Oral History Interview with Dr. Andrew Best June 9, 1999

ORAL HISTORY INTERVIEW WITH DR. ANDREW BEST June 9, 1999 Inteviewer: Ruth Moskop Trancribed by: Sabrina Coburn

16 Total Pages Copyight 1999 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. (1:00)

AB: Good morning.

RM: It's June 10, 1999.

AB: June lOth? Is today the tenth?

RM: I hope so Dr. Best. Today's the ninth.

AB: It's June the 9th, 1999. I thought my little computer said...

RM: You're right. Today's the ninth. I've been saying it was the tenth all day.

AB: Okay, June the ninth.

RM: Today's June 9th, 1999. My name is Ruth Moskop. Did I get that right?

AB: Yeah. That's right.

RM: I'm here to record an interview with Dr. Andrew Best. Dr. Best, do we have your permission to record this interview?

AB: You certainly do.

RM: Thank you. Dr. Best, you are familiar with Dr. Malene Irons' work as a pediatrician...

AB: Yes.

RM: ...and I wonder if this morning if you feel like commenting a little on that? You mentioned her humanitarian efforts and how she really was a mover and shaker in integrating Pitt County Memorial Hospital.

AB: Yes.

RM: But I think you probably have some insight into her professional activities as well. (0:57)

AB: Well, I certainly do. When I came to Greenville and joined the staff in January of 1954, I found Dr. Malene here, and she and Dr. Earl Trevathan were handling most of the pediatrics. Of course, Dr. Trevathan came to Greenville just about the same time that I did to set up practice. Dr. Malene was a very proficient person. She was a very caring person. It was no doubt in anybody's mind who might happen to be coming by and looking on her as she worked from a far as a doctor in te emergency room. It was very obvious that here was a person who, first of all, knew what she was doing and who cared about her children. She had the greatest concern and care for all of the children. I never asked her to consult with me on a baby that she did not come promptly and freely. There was no hesitation. She would evaluate the patient and give me her recommendations and tell me whatshe thought needed to be done. One of her greatest concerns, in the early days, was the fact that her minority premature babies could not be admitted to the newborn nursery where there were isolates and that's those special cubicles with extra oxygen and ...(3:10)

RM: Warmth.

AB: ...special equipment for those premature babies who had not yet developed the physical stamina to do the physiology that was necessary for their survival, growth, and development. I would say in my experience with a lot of physicians in a lot of areas that Dr. Malene was perhaps one of the most compassionate and caring, always professional doctor, pediatrician that I have ever known. Of course, my professor in pediatrics when I was in med school would belong to that same category. There was Dr. E. Perry Crump who would belong to that same category. I could not really judge and appreciate Dr. Crump's total personality as a medical student, and he was the professor and head of the department, who was responsible for those Friday examinations that would be thrown at medical studnts. As an equal and as a person who is on her own, you know that whatever her applications are to her profession, then they are the result of things that she believes in as a part of her own experiences. Now a word on this isolate proposition. Where the minority babies, no matter premature or what not, had to come down and be in...They could not be admitted into the newborn nursery. They had to come and be in the bed with the mothers regardless of what the circumstances were and this disturbed Dr. Malene to no end. I think it was one of the driving forces that made her to see the light to help get involved in the integration of the whole hospital, meaning her philosophies and her concerns. Of course, she recognized early on, especially with the premature baby population, that there was some brain, mental developmental deficient in these babies. It was her project to help establish probably the main prime moving of getting this Developmental Evaluation Clinic started to try to pick up on what was going on in these kids who began to show some mental deficiencies as they developed. Slow learning for example-inability to cope like other kids of their ages. In my view, of course I referred any number of kids to her, to the Developmental Evaluation Clinic and I counseled many of my parents in looking at the children coming into th octor's office for their inoculations and immunizations. As a professional, naturally, I could see some slowness in a child that maybe the mother had not detected. So, I would say, "Now listen. I think that you need to take this child to get to an appointment with Dr. Malene to get the child tested." That was a way that we used to get... (7:45)

RM: To refer.

