Gray School A Medical 'Miracle'
Davis, Winston-Salem Journal-Sentinel, September 10, 1961
COY C. CARPENTER has been the
dean of a medical school since 1936 and, as the saying in that craft goes,
"Old deans never die. They simply lose their faculties."
But no one, not even-his detractors
(and of these he has a gracious plenty), suggests that Dr. Carpenter has
lost much of anything over the past 25 years. His greatest faculty — and
it's as sharp as the legendary serpent's tooth — is finding things, and
this faculty he most certainly has not lost.
As a matter of fact, Coy Carpenter
found a shoestring 20 years ago and over the past two decades he has built
a shoe to go with it. Succinctly stated, that sums up the tale of the
magic cobbler who stuck to his last until he built the Bowman Gray School
Dean Carpenter tells the story
in quite different words. Looking back over the past 20 years he shakes
his head sadly and says, "I was a fool optimist....a damned fool
optimist at that." There is a good deal to be said for this point
The story begins, as so many
stories about doctors do, with the American Medical Association. In the
mid-1930s the Association was greatly grieved that the public could not
afford to pay for medical services. Times were hard for the medicine men,
and the head shamans of the AMA concluded that in order to make the profession
a profitable dodge it would be necessary to reduce the number of doctors.
This could be done either
by cutting the size of the classes in the four-year medical schools or
by eliminating the two-year medical schools then operating in the nation.
The AMA zeroed in on the two-year schools. For them it was either close
up shop or shift to a four-year basis.
For understandable reasons
the decision caused consternation in the heart of Coy C. Carpenter, then
dean of the Wake Forest College School of Medical Science. Like the medical
operation at the University of North Carolina, this was then a two-year
school and, as such, it was high on the AMA's list for extinction.
Mere item of 10 Million
And extinction is not too
strong a word. In the late 1930’s the AMA, while holding a pistol to the
head of two-year schools, comforted the victims by telling them that it
would cost no more than 10 million dollars to shift over to a four-year
basis. For the Wake Forest School of Medical Science, this was somewhat
impractical advice. Founded in 1902, the school began life with a staff
of one (salary $1,000 a year) and $700 worth of equipment. By the mid-1930’s,
when Dr. Carpenter (Wake Forest publications regularly referred to him
as "the popular pathologist") became dean, the school really
was short of money.
But the work of shamans is
a wondrous thing. The edict of AMA triggered a set of developments which,
to this very day, Dr. Carpenter recalls with bemused astonishment.
To start things off, the trustees
of the Bowman Gray Foundation in Winston-Salem, alerted by the AMA’s edict,
offered to give all (principal and accumulated interest) to the University
of North Carolina if that institution would (1) move its medical school
to Winston-Salem and (2) enlarge it into a four-year operation. The trustees
of the University gave that proposition a very short shrift. They preferred
poverty in Chapel Hill to gold in Winston-Salem.
When Coy Carpenter heard of
this incomprehensible development, he hustled up to Shelby where he met
with Odus M. Mull, one of Wake Forest’s truly valiant alumni (a crack
politician to boot) and Governor Clyde Hoey. The dean’s proposition was
just what you suspicioned: get the Gray family to hold out the same offer
to Wake Forest and see if they could withdraw their hands from the bait
before they were fanged.
A Prompt Acceptance
On August 2, 1939, the trustees
of the Bowman Gray Foundation made their offer; move the two-year Wake
Forest School of Medical Science to Winston-Salem and enlarge it to a
four-year operation and you get the principal and the accumulated interest
in the Bowman Gray Foundation.
The Grays must have been flabbergasted
at the alacrity with which their offer was snatched. By Aug. 3, the deal
had the approval of the trustees of both Wake Forest and the Baptist Hospital
But their astonishment was
pale indeed when compared with the jolt Coy Carpenter received when he
first peeked into the books of the Bowman Gray Foundation. The Dean, always
the optimist, had been thinking in terms of say, five million in principal
and, say, a few round hundreds of thousands in accumulated interest.
