{"@context":"http://iiif.io/api/presentation/3/context.json","id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/iiif/8s4jm25985/manifest","type":"Manifest","label":{"en":["Dr. Ralph Morgan"]},"logo":"https://d9jk7wjtjpu5g.cloudfront.net/organizations/logo_images/000/000/246/original/CenterForHistoryFamilyMedicine_2c_RGB.png?1773344256","metadata":[{"label":{"en":["Date"]},"value":{"en":["1991-07-30 (created)"]}},{"label":{"en":["Format"]},"value":{"en":["audio file"]}},{"label":{"en":["Keyword"]},"value":{"en":["Society of Teachers of Family Medicine","Dr. Ralph Morgan","family physician","family medicine"]}},{"label":{"en":["Subject"]},"value":{"en":["Dr. Ralph Morgan (personal name)"]}},{"label":{"en":["Language"]},"value":{"en":["english (primary)"]}},{"label":{"en":["Rights Statement"]},"value":{"en":["\u003cp\u003eThis item is protected by U.S. copyright and related rights. 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This is a conversation with Dr. Ralph Morgan, Silva, North Carolina,\n\n7/30/91.  So can you tell me how--you grew up in this part of North Carolina?\n\nA.  Actually I was born in Brevard, and I lived in Waynesville till my third and fourth year grammar grades, and then we moved to Asheville for a year, and then went away to school at the age of 13.  I went to preparatory school and I earned a scholarship there, (a special job) I had, Christ School out in Arden, an Episcopal preparatory school, so I can't say whether I grew up in Brevard and Waynesville or Asheville or whether I grew up at Arden, in Christ School, but at any rate it was a combination of those things.  During my summers while I was at Christ School I went, spent over at the Pelham School of Crafts, which was, my aunt founded and I had light work around there of different kinds, and then in the summer of 1930, it was the Morgans founded and operated the school, it's now one of the biggest and best in the country, but at any rate, one of our friends knew something about pewter work, not as a profession, as a hobby.  And it (??) pewter adapt to subjects which they taught, so I spent the summer of 1930 just working things out for myself mostly, but with a little help from this friend.  And then when I was--the fall of 1931 came, I was scheduled to go to the University of North Carolina, and by that time I had made and accumulated some materials and tools that I could do some fairly creditable work.  So I rented a part of a garage from my home there, and did the pewter work there.  And actually I put myself through University and medical school with the pewter work.  Well, it was--jumping a few years, when I came back after the war, you couldn't get any metal without the (??), I wanted to keep in touch, I was a member of the Southern Highland Handicraft Guild, I wanted to keep in touch with it and I wanted to help the economy, the economy was fearful here at that time.  The best labor in 1948 you could get for 50 cents and hour.  And of course 50 cents in the mountains would buy more than 50 cents I believe in Buffalo or Chicago, but still it was terrible then.  We did start the (silver places) and the craft business, which we still carry on.  And we've had as many as 28 people working in the complex down there.  Not all of them ours, we have a potter and he has a helper, we have a glass man and he'd have a series of college students working in the glass and so forth.  So that became a tie here after we went up the line.  Now after finishing the University of North Carolina and 4 years in the Navy, 3-1/2 or 4 years in the Navy, I went back to the Bowman Gray School of Medicine there at Wake Forest University, because the cardiology department appealed to me.  Tensley Harrison was there, and I really sort of idealized the man and his work.  But when--\n\nQ.  Cardiology was still relatively new at that point.\n\nA.  Yeah, but there was a fine one, Dr. Albert MacMillan, one of the prime graduates of Duke at the time, a cardiologist, and when I got there Dr. Harrison had left, but so anyhow I was disappointed but not--and I was there for a good part of 3 years doing my residency.  And the reason I went--also a reason I went there was the fact that we looked at the cities, everybody told us that to practice a specialty you had to live in a city.  I didn't know any better than that at the time.  And I thought of the cities in North Carolina, I preferred Winston-Salem in which to live.  So that was my aim, and I just about finished and I bought some equipment and picked out a building where I wanted to work with some of the ones that were finishing, graduates at the (??) and then I got with a distant cousin of mine, Dr. T. D. Slagle(?), 1948, and he was a man who was reared, born rather, in this area where we are now, in Franklin, Macon County.  And he had an idea of going to Seattle.  He had some connections out there.  And then we looked at this situation here.  From Asheville to Knoxville, so far as we knew, we didn't know everything in East Tennessee, there wasn't a single specialist, there wasn't in North Carolina west of Asheville, and from Knoxville down to Gainesville, Florida, there wasn't anybody that had specialists.  And we talked it over and I had known Silva only as a very scrubby-looking little town in 2 decades before 1948, and I knew I wasn't coming here, but when he and I came to look at it, we realized that really here was a unique situation.  (??) county services that were almost nonexistent here, 20th century medicine was really not here.  There were four old gentlemen who practiced, and one was 70 and the others ranged from 70 up to 86.  Every single one of those men had started the practice of medicine from the back of a horse, horseback.  They really were, literally.  And back in the last century, you know.  So--and they were delightful people, they were devoted people, but they, through the years of very hard work they had dropped out of study, and (Ray Scalla?), who was a fine surgeon and was a fellow of the American College of Surgeons, through dint of being self-educated and study and all, he died 4 years before.  Dr. Slagle was a very fine surgeon, my friend, distant relative.  So we decided we would come here and see what we could do.  Well, an idea was to get about, eh, maybe 12 physicians.  We thought that really one should have, to do 20th century medicine you should have nearby, and at your elbow, somebody in medicine, somebody in pediatrics, somebody in anesthesiology, somebody in radiology, and then an associate in internal medicine and then later an associate in surgery.  And we thought, looking at the whole western counties here and the southern counties west of Asheville, not a single specialist.  