AB: Yeah. To determine that...Well, in speaking to the mother, we had always to be very careful not to imply that the child was an imbecile or a moron or like some of tose mentally deficient kids, but to say that the child needed to be tested so we can see where he or she is so that we can do some things to help bridge these gaps or to get them. up to par. Dr. Malene was always most gracious in taking those children and doing the studies. I don't remember one bit of criticism coming back from the parents, mostly the mothers that I sent to her about her performance or her edside manners, her rapport with people and this kind of thing. It was beautiful to behold. In many cases, especially with newborn babies, if the baby was large, like I remember it was a diabetic mother. The baby weighed about 10 1/2 pounds and was kind of a difficult delivery. In making the delivery, there was sometugging and twisting to get the baby out and there was actually some brachial plexus damage on the right shoulder of this young baby. So, I had Dr. Trevathan to see this baby immediately before the baby ever left the delivery room and he made certain observations. Of course, Dr. Malene helped to follow the child along and...this is the one case that the child was twelve years old and I got sued for a quarter of a million dollars for malpractice, because of that birth injury. Of course, both Dr. Malene and Dr. Trevathan testified for me when the lawyrs came around to take depositions. They permitted themselves to come and be deposed as to the quality, care, and the immediate diagnosis that here was a birth injury. The father of this twelve-year-old boy, who had grown up to be abou six feet. ..and he didn't have enough muscular, neuromuscular damage in his rm. The boy played basketball and all. It was an attempt by the parent to get some money. People are always interested in getting something for nothing. One of the hard things about this particular case is that when the mother came to me pregnant with this child, she had some problems herself. First of all, she was a diabetic. Secondly, she had a whole vagina full of venereal warts and thirdly, she had had no prenatal care, and up until the fact of when I first saw her, she was in her eighth month with no previous prenatal care. I took her in and treated her and because of a strong possibility of maybe some syphilitic infection, I went on and gave her the treatment for syphilis, the penicillin. Those 2.5 or so, 5 milli units of bicillin, which was standard at the time. The other side of this altercation was I was not paid for any of the treatment except this patient's mother sent me a lone, poor pitiful $5 bill, and for delivery services, I got not one penny. (13:32)

RM: This was the mother's mother.

AB: Yeah. The mother's mother.

RM: The grandmother of the boy.

AB: The grandmother of the baby sent one pitiful $5, but all of that office treatment for the venereal warts and the possible syphilis, all of that infection, trying to protect that unborn child, not nary cent. Yet when the child grew up to be twelve years old, I get slapped with a suit. Of course, the parent got a lawyer from over here in the Wilson area, and they were anxious to get the thing running because in another year or two, the statute of limitation would have been passed. That's not the whole part of the story. Maybe twelve months later, the lady was pregnant again. I delivered baby number two. Baby number two did not have any deficients like that. So, here it is there are two babies in this family and I delivered both babies. I had not been paid, but yet get slapped with a quarter of a million-dollar suit. (14:56)

RM: Unbelievable.

AB: Unbelievable. Of course, the insurance company settled out of court. You know how all of that legal jargon that they put forth, that in paying off in settling, there was no...

RM: No fault?

AB: They don't use that term "no fault," but there is nothing to say that I had committed a crime. Without prejudice, that's the legal term. Without prejudice to me, they settled about a quarter of a million-dollar suit for about $10,000. So, it was very obvious that there were people out there trying to get something for nothing. No matter how great a steward I have been of compassion, when the eyesare on the dollar, they get green in the view.

RM: They forget fast.

AB: Yeah. They forget real fast. (16:29)

RM: Well, how has the whole malpractice situation affected your attitude about the practice of medicine?

