INTERVIEW OF MICHEL A. IBRAHIM, MD DEAN SCHOOL OF …sonicsouth.web.unc.edu/files/2018/11/Ibrahim-Michel.pdfMICHEL A. IBRAHIM, MD DEAN SCHOOL OF PUBLIC HEALTH BY ROBERT KORSTAD, PhD

INTERVIEW OF

MICHEL A. IBRAHIM, MD

DEAN

SCHOOL OF PUBLIC HEALTH

BY

ROBERT KORSTAD, PhD

Transcribed by

Jennie S. Maurer

SPH

Interview number L-0072 in the Southern Oral History Program Collection (#4007) at The Southern Historical Collection, The Louis Round Wilson Special Collections Library, UNC-Chapel Hill.

L-T-3-

Interview

with

Michel Ibrahim

July 6, 1989 \j)#\z ON "Kft C <Uj"Ctf C

by Robert Korstad

Transcribed by Jennie Maurer

The Southern Oral History Program University of North Carolina at Chapel Hill

Original manuscript on deposit at The Southern Historical Collection

Louis Round Wilson Library

Copyright c 1992 The University of North Carolina


Michel A. Ibrahim

Page 2

Robert Korstad I guess if you could just tell me a little bit about your family and

your background and growing up in Egypt and how you got

interested in medicine.

Michel A. Ibrahim It is interesting that you always go back and talk about family

and origins and history and all that. My father was a principal of

a high school, which was then the English Missionary School, so

I have quite a bit of contacts with England in many ways,

through that type of connection. And also I come from a

Christian family. Way back, as far as I remember, so in essence,

you see, the predominant culture in Egypt is the Moslem culture,

which makes close to ninety percent of the population. We, as

christians in Egypt have our culture and values more biblical and

more, maybe western than Moslem, in a sense.

An interesting statistics would be that when I went to medical

school, although christians and Jews made less than ten percent

of the population, they made over fifty percent of the students in

the medical school. Which in essence, if you are a minority,

religious minority, living in a culture which is different, one way

to make it, is to get into the professions. Otherwise you just get

no where. And at the time I was growing up, you know, Egypt

was quite a bit British, the British were a colony like the United

States was years ago. Actually, almost every country in the

world, was a colony with a british at some point in time.

When I was growing up, the country was much smaller than it is

now, Cairo was less than three million people and a lot of

cosmopolitan influence, British, French and that type of thing.


Michel A. Ibrahim

Page 3

But because the medical school was heavily british influence in

its curriculum and education and professors and all that, so the

relationship with England was very close in terms of education,

politics, that type of thing, so that was kind of a lot of influence

in my growing up with my religion in the country as well as my

contact through my father.

I was interesting in learning. After I got into medicine I really

wanted to be an ear, nose and throat surgeon, and I tried that a

little bit in Egypt and in England to specialize in ear, nose and

throat surgery and then I somehow tried it for a year or so and

decided I don't want to do that, and then I got interested in

public health and prevention and I thought at the time, where

would one go to study public health. England was closer and

England had only one school of public health, and England was

not necessarily known very much in public health, quite a bit of

their public health community medicine education was in

medical schools, big departments in medical schools. I wanted,

really to get away from the medical model, I wanted to be more

community type of thing, and the University of North Carolina

had tremendous reputation in Egypt and many other countries,

partly because there were many graduates of the School had

been there.

RK: So did you know people in Egypt who had already to be North

Carolina?

MAI: Yeah, and they talked about where does one s tudy - the

University of North Carolina- and the Ministry of Health for

example, had the University of North Carolina on their list as one

of the good universities to do that. So initially, then and actually I


Michel A. Ibrahim

Page 4

came - left Egypt for good and came here in 1960, September

10th, 11th or 13th, 1960 and came to study biostatistics.

