only transportation we had was a bus up the lake to Cornell or somewhere. But anyway, so that was in '41, and I graduated in '44. By that time, the war was still raging, so some of us-science majors mostly-signed up for the Navy for wave officer training school. So we went to Northampton, and I was in the Navy about 2-1/2 years. And I never went overseas, but 1... And I don't think I contributed to the war effort. I did, well, electronic administration, but I did travel a lot in this country, which was a broadening experience. I was young I was only 20. I remember that there was a presidential election at that time, and you were able to vote even if you were in the service, but I wasn't allowed to vote because I was under 21.

JW: That's right. I wasn't either.

HW: Yeah, you remember that. So, anyway, at the time, I ended up in Washington, DC, with some roommates kind of towards the end of the war, and one of them wanted to go to medical school, and the other one had a father who was on the faculty at the University of Maryland, so we applied to medical school and got in. Of course, there were a lot of other people getting out of the service at the same time, so I don't know whether that made it easier or more difficult to get in. I really don't know.

JW: So you entered medical school in what year?

HW: In 1946.

JW: '46. OK.

HW: At Maryland University of Maryland. I think I applied to Hopkins but didn't get in didn't know anybody on the faculty. But we had 10 women in the class.

JW: Ten women?

HW: You know, nobody made much fuss about that. They didn't have any quotas of any kind. Maybe they just...

JW: The majority were men...

HW: Oh, yeah.

JW: ...in those days.

HW: Oh, yes. Not like it is now. The majority is women, right?

JW: Yes. That's changed. Well, anything unusual in that medical school curriculum? four years and you graduated in 1950?

HW: Everybody took the same thing, and they all came out with a good foundation, which we called general practice, didn't we?

JW: General practice was the term in those days.

HW: That's what we called it. And then I applied to... Why did I do that. Chicago, Hospital and Charity Hospital in...

JW: New Orleans?

HW. Yeah, and also Baltimore City Hospital, which I thought was a very good place to train.

JW: All good hospitals in those days by reputation.

HW: But meanwhile, I had met my future husband who was well, I'd met him before but I guess I started dating him and he was a resident in Orthopedics there, and I thought, 'Well, might as well stay in Baltimore.. So we did. We had what we called a rotating internship.

JW: Yes, 12 months?

HW: And then during those 12 months, let's see, that's when I started going with John, and then I had a residency in Internal Medicine at Women's Hospital in Baltimore. And then we were married.

JW: How many years did you do that?

HW: Two.

JW: Two years, so you had three years...

HW: No, I didn't. I had one rotating internship and one in Medicine, so I never got my full Internal Medicine... That's what I had planned to do, but I didn't. In those days, women physicians went where their husbands went, and he went in the Army.

JW: I see.

HW: So, yeah, I think that's how it was. And he went to... Well, at that time, they needed orthopedists very suddenly then, so he didn't have time... I remember he put his uniform on, and he didn't know where to put his insignia, so he had to look in a magazine to see where you would put your bars.

JW: Great. That's what you call resourceful.

HW: Yeah, and I think that must have been in... We were married then in 1951, and that's when we went to Camp Poke in Leesville, Louisiana. Meanwhile, I had my Maryland medical boards and thought I better take national boards so I could practice wherever we went, and I did in rural Louisiana-filled in, you know, for general practitioners. And then we started our family, and we had our first son named John. Then we went to Camp Gordon in Augusta, Georgia, so by that time, we had two little boys. So we put everything in a trailer-the television set-we had television sets in those days-that was pretty exciting.

JW: What was the size of the screen?

HW: Oh my goodness-little bitty. So we put everything we owned and moved from Leesville to Fort Gordon, and we followed the moving van because we had no place to stay. We stayed there for the rest of his tour because he never went out. By that time, see that was the Korean War-and by that time, he did not have to go to Korea, and so then we got out of that, but he hadn't quite completed his Orthopedic residency, so we went to New Orleans, which is where I wanted to go in the first place. By that time, I think we had two little babies and, of course, no money.

JW: Didn't pay residents much, did they?

HW: No, I made $15 a month when I was a resident. He made $50.

JW: Fifty?

HW: Yeah. So we stayed in New Orleans in a little tiny apartment, and it was so hot. Oh my gosh, it was a hot city. But that was fun. Once a week, we would go out at a good restaurant. And then he had finished his tour of duty; it was extended a little bit because a lot of people were allowed to get out prematurely and were called back, so he decided to...

JW: For Korea?

HW: Yeah, so he decided he better complete his tour and not have to pull up and go. So there was no question really about where we would go, which was back home to Greenville. So we came here, and he practiced out of that little... Do you remember the little green-shingled house where George Pugh's filling station was?

JW: No.