AB: Really, it has never affected my attitude. It had made me mindful and to be careful to do the things that are professionally sound and things that can stand up. The most important thing for doctors protecting themselves against a malpractice accusation is to have good office notes. In the situation where any doctor that's seeing as many as patients as I was seeing, the notes sometimes got sparse. If I looked, maybe, and you have swollen tonsils with pus running all over them and you have your pharynx full of inflammation, temperature of a 104, where the nurse has already taken the temperature. It could be sore throat or strep throat. You usually...in many cases, before the day is over with constant harassment for mapactice... when you made a clinical judgment that you had a case of pharyngitis and tonsillitis and the approach would be to start treating it with penicillin. 99 times out of a 100, penicillin would be effective in getting it cleared up in two or three days and that would be it. But, the office notes, the prolonged office note might would say, "The patient was examined and it was found that the tonsils were markedly enlarged and inflamed and there was pus protruding from the follicles of the tonsil"; you would go ahead and describe it. She was treated with penicillin and well, when you come back two days later, the temp was gone, which was maybe 104 when I saw you. The throat looks better, but there's still some residual and continue her penicillin treatment. Well, in the days when I was 50 or 60 patients a day, those prolonged, detailed office notes just weren't there. You might find an abbreviated note saying, "Okay, after I have examined and see the clinical findings, temp known to be 104o, patient claims of inability to swallow, onset of sore throat 24 hours ago, treatment-penicillin by IM injection and give prescription to get some more. Usually at that time, we gave the oral suspension because of the inability to swallow pills. You, the patient, got well and I would see you a week later and it seemed to be all gone. Everybody is happy. Well okay, that's about the size of it. In other words, that abbreviated office note permitted me to see somebody else. I had 60 people that were waiting to be seen. But now, if there happened to be a complaint somewhere, four, five, or sx years later down the line, sometimes...Well, the first thing that those lawyers would do for the plaintiffs making an accusation, would be to come in and have a court order to subpoena the records. Now, those abbreviated notes which were completely adequate for me to make a diagnoses and to prescribe treatment which had been effective, those lawyers, in trying to make a case, would come in and say, "According to these notes, we don't know if whether he made the right diagnoses or not. It could have been lupus or it could have been lymphoma." They would go to the books and outline every other thing that it might have been and they would say, "It might have been oral thrush indicating that you had AIDS or something." The best defense, in a summary statement, agaist malpractice is to have good office notes and in cases where there might be a cocern about a differential diagnosis, get a consultant. Now back to the case that I mentioned about where Dr. Trevathan and Dr. Malene Irons had seen this baby that from the time before the baby ever left the delivery room, they recognized that there had most likely been some nerve damage. Now, 85 percent of those kids that had gotten a little nerve damage by stretching the brachial plexus during the delivery process, by two or three years they recover and its all over but evidently this young man did develop some permanent damage and they came back to haunt me even though, I'm the first to recognize that it could have been a whole lot worse. Because even after all of the rhetoric and the depositions and the struggles and what not, when you start a suit off with a quarter of a millon or $250,000 and end up settling for $10,000, even the lawyer for the plaitiff must have seen that he didn't have much of a case. They agreed to settle without prejudice to me, so that was okay. That was about the nearest brush that I had with the malpractice people, but I have seen it. I would say in the last ten years, maybe the last fifteen years, we have seen more people coming in for mapactice than ever before. My country diagnosis is the "something for nothing" syndrome among people. It is very prevalent among people. See, at one time in the practice of medicine, the doctor was such a beloved individual in the community among families...They had the rapport with the families that it would be unthinkable that you would sue your doctor. Now on the other hand on malpractice, I have on many, many occasions where I had good rapport with the family, and the family will come into me complaining about Dr. Jones or Dr. Brown and, "Yeah. I'm going to sue him." I have been to able with no fan fair at all to say, "Look, that's not the thing to do because the way from what you tell me..." See, without ever saying anything to Dr. Jones or to Dr. Brown myself, is to tell them, "From what you tell me, and I am a disinterested neutral party, what he did was good medicine." And I've very often used the expression, "Ruth, I'm good. I know I'm good, but I'm not God and I recognize that I'm not God." So, with that kind of recognition, I'm subject to, shall I say, errors of ignorance or errors that made, in good intentions, in trying to help somebody in very difficult circumstances. It is not every disease process that is easily distinguishable from other more malignant or more serious processes. In many instances, I have been able to maybe get the family off of that suing route. One lady I recall, she was going to sue another doctor, I said, "You know what, you are going to get yourself embarrassed, because there are some things about this that you don't know." Say for example, she was going to sue the doctor about not doing something or did something that he should not have done or he didn't recognize that this patient had ancer. But then when it came down to the final analysis, they found another patint had been into see the doctor. The doctor could not have recognized that the atient had cancer, because the patient had a history, even about simple things, of not keeping or making appointments. So, I had, from my knowledge of people and nurses and folk were familiar with the case had filled me in on it and so, I had some rapport with the family. So I said, "Look, you are going to get your feelings hurt and you are going to get yourself embarrassed. Now, it will be obvious that you are seeking some money from the doctor which you don't deserve to have." I would tell them straight up and it hasn't been, oh, maybe about three or four years ago, there was a case where the family was concerned about an undesired, unwanted pregnancy. I'm the family doctor, but I didn't know about this. The girlwas in college and came home with the pregnancy. So, she was taken to a clinc, where the pregnancy was interrupted and as something that happened very frequently, evidently some of the placenta was not expelled. A piece of the placenta does not expel, sets up a focus for bleeding to continue to be a nagging thing, spotting, bleeding a little bit more a day, because that placenta that doesn't shed off does not let the uterus contract to the point that it stops the bleeding. So, it just sets up a spot or focus for bleeding and of course, that dead placenta sometimes gets infected. The routine treatment that the gynecologist does is a D&C and clears it all out and puts them on antibiotics and there's no particular problem. Anyway, after the patient had been home maybe a week and was still having some problems, the family took the patient to another doctor. This other doctor said, "The people who treated this young lady, they were wrong and they didn't do what they were supposed to do." He had the family all upset. .. saig... and the idea was that the father was going to sue the clinic for a problem with the child. So, I listened to him and he said what this other doctor had told him that the people didn't do the job. That was this other doctor had informed it. I sad, "Listen, that is something in an interruption of a pregnancy like that." I explined to him the mechanics of some of the afterbirth being left and went through all of that. I said, "That's something that happens and you can't trace that to anything wrong by the first group of doctors that treated the patient. Now, if you were to file a suit and in this case, let me tell you what you are doing for yourself. You are exposing your daughter about a problem that is more or less private and that a problem that should not be thrown open to the public, but you are ubjecting her to her whole life and everything to putting her under the microscope, but more importantly on the television." I said, "Then when it comes down the legal aspects of it, which will deal with whether the first treated physician did something wrong, or did not do anything outside of the regular routine of professional practice that is acceptable, you'11 come up spinning your wheels and you'll get the ruling against you so far as liability is concerned." Now, this father of this young girl, 18, 19 year-old girl, has a lot of confidence in my jdgement and in my advice. He said, "Doctor, I tell you. I hadn't thought about that." I said, "From what you're telling me, the child appears to be well and the problem so far as any bleeding and spotting is concerned has been solved and I hoe that the people put her on birth control pills and let her go on back to school and get her education. The best thing that you can do is say thank-you Jesus and forget the whole bit." He said, "You know, you are exactly right." The father said that the reason that he got kind of upset was this second doctor that went through saying that they didn't do their job. So, that's a side of medicine where if...it's always good to have somebody whom you trust and you can go to when you are excited or you are troubled or your anxiety...somebody who's brains can operate outside...(34:29)