And the first person I met, I spent one night at the Carolina Inn

and -- actually I got up in the morning and asked the Clerk

where is the University of North Carolina, I was use to living in

big cities, and I thought he would tell me, you know, take a cab

or take a bus, "where is the University of North Carolina?", he

says, "across the street". And the first person I met was Ralph

Patrick who was in Epidemiology met me at the Inn and he took

me to meet my advisor in biostatistics. So I went to a wooden

shack in front of Lenior Hall and went in and my advisor was

Bernie Greenberg (laughter)-who was my predecessor-and he

advised me on what courses would I take in biostatistics and that

really was my introduction.

RK: Had you been to the United States before?

MAI: No.

RK: So this was your first visit?

MAI: ...I had been outside Egypt, but not the US, this was the first trip

to the US.

RK: So you came through New York?

MAI: New York, directly to the Carolina Inn. (laughter)

RK: I guess you had been exposed to ...


Michel A. Ibrahim

Page 5

MAI: Yeah, I was a cosmopolitan. Well of course I was impressed like

everyone will tell you. They come from anywhere in the world,

especially Western countries like France, England, Norway,

Denmark, Switzerland, the first impression, how vast this

country is. Now, you don't think about it, but it is a continent

and people forget that. And I flew from New York to here and we

would still look at the map, just a little tiny thing on the map.

RK: Was the south different?

MAI: From the North? Well, I really didn't get to stay. I was surprised

how things were maybe a bit slower than expected and maybe

the accent because I was used to a lot of movies, to see movies

and things, and several visitors from the US but none really from

the south, it was kind of my first exposure to the South. I

remember it was hot. also kind of unusual, although Egypt was

hot but dry, it is a Mediterranean climate, here it was hot and

humid.

RK: How did you find the classes and the students and the professors

when you came?

MAI: Well they were superb, my problem has been I came directly from

medicine, from patient care, and I thought that public health

really would be more -- have a lot more medicine in it, and that

wasn't the case, because my first course was in statistics with

Roy KeWer(sp) whom you may have interviewed?

RK: No, I haven't talked to him yet.

MAI: He is an old-timer, terrific teacher, one of the best. As a matter

of fact I sat and listened to him talking about stat ist ical


Michel A. Ibrahim

Page 6

problems, about means and standard deviations and I said, what

am I doing here, you know, I couldn't really do a Kai(sp) square

test and a T test and I realized ... I thought maybel'm misplaced,

you know, I wanted medicine. So I went to Roy Kebter and said,

Professor Kpbler am I in this class? He said,"what's your name?",

he looked down, and 'yeah , you are." So I tried to do a

biostatistics program. I must say it wasn't really for me that

much to specialize in biostatistics, becuse I really wanted to use

my medical background, so Bernie and I-Bernie Greenberg-

talked about what I really would be doing and he advised me in a

way that really changed my career, he said after the first year in

biostatistics, and I was going to get a Master which I did, a

Master in Public Health in Biostatistics, he thought I really

should do doctoral work in Epidemiology. Because that's really

where I could use my medical background. He introduced me

then to John Castle, the former Chairman of the Department of

Epidemiology. He had been chairman for almost eighteen,

nineteen years, and John Castle was sort of the second person

who really formed my career and I got into epidemiology in 1961,

Fall of 61', and I spent three years in that Department... I spent a

year in the School of Medicine, with the Department of

Community Medicine doing post-doctoral work, but altogether

three years in Epidemiology and community medicine in the

Medical School. And I found the epidemiology was what I really

wanted, although I must tell you that every year that went by, I

missed medicine so much I wanted to go back to patient care, so

I would apply to various hospitals and I got responses from Duke

University and responses from Wake Forest, Bowman Gray, to

get a residency you know, and then go back into practice. I tried

to do that. Duke was paying something like $25.00 per month

plus room and board, which I needed money to live on. Wake

Forest was much better. They wanted me to join them, initially


Michel A. Ibrahim

Page 7

work in the laboratory and then work myself up into a residency

program, and I remember they were offering something like

$500.00 a month, which was a lot of money. And then I come

back to Bemie Greenberg and John Castle and said, listen I have

this offer from Wake Forest to go back and really I wanted to go

back to clinical medicine tht's what I really love: they said, well

wait, stay another year, you know, we will get you a fellowship,

who knows. And I really did for the three years while I was

learning epidemiology, I always took it from year to year,

anticipating that I may actually quit and go back to medicine.