So we came here and had a 20-bed hospital that was built in 1925, and it was really run down, and the laboratory was a zero, there was an old microscope that wouldn't work, there was a fair but simple X-ray device, but it wasn't adequate, so we thought we had a long way to go, and we did.  So--but my, his, Dr. Slagle's outstanding skill in medicine and surgery, he had in--sort of a medical missionary in Puerto Rico for about 5 years prior to the war.  And he had more education than anybody I knew at the time.  Dr. Slagle has had, if I remember correctly, he had at Bellevue and other hospitals there in New York City, he went to Cornell, worked his way through there, too, and through UNC.  But as I remember he had had a year in rotating internship, and then he had an assistant residency in internal medicine.  Then he had an assistant residency in urology.  Then he had about 6 years' training in surgery.  So he was really fantastically, a man who just was interested in everything in the world, everything in medicine, everything in life.  Well, you know, that drew me to him, but we decided to come here and get things started.  So we had, I don't know how much detail you want, but there were some things that--\n\nQ.  Well, I'm curious what, you know, going back and saying what, why Silva--\n\nA.  There were things that were dramatic, really, and if you want to hear one of those stories--\n\nQ.  I'd love to.\n\nA.  --I'll tell you.  Well, I was a pediatrician here, as well as an internist and a cardiologist.  And the last 3 months at Bowman Gray, I knew there would be no pediatrician.  The last 3 months I was there I read The Complete Pediatrician by Davidson, that was a famous book in pediatrics, I guess for generalists and almost everybody.  And then I made rounds with every pediatrician for 3 months there, and I was, you know, fairly proficient in some of the rubrics of--and I came here in addition [tape machine jolted or something]  I did that.  In addition to general medicine, internal medicine, and cardiology, I got the first electrocardiogram here, I really brought with me from Bowman Gray the very choicest young woman, technician there.  Ten wealthy doctors were trying to get her to come from all over the state, and the chief of the department there, of technical work, and School of Technology there--'Dr. Morgan, you can't get her to come here, she's, they're after (him) from all over, and she's already out, you know, virtually hired by half a dozen different people in different parts of the state.'  Well, I knew her on the service, and we liked each other, and she was on different wards and different parts, departments, you know, she'd done work in, so I talked to her about it.  She said, 'Sounds good to me.'  So I brought her here and did set up really the first laboratory, Waynesville had almost nothing at that time.  It had a laboratory, but it really wasn't the class that I was accustomed to, and she put in a laboratory that was equal from all intents and purposes for our needs to what they had at Bowman Gray.  So that was a great help to Dr. Slagle and to me and the others--\n\nQ.  You mentioned about the pediatric, you'd done 3 months of pediatrics at the end of your training?  To kind of get yourself ready?\n\nA.  Yeah, and I came here and I had quite a pediatrics practice here.  You might not like this detail, but I kind of like it.  \n\nQ.  I like it.\n\nA.  One day I was getting just as busy--when I came here, Dr. Slagle was here a week before.  And he had done about 6 months right after the war when Assignment and Procurement was trying to get doctors all over during the war, and then at the end, when old Dr. Chandler died, there wasn't anybody that was really up to scratch, in, you know, contemporary medicine.  So on the way we're looking for other physicians, and again we thought maybe 10, possibly 12 could really take care of this county.  When I came here I had a whole week solid booked from Dr. Slagle, and I had it, was solid booked from then on until the time I left.  But at any rate--so I don't know how many pediatric patients I had, dozens of them, you know, and I was fairly good considering with 3 months' graduate training in pediatrics, (??), phone call came and wanted to know if I would--this illustrates to me some of the romance of living and some of the romance of being a physician--and, 'Would you come see my little girl, she's real sick.'  And an appointment was made and I went out to the home, fairly near here, up on one of the creeks, there was a real sick little girl, 104 fever, with a strep throat.  And I gave, thought I'd give her some penicillin, it was fairly crude in those days but it worked for her.  And the mother said, 'Well, Dr. Morgan, could I ask you just a few questions?'  And I could see right off the bat she was a devoted mother and a devoted woman with common sense and everything.  At that time the only maternal services or interest was in the Department of Labor, and it had a little booklet for mothers and nurses and other people, the Department of Labor, and she had really worn that thing out.  It was soft cover, you know, paperback cover, and she went over things, and she--some of this doesn't need to be in the book--\n\nQ.  I'm not going to, just--\n\nA.  But what I did was (noise??) went over with here, and what Dr. Morgan says here--\n\n[horrible noises, tape paused]\n\nA.  --not necessary, one thing after another, but (??) for pediatrics.  So I explained to her that yes, we had to arrange for their children to get over--she had four, I think--to get some of these things, and I would get them enrolled on my service.  I went right straight home, I realized that my heart patients particularly were so numerous, this is about a year after I'd been, not quite a year, I guess, and not only was I unqualified to be a finished pediatrician, but also I didn't have time to, you know, I was working night and day.  So I got on the phone and talked to a fine person whom I met during my residency at Bowman Gray, and--Baptist Hospital, Winston-Salem--and he was a sincere person and interested in church work and missionary work and everything.  At any rate, he was in Boston, Children's in Boston, and he'd done an extra year's work in oncology in pediatric age group, and so I got on the phone and called him up.  And I hadn't communicated with him, maybe a Christmas card, but probably not, because time had passed, he was just one year at Bowman Gray.  So I said, 'You must be about ready to start practice somewhere, aren't you?'  And he said, 'Oh, yes, Ralph,' he said, 'I've been looking around and some of my friends have been asking me about it.'  