RM: Of the immediate emotional.

AB: ...of that emotion. That's exactly right.

RM: Well Dr. Best, you mentioned a little while back about giving injections of penicillin as the first treatment for obvious infections.

AB: Yeah. Yeah.

RM: And you also mentioned the context of people who don't pay you for complicated procedures like delivery and I'm wondering when you administer drugs here in your office, do you expect compensation immediately or is that on a flexible scal, too? (35:04)

AB: Well, following the pattern of my old family doctor, which we talked about, Dr. Joseh Harrison, who gave his very life for the welfare of people and never got any compensation for it. When a patient has shown up in my office through the yer, the patient shows up, the problem gets considered as far as the diagnosis is concerned and we administer what we perceive to be the appropriate treatment. But no thought of the usual current practice of people in doctor's office saying, "Well okay, you have a bill of $20 or $25 here and we can't treat you and we can't see you." I've never shared that philosophy. Sometimes, I have people who are egligent and who are just plain deadbeats. I have to threaten them a little bit and say, "Look, you have a bill here for $300. You are going to have to pay this bill or pay something on it before I will go ahead and treat you." I have never in my whole 45 years 5 months and this is 9 days, I have never sent out what they call a bill or a done unless somebody. I used to in this farming population...I used to have a lot of patients who were on the farms and their overall agreement or arrangement was, "I'll come and pay you in the fall when my crops come in and I sell my tobacco." Usually, they would come by or sometimes they would callthe office and say, "Look, mail me a copy of my bill so I can come in and pay you." Well now, that kind of a statement. We would supply those people with a bill. So far as sending out regular bills, or the people used to call them dones, you done in need for some money. I never sent one out in all of the years of my practice and that I'm sure accounts for the fact that I am somewhere between the poverty stricken doctor and the pauper, because people who get your services, if you don't urge them or you don't get nasty, they just won't come back and pay you. Now, I know that I have been the victim of circumstance in this, but I don't beat myself over the head for having permitted those people to take advantage. (39:00)

RM: Well, you've probably provided not only services then, but medication for which you haven't been reimbursed.

AB: Sure. That's exactly right. Now, in the first days, the first few years when I first came to Greenville, we didn't have as many drug stores or pharmacies as we have now. I used to dispense medicine. I had my own drug room and more or less pharmacy in the office and I would dispense medicine. I guess I had been pracice ten years or more before I decided that it was not profitable for me to go and order medicine, which I got to pay for at the end of the month and dispense it with no pay. So, I dropped the dispensing, but the injectables and all of those things, I still had to order and keep my supplies up. Then as more pharmacies came into town, I remember the late Mr. Hollowell of Hollowell's Drug Store came by and we sat down and talked. We talked factually and in a friendly sort of way about dispensing, that is the economic pros and cons about dispensing. So, I just ceased to dispense. (40:53)

RM: As a result of that conversation, did that help you make up your mind to tum it over to Mr. Hollowell?

AB: Well, yes it did. I said that we sat down and had a factual and friendly talk and it was not that he was trying to enrich himself, but he knew some of the problems that I had in collecting and he knew that a busy doctor. ..at that time, I worked. My work schedule was five and half days a week and from nine until, usually I wol get out around three and take a two hour break and be back around five or six and go until 8 or 9:00 at night. One particular day that I remember, after getting out of my office, I made 19 house calls. (42:10)

RM: Wow.

AB: It was after that before I could get home.

RM: I hope you had a reliable vehicle.

AB: Yeah. I had a reliable vehicle then. Anyway...

RM: Let me turn the tape over, Dr. Best.

AB: Okay.(42:19) End of tape 1

RM: Nineteen house calls, tell me about that. How can you do that after 9:00 at night?