RK: What was John Castle like?

MAI: Tremendous man. Very bright. He influenced the field of

epidemiology from one angle that was in many ways unique. He

did not invent it, but he really pushed it very hard, which deals

with the social and psychological factors of the effect people's

health. See, most of medicine was very much biologically

oriented, you know, we think of germs and degenerative diseases

and immunilogical problems, he came and, advanced, the theory

of social factors. Psychological factors, and that was a major

contribution on his part and he influenced me that way as well.

He was a very good Chairman. I was a student then at the time.

He also was my primary adviser on working on my dissertation

and actually my dissertation was related to a method issue that

deals with psychological factors and heart attacks.

RK: He had done some work on that, I think, too.

MAI: Yes, cultural values, societal values and stress how they relate to

illness.


Michel A. Ibrahim

Page 8

RK: Did Ed McGavran teach at all at that point? Did you have any

contact with him?

MAI: He was dean then, and I saw him from a distance, I was a

student. It is good that you mention that because I m going to

tell you some encounters with McGavran when I came back from

Buffalo. See I left in 64', I received my education I knew Bemie

Greenberg very well, because he was my first advisor in

biostatistics, I knew John Castle very well, I knew lots of the

faculty in the School, but at the time as a student, you see, you

really dont' know the dean very much. You will see the dean

once in a while and he will welcome you, but I don't think he

would really have known me that much at the time. I left then in

64* and I accepted a position on the faculty of the Medical School

in Buffalo. I did that for about four years and another four years

of., or three and a half actually with the ....I was a health officer

in the Erie County Health Department, and the Erie County

Health Department was the turning point in my becoming

interested in administration, leadership and politics. Economics

of heal th care. So it really got me away from being am-"

academician, interested in acquiring knowledge and I became

interested in applying what I had learned and doing it within a

political system, you cannot do it in vaccum, do it within a

political system, it was fascinating to learn the Republican Party

was the party in power and my appointment and my colleagues

were political appointments, so it was fascinating to me how to

blend my science background with the politics.

RK: Why did you take the job in the first place? I mean what lead

you to go off in that direction as opposed to do something else

when you finished your PhD here?


Michel A. Ibrahim

Page 9

MAI: When I finished my PhD, I wanted to -1 was on the faculty of the

Medical School and I loved it, and really I was spending my life as

an academician and a physician epidemologist, doing research at

the Medical School, but in 67', as you may recall, was the heart

of the Viet Nam War and I remember there was ... I was at a

party with the Health Commissioner of Erie County and I was

telling him I'm really packing and leaving, I may not see you

again for a while, I was being processed within weeks to go to Viet

Nam.

RK: Is that right?

MAI: I was within weeks.

RK: So you were a U S citizen?

MAI: Oh, yes, I was a citizen for some time. And then he said, well you

know, we have a vacancy, we need physicians in the Health

Department, as a Health Officer, if you were to Join us, I don't

know, but the draft boards are local, and the draft boards may

value your services to your county compared to sending you to

Viet Nam. So I thought about it, and I said, I really would love to

serve my country and I wouldn't mind dying for it at all, except

Viet Nam wasn't the place to die for this country. Even at the

time, I thought such a waste, and I really wouldn't mind dying for

the US but not in Viet Nam. That bothered me. It was kind of a

moral dilemma for me, this country has been terrific to me and

my wife from here and my kids, and I would like to serve, but is

that the best way to serve? S o . . . Well anyway, I said fine.

Initially you could get deferred by the local draft board if you are

essential to what you are doing, so the Dean of the Medical

School went to the draft board and said, please don't him to Viet


Michel A. Ibrahim

Page 10

Nam, cause I need him, he is esential. And everybody laughed

and said, what do you mean esential, so many of them in the

medical school you need them. Anyway when I decided to join

the Health Department - the health department is political you

^4iow, get into your politics, I went to my last, the last hearing

with the draft board to see— they hear me one last time whether

they defer me or not, and at that time I wasn't having an appeal

that I'm really essential to the medical school, which I didn't

think they would buy anyway. I remember I went that night to

the draft board and the Buffalo News had a front page article in

the ? section which said,"Professor joins Health Department",

and they talk about me, that I am joining the Health Department

and I'm going to stamp out venereal disease and gonorrhea, and

syphilis and tuberculosis and, of course, people sitting out, said,

yeah, keep him here. That's how I got into the health department.