And I said, 'I want you to come down here and see this place before you choose.'  And I knew his wife was reared around Ridgecrest, you know where that is?  That's just before you go down the mountain, I started to say Baptist Heaven, it's Baptist Southern Assembly where all the (??) Baptists--\n\nMrs. Morgan:  Yeah, it's called (??) Methodist.\n\nA.  No, yeah (??) Methodist, same thing.  At Ridgecrest.  But anyway, I thought by the chance, you know, the wives always come into it, so I invited him down here, he didn't think he could come, but I made arrangements for him to get down here, transportation, and he (??) the most interesting preparation so far as information was concerned, and I've known dozens, I've known almost hundreds of recruits, people who were getting ready to practice medicine, and they spent a week, and he went into every store in town, to every minister in town, he went to the Board of--the County Commissioners, and he liked what he saw, and the University was in its elementary stage at the time, went up there and--oh, principals of the school, I think the superintendent of education, and he came--one week, he said, 'Ralph, if my wife wants to come here,' he said, 'I'll come.'  And he really revolutionized pediatrics, (??) anything west of Asheville.\n\nMrs. Morgan:  Oh, everybody loved him.\n\nA.  Thursday is his days off, he had a free clinic in one of the counties, all the seven counties, at least twice, once a month or at least twice a month he'd call the well baby clinics, and he said they was anything but well.  So I just set up here the things in our hospital, we got our new hospital that we really needed, and it surpassed anything in the area.  Well, anyhow, that was a great shot in the arm for Doc Slagle and me.  Then we got the eye, nose and throat man, who was excellent, and a man who turned out to be in poor health, and he was here for 3 or 4 years, something like that, then a couple of practitioners, general practitioners came, and they were all full of spice and vinegar and going to revolutionize the care of medicine, which was fine, some of their ideas were not quite as mature as what Dr. Slagle had learned in his many years of practice.  He was down in Puerto Rico 5 years, and went directly from there, 5 months before Pearl Harbor, and got in the Navy.  And his wife and my wife, well, that's how we got to know him.  He thought Chapel Hill would be a good place for his wife.  He knew war was coming, and he thought Chapel Hill would be a place for his two young kids and his wife and there--they were (??) with Ruth and Mrs. Slagle, and at any rate, these two men were full of energy, and rather, they were able--in a way they, so there were a lot of things they had to learn.  One night we had a medical meeting up there, county medical meeting, and they didn't show up, and they said, 'We're going to do all deliveries in the home.'  Well, we thought that was a pretty big step and responsibility, and no better than a hospital had developed at that time, but anyhow we had facilities there.  And they came in just as we were disbanding, covered with sweat and they were concerned and tense and all, and they had attempted one delivery and shock occurred right (??) about 10 miles out.  So that's the last home delivery they had, they had the IVs, glucose, and got their blood pressure so she did have a pulse, and got her in, and saved mother and baby too, but then they developed a lot, and he developed later a prenatal clinic through the Health Department and a lot of fine things.  He's dead and gone now.  \n\nQ.  But it seems like one of the characteristics that I'm hearing about all the people who decided to come here at the time that you did, was that they wanted to transform not just their own practice and do a good job but had a much bigger picture of where this needed to go.  Why do you think that was, and what do you think--\n\nA.  Well, I think probably you're looking at just two or three--we sold, did a good job of selling them on the possibilities, because we felt that our family practice and general practice, whatever you want to call it, at that time (??) practice medicine, but you better have somebody closer than Asheville, it's 50 miles, 52 miles at that time, if you're really going to do it, for two reasons.  One reason is so you can lead a little better personal and professional life, rather than sitting up with somebody all night because you can't get them to Asheville until tomorrow morning.  That kind of thing.  The other is that in a very poor, in a very poor county, I think I mentioned to you about the wage scale for labor, and I don't care what they have in Asheville, a lot of people are not going to get what they need in a place like Asheville.  You just can't, you know, they don't have the money, they don't have the resources, they only have one truck, maybe, or maybe one car, and the truck has to be used at work every day, and getting them--from a practical point of view, if you don't have some of the specialties out, closer at home, then you just can't get human beings what they need.  So if you've got the family practitioners and you've got the obstetricians, we had three obstetricians here, we had five general prac--family practice people that do deliveries.  So it's here then, you see.  So I think these people who were young, as you were at the time, and wondered how you were going to handle the problems of a practice and do a good job and still remain, doing just procedures that are, can be adequately done here, you've got to have your laboratory, you've got to have the X-ray.  And we recruited from the day we came, and we wanted family practitioners, we also wanted, long time before we had an obstetrician, but we just, wanted Dr.--I mentioned to you about doing the home delivery, he was really a rare, good man.  We had another man who was in general practice here, and he was just about as competent as the, with due respect to (??) residency, he could handle almost anything in obstetrics.  And he had natural mechanical sense.  He had a great interest in obstetrics, and he could handle these complications just about as well as people I've seen in some of the teaching centers.  Really, he was [noise??].\n\nQ.  Were there, how long would that, do you see, as you look back, do you see that the time you've been here has had some, there have been stages of one sort or the other.  I mean, that's the term I'm using, but have there been natural kinds of periods that--\n\nA.  Yeah.  The old, first place we had to get for our, to do our services correctly, you really had to do something about the old hospital, because 20 beds and--I actually did a good part of the laboratory work up there for the hospital.  