AB: Well, I was a little younger. I had a little more energy and I just kept going. Afte making those 19 house calls, then I came home around 2:00 in the morning after making the last one, but I could do that then. My philosophy was that to those people who had, first of all, transportation problems or people who were not able to get in to see the doctor, well, if they couldn't get to medicine, we had to take medicine to them. That was the justification in my mind for rendering the type of service that I was trying to render to the community. (1:01)

RM: You still make house calls, is that correct?

AB: Yeah. I am about the only one left who will make a house call. I will make house calls now to people, when I survey the situation, if he is a semi-invalid or a semi disabled person who can't make it to the doctor, then I will go ahead, even today, and make a house call.

RM: Well, you have had a long career.

AB: Long career. I think there have been some good things for me to be consoled and satisfied about. I recognized more than anybody else the value of my service to the community in terms of getting medical care to that patient who otherwise would be uncared for and that is worth something. That's what my idol. ..holding Dr. Harrison as my idol...that's what that was all about, that kind of concern, that sort of compassion. (2:30)

RM: You had mentioned another time when your compassionate concern got you in trouble and wound you up with some adventures in the Attorney General's office.

AB: That had to do with those numbers of people that I was seeing. I never turned anybody down. Whoever came, whoever showed up in the office got served because we didn't stop until we served the last patient. In many cases, when I was right here in this location, there would be standing room only in the waiting room There would people sitting outside on the stoops waiting to get in and even somepeople who would just wait in their cars until somebody cleared up so they could get in. That was, In itself, created a situation where, as I was telling you not too long ago, where my approach was characterized by seeing the patient, making a diagnosis, and in many cases, we can make a clinical diagnosis and getting the patient treated and move along to get to the next patient. Well, the background of this whole situation came about when some, for want of a better term, smart alec in te Attorney General's office, in making an application...See, at that particular time the Drug Enforcement Administration was concerned about a developing drug problem and they provided some funds and said, "Well now, if you want to put on a special project to fight this oncoming drug problem, if you make a proposal and we'll say the proposal is approved, we'll give you a grant to do this" This group met with the executive committee of the North Carolina Medical Society. Now, all of this that I am telling you now was hindsight. Nobody knew about it beforehand. They went down to Pinehurst and convinced the xecutive committee that the root of the drug problem is in the doctor's office. "Yes, doctor, Mr. Committee Chair, your doctors by in large are good, but you have some rotten apples in the barrel and we will filter out those bad apples for you." They convinced them, they wrote the proposal, and they got the grant. Now, the root or the source of the drug problem, which I'm sure by now everbody knows, expanded. We have never been able to get our hands on the tail, even the tail of the problem. It had nothing to do with the practice of the doctors, the regular professional doctors. That wasn't the scenario when these young, ambitious guides went in and sold them on the idea that we're going to clean up this problem for you. Another thing they did, they went through all of the regulations and directives for drug control and they took a directive that was inteded for street vendors, not even applied to prescription writing, and they bent it aound and twisted it around to try to make it apply to doctors writing prescriptions. This is it. They twisted it and they wrote up the, not the subpoena, the charge on the various doctors. When I got arrested and charged, the charge said, "Not..." Now, this was very vague. I was charged with professional conduct not within the confines of my professional practice. It was very vague. So, what they did, they sent out people from the SBI. They sent people to go in and what they call, they're testing the doctors, and what is peculiar from my analysis after the fact...I'll keep repeating after the fact, because prior to that, not a single doctr even suspected that there was anything happening that would put him in jeopardy in terms of what he was doing or his intent. So, when those agents would come in and ask for service, you considered them as everybody else and you thought that the person deserved some consideration. You did it and if you didn't, you turned them aside. (10:03)

RM: Consideration with regard to...?

AB: Whatever they were complaining of. Now for example, the first SBI agent, and I didn't know it at the time, who came to see me, was some guy named Mike Bolus. He came to see me as a sales traveling salesman. He showed me a bottle and e wanted me to write him a prescription for some Dexedrine. He showed me a botle. He said that he lived in Greensboro, but he showed me a bottle with some fictitious doctor's name on it from Winston-Salem and he said that this doctor in Winston-Salem had been prescribing him some Dexedrine, something that would kind of keep him awake in his travels as a traveling salesman. I told him no. I said, "I couldn't do that." He said, "Well, can't you just give me a few to tide me over until I can get back to see my doctor in Winston-Salem?" I said, "No. Maybe he has a reason to prescribe it and I don't. I just won't bother. I don't see any justification for it." Then he asked me, "Well, what is my bill?" At that particular time, my charge was only, for an office visit, this should kind of tellyou, was only $7. So, he said, "What's my bill?" I said, "$7." He paid me and ent on. This was a white guy. Now, he went off and he was the lead SBI agent for this area and he went out and recruited a black girl and she shows up. The nurse registered her in, went in to check with her, and took her blood... (12:38)

RM: Who was your nurse at that time?