HW: We rented a little house on Harding Street until he set up practice. That's when I had another baby-the third son. So I decided at that time, and I must say it was difficult at that time to go into part-time anything, and that was my one criticism. You either had to do public health clinics, which I did, or... It was very difficult to work part-time-to get a job part-time� unless it was public health.

JW: Why was that?

HW: Because I didn't have my boards, see. I think I didn't...

JW: But I mean, the need for medical service would be such that...

HW. ...you'd think that...

JW: ...the boards shouldn't interfere.

HW: ...and also, I was not going to put the children in daycare. You know, I had three little tiny ones. That was, of course, the real reason.

JW: Did you have a maid or a nanny?

HW: Yeah, I did. Of course, the salary at that time was disgraceful, but I did have help. In fact, we were talking about the changes in political-how things came about, and I've never been a real activist, but I was a little bit of an activist. I remember taking the lady that helped me down to the fire station to register her because I was going to make a statement and everything, and I was not very well received, but things have really changed for the good. They're much better. So anyway, I had the third baby. Dr. Pott delivered Lamont, and so that made three little ones, so I really felt like I just-it wasn't the thing in those days to let someone else raise your children the way they do now.

JW: Can I interject here and say that when I began practice in 1955 in Wilson County, John-your husband-was the first orthopedic surgeon east of Raleigh, North Carolina.

HW: I've heard him say that.

JW: He was. There were no other orthopedic surgeons east. In Wilmington, there may have been one, but there wasn't anybody east.

HW: And you know that was really a disadvantage in a way because we got that place at the river, which was only 35 minutes away, and it was wonderful because the general surgeons� Howard Graddis and Steve Bartlett-would cover him for an afternoon while we would go down there, and it was really easier to get away then than after he got partners. It was fun-it really was.

JW: Ends up with time and I started to say wages, but that's inappropriate in this discussion. Well, we've gotten you all the way from New Jersey to Pitt County, North Carolina, which is what we've been struggling for.

HW: We sure have.

JW: All right, now we've filled in those details. Let's go back to when you were helping your dad in his dental office. How many people did he have working with him? Or was he a soloist?

HW: One.

JW: One.

HW: Now, the situation was [that] we lived in the city, very much city, right across from New York. Manhattan was kind of like my hometown because I could get on a bus in those days and go hear Frank Sinatra over at the Roxy. But anyway, we lived in a very citified place, in a three� story brick house, and daddy's office was upstairs on the third floor so we had a view of all the city and the traffic and everything. And he did everything. He was a general dentist. He loved doing dentures. I mean he really took pride in that, and he was a very outgoing person-a lot of personality, and patients really...

JW: What was your father's name?

HW: Milton Edison Husted.

JW: Husted.

HW: Husted. That's my middle name-my maiden name-and my middle name is Lamont, which is my mother's family. But Milton was his father's name. His name was Milton Husted, and he was a superintendent of schools in that county-Hudson County, so he was a professional educator. He had gone to Columbia and studied under progressive educators Dewey of the Dewey Decimal System-and so he thought all little girls should learn to read early, which he did he would come and teach me to read. So I was a year ahead of myself in school, which as I look back on it, I don't think that was a good idea. I still think you should go to school at the same age as your peers because you're at a little bit of social disadvantage-'cause I was always the youngest everywhere I went. Now I'm the oldest everywhere I go.

JW: It's called maturity.

HW: Well, anyway, I was a little bit immature.

JW: Well, let me ask you something. Growing up we're about the same age did you have any ravages of childhood like measles, mumps, chickenpox, whooping cough?

HW: No. I don't ever remember being sick, and the pediatrician lived across the street.

JW: There was a pediatrician that provided care for you?

HW: We had a pediatrician across the street. I don't ever remember going. The only thing I remember of my childhood is getting my picture taken. They would take us to a photo studio and say, you know, 'Look natural.. I don't know why I should remember this, but they'd take a metal thing and put it on your head like that. Now why should I remember that. I don't remember going to a doctor-maybe I got a shot or two. But it seems really strange for my one photograph.

JW: I don't know what that was either.

HW: Well, you never had your picture taken as a child?

JW: Kodak.

HW: It must have impressed me. And I was a Girl Scout and all that kind of thing. My mother was captain of the Girl Scout troop.

JW: Well, now, we better jump ahead from-you didn't have any broken bones as a child...?

HW: No. I should have...

JW: ...didn't require any sutures or stitches for cuts...?

HW: Oh, yes, yes. That's right. I remember my older sister would take me... This is city now, you know-you didn't have many trees. We had paved sidewalks and paved roads in front of the fire station--that's where I roller-skated. And we skated down these terrible hills, and I remember falling one time, and I still have scars on my leg. My sister would wrap me up and take me home, and we would close them with a Band-Aid instead of-you know-you just didn't go the hospital.

JW: They had Band-Aids in those days?

HW: Well, maybe they weren't-you pulled it together with a Steri Strip with a piece of adhesive tape. No, I don't think I was ever sick.