Free, you know?  They had a lady there that had skimpy treatment training in laboratory technique.  And she was the official head.  And then finally I did, and all of us did this kind of thing, we got the hospital to get the technicians up there that were pretty good.  Salaries were so poor they couldn't afford them and they'd usually leave and often I'd have to do all their work down there.  Anything to push the hospital.  And then we had to have a little more space.  And they had a man here who was gung-ho for, being a community service-oriented man with some financial means, and he had some, quite a little history and experience at building, and he built, let's see, 10 more beds, brick veneer, a new kitchen underneath for dietary, I think it was $30,000 he built those--and (beds) for, and just (??) getting the best labor that he could, which was good, pretty good, at prices that they would work for, and (??).  After that, the first time the Joint Commission came by to check hospitals anywhere in the country, we invited them (??), well, in the meantime we'd had a fire there, one of the laundry chutes had caught fire, and it was a big deal.  Didn't destroy the hospital, but unfortunately all the oxygen was stored right near that.  Disaster (??) to run and get that (??) still burning.  Well, they came and said, 'You've got a lot going here that you don't see in rural areas, but we'll give you tentative approval for 1 year.'  Well, they came back in one year and said, 'Your records won't quite, won't make it,' but we knew it, we knew--what we did to get our records better, the doctors chipped in and bought a Dictaphone.  And then they also chipped in and bought a fine X-ray machine.  That X-ray, there was a fine radiologist in Asheville that had been in, (invented those things?), went in for himself and didn't like it, so he sold his machine for $20,000 in those days, and we got it for $14,000, well, we all paid for that, too.  So we got a--and then we got a radiologist from Asheville to come out here and work.  Everybody said we couldn't do it, they said they knew the radiologists there, they weren't very interested in community medicine.  (??noise??) sat in our office for an hour, and we didn't know what the fellow, we were in some trepidation because (??) that doctor won't come out there and help you folks.  Doctors said that and other people said that.  And when that hour comes (??) 'Dr. Morgan, Dr. Slagle, we don't know what we can do, but we'll do something.'  So they said, 'We'll let you know, but we can come out in maybe 2, 3 weeks.'  In 10 days I got a phone call at 4 o'clock in the afternoon.  And, this is kind of the romance of medicine, you know, they said, 'Dr. Morgan, we'll be out there tomorrow morning if you've got some patients for us.'  Well, I still had six patients, I remember, in the office there.  I said, 'We'll have them here.'  Well, there were four cases that I wanted to have an upper GI done (?noise?), it was pitch-black dark, and I had to go out, these people didn't have telephones, tell them how to prepare for the upper GI, and one of them at 9 o'clock, I'd gotten wrong information about how to get there, at 9 o'clock they're getting ready to turn off the lamp, it was a lamp deal, and he told me to go out a certain road and at the second turnoff, go right to the house.  But he forgot one turnoff, so it really was the third one he meant, and I wandered around through, I guess it was 10 o'clock when I finally got there.  I saw a lamplight out of there (??) barn, and--'Well, Dr. Morgan, we were expecting you earlier.'  Anyhow, he came and I really had done an upper GI series on, I did this all through my residency, I knew there'd be no radiologist here.  And I set almost all the 3 years when I was at Bowman Gray, (??) got a good friend, head up the department there, I watched every film every day, he got so he'd quiz me, 'Well, Ralph, do you think this is satisfactory film?'  And (??) I said, 'Well I think it's very good to me except (???),' that's when I was pointing out, I thought (??) recognize that (??)\n\n[tape interrupted]\n\nA.  --medical practice and this thing (??) some comments, thoughts or feelings about the practice of medicine from the year 1, you know, way back (Oser??) and all the others, so many of his things I just think it's a magnificent--'Listen to your patient, he's trying to tell you the diagnosis.'\n\nQ.  Well, have there been times that you know, I talk about the term nodal points for my own purposes, but you know, points at which there'd be a--crisis of faith might be a little strong, but just where you got to the point where, as a couple or as a family you said, you know, 'Maybe we ought to think about not staying here and going someplace else,' or that you made changes in ways that have made it possible for you to stay on?\n\nA.  Well, not exactly moving away.  There was one time, at one period in my life here I tried to spend a week at a medical center every quarter, mostly on cardiology, and I did that for a long time at the University of North Carolina, Bowman Gray, Duke, and about that time, a good many years ago now, but still I was superannuated so far as taking a fellowship is concerned, and some of my friends at one of the universities, I won't name it, but one of those three universities, said, 'Ralph, we just can't'--and the department head was there, a very famous man in medical circles, he said, 'Yeah, we can get you a fellowship here.  Tell you what I want you to do.  We'll get you a job as assistant professor here of medicine, and you'll have to, you know, you can be here and lecture these students on all phases of medicine, whatever.  It wasn't particularly family medicine, they were talking about training of medical students, and interns and residents.  And I thought, 'Well, let's keep that in mind and I'll let you know about it.'  I had to consider how stale I would be on a lot of things in academic medicine to really do that job well.  And I thought I could do that.  Then I thought of my little wife at home alone, penniless, and I decided that I probably couldn't even afford to do that, so I didn't do that.  That's the only--there were times that were pretty difficult.  I'll tell you, I can talk about one of the turning points of medicine here in Silva.  We'd had a series of problems in the little hospital, the little 20-bed hospital.  And they were mostly based on financial problems because every year the hospital at that time would be in debt a few thousand dollars at the end of their fiscal year.  And at the end of the fiscal year there was a very great man whom I wish I had known who started anything in this county.  