‘It’s still a miracle, and it always will be’

Sylvester McRae has delivered about 10,000 babies, most of them here in Columbus.

As a career OB/GYN physician, he sees life from the very beginning. He recently sat down with Ledger-Enquirer senior reporter Chuck Williams and photographer Robin Trimarchi to talk about it — and a lot of other things.

At 63, he can begin to see retirement. As a doctor, he understands the Affordable Care Act in a way many don’t.

He moved to Columbus in 1985 and has grown found of the city.

Here are excerpts from the interview, edited for length and clarity:

Q: Your last name’s McRae, you grew up in McRae, Ga. What’s going on there?

A: Oh, do I have a history! My people are actually from South Carolina: my grandfather William McRae, who interestingly enough was born approximately 1854, and his wife was born in 1863. So those years, of course, have significance. So …

Q: So your grandparents were born slaves?

A: Absolutely. So, my grandfather was actually a slave, my grandmother was actually a slave. Around the turn of the century they moved to Telfair County. So, when my father left the farm and went to Philadelphia and came back, he and my mom settled in Helena, which is contiguous with McRae, but he had brothers who lived in McRae and when my brothers went to school, even though they were actually from Helena, they got a kick out of being McRae from McRae.

Q: How do you get from there to med school over two generations?

A: Well, somehow, growing up in Helena and McRae, it was always “be the best that you can be and, of course, make an honest living.” Now, my dad was very smart. He made us do manual labor, we’d pick cotton, pick the watermelons, get construction work. He said you need to see what the other side is like should you choose not to get an education. It was not looking down on those but, he said, these are the kinds of work you do.

Q: So, you obviously were a pretty smart guy.

A: I’m all right.

Q: OK. How did you decide on Fort Valley State?

A: That’s interesting. I had an older sister who was actually 17 years older than me — and now she was smart!

Q: Were you the youngest?

A: No, there was one younger than I. There was no genetic counseling about what age you should stop having kids. It was about having kids when the Good Lord saw fit. So, she was 17 years older than me. She went to Fort Valley and she was an educator and ended up getting an educational doctorate before she expired. Then I have an older brother who is now a dentist, who went to college and didn’t have a clue as to what he wanted to do. Initially thought, “Man, perhaps teaching,” and then … we had a good pre-med program, had great advisers at Fort Valley. He and one other young man were the first African-Americans to be accepted to the Medical College of Georgia, Dental School. Yeah, Matthew. Matthew went to dental school, and then …

Q: So, you were seeing higher education modeled, right?

A: Yeah, that’s a good way to put it. Well, whether it was modeled or not, I knew what hard work was like, so I wanted to see what was on the other side. I went there with an idea of, I knew I’m not going to teach, but I knew I didn’t have the patience to teach and I thought perhaps I’ll work in the lab somewhere. The brother who’s three years older— who’s actually smart, a genius — went to med school at the Medical College of Georgia and he just interestingly enough happened to be No. 2 in his class. He was the first to do medicine and I said, “I don’t think I want to work in anybody’s mouth, I’ll do the medicine thing.” And that’s how I got into medicine.

Q: So, your parents raised two dentists, two physicians, and an educator with a doctorate?

A: Yup.

Q: That’s 5 for 5 where I come from.

A: Yep, wish I could do as well.

Q: I mean, in two generations that is a phenomenal change.

A: Absolutely.

Q: Is it something you think about sometimes?

A: We do, and the interesting thing is there’s a book written by Dr. Russell Mootry called “Diamonds.” In that little town, in that little area that was challenged economically, there’s probably, let’s see … six or eight doctors, and maybe five to seven dentists that came out of that environment. Russell Mootry realized that this is exceptional and actually wrote a book that basically highlighted the accomplishments of these poor kids from this challenged background.

Q: Sounds like the dirt was good there.

A: The dirt was good. And the teachers were your foster parents. They made sure you stayed on track.

Q: As somebody who delivers babies for a living, how do you describe the wonder of life?

A: Well, it’s still a miracle. Now, the tort systems and the courts have tainted it, but it’s still a miracle every time one comes, and sometimes we make a difference — you know, we stick a hand in and help in some way, form or fashion — but it’s still a miracle, and it always will be.

Q: What do you think when you hear that first cry?

A: Again, I mean … in a quiet moment, you realize that you are allowed to participate in something special.