JW: How about your tetanus. Do you remember getting immunizations and like that. Diphtheria, toxoid...

HW: I'm sure I got some shots, but I don't remember.

JW: Did you have your tonsils when you started school

HW: Oh, yes I did have my tonsils out. Routinely.

JW: How old were you?

HW: Well, I don't know, but I was very young and they just took 'em out for no reason.

JW: Why?

HW: They didn't have to have a reason in those days, did they. How about you?

JW: I can tell you, in Maryland, when I was starting kindergarten, it was required state law-that my tonsils be removed at age 5 to start kindergarten.

HW: I'll bet that's what happened to me.

JW: You were just up the road in New Jersey. About four years later, my brother was the same thing-it was still going on, so that was in '29. In '33, they were still doing this-requiring your tonsils out because they were a foci of infection. They didn't have any antibiotics, and they felt that this would get...

HW: It made sense at the time.

JW: I suppose it did.

HW: It did. What state was that?

JW: Maryland.

HW: Uh-huh. Well, I bet it was a law in New Jersey, too.

JW: Well, that's interesting. Now, you...

HW: You'd think I would remember it.

JW: That's why I'm here-to jog your memory. Because you have conflicting memories. Tell me about your medical school. Did you have a favorite professor or one that you feared more than anybody else?

HW: Uh-huh, yeah-Dr. Uhlenhooth he was Swedish or something.

JW: How do you spell that name?

HW: U-H-L-E-N-H... He was an Anatomy professor. Very, very demanding very demanding professor. Then, we had a Bacteriology... I don't remember their names particularly.

JW: Sorry.

HW: And one of them was a Bacteriology professor, and he just wasn't... I never did do well in Bacteriology. He wrote tiny little letters that you could hardly ...

JW: Did you take a lot of notes?

HW: Yes. I'm a great note taker.

JW: Took a lot of notes.

HW: Yeah. Because I think better when I write-even today. If l want to...

JW: And you studied your notes for exams and things?

HW: No. I don't think I did.

JW: Did you have a lot of exams in medical school in those days?

HW: Uh-huh, yeah.

JW: Every week?

HW: Fairly regular. Yeah, uh-huh. I think so. It was quite structured. I think Maryland was more structured. Hopkins was more like Duke-more, you know, the requirements were different, and their theory was different. But we didn't have much clinical experience. We didn't see, really see any patients except for perhaps disturbed patients maybe a little bit in our sophomore year. But we weren't... We had history and physicals in the sophomore year but not much clinical exposure, which I think was a good idea.

JW: You were taught Physical Diagnosis then in the second...

HW: Sophomore year.

JW: Sophomore year?

HW: I think so.

JW: And then the third year, you were in clinics?

HW: Yeah, and of course we had Pathology and stuff. The third year, we finally got in the clinics. I don't think we got to wear a white coat until we were, you know, at the end. Now, they give 'em to 'em when they enter the building.

JW: First year, yeah.

HW: I don't think that's a good idea.

JW: Start 'em out with a growing up process so they want to mature early, I guess. The place that you stood in your class academically, and I don't want to know that, but I want to know...

HW: I'll be glad to tell you.

JW: ...did that determine where some of your classmates went to their internships and residencies?

HW: I don't think so. I don't know.

JW. Was that talked about when you were a medical student?

HW: No.

JW. ...that where the top of the class goes has the opportunity to go to certain prestigious...

HW: No. I don't think so. I don't remember that it did.

JW: There was a lot of that where I went to school.

HW: Really?

JW: But that was a two-year school, so you had to...

HW: Oh yeah, that's right.

JW: And then it filtered out.

HW: Maybe it was just that I didn't think much about it. But I was pretty much at the top of the class. I wasn't the top, but I didn't really worry about that.

JW: The other nine ladies in your class, did they all graduate?

HW: Yes. One of them is a cardiologist in Ohio. They went every which way. I still correspond with one. One married a classmate and is a pediatrician in Atlanta. She retired recently and has moved to North Carolina in the mountains and thinks she's in heaven.

JW: She is.

HW: Oh, I mean, really. She discovered life and the community and all those things which they never knew before.

JW: Uh-huh. Big city-Atlanta.

HW: Yeah, a big city, and they worked all the time. She did have three children, though.

JW: Would you tell me something more about your father's dental practice?

