Documenting the American South Logo
oral histories of the American South
Excerpt from Oral History Interview with James Slade, February 23, 1997. Interview R-0019. Southern Oral History Program Collection (#4007) See Entire Interview >>

Limitations for a rural physician

Catherine Slade, who worked for three years as James's nurse in his private practice, remembers her husband's experience as one of three African-Americans in a dormitory at UNC-Chapel Hill. She remembers also the limitations under which a physician in a rural area labored. Poor parents might not be able to leave work to take a child to the doctor; Slade missed collaborators with whom to share ideas; and critically ill children might have limited access to care; or Slade might not be able to run certain tests.

Citing this Excerpt

Oral History Interview with James Slade, February 23, 1997. Interview R-0019. Southern Oral History Program Collection (#4007) in the Southern Oral History Program Collection, Southern Historical Collection, Wilson Library, University of North Carolina at Chapel Hill.

Full Text of the Excerpt

From the nursing standpoint, did they try to limit the black nurses?
CATHERINE SLADE:
They were not in supervisory positions, even though they were qualified. May I address some of the things that he's said?
KAREN KRUSE THOMAS:
I'd love for you to!
CATHERINE SLADE:
You were asking him about problems when he went to medical school, and he said he never had any real problems and they seemed to accept him. I think that was because he was a good student. He had something that they needed, and that's why the students would come and study with him. You don't go and study with someone who doesn't have anything to offer. He was in the dormitory, was it just two of you on that floor?
JAMES SLADE:
At one time there were three, because there were two black law students.
CATHERINE SLADE:
Two black law students and one black medical student had one whole floor in the dormitory! On the other halls, they were three in a room.
JAMES SLADE:
It's hard to complain about that, though!
CATHERINE SLADE:
You were also asking about why many doctors didn't come back to Edenton, and why he came back to North Carolina after he was away. Although he could go to many other places, he is not the type of person who's looking for big city lights or any of those things. He's very happy and comfortable and pleased right here in Edenton, because it offers everything he needs or wants. As far as some of the cases he has treated, now with us getting a little older, it's not infrequent that we'll meet someone, and we won't have any idea who they are, and they'll say, "You saved my child's life." I remember before his office was ready, they were still working on it and we had moved back to North Carolina, there was a child that was struck by a car. We both came to the hospital with this child, and started to Virginia with the child, to try to get him to a neurologist at another hospital.
JAMES SLADE:
They didn't have helicopter service.
CATHERINE SLADE:
The child died before we could get there. Some of the people felt that he was being over heroic, trying to save the child, and felt like you should just let him go. We felt that we should try to get him someplace where he could be helped. As far as diabetics, he has had some very, very sick, almost dying, diabetics. I can think of a couple of them, they were children. You don't see as many bad diabetics now.
JAMES SLADE:
There was one girl, she was already in the coma. She had a pH around six, which is way up.
CATHERINE SLADE:
He treated a boy with meningitis in the first or second grade. They were used to sending meningitis patients away, and he treated this six year old fellow. He was real sick, and it got real touchy at times. It was difficult for him [Dr. Slade], because he had come from a big medical center and teaching hospital with people who he could consult with. I feel that one of the reasons we don't see as many sick peopleߞI used to work with EIC, and we had family planning clinics, and I would help in the health department. With EIC, I would visit in a lot of the homes, and one of the problems would be transportation. That's not as much of a problem. Education was a problem. With TV and clinics and all these things, people now don't let their children get as sick. They don't still keep them home without recognizing that they should get them to the doctor. We used to see a lot of babies who had not had their shots, and they would say it was a problem with transportation, plus taking off from work. The husband might have to take off work if the wife couldn't drive. That was a problem.
KAREN KRUSE THOMAS:
These sick children that you used to see more of, what kind of background were they coming from?
CATHERINE SLADE:
I think they were coming from people who were low-income and uneducated.
JAMES SLADE:
Not all of them, though.
KAREN KRUSE THOMAS:
Were they isolated in rural areas, or why were they uneducated?
JAMES SLADE:
Some of them, it was like parent like child. A lot of the parents didn't make it through fourth grade, and the children would drop out too, especially with single parents. Some of the sick ones we saw came from relatively well to do families, like the diabetics.
CATHERINE SLADE:
Some of that was becauseߞI don't know if they just didn't recognize it, or what it was, but they had gotten pretty low. Some of them had gone to other doctors. A lot of the tests and things that they do now more frequently, they didn't do them with children back then. I don't think doctors routinely would check blood.
JAMES SLADE:
We did urine tests, primarily. We didn't do blood sugar, because you didn't have office glucometers when we started out. We could do hemoglobins in the office, and urinalysis. We had the dextrose test, but it wasn't very reliable.
CATHERINE SLADE:
It just wasn't something they automatically did, like using x-rays to find pneumonia. A lot of them didn't do chest x-rays.
JAMES SLADE:
We had to really battle sometimes to get chest x-rays. I was getting chest x-rays day and night, and they weren't used to going x-rays here at night too much. They did it, but they fussed.
KAREN KRUSE THOMAS:
Did you have an x-ray machine in your office?
JAMES SLADE:
No, we had to take them to the hospital. They had a lab there, but it wasn't open after hours. I had to read my own x-rays at night, because the radiologist only came once a week. I remember one lady in particular who wasn't all that happy about doing an x-ray. She did it, but didn't her husband call afterward?
CATHERINE SLADE:
We don't know who called, but somebody called in the middle of the night and threatened him.
JAMES SLADE:
We didn't let that stop us. The person who didn't want to do the x-ray finally did it, and the next thing I knew, she had her children down at the office! [Laughter]