Q: Obviously it’s more than participating. In a good situation, everything’s normal, but things can get out of line in a hurry, right?

A: That’s why we’re trained, and that’s why we try to deliver in a controlled environment for those rare times when it doesn’t. You know, usually we are able to intervene and make a difference, and that’s what the training is about, and that’s why we’re here.

Q: When you started, where it was essentially you and a nurse and maybe the father in there, now there’s birth photographers — I mean, it’s all changed, hasn’t it?

A: It has changed.

Q: For the better or worse?

A: It’s good. It’s good, yeah. The dads need to be there, the family needs to be there. But, I mean, you don’t need to have half the town, you know — so many folk you need bleachers.

Q: You are 63. Can start to see the end of your career now?

A: Absolutely.

Q: How much longer can you deliver babies?

A: As long as I feel good. You know, I just had my knees replaced in November, I took eight weeks off. I call it my maternity leave. … As long as the work environment is good and the Good Lord is giving me the strength and ability, you know, I might not deliver 30 babies a month but I might do five or 10.

Q: So how many are you doing now?

A: Probably, I’d say … 12 or 15.

Q: How many kids have you delivered over the years?

A: Oh, over 10,000. I started delivering babies in my junior year which would have been around ’77, so ’77 to 2017, that’s about 40. …

Q: Do you consider it a privilege to be able to be in on the most intimate part of somebody’s life?

A: Absolutely, yeah. But this is, I think, what I was put here to do. In time of frustration I would joke and tell my buddies, “You know, I would have made a great forest ranger.” I love the outdoors, I love the animals, and here I am. I think, this is my calling.

Q: Let me ask you about St. Francis. The hospital obviously went through tremendous financial issues, ended up being sold. How difficult was it going through what St. Francis went through when the financial situation reached what it did?

A: It was difficult, and it sounds mushy, but I feel probably more for the folks who dedicated their lives, the families here, that … this place means so much to them.

Q: The philanthropic side, right?

A: Yeah, yeah, I really have been impressed. They’ve given it their all — I mean, their time, their money. They love this place. They love it. Now, I hate it for them, that even though they are still involved, that bond, that brand … and LifePoint (Health) was great in coming to rescue the institution, but those folks … long before I came here, this was their baby. And I admire that.

Q: This was a community asset, owned by the community.

A: Absolutely.

Q: How has that changed in the last year-and-a-half with LifePoint in here?

A: There are services that were once the highlight of St. Francis. … The cardiovascular-thoracic program, I mean, it’s probably second-to-none, so that has had to undergo some retooling. You know, some of the guys just got older and just didn’t feel like doing the intense operations anymore, and there were people who came, and when things started to change, they left. So the cardiothoracic program, which was kind of like a branding for this hospital, is getting back up to where it needs to be, but there was a time when it really suffered.

Q: Is the short-term pain of what happened over?

A: There are still challenges, even with LifePoint being in place, and for the financial resources that is poured into it, there are still challenges. In today’s economic situation, it is difficult for hospitals to break even, let alone generate income, so you have to look at every service, and it’s recognized that some services will never make money, you just try to control how much they lose. There are other services that you hope will do well enough that will offset the losses from our other services, but it’s a slippery slope.

Q: Where’s obstetrics fall in that matrix?

A: Now, typically obstetrics, with young people short-staying in the hospital, typically obstetrics is a money-maker, for lack of better terms.

Q: How has medicine changed since 1985, in the 40 years you’ve been doing it?

A: Oh man, by leaps and bounds. When I was in training, one of the things that gynecologists were starting to do was something called laparoscopy, where they would, under general anesthesia, put a tube in a lady’s abdomen and look around to try to determine what the abnormality might be. If women had surgery, if they didn’t have vaginal surgery, most of it was done open. Tubal ligations would stay in the hospital. I remember one of my attendants, who was an excellent surgeon, he said, “You might have damaged a bowel and didn’t recognize it, so you have to keep them overnight.” Now my hysterectomies go home on the same day.

Q: That was unheard of 30 years ago, right?

A: Yep. So, most of the surgery that we do, the majority of what I do — probably 95, 90 percent of them — go home the same day.

Q: Is the doctor still in charge?