HW: Okay. It was a one-man operation, and he had three little suites upstairs. We lived in I guess you'd call it a townhouse now. He'd go downstairs for lunch, and then he'd go down in the basement and adjust his golf clubs; he was a great golfer. In fact, all dentists have that in common. I don't quite understand why. But anyway, he practiced alone. He loved his practice, especially dentures, and he had one nurse-her name was Anna-and she did the bills [and was] the assistant. We had one little typewriter. In fact, I still have the old typewriter in there that he used to use, and when I worked in the summertime, I filled in-I did the bills, the typing, the appointments, the...everything. But that was kinda fun. He was good-he was very good-but he was not what I would call gentle, and I remember standing there holding the patient's head while he'd pull-it's a very gory thing-teeth pulling is just worse than any surgery. He would have the pliers... Why should I remember this. ...and these glass bowls. And he would tap it on that porcelain bowl, you know, and then my head would go like this, and I'd say 'Oh, I'm not fit for Medicine because I can't stand to see a tooth pulled.. And the whole place smelled of formaldehyde and, of course, I didn't like that. So I decided dentistry was not for me. But they never did-they never pushed me towards any particular field because I could pretty much do what I wanted. They were very laissez faire. That was nice.

JW: Did your sister become a physician, too?

HW: No. My sister is very much the homemaker. She had four children and married and stayed in the home-near the family home.

JW: Did she marry a dentist?

HW: No, she didn't. She married... All her side of the family, unfortunately, are lawyers or judges. Her son is a judge, and my grandfather-they were all... It was very much in the legal profession.

JW: All professional people.

HW: In fact, I just visited up there, and she has three girls and one boy, and three out of four are attorneys. No, her grandchildren are attorneys. So, it's a complete difference. It's just too bad.

JW: Why is that too bad?

HW: Oh, I think one of the problems of Medicine today is this litigious society.

JW: Oh, yes. I agree with you. HW: It affects a lot of what we do.

JW: But don't you think they discovered that we like to pay insurance premiums?

HW: Uh, yeah...

JW: ...and like fishermen, they are going out to fish for them.

HW: Yeah, uh-huh.

JW: Now, let's talk about Pitt County since you've spent most of your life here.

HW: I certainly have.

JW: After you got out of the service, along with having children, you worked at the County Home?

HW: Uh-huh. When the children got a little bigger, I really didn't want to lose... For a few years there, I had three in diapers and not a whole lot of help, so I tried to keep up, and I couldn't find anything else-maybe I didn't look hard enough for it. But I did work at the County Home, and I did the public health clinics. I think that was in 1955, something like that, and I did the maternal and infant clinics-babies and mothers... We called 'em VD Clinics in those days. Of course, now, it's STDs.

JW: At the Health Department?

HW. Yeah, uh-huh.

JW: Who was the health officer?

HW: Dr. Fox. No, he was... Dr. not Humber. I don't remember. Earl would remember. This was before Dr. Fox. Let's see-now it's Monroe, then it was Fox.

JW: Now it's Morrow.

HW: Morrow.

JW: John Morrow. His mother was state health director.

HW: Yeah. Ms. Fisher was the nurse. I called a couple of the old nurses I worked with, but most of 'em are not around. But they were good nurses. We had one clinic over the ABC store I think it was in Bethel, and we went to Farmville and Ayden, and then we had clinics here.

JW: You would go with a nurse?

HW: Yeah, we went with I think it was two nurses. I mean, these women were they worked on the farms, and the transportation was a real problem. But they could... It was kinda like a big wonderful day when they got the baby and they all got in the truck and they all came of course, they had to wait a long time-but they were singing. The ones that I thought could be delivered by midwives, you know, we'd say okay; and the ones that weren't, we would refer into the city or to the physician in the town. But that was very satisfying because you felt like they weren't going to get any other care anywhere else. Then after-that was in 1958, something like that-but after a while and I continued to do those clinics, even after I started the Student Health Service, which was in 1960-something. But then the state in its wisdom that's sarcasm decided that they would have a better clinic if they could have it in Greenville. So they closed all those clinics, and the patients were supposed to come into... I guess eventually- I never did any research to see whether they all came or not. I don't know where they went, but I guess they got care somewhere.

JW: You peaked my curiosityin your prenatal wellbaby clinics, you referred these pregnant ladies to midwives?

HW: I okayed them.

JW: You okayed them?

HW: I okayed them. I didn't deliver them.

JW: No, no. But for midwives to deliver at home?

HW. Yeah, uh-huh.

JW: Were these midwives licensed by the state?

HW: Yes, I believe they were. I think so. Now, later on, there was more of a midwife program here, and they would call me at night for some reason to get permission. If they were mothers that I saw in the clinic-now I don't know how I remembered whether they were okay or not� maybe they described the situation on the phone and I said okay.

JW: But they had to get your permission before they could deliver that baby at home. And when did the home midwives stop. Do you recall?

HW: I don't know. But you remember Herbert Hadley was very much against that because he delivered a lot of babies, and he was very much against the midwife program.

JW: I was, too.

HW: Yeah. He delivered a lot of babies. In fact, there are several little babies out there now called Harriet Husted Wooten that he named after me.

JW: That was the favorite thing that doctors did with some of the children that... They named them after their children or their colleagues in those days.