Mica mines, calin(??) mines, buspar(?) mines, he built the first hydroelectric plant facility, which is still in use, the bank, the first builder's supply company, the first real, really large general store down in Silva, and he had--every year he would, he gave a third of the stock of that hydroelectric plant to the hospital.  One time he rescued that hospital before I came here (??), because the doctor who built that hospital, there was two of them, but the one that had most of the input, that was old Dr. Candler(??), he had mortgaged his home to build that hospital.  That hospital was, if you saw some of the old bills you would understand why they were in financial distress.  And those bills were, although characteristically very small, because they didn't have anything more than that to pay for.  (??) used a telephone I think about--so they had hired I think 11 different administrators of the little hospital in 13 years, and when one of them wasn't satisfactory, they'd find a bookkeeper or somebody, that's all the training they had.  Well, naturally it wasn't working, and then finally they did get a person who was trained and he was absolutely unsuitable.  There's a lot of, so many things wrong with him, I won't mention any of them, and the hospital was in a crisis.  The board felt this man was pretty good, and they didn't know what they should have, and finally the administrator--everybody was at cross purposes at the time, the only time it ever happened in the hospital, 'cause nobody knew as much as some of the doctors knew, and we didn't know enough about hospital management.  So there 24 members of the Board of Trustees, and there were four of those men who knew what was what in management.  One was a business man, one was the superintendent of the paper mill here, another was a builder and another was one of the superintendents of the paper mill, there were two, two men at the paper mill, it was busy, you know, and (??).  And those were the only four that really knew what we had to have.  And we couldn't afford, couldn't convince the other 20 members what we all had to do.  But then we had a meeting, were told about a new hospital, and we had consultants and architects to look at it, that's about all they did, and they were all at cross purposes.  And people lost faith in me specifically because I wanted something which was impossible to get.  Well, I didn't know that anything was impossible to get at that time, and I don't now know that.  But at any rate, this administrator, boy he hated me, just up and down, and then these four men, one member made a motion that we get a hospital consultant to come here and see what the problems were, 'cause God knows, the problem was staring everybody in the face.  So they--all this is pretty confidential--\n\nQ.  All this is, what we're doing is kind of--\n\nA.  Okay, so the first thing they did was try to get a man that, the cheapest man they could get, I guess, because they didn't have any funds to pay him, really.  And I was very sympathetic with all this going on (??), well, he was in some, had some problems of his own, some mismanagement somewhere along the line, and then they tried to get the superintendent of the hospital in a fairly large city in this part of the world, and he wouldn't take it.  He decided it was beyond him.  And then they got the best man in the South to come here and look at this thing, and he was a magnificent person.  And I'd been the butt of a lot of criticism here, and I think I was the last one he talked to.  But he said, now, Dr. Morgan at the beginning, and I'm going to talk to every member of the Board of Trustees, every nurse, every nurse's assistant, every orderly, every food operator, and everybody in the Board of Trustees, as well as their superintendent, and he said, 'I've been in this a long time,' he said, 'I never try to convince anybody to change unless, it's hard to get them to change in less than a year, but sometimes you get somebody to change their attitude in 6 months, if you're careful.'  So he got to work and he talked to me at length in about the middle of his investigation, and he'd say something, 'Did he say that to you?  Did he want to do this?'  And I said, just check and ask him.  Most of the precepts that I had I think turned out to be quite sound and he told that administrator, 'You must resign this place or you will, I will suggest that they fire you.'  And he was money-hungry and doing some things that really weren't--can't turn it off, we'll use the word, but--\n\nQ.  When would this have been?\n\nA.  This is after about 10 years.\n\nQ.  So 10 years after you--\n\nA.  Yeah.  Must have been 13 years, because we had--about 10 years was when we were developing so much, had to (??) all of these instruments--\n\nQ.  So it really too, you say it took 10 years to really get things organized, but--\n\nA.  Well, as he said, to get out of the old Anglo-Saxon, said these people can't help it, the old Anglo Saxon theory was work very, very hard for a dollar, save most of it, try to live on half of it, and he said that was not going to promote progress.  He said, 'but this is their heritage,' and he said a very rich heritage, but it won't do in this day and time to do that--carry that too far.  Well, in about 6 months he made his recommendations, and he got--he said, 'I can get a superintendent, an administrator here, I think I can get him, he's a very fine man, he's an assistant administrator down in South Carolina, and I know he's a good man.'  Well, he did all of that, we met Tom Morgan, who retired just 4 years ago, just build, build, build, ever since you got a man that knew how to get things done, how to talk to the big foundations, how to talk to all the foundations, and then we built the new hospital.  And I'd like to just mention about that.  The only county was in an uproar, everybody felt that (???), really knew, hardly any knew a little bit about it, and so the man who became the governor of North Carolina was a Navy peer(??), and he was--\n\nQ.  Which one was this?\n\nA.  Dan Moore.  And he called me, and that was kind of a romantic thing, I met with the assistant (??), and he said, 'Ralph,' I said, 'You know, something's got to be done.  Everybody says we can never afford a hospital.'  And then there was sort of drama, really, that Dan said follow it, I said, 'We got to do, we got to have a new hospital.  We're crowded, you're in the halls up there, and the halls weren't very pleasant, they're kind of dark,' and he said, 'Ralph, who is it in this town you could trust.'  