AB: Doris was not my nurse at that time. Doris was a part-time person. She would help with administration, but she was not nursing at that time. So, the nurse took her pressure. So, when I went in to interview the lady, she complained of inability to stay awake. She said she fell asleep on a customer. I asked, "What are you doing?" She said, "Well, I am working at the bus station at the cafeteria at the lunch counter by night and working at Hardee's by day." I said, "Well, it looks like your problem is that you need to put one of those jobs down." She said, "Dr. Best, I fall asleep on my customers and I just can't function. I got to have two jobs to pay my bills and make ends meet." She gave me the typical histry of a condition called narcolepsy. She asked me for Dexedrine. That's the same thing that Mike Bolus had asked for. I told her, "No. The drug of choice for hat you complain about is Ritalin. It is not Dexedrine, it's Ritalin." Now, Ritain comes in 5, 10, and 20 milligrams and you can take it two or three times a day. So, I took the middle dosage. That was just how conservative I was. I gave her 10-milligram tablets and just take them twice a day. Very conservative and I gave her 36. That's an 18-day supply. The lady returns 23 days later and says that she is getting good results, so I allowed her a prescription for a refill, another 36. At that time I warned her, I said, "Listen, we can't stay on this drug forever and f you find yourself getting a little nervous or a little jittery or something like that, first of all, you stop the drug and get back with me." She went off and she stayed off21 days. She came back and I asked her how she was doing. She said that she was doing okay. I said, "All right." Six days later, she came back in and said that the medicine was making her nervous. I said, "Well, I told you that might happen. I have two questions. Did you stop taking the drug?" She said, "Yes." The book said that Phenobarbital was the drug to counteract Ritalin. At thtparticular time...See, I had gone away from my dispensing per say, but I still had some stuff there. So, feeling sorry for her, this poverty stricken young lady who was trying to make ends meet, I just dispensed her some PhenobarbitaL So, it went on. A few weeks later, a guy showed up and said that he was a long distance truck driver and that he wanted something to keep him kind of awake while he was driving his long distance truck. After examining him, he was weighing about 210 pounds. He was 25 pounds overweight. I said, "Some of your sluggishness may be do to the fact that you are overweight." Instead of dealing with his sleep problem and at that particular time, there was a drug called preluden that was used to curve appetite so a person could lose some weight, along with a fluid tablet, which was something like lasics. So, that was my presription and so it went on off. I guess ten days later, here comes another truck drivr, and he wanted to get some of that same medicine, he mentioned the name such and such a person that was in to see you. So, I told him, "Wait a minute. Wait a minute. I didn't give him anything to keep him awake. Now, your friend was overweight and that might have been the cause of his sluggishness, not inability to stay awake. We were trying to keep some of the weight off of him." I went on and talked with him and said, "No. I can't be giving nothing just to try to keep you awake." So, it ended up, the first guy was about 40 pounds overweight. This guy was maybe about 25. So, I gave him the same to try to pull some of the weight off and that was it. I'll do anything, that was on March the 26th, which was...I'll characterized it one of the blackest days in my entire life. Words can't describe the day that events happened at 401 Moyewood Drive in Greenville. Neither can they express my emotions as to how I felt, because on that day, I carn to the office and I was a little late getting here and yard was full of cars, peope were sitting on the stoops. When I walked, folk were crowded up and so, I carne into the back, and one of my girls said, "Dr. Best, there's some guy out front that wants to see you." I said, "Who is it?" She said, "It's the SBI and he said thathe is a SBI agent." That didn't bother me because sometimes the SBI agents would come by to ask me things about other folk and investigating. That was nothing unusuaL So when I came on in, there were two agents, two guys that were together up front in the waiting room. I could see one and another one over ther near the door. I said, "Good morning. I'm Dr. Best." The guy was so much progammed as to what he was going to say. I said, "Corne on in." He said, "Are you Dr. Best?" I said, "Yes. I am. I just said that I'm Dr. Best." He said, "Well, Dr. Best, you're under arrest." I said, "For what?" He gave me the names of somepeople and said, "I have a subpoena for the records on these people." So, he gave me the real names, but see those people registered with me under aliases, under assumed names. Then he said...I said, "Well, let me see ifl can get it." We wre back in this part. He said, "Well, you can't leave this room." So I called this elderly lady who was working for me then, Ms. Staton. I said, "Ms. Staton, come back here. Give me the names that I got." He wrote the names down and Ms. Staton carne and bought me the records. So, I said, "Well, what are your charges?" So, he read me the charges to me. He started off on this stuff about what you say. I said, "Forget all of that crap. Now, let's get down to business." So, I said, "Now, I need a copy of my records. What are you gon...?" He said, "I'll get a copy. I can take the records and I'll bring you a back a copy." I said, "Well, I have a copy machine right back in the next room." So, I went back in the back. He said I couldn't leave this room, but he followed me on back there and watched me while I made the copies. I bought it all back in this room. I said, "Well, you can take the originals or the copies. It makes no difference to me." He said, "I'll take the originals." I said, "Okay." Then I turned to him and said, "Listen. Is there any way that I can meet you at a given time and a given place so I can try and get my staff to work and give me staff assignments?" He said, "Well, there ain't no way." I said, "Well, I got some people in here that are pretty sick and need attention." He said, "You got anybdy about to die?'' I said, "Well, I hope not." So, he said, "Well, you have two options. One, that one of the agents will ride with you and you can come on downtown or you can ride with one of us and we'll take you on there." Now, they had two official cars out there and there were a total of six agents, three in each car. I didn't know until I had gotten back that...Now, there were two agents that were in here with me, there was one posted at the front who was armed at the fron door, and there was a guy walking up and down in the parking lot in the back where we park our guys. They told me that he something like a beach towel thrown over a weapon, which was more or less like a sawed-off shotgun. As I was coming in the back when they told me that they wanted to see me, one of the girls was going to come and get me, this Mike Bolus said, "Well, we'll go with you." So, that's when the elderly lady spoke up. She said, "She told you she would get Dr. Best so, you stay right here, because you know, ordinarily we're not etting people come from front to back. Folks might be undressed or anything back there waiting for the doctor to see them." So anyway, he stopped when she said that. Sylvia got me and I came on back up there. But now, here it is if you set he scenario, where here I am a law-abiding citizen and I never had any kind of brushes with the law. I always tried to do something to help somebody and the evidence of that crowd here, maybe at that time 25 or 30 people, and then they break in with something like that and have a person parading up and down out there in the back thinking that I might run out the back. What the devil? Where am I going to run to? What am I going to be running from? I ain't done nothing. So, we went on down to the courthouse and they read the charges. I was fingerprinted and it so happened that...You've probably heard me mention before Dr. Ray Minges. He was the Pepsi-Cola Minges and he was a good surgeon. He practiced surgery for a hobby because he was making his money with the Pepsi Cola millions. I was lucky to have caught him. I called him several times and his line was busy. Finally, I got through to him and his phone rang. He picked it up and I said, "Ray, this is Andy Best. Will you come down here and bail me?" He said, "What's the matter Andy? What's the matter?" I said, "I don't know what the matter is but they got me under a $15,000 bond." So, he said, "I'll be down there in a few minutes." So, Ray came on down and signed my bond. Then I turned to this Mr. Bolus and said, "Now look, what kind of publicity is going abou all of this carrying on?" I was concerned about the publicity. So, he said, "So far as we are concerned, there won't be any." The biggest lie in the world. I got n my car after they got all of the fingerprinting and that bond signing and evrthing on me. On my way from downtown back to the office, I had my radio on and the announcement came on that 20 doctors throughout North Carolina had been arrested for illegal prescriptions and for drug trafficking and that they were...They went to talk about this scam and this bust. They called it a bust and they already had it set up that they were going to have a news release at 12:00. (28:55)