HW: I'm a little vague about those details-about the midwife deliveries. I really am. We checked 'em. You know, we looked for eclampsia and all like that, but we put a lot of them on diuretics. Remember when we did that. Now, that's a no-no.

JW: That's right. It changed.

HW: Uh-huh, changed.

JW: Now, did you follow-up. Did they have well-baby clinics. You saw those children?

HW: Uh-huh.

JW: And did you have any problems much?

HW: No, if I had a problem, we had a... Well, once a month, maybe, the pediatricians would come in, and Earl or whoever got...

JW: Dr. Haar?

HW: Yeah, Dr. Haar and Earl. And then they had the orthopedic clinic once a month that John did.

JW: This was pretty much a gratis thing that you did, was it not?

HW: No, I was paid. I was paid-not a whole lot-but I was paid by the...

JW: County?

HW: No, it was state.

JW: State?

HW: The state. I believe it was the state.

JW: I did some of this at Wilson County Health Department when they were responsible for Greene County, and I had a clinic like this over in Walstonburg once a month-prenatal and well child. I was paid $10.00 a month for that clinic, and then it got raised to $15.00.

HW: Yeah, I think that's about right.

JW: And that was back in the 60s.

HW: Was that county or state money?

JW: I thought that was county money, but I don't know. I don't recall.

HW: Now I was paid when I worked for the County Home $15.00 a visit. There was a question somewhere here, was it gratifying. And I think it was. I really felt like it was. I supervised their diet. Do you remember the County Home?

JW: No.

HW: Well, of course it's torn down now. It was out there where the Mental Health Department has a greenhouse. Well, the County Home, you know, out there around Firetower Road or...

JW: Bell's Fork?

HW: Opposite the Farmer's Market-out that way. And the County Home was a brick, U-shaped brick building, and each patient had a single room that entered into the porch, and then they would sit there. In the summertime, they would shell butter beans, and then they ate all their own... They had a good diet. And they had a little social life, and then they'd all roll into the dining room. And I used to review their healthcare. I remember we had a severely crippled, rheumatoid arthritic patient, and he was always upbeat-always. But anyway, I talked with the cook. Of course, they didn't have a dietitian, but they had good meals high cholesterol meals. Oh my, they ate 'em. But I supervised and examined them when they got sick and put them on medicines for their high blood pressure. Reserpine-I think we used a lot of reserpine in those days. But anyway, I used to review the diet, and she would write it down. One day, I looked at it, and it said, 'rubber beggars.. And I thought, 'What are we eating here?. She said, 'Rutabagas.' So they were having pork and 'rubber beggars.. I do remember that. And then once in a while, the county commissioners would come out and inspect it, you know, and say 'Oh my, we need to put these patients these poor people-in nursing homes.. Of course, they did, and then they didn't have to pay for the County Home upkeep because they could get Medicaid.

JW: Is that why the demise of the County Home?

HW: I think so, but I was never privy to...

JW: So that was probably federal and state money that paid for the care of these people in the nursing homes.

HW: Yeah, because they could get Medicaid.

JW: How many patients did they have out there?

HW: They had about 30.

JW: Thirty?

HW: Yeah.

JW: Were they black, white?

HW: Well, we had some white mostly black.

JW: Some white mostly black.

HW: That's how it is in nursing homes now.

JW: Did they have families?

HW: Yes, some did, but not many because most elderly, chronically ill blacks are taken care of by their families. Don't you agree?

JW: Yes. Now, that's fascinating-that phase of almost indigent care or indigent care for the elderly, which we are rapidly becoming, and everybody's talking about long-term care insurance. Was there any health insurance in those days?

HW: Not that I remember.

JW: Not for that kind of person. Insurance for surgery?

HW: Perhaps. It was just handled so...

JW: When I came to Greenville in 1967, there was no medical pay insurance for physicians to take care of people with heart attacks, diabetes, pneumonia, etc., that you put in the hospital. Then they got a five-dollar-a-day plan out, but there were fees for surgeons because surgeons fed the hospital and brought patients in, did they not?

HW: Yeah, from elsewhere.

JW: So this is why Blue Cross/Blue Shield and others encouraged hospitalization.

HW: I guess so. I really didn't know much about that end of...

JW: Economics.

HW: No.

JW: Being fortunate to have a husband who was producing...

HW: That helped.

JW: That helped some. And you gave a lot of timea lot of service, which had it been paid for at a going rate would have been worth a considerable amount of income today.

HW: Oh, yeah. But I enjoyed it.

JW: You enjoyed it. So that was one of the satisfactions of it.

HW: It was very gratifying. Much more so I think-well probably more gratifying than working at Student Health. I thought about that statement a long time because that doesn't sound good, but you got to know them. It's something that you always enjoyed-continuing care with the patients. But with Student health, you saw them maybe-well you saw the really, really handicapped ones-but as far as the average student, you know, you didn't see them that often, so you didn't get the gratifying feeling that you would...