And with in retrospect it was a wonderful three and a half years

of my life, just absolutely spectacular. I loved every minute of it.

RK: It was a big change, though, from being an academician?

MAI: Oh, yeah. But you learn very quickly. Very quickly.

RK: But you get to apply I guess a lot of the... particularly as an

epidemologist.

MAI: Yes, apply the science I knew about the population, the disease

burden of populations and how one would devise programs to

deal with these issues. Realizing that science is not sufficient.

You also have to deal with other factors in terms of government

interest and people interests and industry and media and all of

these impact on what you are wanting to do.


Michel A. Ibrahim

Page 11

Jus t before I forget, when you said McGavran, because when I

came back in 71', when I left Buffalo and the health department,

I said I really want to go back to academies and be a professor,

no administration, I don't want to administer anything. You see

you laugh because you knew what I did there. Otherwise I really

would have gone into administration from Health Department, I

could go to bigger and better health department, but I really

made a conscious decision, so I came back in 71' , and in 71 '

Dean Mayes, was dean then if I'm not mistaken, cause McGavran

finished and Mayes came on and I was a professor then in

Epidemiology. The first thing I think about is I was a student of

the department and then I was professor, although I had a seven,

eight year absence anyway, people find it difficult to move from a

student to a professor in the same place, if you do it overnight. I

had a period of absence, but it was a joy to become a professor in

the department where you were a student. Which is really

doubly joy tht not only tha t I became chai rman of tha t

department and then Dean of the School, so it is kinda of....

although you really think about it, I don't remember being a

student here now that I'm dean, you jus t go through these

phases and you just play the role at the time. I suppose to

others it is fascinating, here is a student trim and (unintelligible)

to me it is just, you do it, and it becomes gradual. But anyway

what is fascinating, when I came back in 71 is that I got to know

Ed McGavran very well as a colleague and that is another thing,

he was a famous man who really founded this school and made it

what it is, that he and I then would be colleagues and chat about

all sorts of things, but I had close encounters with him in

continuing education, he was the Director of continuing eduction

for some time, or at least a very active participant. So I went

along to teach epidemiology with him in the ourses he was giving

and what was interesting also that he was my former dean so to


Michel A. Ibrahim

Page 12

speak, he would defer to me when we talk about Epidemiology

because he assumed I knew more than he did, I probably did,

but he still was a big figure. So that was nice.

When I came back Mayes was in his last year and was still

professor and then Dean Greenberg became dean in 72'. And

then John Castle got ill, I was made acting Chairman and then

Dean Greenberg appointed me as Chairman of the Department of

Epidemiology in 1976. although I was acting for two or three

years before that.

So another interesting history here, is again, Bernie Greenberg

who used to be my advisor as a student now he is my dean and

I'm Chairman, a different type of relationship.

RK: What was the atmosphere like here in late fifties and early sixties

when you were in school?

MAI: It was very small, much smaller than it is now, of course, and

you get to know most of the students, most of the faculty. Many

of the students were older physicians in their fifties and some

were even sixty. Coming back to learn -- to get their Masters

degree. Many of them were MD's, coming back to get Masters

Degree so they can become Health Directors or what have you.

RK: For local counties and things?

MAI: Yes. There were a lot of those people. Actually I felt, I'm out of

place, I was so young, but I wasn't, maybe twenty-six, twenty-

seven. And I felt, you know, all these old people in their forties,

fifties and sixties. Which things change now quite a bit. The


Michel A. Ibrahim

Page 13

average age was much higher than it is now. Much older than it

is now.

RK: Those people all have a lot of experience, I guess?