And I said, 'Well, one of them would be Dan Moore,' I knew him then as a distant relative of ours, I think, about two or three generations, and then I named Dr. Slagle, and then he mentioned one, and then got six men that he and I felt we could trust.  And they got together and said--knowledgeable people, educated people--they got together and called a mass meeting of the people of the county.  And I'll never forget Dan Moore, and it was packed, the courthouse was packed.  He said, 'Ladies and gentlemen, we came here to discuss a sore topic, subject to everybody here.  And everybody is not here that lives in Jackson County.'  He said, 'I know there's some diversity of opinion and feeling about this subject we're discussing,' and I want to tell you, I was asked to chair this meeting, and he said, 'I can tell you, you can say anything you want to when you're here, just so you're observing the annals of law certain things against libel, slander,' he said, '(??) and boy, he presented (??), he had a lot of people there in Asheville and different people to talk, and the (??), including most of the members of the boards of trustees (??) to talk.  Then the Jaycees, Junior Chamber of Commerce were there, and they were primed to take up the ball if they would.  He was going to suggest that we have a fund-raising countywide, and they agreed to take responsibility of doing it.  And before we left there, everybody agreed that we were going to have a new hospital.  There was one ace, C. J. Harrison (??) 10 years have passed since his death, was about to be completely probated as (??) resolve, and we had $150,000 and we knew we could get it from selling the power plant down there, because (??).  (??) Lumber Company of America (??), so we had $150,000 to start.  And I think we raised something like, in addition to that, I think it was almost $200,000, and 87 percent of the families in the county contributed, 87 percent.  But it was a very happy day.  And then we got some of, we got some (??) Burton money, and we built that first thing.  And from then it's grown and Don Morgan came on about the time the new hospital was almost--no relative of mine, he was down in Atterson(??) South Carolina, but that was a great turning point, you see.  From chaos turned into harmony and creative activity in one night, by pulling together the right--putting together the right thoughts of all of the people, virtually, because everybody didn't agree that--it followed exactly in the trend that I wanted it to, and--then they disagreed within the medical staff about what we should do and how you should do it and what our capabilities were.  And at one time--every doctor except one other that I--Dr. Slagle was even discouraging, seemed so damn much stuff that was horrible that year that administrator was here, and one physician, a long-time friend of mine who I got to come here, a woman whom I had known at Chapel Hill, fine physician, she practiced many, many years--she died just 3 years ago, but she was out of practice for a urological disorder for the last 10 years of her life--anyhow, there was a real turnaround, you know?  And everybody rolled up their sleeves and the doctors would begin (??) scratch around (??).  All of that--but again there's a lot of drama, I think, human drama in the thing that, that ensued since the first of July, 1928, and then 1956 when we finally got the hospital completed.  It's just been one success after another, and that same--it's rare that a superintendent stays in service that long, from about 19--what was it, '55, maybe, '56 when this meeting was held--that's only 8 years, isn't it?  Anyhow--\n\nQ.  Eight years that felt like 10 or 12.\n\nA.  Yeah, it really was--(?) you got the number of that so-called administrator that (??).  \n\nQ.  Can I--one of the things I wanted to do--turn this over first--is also ask you to reflect a little bit about being, the life of a physician in a community that's a small community.  I mean--as you know, one of the difficult parts of, for me to talk to younger physicians and medical students about, living the life in small communities, if they see that as sometimes problematic.  But I have come to know through this project that it's something that's a source of great enjoyment and pleasure that people get.  But yet, you know, there is one of the issues of being a doctor who, you know everything about everybody, as well as people I've talked to say, 'Well, you know, small towns, everybody knows everything about everybody else,' so--and that's good and bad in some ways.  But have there been difficulties associated with that, which would be a physician in a small town that you hadn't anticipated?\n\nA.  No, not really because, other than we knew that the system (??) but everything was archaic and we started from scratch.  And we had, Dr. Slagle and I just had fantastic results the first few months or year that we were there, and then after that everybody got used to fantastic results.  Because (??) it a different ball game, because you know that for instance getting care from the old-timers, and it's been hard for us as young physicians, there are certain symptoms and you can find in very closely associated, for instance, with gastrointestinal disease and gall bladder disease and heart disease.  And there were many people that have been trained, been treated, rather, for heart disease when it wasn't, and vice versa.  I've had the gall bladder disease and GI disease, and the people couldn't believe that they'd been treated for years, and thought we were wonderful when we were nothing except adequately trained.  And somebody sarcastically said, and this was another doctor in another town, and there was--we were getting unjust praise, and one doctor in another town, he was not particularly altruistic, and wasn't very (??) to our ideas about medicine, but he said that 'you'd think that Dr. Slagle was Jesus Christ and Ralph Morgan was John the Baptist.'  At any rate, we got the confidence of the people, and the people realized when those other physicians here were giving out straight dope, ideas about the care of--and then our methods of organization, our workup, I always (??), the same system of physical examinations and histories that I had learned as an intern and a resident.  You know, they were all we always followed, and it was slow but it paid off.  We agreed there was times when it was awful hard to get people to get over the idea of requesting house calls when you could manage and handle at home, and we solved that, although I made house calls occasionally till the day I left practice, 'cause I think it was that--if the patient was really too sick to come in easily, and not--pretty certain he was sick enough to go to a hospital, I felt that I as a physician wanted to accept the responsibility of going out there and seeing what it was and explain why they had to go to the hospital or if they could be treated at home and come into the office next week.  