JW: How long did you work for East Carolina University Student Health?

HW: Twenty years.

JW: Twenty years?

HW: Yeah, just about that. And that changed a lot, too.

JW: That was from what time to...?

HW: About 1965 to '85 or '86. And that changed a lot. At that time, when I first went, we didn't have a full-time physician. Dr. Fred Irons was the head, but he still had his practice. And then Dr. Fore-let's see, Bill Fore and Don Tucker and 1... When the children got a little older, I thought, 'Gee whiz,' you know, 'I really gotta do more than this,' but I decided that might be a good way to get back in, and so I did that. As I look back on it, I don't know that that was such a wise decision at the time, it was available.

JW: You were fulfilling a need that East Carolina University could not provide for the students. Prior to Dr. Irons' leaving practice and going full-time with the university, did the students not just sort of go out into the town and buy what services they needed?

HW: I guess so because most of them didn't have insurance. I remember when the students didn't have insurance, and I guess I don't know what happens to them now, but there have been changes in... You know, we never had appointments you just dropped in, and some of them had long waits, but I think we gave excellent medical care. We certainly had the best lab around. If you saw a student who was really sick with mono or something like you, you could get the test, the blood test, the blood work, the mono, and put them in bed. We had 35 beds, which I think was wonderful for students. We were in loco parentis for a while, and then they changed that. And so, the student had quite a service for whatever they paid $15.00 and there were very little fees involved. We could draw an SMA-12 for like $10.00 and get it back the next day. And the lab work itself was done-remember Barbara Wynn was head of the lab?

JW: Yes.

HW: And, of course, Lib Proctor was...

JW: Lib Proctor was at the lab, too.

HW: That's right. And we could get a full blood count and a reliable differential. I mean, they knew what an abnormal leukocyte looked like. You didn't have to wait a week or two weeks the way they do now, and it was free.

JW: That would be an economic thing, and I don't know anything about... Dr. Adams used to do some of those clinics. When I came here, we did a clinic with him from 5-7 at night, and then we would rotate Saturdays and Sundays. We were paid some money I don't recall how much.

HW: Fore and Tucker and you and Charlie. And then when I started, I had I guess the noon clinic or something like that-before I went full time.

JW: Dan Jordan left Bethel and came in full-time because of his health, was that right?

HW: I guess it was. I was there when he came, and he and I had offices. Then we got an FNP� nurse practitioner-and we saw a lot of patients. And then, of course, we had a lot of GYN; I got stuck with a lot of the GYN [cases].

JW: Those sexuallytransmitted diseases?

HW: Yeah. And then Harry McClaine came.

JW: Yes.

HW: He did a lot of the surgery stuff--relatively minor surgery.

JW: He was a classmate of mine.

HW: Harry was?

JW: Yes.

HW: Is that right. I liked Harry. I really did.

RM: What kind of surgery?

HW: Hemorrhoids, pilonidal cysts, pilonidal sinus cysts, Bartholin cysts. He did most of that. I did some before he came.

JW: Most anything that could be done by a local anesthetic?

HW: That could be done in...

JW: If it required more than that, it was referred.

HW: Right, but we had some interesting cases. Of course, it was during the initial discovery of several things toxic shock syndrome I remember when that was first a syndrome that we...

JW: Did you have any patients with that over at the infirmary?

HW: Uh-huh.

JW: You did?

HW: Yeah, but I got rid of them as soon as we diagnosed it.

JW: How do you mean you got rid of them?

HW: I sent them to the hospital before they...

JW: To a gynecologist?

HW: To the emergency room whoever was... We had several, and that was dangerous. And ruptured ovarian pregnancies. You know, we had a lot of pregnancies and lots of referrals for abortions. Lots of people on the pill. Lots of sexually-transmitted diseases.

JW: Was there a question about morals regarding students wanting to take the pill...

HW: There was with Fred.

JW: ...and the controversy about parenteral support or release?

HW: There was ear1y on in the early 60s, and I remember one physician saying as long as he was at the Student Health Service, we would not put anybody on the birth control pill. Of course, soon after we you know, we sold 'em for a dollar a pack-and now, they're, what, $35.00?

JW: Yeah.

HW: It's just ridiculous what they charge now. And then we'd have the vegetarians who would not take the pill or some would, even though they were vegetarians. I mean there were very conflicting ideas.

JW: Was there much gonorrhea, syphilis, things of that sort going on?

HW: Yeah. Well, not so much syphilis. Most of the syphilis I saw was in the main Health Department because I was still doing that. But a fair amount of sexually-transmitted diseas. Chlamydia, which of course now is considered an STD-and papilloma-type virus, which we thought was so innocuous, and everybody had it, and it causes cervical cancer. It's considered an STD. So, it was...

