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KAREN KRUSE THOMAS:

And it's hard to know what fosters that, what makes one community cohesive, and another have a lot of infighting.

JAMES SLADE:

When they had the daycare episode in the '80s, it split the community. But last year a team from Oprah called my office and said they wanted to interview me. They came down, and the whole community was interested in Oprah coming to Edenton. It didn't make any difference that they were interviewing a black physician. When they decided to put it on TV, the whole town wanted to know when it was going to be on. That brought the community together.

KAREN KRUSE THOMAS:

What did she interview you about?

JAMES SLADE:

I work with the migrant clinic, and the lady who's head of Rural Health in Raleigh came down to the clinic in Plymouth on a Wednesday night, and then came again to the one in Elizabeth City on Thursday, and she evidently was impressed that I worked both clinics. I think she must have told the Raleigh News and Observer that they should interview me for Tarheel of the Week, I think it was in the November 19 issue. Oprah's people picked that up, and wanted to have me on the show. At the time, Mrs. Clinton had written the book It Takes a Village, and were going to have her on the show, with people who had made a difference in the community, especially with children. I thought my nurse was kidding me when she said Oprah was on the phone. So they filmed me driving my old car to the nursing home and the hospital. Then they invited us to Chicago for the show. I got a lot of complimentary letters from the mayor and different people. That set a good tone for Edenton, especially after the other episode. They thought national recognition was positive. And it didn't make any difference that I was black, they were just glad that somebody from Edenton was represented in a good light. They interviewed people at the hospital, so they got to be a part of it, and some of them got to be on TV. That's one thing that integration has done, to remove barriers where people can come together. One of the ladies who's head of the clinic at the hospital is black, and they sent her to school to become an LPN. She used to work the emergency room, and now she's head of a clinic. That probably wouldn't have happened if it hadn't been for integration. Overall, it's been more positive than negative.

CATHERINE SLADE:

We're not trying to convince you that things are perfect!

JAMES SLADE:

No, but at least in terms of health care, we offer a lot to the people of the area that they weren't getting 30 or 40 years ago. The thing we have to be careful about now, we're thinking about affiliating with Pitt, so we can't be pushed aside by managed care. That's still in discussion. As long as Medicare and Medicaid didn't go to managed care, we might be able to survive, but if they do, we need to be in on whatever network will maintain our base. If our patients get sent somewhere else, we'll be in trouble.

KAREN KRUSE THOMAS:

When you say that things aren't perfect, what are some of the biggest problems remaining for black health?

JAMES SLADE:

It's getting better in the area of housing, if you have the money you can pretty much live anywhere, but it could certainly be improved. Can you think of any other areas?

CATHERINE SLADE:

I think in hospital personnel, as you said about black role models, that there could be improvement in seeing more blacks in administration and supervisory positions.

JAMES SLADE:

I don't know if they're not applying, or if they're applying and not being accepted. I think that ten years down the road, we'll see improvements. Some of the young people are quietly going about getting their training, and we don't necessarily know about them. I had to speak at the school on medicine, and at least one lady came up and said she wanted to be a pediatrician. It's important for some blacks to remain in roles where they're visible enough to be seen by the young people. If not, they won't have the drive to get into those positions. It's especially important in schools, where the children spend so much of their time. We have a black principal here now, but when I was coming along, the students were separated, and naturally, the head of the school was black. For a while, that vanished, and a lot of the teachers vanished, but now they're beginning to come back. Where blacks had their role models, they suddenly got diluted. We do have black physicians in the ER, but they're short termers. We could certainly use more. We had one apply for internal medicine, but the internist here at the time wasn't sure he wanted a partner, and he didn't want to go into practice by himself.

CATHERINE SLADE:

Another thing that I think is important is not letting blacks be figureheads. If you're going to put them in a position, let them have the same privileges and rights as that position has stood for in the past.

JAMES SLADE:

I think a lot of times, you've got to get to know an individual before you can trust them. That's one of the main things that segregation did, it kept you from ever getting to know the person. You might know what somebody told you about the race, and then you ascribe the same qualities to everyone in the race, since you didn't know any of them. That's detrimental. If I had to say, let's have it like it was with segregation, or let's have it like it is with integration, I'd say let's have it like it is, and let's try to improve it. I can tell you, it's no fun driving up and down the highway for 800 miles without anywhere to sleep. We went through that when I was in the army. I remember one night, we went through Mississippi, and that was one state I wasn't interested in staying in, period. We saw this one sign that said, "Colored Motel." And we pulled in, because you didn't see many colored motels, and you couldn't stay anyplace else.

KAREN KRUSE THOMAS:

I don't know of anybody who would actually say, let's go back to segregation. But I think some people have started to say, we made these changes and expected certain results, and in some ways, we haven't gotten them yet. And I think health is one of those areas.

JAMES SLADE:

People are slow to change. You can put a person in a position, but unless people have confidence in the person, they're not going to fully trust him. When I first came to town, some of the doctors didn't refer [patients to me], and some of them were brave enough to refer. The ones who referred, and the patients didn't die, then the other ones got up enough courage to refer. It's an ongoing thing. You could bring the best pediatrician in the country to town, but it's going to be a while before people have enough confidence to refer patients to him. And that's not necessarily based on race.

CATHERINE SLADE:

But don't you think that at that time, it was a lot worse.

JAMES SLADE:

They probably would have referred to a white physician, and would also have tried to get him in their group. But if he had preferred to stay out of the group, I'm not sure how many referrals there would have been. You always have to remember that bottom line's important!

CATHERINE SLADE:

We say sometimes, they found out we won't bite. [Laughter]