RM: That was the sting that morning.

AB: Yeah. That was the bust they called it. That's why they were rushing so, because it was going to be announced at 12:00. I said, "Urn hum." So, I came on back to the office.

RM: They had a good choreographer.

AB: Yeah. Some of the people had left the office and had crowded down there around the courthouse to see what was happening to me. The other people that had been waiting to be seen, they had scattered out. Then I came on back and told the staff what had happened and what had transpired in the meantime. Well, then the case was set for around October or November or somewhere along there. It's in that statement there when the case was set. There were several things that happened in te meantime before the trial was set. My lawyer made a motion that my case woul not go to the grand jury until we had had a preliminary hearing. We were very hopeful that at the preliminary hearing, we would get a chance to cross examine those so-called witnesses, those agents who had been in. We could get a chance to get the picture in of what was happening, how things were developing. Three times we went for a preliminary hearing and of course, Judge Browning had greed with my attorney that I should have this preliminary hearing before the case was sent to the grand jury. They twisted. Three times we showed up in cour for a preliminary hearing and the SBI or nobody did not show. Mr. Blount, my lawyer, told me, he said, "Know what they are doing? They're shopping for a judge." They knew that Judge Browning's...See, the judges are assigned for a certain period and at the end of that period, they rotate off. So, they waited until Judge Browning rotated off and they got a new judge and they got to him. He ruled to let the case go to the grand jury even before the preliminary hearing. The case went to the grand jury. The grand jury found quote "probable cause" and theyscheduled a trial. Then my lawyer talked to me and said, "Well, we still wantthe preliminary hearing." Our effort was now, we were going to get to those witnesses so we could cross-examine. They crossed us up. First of all, there were two things, getting a grand jury indictment before a preliminary hearing. The preliminary hearing, no matter what it is, does not effect that grand jury's action. Where as, if we had gotten the preliminary hearing first, and the preliminary hearing found no probable cause, then we would have had a weapon even most of the time. The grand juries are reluctant to indict where the preliminary hearing has ound no probable cause. (33:17)

RM: Sure.