A: No. No. The financial entities are in charge. You know that colleague who will probably say, “Why did you stay like that?” But we’re employed. We have a boss. Now, it might not be as stringent as working on some other jobs, and you could try to dress it up and say we are affiliated, or we have an association, but at the end of the day you have a contract, and you have some entity to which you have some … I still applaud the guys who are in private practice. Up until 2010, I was in private practice, so I know the challenges, and I feel for those guys who are still out there battling. The things that have occurred, sometimes I wonder if it was not done to push us out of private practice. And I don’t mind telling you this, when I was paying my malpractice premium, as a solo practitioner I was paying $66,000 per year. As I am affiliated with St. Francis, my premium went to $16,000 a year. So that’s $50,000, and my question is, “How do you explain it?” Well, it’s because you’re part of a larger group. I said, “I’m still practicing the same medicine, and I’m still doing these complex things; how can you insure me for $50,000 less than when I was in private practice?” Why is it that?

Q: Did you get a good answer to that?

A: Oh, no. As an individual in private practice my supplies cost one thing, where if I’m a part of a big entity, we’re group buying, and I guess if a big enough group got together and went to Winn-Dixie, or Publix, or whatever, you could get discounts. The groups get the discounts. I’m limited as a solo person as to how much input, or how much bartering, for lack of a better term, I could do in terms of contracting with some entity, but as a group, that’s power.

Q: That’s real money.

A: Even for Donald Trump.

Q: You brought it up. You did it to yourself. What do you think about the debate over the Affordable Care Act?

A: Well, I’m going to say some things that you might have to come help guard me. In America, we do well enough that everybody ought to to have access to some type of health care. Now what disturbs people is that not everybody is going to get the same level of care. Some people have difficulty with that, so how do you design a system where, if not everybody, but most folk have access, but you have tiered care? Some people go to work and make $200,000 a year, some make $20,000 a year. So if you’re offering a service, should the person who makes $200,000 a year be limited to what the person that makes $20,000 a year (gets)? So let’s have a basic service, and if you want to go above and beyond, then if that person’s willing to pay, let them pay. I don’t know how you build that into a system. Now, affordable care. … And I say that to say that Obamacare was a step in the right direction. Does it need work? Yes, it needs a lot of work. Do you need to pull it off the table? Probably not. Fix it. You know, you Democrats and Republicans, all y’all do is go up there and fight. Come together and fix this thing, because we got, what, 20 million folks who now have insurance who didn’t have it before.

Q: Are some of those your patients?

A: Some. But the interesting thing, I was in a meeting this past weekend with a physician who said, “I had Obamacare and I had to give it up.” And this was a physician. She said, “My premiums, my co-pays were just going through the roof.” She said, “I couldn’t afford it anymore.” So, let’s insure as many people as possible, but let’s make sure that it really is affordable. So, what needs to happen? They need to stop the bickering and figure out how to fix it. They could do some things to make it work, I think — I think.

Q: What is it about Columbus you really like, and what is it about Columbus that frustrates the heck out of you?

A: Well, I still think of Columbus, you know, metro Columbus is, what 250, 275 (thousand)? Columbus is a big country town, and all the ills that you find in a great metropolitan area we may have to a degree, but nowhere near that magnitude. So when I left Florida, I was looking for a place that had diversification and industry, and there were a significant number of physicians that suggested to me that they might be returning in five or 10 years. And if it was Georgia, you know, start around Columbus. I had no idea what Columbus was like — even in Fort Valley with the way the road system was and limited transportation, I didn’t have a clue until I visited back in, oh, what was that, maybe ’83, ’84. I’d never been to Columbus.

Q: Are you glad you found it?

A: Oh, man, best thing that could have ever happened.

Q: What is it you like about Columbus?

A: I don’t know, it’s a country town. I fish, I hunt. …

Q: So, you’re a country boy?

A: Oh, I’m a country boy. Yeah, yeah, when I moved to Florida, the black guys used to tease me because I had a truck. Within the next week or so they were all wanting to borrow it.

Q: So, I asked you earlier, and I’ll kind of ask you again in a little different way, so you see yourself doing this for a few more years then, huh?

A: Absolutely.

Q: What’s retirement look like for you?

A: When I had my first knee surgery, I was down for about nine days, and I learned something about me. I don’t sit at home well. You know, after a few days I’m only going to read so much, I’m only going to watch so much Netflix, and the same thing, I was out two months this time. I’m not a stay-at-home person, and I can’t see myself gardening. I love golf, I’m going to play golf everyday, and I love fishing. …