JW: We learned with time, didn't we?

HW. ...a transition. Yeah.

JW: Interesting about the attitude of students-toward the physicians and nurses over at the Student Health Service.

HW: Well, I think they always thought, 'Oh well, you know, it's free so it's not worth a whole lot.' But then if you got a patient like that, you'd refer 'em, and then soon they'd be back and say, 'Well, you're free but you're not so bad.' JW: Do you think that was just student attitude? HW: I don't know.

JW: Did you have much contact with students and drugs?

HW: Oh, yes. I remember one student came in this was in the 60s, you know and he had the usual curly hair and everything, and he was kind of stoned at the time. And he took something out of his hair and said, 'Hey, doc, don't you want to try it?. You know, they were very open because they knew that we didn't...

JW: What were they using?

HW: Well, a lot of LSD.

JW: LSD.

HW: Yeah. Not ephedra. PCP some and a lot of pot. Now, I don't whether it's more...

JW: Alcohol?

HW: Yeah, but we... There wasn't any law against you know, that stupid law they have about drinking under 21. I think that was an absurd law, and I think it will be repealed. Don't you?

JW: Good possibility, although Mothers Against Drunk Driving are very much opposed to that because if you don't use alcohol, you can't kill anybody with your automobile.

HW: Yeah. We didn't preach much about tobacco. Now, I do say that if we were going to put somebody on the pill, they had to listen to me or who else did it? Dan. Dan and I made a video once. We used to require one night a week. We would take turns discussing the dangers of the pill, preach abstinence, preach what we thought was right, and we required them to go, and they had to go.

JW: To get the prescription?

HW: To get the prescription, and then we had some complaints from higher up about that.

JW: How high up?

HW. Well, I think it...

JW: Chancellor?

HW. Yeah. It was transferred to me by somebody from higher up.

JW: From the administration of the academic institution.

HW: It was an infringement on delivery of healthcare or something. So then we put it on video and suggested that they see it.

JW: Did they?

HW: No. They thought they knew it all. But we did for a long time. And then when we did write the prescription, we would get them to sign a release because, you know, I remember, I thought some day they were going to find out that it was going to be linked to cancer and everything, and we'll be liable. So, we did. A lot of people thought that was foolish. Some of the doctors wouldn't make them sign it, but I did.

JW: Interesting-you mentioned smoking and our attitude today. Did you ever smoke?

HW: Well, yeah. Not a whole lot, and I knew at the time it wasn't healthy. Didn't we all know it wasn't healthy-kind of?

JW: I suppose, but it was kind of a tongue-in-cheek thing.

HW: Yeah. But I think this campaign against tobacco-why they do that and not do alcohol is beyond me. It's political interest.

JW: It is interesting that the whole profession has changed its attitude about tobacco and smoking. Sure, it was known I guess for 50 or 100 years that it was a bad product and caused certain people chronic lung disease and things of that sort-those that actually had the cancer. But there were a lot of people who smoked and never had cancer of the lung.

HW: So true. Well, why hasn't the medical profession done more about alcohol?

JW: I don't know, it's probably all enjoyed as a social type of thing. But who can decide or I should say this-how do you decide this person will be a social drinker and this one will be an addict or an alcoholic?

HW: Well, with genetic-with mapping the human genome maybe we can find out.

JW: We are getting into the future. This is supposed to be about the past.

HW: That's right. We're talking about women in Medicine.

JW: Women in Medicine. That's very good.

HW: Well, in our era we were treated the same as men in Medicine, which I think is the right way. We didn't get pregnancy leaves, we didn't have built-in tennis courts and fitness things, and we worked a long day and were expected to produce as much as men. From what I see, and I have several relatives in Medicine today, I think the men are bearing the burden of women's careers, and I just wonder in the long run, will they produce as much. So much of it is subsidized by the government, and I just wonder whether in the long-term they will produce as much. But I don't know that. I have a few questions that I would like to pose about the amount of money put in biomedical research now-in stem cell research-whether that's going to happen or not. I feel like there's a limited amount of money available, and I think it would be better spent in educating more teachers at the elementary level--educating more people for a role in statesmanship and ethics and history. I think the money is better spent. Sure, we can find new techniques for robotic surgery, but we're trying to prolong life when we should be trying to prolong the healthy years of life. I don't know how they'll do it, but I just wonder if biomedical research ought to be somehow limited. We can't handle what we've got, and I don't have a solution.

JW: Along that line, let me ask you a question about the two little Mongolian children who were brought to Greenville last week to have cardiac surgery by our cardiologists here at the university. Do you think that's why the university was created in Greenville, North Carolina?

HW: Well, I never thought that we needed another medical school.

JW: I see.

HW: That's one of the questions posed-did we need that. And at the time, there were physicians in the medical society who were not in favor of it.

JW: Yes.