What he found was $600,000
in principal and $150,000 in accumulated interest. This was a far cry
from what he had looked forward to with such slavering anticipation and
it wasn’t within a long hoot and an even longer holler of the 10 million
the AMA suggested as a minimum for the establishment of a new four-year
But it was all there was and
Dean Carpenter, in the "make-do" tradition that built North
Carolina, accepted the shoestring in the hope that he later could find
a shoe to fit it. In so doing he perpetrated what is probably the classic
understatement of modern medical science. Asked by Gordon Gray, a trustee
of the Bowman Gray Foundation, if it was possible to establish a four-year
medical school on such a modest sum, the Dean said, "We’ll do it
by not spending money we don’t have." At the time this meant not
spending just about all the money there was in the world.
To make matters even more
unfathomable, Dean Carpenter entered this venture with his eyes as wide
open as a startled owl’s. He says:
"At no time did the Gray
family indicate to me that more money would be forthcoming. They were
very frank about this. The $750,000 was it."
At the time – and you may
be sure that he rues this recollection – it didn’t even occur to the dean
to tap the local Chamber of Commerce for a contribution. "Years later,"
he recalls with a sigh, "I was told that Charlotte would have raised
more than a million to get the medical school. In Winston-Salem this possibility
didn’t occur to me until it was too late."
But, country boy as he was
in some respects (and you can bet this was only a passing phase), the
dean was a canny operator in most others. He’s probably the only man in
the world who built a medical school out of a shoestring and then saved
The trustees of Baptist Hospital,
as part of the move of the Medical School, agreed to raise the money necessary
to enlarge their plant from 82 to 200 beds. (Actually the hospital was
enlarged to 300 beds when it developed, as it swiftly did, that the new
medical school was not going to be able to rely on the 400 beds of the
City Memorial and Kate Bitting Reynolds Hospitals.) The trustees also
provided a site on the hospital grounds for the new medical school.
Some Financial Juggling
Dr. Carpenter put up the $18,500
shares of R.J. Reynolds in the Bowman Gray Foundation as collateral for
a loan of $431,187. He got the loan at 1 per cent (later 1 ½ per
cent) and he collected 5 per cent in stock dividends. In this manner he
kept his stock, got his medical school, and earned some interest in the
It was just over two years
from the day Coy Carpenter accepted the Gray family’s offer to the day
– Sept. 10, 1941, just 20 years ago – the first 73 students began to dissect
cadavers in the new Bowman Gray School of Medicine.
In those 25 months Coy Carpenter
saw at least the first glimmerings of the error of his ways. For the next
20 years those glimmerings developed to a point where they became positively
Even today the best of the
medical schools have difficulty recruiting – and keeping – a full time
staff. In 1939-41 the Bowman Gray school was little more than a figment
of the dean’s feverish imagination. Any man joining the staff of that
school was not only taking a gamble but, in the opinion of the best medical
minds in the business, he was embarked on a hopeless gamble at that.
But Coy Carpenter recruited
his staff. He drew on the following sources:
1. In July 1940 he brought
the following men from Wake Forest to Winston-Salem: Camillo Artom, Loren
Chastain, E. King, Roland Miller, Robert P. Morehead, N. C. Thomas, H.
M. Vann and Herbert Wells. This was the nucleus.
2. Then he relied heavily
on the loyalty of Wake Forest alumni. Dr. Wingate Johnson and Dr. Felda
Hightower were recruited largely on this basis.
3. Breathing enthusiasm
and selling faith Dr. Carpenter enlisted young men willing to take a gamble.
If the gamble paid off the Bowman Gray school offered a short cut to academic
advancement. Dr. Howard Bradshaw (surgery) and Dr. Fran Lock (obstetrics)
are examples of men willing to move to Winston-Salem and take the risk.