So you, you know, they did have faith in us.  And everybody said, (??) make appointments for people to come here, they always go there and get on the list and wait till their turn and they're seen.  It wasn't 3 weeks after we instituted that that they were raising hell that they were supposed to seen at 10 and couldn't be seen until 11, you know, because we had an appointment, and I thought you checked appointments in the thing.  (??) raise a big fuss.\n\nQ.  Shows you how fast people can change.\n\nA.  Yeah.  So I had to explain that you can, you can't give a patient what they do for the money they pay if you don't have a nurse to help, if you don't have, possibly (??) fine laboratory.  (??)  (????)  And again getting back, Ruth says I do go on--\n\n[tape side changed]\n\nA.  --I think the question was, how can you do it?  And as I explained that this was a, some unique features of it, in a sense started almost from scratch.  But I don't think it's unique, I don't think any human situation is actually unique, because it depends on what your objectives are.  We had an objective and we worked together, and always have worked together.  Now we've got 42 positions here, I think it is now.  Now three radiologists and four obstetricians and four pediatricians, interested--a psychiatrist (??), five dermatologists, all down the line.  Specialists in (??), and a cardiologist, 'cause it took me 4 years to find Earl Habbock.  You know Earl?\n\nQ.  No, I didn't.\n\nA.  He trained at UNC.  Fascinating career and how he came to be a physician.  He's just doing great guns in cardiology here now.  Sonos and all of that business, the only thing we don't have is a CT lab.  And we don't need that.  But if one contemplates the community medicine, I think it, community medicine should describe us here or something, some idea of your life that they--the family practitioner, they have, we have one group here which as about four or five in it, but also they're in with two very well, highly trained, Hopkins-trained internists.  And they did have a pediatrician, a very, very fine pediatrician.  She decided to go out independently for some reason.  Organization I guess.  But to go out in family medicine without close ties with other specialists, and you know, you consider that as a specialist, family practice, and you must tell yourself, or your program to those in other fields and you can do that.  There's not any conflict between family practice and internists here, I don't think at all.  It's a long story, but not particularly--on occasion there was a great conflict between family practice--unfortunately trained down in a place in Georgia, what's that (??) hospital, primarily trained there--\n\nQ.  Columbus?\n\nA.  Yes, it is Columbus, isn't?  At any rate, this man wanted to do vaginal hysterectomies and all of that, and in a way he could do that, and he'd attempt that and get permission to do that.  But mostly we had none, so family practice is not incompatible with a group of specialists or a group of cooperating specialists.  But I always feel very insecure, and I have (??) out of training before I come here, no fellowship, but I studied all the time, but being in a place that does family practice where I couldn't see a urologist.  We have a very fine urologist.  We have a woman in physical medicine here.  Fantastic.  So it's, it can be done, but there are certain things that you've got to realize, and my friends at Duke and Bowman Gray, unbenownst to me at the time, 'Ralph is making a horrible mistake going out there.'  They knew this part of the world, of the state.  They said, 'he will be, he'll go hungry or he'll be doing general practice.'  And I did a lot of things that were in the order of general practice.  For instance, my cardiac patients, if they had bronchitis, I didn't refer them all because, well, first place, economic status.  If (??) an extra big bill.  If you know all about a patient that you can learn and then have an acute illness, I considered it un-Christian, if you want to use that word, or injudicious to send them (??), you know for a cold or--before we had it, at one time we did not have an eye-nose-and-throat, we have ophthalmologists now and we also have otologists here, so--but it was an earache and (??) information, hell, I took (??) and gave him some antibiotic.  But if I had these people like that and something serious was troubling them, you'd have to send them to Asheville, that would have been a very hard thing from, what is it, what does the (??) call it?\n\nQ.  Triage?\n\nA.  Logistically it would be hard to--\n\nQ.  That's right.  Some folks have written about doctors in small towns that are distant from say, consultants in one way or the other, face questions about management that aren't part of what somebody--I send somebody a mile to the hospital, to the medical school.  If I had to decide whether it's worth it, so to speak, for this person to go to a mile, but what would it be like if I had to send them 30 miles?  You know, is this serious enough that I want to take--it creates a way of thinking about medicine that's very different than when you're in a (??) environment.\n\nA.  I have a feeling about general, about family practice or general practice, we used to call it, and they've had them up at Cashers(?) on the (??).  They've come to me, some of them, for advice and sometimes they took it, sometimes they didn't.  (??) go up there, they had an interest in it and they went there and some of them didn't do what they said they were going to do.  But my feeling is, that's 30 miles, and my feeling, where you're 20 miles, 30 miles, or even more, like out in (??), you ought to have a partner, and by a partner I mean a person who has your ideals and your objectives, whether you have any business relationship or not, somebody that you can count on, somebody that he or she can count on.  And my--they talk about somebody that (??), I don't know (??), better have two of you, otherwise you won't get any time away.  You should have these things in common.  And sooner or later, the big divisions in the practice of medicine are surgical and medical, you know?  Whether it's pediatrics or whatever.  And one of you should take some--if you're going to get along and do what you want to do, one of you should take some summer work or a month work or clinical work in--for instance, if you decide you want to do obstetrics, you better spend some time on that, and if you're going to sew up wounds and set (??) fracture you ought to get some training in that, and the same way in medicine, a medicine man ought to go and do some special work in diabetes and heart disease and gastrointestinal disease.  