AB: But, it was a tactical and technical maneuver that they intentionally were doing to try to make their case stick. So, we went on to the preliminary hearing and we said that we know that's not going to matter to the grand jury. We know that, but we get a chance to cross-examine and get some of our information that we want. So, three more times we went and they wouldn't show. Finally, when they showed for the preliminary hearing, only Mike Bolus, the lead agent appeared. They came up with...Of course, my attorney should have known this, but I don't know. I didn't blame him. We discovered that the rules and regulations permit a lead agent to testify as to what his field agents told him. So, that was protecting those field agents from the cross-examination. That was what all of that was for. They planned what they told him. So, we couldn't very well cross-examine him about what went on between me and the field agent. That was definitely a maneuver to protect. So, we went from there on to...The trial was scheduled in late October or November and we went to trial. We had seven minorities on that jury. We had five white folk. The first ten people on that jury...The peculiarity about them was that their level of education was eighth grade; their average level of eucation. They had no previous jury experience. That was the first ten people chosen. The two ladies who were jury number 11 and number 12, had had previous jury experience. One of them had finished the community college and the other had finished college and she had previous jury experience, too. So, this lady who had finished college became the foreman of the jury. Those two ladies manipulated those inexperienced, uneducated people and they came out, they had what they call six counts. Still on all of this, now they found me on this lady who needed Ritalin, they found me not guilty on the original prescription. They found me guilty on permitting the refills on her Ritalin and not guilty on the Phenobarbital that I dispensed. Now, the other two agents, they found me not guilty. So, out of those six counts, they came up and found me guilty of two counts of the six. So, we immediately appealed it and so it went to the appeal's court, Court of Appeals and that's where I came in. I had been letting my lawyer do all of the thinking and all of the talking but, when we got ready to do our pape. I'm trying to think what we called it. What do you call that document that you ut together to make the...? (38:32)

RM: To make the appeal?

AB: ...to go into court? I'll think of it in a minute. I sat down with my lawyer.

RM: Brief?

AB: Brief that's right. My brief. When we were getting ready to draw up that brief for the Court of Appeals, I didn't participate in that one necessarily, but I had great participation in the brief that went to the Supreme Court. I had a friend on the Court of Appeals who was not one of the three-judge panel that was on my case. In the Court of Appeals, they use a three-judge panel to come up and decide whether they are going to affirm the lower court decision or whether they are gon to throw it out or whether they are going to send it back. Well, in the meantime now, there had been a lot of publicity generated about my case. A lot of publicity. There were people in high places who questioned, "We don't see how this could be, based on my reputation." There was a lot of stuff that went into it, but the judges on the Court of Appeals said, "This is a case that we've never had one like it before. We're setting a precedent. It's a landmark case." That's the way they described it. "We're not going to touch it." They decided, it was a conscious decision that they were going to put this case on a track for the Supreme Court. So, how did they do it? Simple, two judges vote to uphold the lower court opinion and one judge descents and then you are on a track going straight to the Supreme Court. That's the way we went. Now, in preparing the brief for the Supreme Court, me and my lawyer sat down and here's where my inpu from the standpoint of the doctor, from a doctor's perspective...my position was hat if they found me not guilty on the original prescription, I should have been found not guilty on permitting the refills. Why, because the essential question in whether a prescription is justified or not, is tied up with the medical purpose of that prescription. (41:36)End Tape 2

(Final audio was not present on this media)

RM: With the diagnosis.

AB: Yeah. Medical purpose. That is considered your diagnosis. Whether the prescription is appropriate for the diagnosis. Well, our diagnosis was Narcolepsy and they found me not guilty on the original prescription. So that said, in effect, that this prescription did in fact have a legitimate medical purpose. We took the position that the purpose of the refills cannot be separated from the purpose of the original prescription. Just pure and simple.

(Tape Ends)

Oral History Interview with Dr. Andrew Best June 9, 1999
Oral history interview with Dr. Andrew Best, a longtime health care provider in Greenville, North Carolina. In this interview, Dr. Best discusses the pediatric care provided by Dr. Malene Irons in Greenville. Dr. Best also speaks about his experiences with malpractice suits and drug trafficking charges that he underwent during his medical career. The information covered in this interview is relevant to the years 1950 to 1999.
June 09, 1999
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oral histories
10cm x 6cm
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Laupus Library History Collections
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