4. The Dean searched
the medical schools of the country for experienced men who were dissatisfied
with their present post and willing to gamble in order to get change.
Dr. Tinsley Harrison came to Winston-Salem in this basis.
But most of all, Coy Carpenter
relied on doctors already practicing in Winston-Salem. In 1939 Carpenter
said, "It is our hope an belief that a medical school can be established
in Winston-Salem and staffed primarily with members of the medical profession
Dr. Carpenter invited all
of the members of the Forsyth County Medical Society to become staff members.
Sixty-three of the local doctors were elected to the school staff in 1941.
Of these, 25 served on the instructional staff over the school’s first
10 years. The list included men like Fred Garvey, James Harrell, Arthur
Valk, J. P. Rousseau, Robert McMillan and Roscoe Wall.
The Young and Faithful
The accent was on youth, for
only the young and naïve are equipped to allow faith to triumph over
experience. And, to be very fair about it, there were times when the staff
– gaining experience every day – grumbled and became weak in the faith.
But, year after year enough of them stayed on to keep the school in business.
From the outset one of the
critical problems confronting Dean Carpenter was the maintenance of pleasant
working relations with the native Winston-Salem doctors.
The bringing of a medical
school into this community meant two things: (1) Greatly intensified competition
for a local medical dollar and (2) a sharp rise in medical standards.
From the very beginning the
dean had trouble. When the move to Winston-Salem first was proposed he
foresaw a medical school that was based on the beds in the Baptist, Kate
Bitting, and City Memorial Hospitals. But this did not materialize. Dr.
Carpenter and Dr. J. B. Whittington, director of the city’s two hospitals,
never were able to work together. The doctors in the community divided
into two camps and a town and gown controversy that was to smoulder for
In 1940, when asked by a reporter
what Winston-Salem needed most in the new year, Coy Carpenter said, "Unity
in the medical profession. In 1941 we will begin to feel growing pains
that may irritate." This was another example of the dean’s masterly
skill at understatement.
For most of the past 20 years
many members of the local medical lodge distrusted and detested Coy Carpenter.
Justified or not, this was a cross the dean had to shoulder. Irrespective
of the merits of this prolonged and bitter squabble, the clear fact is
that Dr. Carpenter rode out storms – some of them severe – that would
have capsized a less stubbornly optimistic and skillfully opportunistic
Except for chronic problems
of financing and the difficulties of recruiting a staff, the initial years
were relatively smooth. From the outset there was no difficulty in obtaining
top flight students. With the outbreak of war, Uncle Sam ordered an accelerated
program of medical education.
The Bowman Gray school went
on war footing (all but 14 per cent of the student body was in uniform)
and new classes were rammed through the school with frightful speed. This
haste did little to enhance medical education but it did assure enough
students (at $2,500 a head in federal funds) to ease, at least temporarily,
the school’s financial pinch.
But when the war ended and
the school went back to a one-class-a-year basis, that financial pinch
became a savage, gnawing pain.
Tuition – $450 a year in 1941
and $350 a quarter in 1961 – did not begin to meet operating costs. At
Bowman Gray a student pays only 34 per cent of the costs of his education.
The difference is made up by the school. In 1959-60 that difference ran
to about $7,000 for each student over the four-year period. In short,
each graduating class cost the school something like $375,000 over and
above the amount collected in tuition.
The cost of a medical education
causes gray hairs even in well-endowed universities. At Bowman Gray, where
the endowment was less than one million dollars for a number of years,
it was a problem that had no immediate solution except hat- in-hand panhandling.
Short on Research Space
And this financial problem
was aggravated by the lack of physical facilities. In the postwar years,
when big grants – both federal and private – began to flow into the medical
schools for research purposes, Bowman Gray had to turn down more money
than it accepted. There simply was no space for additional research.
The plant built in 1941 was
designed to accommodate a two-year medical school. As the school was expanded
to four years, the plan was to tack on additional new facilities. But
those facilities were not built. First, the war shut down all construction.