Then if you, if a situation develops so far as the population is concerned, you (??) maybe just another pair of family practitioners.  But one--and help each other.  That doesn't mean the other person can't dip in with the other thing, but (??) the population, people in the community ought to know who to go to where they can get this thing and who is--and learn.  And I think that's sound.  It was sound here, we did it.\n\nQ.  I'd like to ask one question, it's an important one for me.  What's kept you practicing here for however many years of (??).\n\nA.  I think that is a personal and emotional response that I have to life.  I was aware of the need, but I didn't realize how great the need was, and I might add that the situation in the other counties was just as bad as it was here, and I thought that they would pick up the way we did.  And one year, 2 years, 5 years, 10 years, and they didn't even have an interest in doing what we were doing here.  Therefore we had people coming (??), and I had wonderful people from Robinsville.  Okay, I'm going around the question a little bit.  But back to my personal feelings, there was some success.  I got a lot of information just from the electrocardiogram that, you know, and nobody knew--doctors really didn't know anything about them.  I never learned as much as I'd like to know about them.  Something (??) say every year.  But at any rate, the big challenge was, I've always had a feeling that you can't always do what you want in life, exactly, you can't always get what you want exactly and totally in life.  But there are things that you can get, and that's satisfactory response to your efforts and work and ideas and dreams.  Okay?  Everything that we had, everything that we've had almost up until now, somebody or some group said it's impossible.  And Ruth always says, if somebody tells me something is impossible, even if it shouldn't be done, then I'm apt to see that it is done.  And that is a challenge and then to see it happen, you know.  It was--I'll tell you what, it was impossible, not so much here because we're in the frame of mind that things are possible here, although at times an occasional physician says, 'No, we're doing fine, that's all we need to do,' but that's been rare.  Okay, getting a cardiologist here, for instance, I realized after approaching 50 years in medicine that if I were ever going to get some of the things in my personal life that need to be done that I'd love to do and should be done, I ought to retire after 50 years.  And that's what I did.  I really retired in, at 50 years now, but it was coming close to that 2 years ago when I retired.  And when you see somebody say that it can't be done--I traveled really to get the cardiologist and others.  I went to Seattle to see somebody up there.  And I went to Los Angeles and San Francisco a couple of times.  I went to Boston, I went to Miami to see folks.  I went to the Mayo Clinic.  I went to my old school, the University of Chicago.  But so far as cardiologists coming to this town, I'd show them the layout, chiefs of cardiology, deans of medical school, 'Dr. Morgan, I admire you for this effort, but I know with all these other specialists you have there you need a cardiologist, but you'll never get one, and I'll tell you why.  All young cardiologists want to do CT work, and you can't afford and don't need a CT lab there, and there's glamor about doing CT work, there's a lot of money in it, and nobody's going to come there that's been fully trained in cardiology unless he has at least a CT lab in his hospital.'  And my response to that was, 'Well, I went there and I didn't have a CT lab and my chief interest was patient care and for that reason'--you know, I didn't say this, I said, 'Well maybe so, or see,' and one or two that made these comments, would be somebody who wants to do patient care, and somebody who's powerful in cardiology, is his main, his chief interest instead of his interest in active practice of medicine.  So here's what happened.  Dr. Havoc, I'll tell you, and that's the kind of thing I knew it too, could be, Dr. Havoc was in the Air Force, and he was assigned for some reason, no good reason, I guess, (??) put him in the Hospital Corps.  And he said to himself, 'What in the thunder did they put me in this for?  I don't know anything about medicine or medical--'  He'd been in there 2 weeks and he was fascinated with it.  And he got I think a promotion or two or three in the 2 years he was in the Air Corps, and it just whetted his appetite.  So he came out of it, and I don't know why he didn't tackle medicine then, possibly he wasn't convinced he could do it or should do it, or didn't have the money, I don't know why.  He went to Duke and did the physician's assistant program there, 2-year program.  Then he went down to White Lake.  Do you know where White Lake is?  Near Wilmington, and he was reared small town, about like Silva, I guess, I don't know, [truck noise] was a very fine (??), interesting character.\n\nQ.  That's probably what keeps you up here too, (??).\n\nA.  Well, (????).  And he finished that and he got his residency in internal medicine.  And then he finished that and he got his fellowship in cardiology.  So I followed him the last 4 years of his training down there, partly in his fellowship and partly in his medical residency, and I got two, maybe three cardiologists who wanted to come, one of them particularly, he saw what we had and said, well, I thought he'd fit in.  Those two or three (?????).  At any rate, this is what happened, and one time about 3 years before he came he found out about us here.  And I wasn't there, he made a phone call to my office.  He said, two and a half years before he came, I believe at least, he said, 'tell Dr. Morgan that I called and tell him that if he hasn't made up his mind about who to get up there, I want him to hold off and don't--have, agree to come until I come and look at it.'  And he did.  And so the last 2 years of his fellowship, why we got along without him, but while he was coming.  But then this thing, it's impossible, something that's worthwhile--I have a, haven't done much in life according to the yardsticks of people, but I got to do some things to my own satisfaction that were impossible for 42 years here, and that was--that was enough to keep me on here and not go to Samboango(??) or back to Durham or back to Chapel Hill or back to Winston-Salem, where I guess I had my deepest clinical roots.  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