MAI: They come with experience and a lot of them - medical experience

- and they get ... there were a few people who really came for

intellectual stimulation, you know. I knew a couple of people

who were retired or close to retiring, who came because they were

intrigued with the concepts of populations and epidemiology and

public health and they want to have just a didactic experience for

a year or so. So that kind of people.

RK: So the classroom environment must have been pretty stimulating

with that mix of people in there?

MAI: The only thing about the town, interestingly was of course

segregation days were then, it was fascinating. And John Castle

who was my advisor, who was out picketing for desegregation

and I got so mad because I wanted him to help me with my

dissertation, I said, you can do that later, I wanted him to help

me to get my dissertation down, (laughter)

RK: This school, I think, even in those days had...

MAI: It was also quite international. There was a lot of students from

foreign countries, western countries, developing countries. See a

large percentage at the time in the late forties - I'm sorry, late

fifties, early sixties, which in the seventies, when Bernie

Greenberg was dean, diminished a great deal, and then it is up

again. It just reflected the characteristic of the time.


Michel A. Ibrahim

Page 14

RK: Right. Did foreign students have ... how did they fit in? You were

kinda part of them, bu t not part of them in having grown up in

Egypt, but having been in the US for some time.

MAI: Yeah, many many foreign s tudents sort of s tuck to themselves

and speak ing the i r own l anguage and t h e old(sp) was left

separate. I'm very easy, now I could have been anywhere. I was

determined when I leave a country I'm going to live like t he

country I live in, it could be anywhere, it happened to be the US.

I was very outgoing. I wasn' t interested at all in meeting with

people from foreign countries or eat that food, I was wanting to

get an American experience. Right away. Like when I went to

England, I want an English experience. But that 's me, and I sort

of don't maintain ties very much, I jus t live the way people live

and I like that, I adjust very quickly and I enjoy that.

RK: How did .. I guess the o ther th ing I was in t e re s t ed in, t he

influence that some ... the School was starting to really grow at

that point and it then had a very difficult time early in the mid-

fifties.

MAI: Yes. And the seventies when I came back tha t - the Dean was

Dean Mayes, as you well know, it was growing very rapidly.

There was lots of NIH grants, lots of research money and that is

really the period of growth of t he school . And expanded a

number of faculty and number of s tudents . This place was no

longer sufficient, which ws opened in 1963, and there was a large

number of faculty and s tuden ts were spread out in the town.

That's why we started asking for a building.

RK: Where did you have your classes when you were a student here?


Michel A. Ibrahim

Page 15

MAI: In many of these, Miller Hall, for example, was one; that's where

the Epidemiology department was housed for a time, this wooden

shacks so to speak were ...

RK: Over here by the Medical School?

MAI: Yeah, and trailers and some medical school.

RK: It was spread out all over?

MAI: Yeah. And I remember when this was opened in 63' there was a

student room actually on the second floor and had a desk that

was a treat to have a desk.

RK: Every student have their own desk?

MAI: Graduate students. Those that were working towards a doctoral

degree. There was a student room for epidemiology and I had a

desk and several of the others would have desks as well.

RK: It must have been a big change when this building was built?

MAI: Oh, it was enormous, yes.

RK: To bring everybody together at least for one year or so.

MAI: Yes, they did, and then they begin to out grow the place.

RK: So how did you feel about coming about here then as a

Professor?


Michel A. Ibrahim

Page 16

MAI: It was in 1971. I felt very good. Initially there is that lingering

doubt that applies to anyone when you go back, there are — you

know, people say you cannot go home again in a sense. When I

decided to move, I made it known to my colleagues that I'm really

ready to leave Buffalo, I loved Buffalo, I loved the work, but I was

ready to make a change, I had been there about seven years and

in order for me to grow I needed additional excitements. And also

I wasn't sure if I wanted to spend the rest of my life in the health

department, as much as I enjoyed it. So I got several offers,

maybe a dozen offers throughout the country in epidemiology

department, chairman of epidemiology department, professors,

and here was one of many offers. And my wife being jus t a

hundred miles away from here, wasn't eager initially to come

back and I wasn't eager to come back in a place where I was a

student. You know, how would I be treated and so on and so

forth. But then we decided that it would be a good place to come

back to. It is a good school, good town. Now we think it really

was a very good decision. We loved it since we came. And our

kids, you know, grow up in this ... Actually, one was born here,

my oldest, Danny, was born in Chapel Hill in 1963, and the other

three were born in Buffalo.