After the war, the plans for removing Wake Forest College to Winston-Salem
claimed all the charitable dollars this community could raise. There was
little left over for the medical school.
From 1941 until 1957 the school
continued to operate in its original quarters. And from 1943 until 1957
those quarters, designed for a two-year school, housed a four-year operation.
Matters were further aggravated
by the reluctance of the Baptist State Convention to accept federal money
for the expansion of the Baptist Hospital or the medical school. This
refusal to mix the affairs of church and state – a refusal that continued
until 1957 – cut the school off from increasingly liberal federal grants.
These problems, always stimulated
by the local town and gown controversy, kept the Bowman Gray School of
Medicine in a constant state of crisis for most of the first 20 years
of its existence.
But there were factors working
in the school’s favor. Ultimately they – combined with the dean’s diligence
in fending off bankruptcy in the interim – called the turn.
The chief of these factors
was the plain need of North Carolina – and the nation – for another four-year
medical school. The wartime demand for more doctors continued into the
period of postwar prosperity. The school had a product that the public
Added to this was the fact
that the war and postwar circumstances enabled the Bowman Gray School
of Medicine to build solid professional reputation in an amazingly short
period. This resulted from a combination of factors:
Because applications from
prospective students ran 10 to 20 times over acceptances the school was
able to select students capable of becoming first-rate doctors.
An acute shortage of interns
developed during the war. As a result Bowman Gray graduates had no difficulty
finding positions in the best of the nation’s hospitals and medical centers.
This provided those graduates with the opportunity to prove their merit
and that of their school.
The young staff recruited
by Dr. Carpenter regularly moved on and up to better opportunities: Dr.
Tinsley Harrison left Bowman Gray to become dean of a medical school in
Texas, Dr. George Harrel became dean of the new University of Florida
Medical School and there were many others like them. Their success helped
establish the reputation of Bowman Gray at the national level.
These same young men – each
one filled with vim and vinegar – began to produce significant papers
in the medical journals and their research began to attract national attention.
Because the school had to
"play it by ear" (improvisation regularly was used in lieu of
cash) Bowman Gray experimented where older and established medical schools
often were handicapped by tradition. In 1946, Dr. Victor Johnson, then
secretary of the Council on Medical Education of the AMA, said of the
Bowman Gray Medical School: "This school is conducting an educational
program that all of the medical schools recognize to be the most progressive.
But it is not done by other medical schools because of the shackles of
Help From Many Sources
These were the things – a
first rate product on the market at a time of maximum demand – that turned
the trick. Help came from many – and, sometimes, unexpected – sources.
The first of these was Winston-Salem
itself. It is doubtful if this school could have been established under
the same circumstances in any other city of similar size and still have
succeeded. In time Winston-Salem’s acute pride in its own came to embrace
Bowman Gray School of Medicine.
The initial gift that brought
the school to Winston-Salem was only $750,000. Until the end of the war,
private gifts to the school were few in number and limited in size. But
then the flood gates opened.
Mrs. Nathalie Bernard gave
the Graylyn estate to the Bowman Gray School. James A. Gray gave the school
almost $1 million for its endowment. Bowman Gray Jr. And Gordon Gray each
gave the school $125,000. (This was the first of several sizable gifts
by Bowman Gray.)
"These gifts," Dr.
Carpenter says, "saved the school from sinking downhill and probably
saved it from extinction."
Endowment Is Increased
Since then other private gifts
(the latest: $500,000 from Bernard and Mrs. Anne Reynolds Tate) have raised
the school’s total endowment to between six million and seven million.
And, for so long as it continues, the annual $150,000 in scholarship aid
from the Z. Smith Reynolds Foundation represents the equivalent of an
additional four million endowment.