HW: And with telemedicine today and high-tech stuff, you know, has it improved the healthcare? Physicians are more inaccessible now-no, maybe more healthcare is availablebut physician accessibility is not. In fact, I sometimes think it's more difficult. Now, if you need a bypass or something like that, then you might be able to see somebody, but otherwise it's not more accessible.

JW: Do you think that the role of nurse practitioners and physicians' assistants has been an asset to providing more healthcare...?

HW: Yes, I do.

JW: ...and distributing that into areas where doctors in bygone days did not go?

HW: Right. I think it's a good thing. It took me a while to get to that point, but I do. It's bringing more regular healthcare to the disadvantaged-to the people who can't get there. But as far as high-tech, I mean, if you want a virtual reality colonoscopy, which I guess we're gonna get, which I think is a good thing, we could drive an hour-and-a-half to Chapel Hill, and I just don't know that we the average citizen-profit particularly from having the medical school. Now, if you need a bypass operation, it is much nicer to have it close to home, but I don't know. I think there's an exciting future for younger doctors. The middle-age doctors-I think it's difficult for them because they've lost their freedom, they are harassed from every angle, and they remember the good old days. But the younger people, like the medical students of today, they really don'. know any different, and so they will be brought up with the idea that this is the way it's done and they should get great satisfaction, but I think there'll have to be rationing of medical care certainly, and there'll have to be a limit to the amount of high tech that's done.

JW: Rationing of medical care. Do you think that that would end up in a national health service?

HW: Uh-huh, yeah. And I think that that might be the way to go.

JW: You think that would be good or bad?

HW: Well, it certainly would be easier on the practicing physician. Now I know that's a very radical statement.

JW: Yeah, but we're the only real country in the world that does not have a national health service at this time of some sort.

HW: But it will limit care-they'll have to limit care. It just can't keep going up. I think there are certain things that we need to do. I think the use of electronic medical records has been a great thing for the hospital. The first thing they did was billing and then appointments, but they haven't used it for the patients. I think every patient should have his own electronic medical record. If it's in a palm-held computer, and he punches a button, and it'll say, 'Well,' you know, 'it's time for your mammogram' or you'll get all of this information, and then you can take it and let your FNP evaluate it. Then, if they say you really need a stress test and then you might need a bypass, you go to the next level, but the next level is not going to have much doctor-patient relationship. That will be transferred to the PA I think. Does that sound too radical?

JW: No, that sounds just about the course it's on to me, and I think that the doctor of the future will be sitting at a console and able to monitor four or five PAs what's going on-and they can ask questions back and forth, but they'll be doing rubber stamping.

HW: And the PA or whatever it is will have the pleasant doctor-patient relationship, and there should be more men going in it I think. I mean, it pays very well.

JW: The pay is excellent. Of course, the medical student that graduates or the resident that finishes with a $100,000 debt today has an obstacle which I never had-and I doubt that you did-of having to pay it back. There are ways of doing that, but I don't know what kind of debt you had, if any, when you graduated medical school. I only had about $2,500 or something like that at 6%. It was the hardest money I paid back in my life.

HW: Of course, some don't pay it back now. You know, a lot of people actually... I don't know what else I have to add which is of any interest. It seems to me we have decreased access to ambulatory care now.

JW: Decreased access?

HW: Yeah.

JW: How?

HW: Well, I just hear so many people say that they can't get an appointment for three months, and that has to be solved. They have to get a lower level of care. I don't mean lower-I mean more general access-and they can do that with their little electronic palm pilot, but people will say, 'Oh you know the average person can't run a computer.' Of course, that's not true at all. I mean, in about I 0-15 years, every patient will have a palm pilot or whatever you call 'em and will know how to run it.

JW: Do you have one?

HW: Well, we have three computers, but I'm not real good at it, but I can Netscape and stuff like that.

JW: I don't have one.

HW: But I can't get my personal medical record without asking for it and looking at it. But you should be able to push a button and say, 'Oh, yeah.'

JW: At the Family Practice Center for the last 2-3 years, all records have been transferred to electronics called Logician it's a program. I can operate that computer and work it and know what goes on as part of the work I gotta do. But when you have a problem like a power shortage or if you have something wrong, you can't print a prescription because you have no prescription blanks and there's no paper-how do patients get their prescriptions at the drugstore refilled? We had that problem last year for about 2-3 days. It was horrible. People were calling in needing this'I'm out of my medicine gotta have this.. Nobody had anything and couldn't get it up on the computer.

HW: I think it's wonderful that the surgeon can press a button and he can get the latest hospital record in his office. That's great. But the patient doesn't get...

NOTE: After the tape ran out, Dr. Wooten offered more comments. Among these were, "Well, what it amounts to is that a patient must be more involved in his own care!" and "Medicine is a business now. That's the sad part.. (These quotations are from Ruth Moskop's notes. She was also present at the interview).