RK: Tell me a little bit about the research that you did after you came

back here. As you made this move back into academics as a

professor and teacher?

MAI: I tried to do health service research, ra ther than strictly

epidemiologic causal type of research. I tried to do health service

in terms of application. So we tried to do studies on nurse

practitioner, you know nurse practitioner was a new thing

happening, we tried to develop programs to evaluate this kind of

program. Health care type of studies. Had a training program to


Michel A. Ibrahim

Page 17

train epidemiologists in health service research. I had a project

on a community-wide treatment and control of high blood

pressure, we used Edgecomb County as one of our community

laboratories. So this was the thrust of my work, is health service

research and application, trying to use my background and

policy and politics and health care economics that I learned from

the department. And up to this day, really my interest is."how

does one use science?" and in public health really the science in

public health is epidemiology and biostatistics, the core of public

health. How does one use the findings of these scientific

programs in the formulation in terms of policy?- health policy. I

wrote a book on this as you know, Epidemiology and Health

Policy. So that has been my interest.

RK: It is interesting how by the time you became dean, you really had

experience both as a medical doctor, as a practitioner in

bios ta t i s t ics and epidemiology and really in public

administration.

MAI: And the medical school, faculty in the medical school. Yeah, I

feel fortunate that I have been exposed to a variety of public

health practices and disciplines and experiences that I feel sort of

.. you know I have a well rounded background in public health.

RK: What were some of the problems at the School when you came

back or took over the department of epidemiology? There were a

lot of concerns in the seventies about curriculum development,

about where the Mill Bank report came out in the early mid-

seventies, it was very critical of the schools of public health.

There was a lot of tension, I think in the school here, between

people who were interested in having this be a more research

\S /


Michel A. Ibrahim

Page 18

oriented institution, as opposed to other people who were

interested in more of the service oriented institution.

MAI: I would have to respond to this question, Bob, depending on what

phase of my life are you talking about? We thought maybe as

dean .. we will talk about that in another session, but when I was

professor in Epidemiology, and Chairman of Epidemiology, I

really didn't care that much about school problems. And that's

what the chair's ... not that I didn't care maybe is not a good

word, I cared about the school problems, but that wasn't really

my concern. I was interested in the Department of Epidemiology

and because we are very much a department oriented type of

school, I felt that my loyalty was for the department.

So the challenges in epidemiology at the time... one challenge

that was unique to this place and important historically... John

Castle was a terrific guy. Enormously popular, enormously liked

by the faculty, staff and students, extremely successful, well

known, nationally and internationally, but he ran the department

as a one-man show. So the Epidemiology Department in the

School of Public Health was really John Castle and Associates. So

one of my challenges is how to institutionalize the various

programs and administration of the department and in essence

get them through a transition phase to learn to be independent.

And I felt this was one important task for me to do, which I think

I did pretty well. You know, in terms of we need to have

admission committees, not just ... you met by, you know, I like

this student and I admit him. Also the department got bigger so

it needed a curriculum committee. It begin to have a better

financial base for the department and make sense of the fiscal

policy of the department, have a promotion committee within the

department, so and so forth. So I had a phase of really - which


Michel A. Ibrahim

Page 19

was un ique to tha t pa r t i cu la r depa r tmen t ' s h is tory- to

institutionalize many of the functions and make it, in a sense, a

department of epidemiology which made up of the faculty and the

chair, rather than the chairman and the faculty.

RK: I think that was true for all departments who came after the

founder of the department.

MAI: Exactly, John Larsh was the same, Dan Okun and .... I get that

exactly Bob, you are right.

RK: You are probably the last... the Department of Epidemiology was

probably the last department to have a full time chair so that he

was here later.

MAI: You are absolutely correct. It wasn't unique in epidemiology, but

it was across the board.