The second tremendously important
factor in the school’s crawl to financial security resulted form the fact
that Bowman Gray’s first 20 years coincided with what probably is the
most expansive two decades in medical history. Money for research – both
federal and private – began to flow into the medical schools in a golden
stream in this period. Bowman Gray swam smack into the center of that
Before the school’s physical
facilities were expanded (first by the addition of the James A. Gray building
in 1957, and later, by the addition of the seven story research center
in 1960) the total research grants didn’t average more than $300,000 a
year. Today they are running close to $1.5 million a year.
The bulk of this money – almost
75 per cent – came from various federal agencies. But large grants – $1.6
million for the endowment from the Ford Foundation in 1959, for example
– came from private foundations too. (In 1941 some of these private foundations
laughed out loud at the very idea of attempting to establish a four-year
medical school on $750,000.)
A third factor in the bounce
of the Bowman Gray School out of the morass resulted from the coming of
Wake Forest College to Winston-Salem and in the establishment of a graduate
program at both the college and the medical school. Besides easing administrative
problems for Dean Carpenter and President Harold Tribble, these changes
enhanced the prestige of the medical school. In the formal fields of medicine,
prestige is almost as valuable as cash in the bank. In fact, the one leads
to the other.
A Pride of Achievement
Looking back over the past
20 years, Coy Carpenter is understandably proud of what has been accomplished.
He is, of course, aware that he is a controversial character. (Men who
have had dealings with him are inclined to either like or dislike him
intensely. There are few neutrals.) Perhaps it couldn’t be otherwise.
Coy Carpenter is the man who
built the Bowman Gray School of Medicine. He did the job with the tools
he possessed. There are men who do not approve of the way he sometimes
used these tools. But few men question the fact that he used them diligently
and effectively. The results of 20 years of work leave little room for
doubt on that score. Consider, for example, these items:
The physical facilities of
the Bowman Gray School of Medicine have expanded from 76,240 square feet
to 184,282 square feet between 1941 and 1961. In this same period the
Baptist Hospital has expanded from 82 to 530 teaching beds.
The school’s medical library
– 2,500 dog-eared volumes in 1941 – now contains almost 35,000 volumes.
(Just purchasing back issues of certain medical periodicals cost $200,000.)
It cost $100,000 to operate
the medical school in 1941-42. This year’s budget is $3.6 million.
In the 20-year period the
full-time teaching staff has increased from less than 50 to almost 110.
In the medical school, the student body had grown from 73 to 210. (When
you include courses for medical technicians and graduate students, the
total student body is close to 700.)
In 1941 Bowman Gray was the
struggling branch of a small college located more than 100 miles away.
Today it is a proud unit of a sparkling new university located in Winston-Salem.
(In 1942 Dean Carpenter, trying to raise money for the medical school,
visited the late W. N. Reynolds. In effect Mr. Reynolds told him, "The
Grays will take care of the medical school. But what about using Reynolds
money to bring the college to Winston-Salem?" This conversation planted
the seed that resulted in the removal of Wake Forest College to Winston-Salem
Beginning to See Daylight
Perhaps the meaning of these
changes is best summed up by Coy Carpenter’s comment, "I don’t like
a one-man operation. Bowman Gray is no longer that. I could pass out of
the picture tomorrow and it would make no difference in the operation
of the school.
This does not mean, of course,
that after 20 years the Bowman Gray School of Medicine is home free. As
Executive Dean Manson Meads says, "We still have to run full speed
just to stand still."
But, as Dean Carpenter says,
"Until 1960-61 every year was one of almost day-to-day scrabbling.
This year, with the $500,000 gift from Mrs. Bernard and Mrs. Tate (used
to endow three of the school’s 13 departmental professorships) we began
to see daylight for the first time."
That’s a sort of light no
one really expected Coy Carpenter would live to see. For, as the late
Dr. Fred Hanes of Duke University said when he received the first honorary
degree ever given by the Bowman Gray School, "In 1941 I knew dammed
well that it couldn’t be done. In 1951 – now that it has been done – I
don’t believe it.
In 1961 Coy Carpenter isn’t
so sure he believes it either.
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