RK: You had more administrative experience when you came to that

than most people who made that transition.

MAI: I had enough experience and sense to use my experiences in

applying it to a very delicate situation. For example, I had the ...

Castle then, was not only the former chairman, but he was sick

with cancer, he was a dying man. How would I then-1 was his

student- sit up and preside over the faculty when he is sitting

there as a member of the faculty and not only the reversal of

roles, but the man is sick and dying. How do I handle that

situation?

RK: It must have been hard.


Michel A. Ibrahim

Page 20

MAI: I brought everything I learned to bear on the situation, and it was

okay.

RK: You had a fairly large faculty about the mid-seventies?

MAI: Close to maybe sixteen, eighteen. Compared to the past.

And then in terms of substantive issues, we began to think that

we needed to expand into other a reas . We have cancer

epidemiology, we are doing a little bit of that, we tried to expand

that, we tried to expand the environment and occupational

epidemiology. We began to expand the hea l th service

epidemiology. In addition to cardiovascular disease which has

been the hallmark of the department.

My challenges were, number one, to get the department moved

into an organizational entity that would be the democratized in a

sense institutionalization of many of the functions within the

department and programmatically move in a big way into areas of

cancer, health service research, which was started, I did not

invent them, but they were pretty small and I did put in a lot of

effort into the cancer health service research and diversify the

department efforts beside cardiovascular diseases and also begin

to recruit students. One thing I did in epidemiology, at the time

the affirmative action was coming into the university and said

well you must have so many faculty and so on and so forth and

so many students, and I realized then it is good to have black

faculty in the school and the university, but I believe then as

Chairman of the department, the best thing we could do for

minorities is to begin with the students. So I really spent some

time with the faculty to increase the number of minorities in the

student body with the belief that if we have more of them and we


Michel A. Ibrahim

Page 21

graduate them, and they go out and saturate the pool, whether

they work for us or somebody else, that really doesn't matter. I

remember one year we admitted four black students out of

sixteen or so, which was very good. Unfortunately, that has not

been the custom that much. I mean every unit in the university

is trying to admit black students but I feel that some of the

efforts is spent on recruiting faculty maybe sort of running in the

same place, you hire a black faculty member and somebody else

hire him/or her because they pay more and what have you and

then you end up losing that, I felt the best contribution we could

make is to begin at the base.

RK One thing I've noticed ... right now I'm reading the Dean's

Cabinet minutes from the 70's, it is interesting how the whole

issue of smoking changes. I guess I just read a memo the other

day in which it must have been Dean Greenberg finally said well

we can't smoke in the Dean's cabinet meetings anymore even

though they are two hour or an hour and a half long, so we will

have a break.

MAI: Smoking break.

RK: Yeah, smoking break so everybody can go out and smoke. And

then about a year later in the minutes of it, it is referred to as a

coffee break and not a smoking break. It is interesting how that

changes. And for an epidemiologist I know that that was a ...

that smoking was a very important issue and also in a State like

North Carolina, how did you deal with the issue, or how did it

change?

MAI: Well the issue is a fascinating one because of the reasons that

you mentioned. It is a public health menace, we know that it is


Michel A. Ibrahim

Page 22

clear now ... the data indicate that it is bad for you in terms of

cancer, heart disease.emphyezima, on and on and on. And also

you have the public health issue which is clear, it is detrimental

to your health, and another equally important issue was the

human right issue. My right and your right. I should be able to

smoke if I want to. And you don't have to smoke if you don't

want to. So that's an issue, but a third issue is how about if you

infringe on my right, what happens if I don't like the smoke. And

it is irritating my eyes. And then a fourth issue is, we are in

North Carolina where tobacco is a big thing. I remember in

1976 or 7, I was invited by the Edgecomb County Goldleaf

Festival to speak at their Festival on health and tobacco, and I

said you must be kidding. Why are you calling me? I have

nothing good to say about tobacco. I would be scared to come to

Edgecomb County and talk about tobacco and health. They said,

oh, no do come we want to hear you and so on and so forth and

we are eager to hear from a health person.

I remember at the time I hung up the phone and called Bernie

Greenberg right away and said, listen they want me to do this

and I knew that if I say tobacco is terrible I'm sure the headlines

the next day would say. Chairman of Epidemiology in a State

supported school hacks tobacco and if I say tobacco is good for

you then, then my colleagues would never forgive me for what I

said, I couldn't win. (laughter). So the way I dealt with this after I

accepted the fact that I would do it and warned the dean then I

would do this, so be prepared. As a matter of fact I sent him my

speech to review, if he had any trouble with it. Because my wife

is from North Carolina and the country there, I met with several

of my friends on the farm and they say why are you troubled by

tobacco and smoking and why do you think that public health

people are not welcome, talking about tobacco smoke. They say


Michel A. Ibrahim

Page 23

well you (talking about public heal th people) single u s out in

smoking and heal th . That really gave me my p u n c h line in a

sense, ... well let me not single out tobacco, so why don't I talk

about health promotion, disease prevention, talk about nutrition,

exercise, on and on and then talk about tobacco smoke as one of

those. So that was a nice way not to attack it, bu t I'm a public

hea l th person, I ta lk abou t hea l th promotion activit ies a n d

smoking is one of them. That was helpful. And then the other

thing, when I went I was terrified, I drove to Tarboro waiting to

speak and tha t is one of the few times I was scared to go to a

meeting, I didn't know how it would go. And then on the other

side when I arrived, actually had dinner, I thought I was going to

be the only speaker, I realized that the tobacco company, public

relation man was the other speaker on the same platform. So I

used him in essence as a barometer. ..When I say something and

they get very mad, I say, maybe I went too far and I didn't want to

offend the farmers

END OF TAPE A - SIDE I

TAPE A - SIDE II

MAI: (continued) and he feels very good about what I said, and he

begins to compliment me. I may have went to far on the the

other side. So I tried to balance it, and I still have the Edgcomb

County newspaper with my picture on one side, his picture on

another and a fabulous report health and tobacco. It was a very

educational piece. I did not attack the state, I did not attack the

evidence, I tried to be .... so that was really my first test about

smoking and health. You know, of course, our policy here and

how we wanted to make it a smoke free building, which was

courage in a way, I didn't know what the implications of tha t

might be, b u t luckily it worked out okay. But historically, it


Michel A. Ibrahim

Page 24

started by saying Bernie Greenberg tried not to smoke at the

Dean's Cabinet was a big decision. It offended a lot of people,

and they had created a break to take care of that, then we had

rooms designated and that type of thing. We've come a long way.

RK: Well it is interesting. One thing I'm trying to do is to take little

things like that and look at them over the period of fifty years, I

mean you have somebody like Ed McGavran who is a chain

smoker, and you know, going from that kind of point even

Rosenau smoked a pipe all the time.

MAI: And smoking, as you well know at that time was the thing to do.

RK: Right, nobody thought anything about it.

MAI: Yeah, we all did it. And you know it is kind of something that

was, pleasant to do, social, you now. You remember, you

probably don't remember the days when people offered cigarettes

at the table? Cigars, it was somethng like instead of offering

coffee, they offered a cigarette, it is passe* now.

RK: This has been good, this has been very helpful. And ....

MAI: Well it is interesting. You are a very good historian, because you

trigger a lot of these stories, there must be another dozen like

these that are buried somewhere in one's memory that would

only come out when you start scratching a bit.

RK: I think we will come back and talk again later in the summer,

maybe July or August and give me a chance to really read

through the materials so that I'm pretty up to date on what has


Michel A. Ibrahim

Page 25

gone on, so I can ask fairly informed questions. That will really

form the last part of the book.

MAI: I will be very happy to talk with you at that time, because it is

fresh in my memory....

END OF TAPE A - SIDE B


Documents

INTERVIEW OF MICHEL A. IBRAHIM, MD DEAN SCHOOL OF …sonicsouth.web.unc.edu/files/2018/11/Ibrahim-Michel.pdfMICHEL A. IBRAHIM, MD DEAN SCHOOL OF PUBLIC HEALTH BY ROBERT KORSTAD, PhD