Some people tried to dissuade Joyce Nichols from applying to the physicians assistant program at Duke.
No woman had been admitted before, let alone a woman of color to any PA program across the country. Nichols had three children who depended on her income, so how would she both go to school and earn a living during this two-year, full-time commitment?
Already on staff on the cardiac floor of the hospital as a licensed practical nurse, she happened to work with Dr. Eugene Stead, the man who established Dukes PA program. The program was originally designed to further the training of ex-military medical staff. But Stead apparently saw something in her and encouraged her to apply, said her husband, McArthur Nichols.
But knowing Joyce Nichols, who died last month after a years-long battle with colon cancer, Steads encouragement might not have even been necessary.
She was a very determined person, McArthur Nichols said. Once she had her mind set on anything, she was not to be denied.
The program was established in 1965, and Nichols graduated in 1970 as the first woman, and first African American woman, to become a PA in the United States.
She learned about six months into the program that the other PA students were given stipends something she had not been offered, her husband said. She inquired and was eventually awarded a stipend as well, but there was no back pay.
But the stipend was not enough to live off, and during her two years in the program, she made arrangements that allowed her to attend class from 8 a.m. to 5 p.m., then work her shift on the cardiac floor from 5:30 p.m. to 11 p.m., starting her shift just half an hour later than usual.
She studied when she got home.
When it came time for Nichols to look for a job, she knew that white doctors worried about their white patients accepting her into their practices. But she already knew what her career goals were, and she did not need a job with a white doctor to reach them.
Having grown up in rural Person County, the daughter of a tobacco farmer and a school teacher, she knew she wanted to bring health care to the disenfranchised, particularly in rural areas.
And before attending the LPN program at Durham Technical Community College, Nichols, who was divorced with three children before marrying McArthur Nichols, spent a few years living in Durhams public housing as well. She knew what it was like to struggle to meet basic needs.
Dr. E. Harvey Estes Jr., the former chair of the Department of Community and Family Medicine at Duke, helped her secure the funds needed to start what would be one of the nations first rural, satellite health clinics.
For two years she worked in the Rougemont and Bahama communities, bringing basics like vaccines, physical exams and prescriptions to a population that was often either too poor, or too geographically isolated to reach medical care. She also instituted a foot clinic, aware that diabetes and resulting circulatory problems were often a problem in low-income black communities.
When her funding ran out in 1972, Nichols took her skills to the Lincoln Community Health Center, which had been born from Lincoln Community Hospital, and also worked to serve the underserved.
Her rural clinic operated for a while longer under the Lincoln umbrella. Along with it she had access to the centers van, which she used to drive more serious cases downtown for further examination. She also focused on nutrition, bringing vegetables from her familys farm to patients who lived in urban food deserts.
Nichols worked at Lincoln until 1995, remaining involved in her communitys needs as well. Her daughter, Symetta Thorpe Williams, remembers her mother taking kids from public housing to bowling leagues. Friends used to call her before a doctors visit to make sure the need justified the cost.
She was a stickler for kids staying in school and doing what they are supposed to do, her daughter said. She thought about herself last.
When she formally retired from Lincoln, her work serving the community was really just beginning.
Phil Harewood, CEO of Lincoln Community Health Center, started working with Nichols just two years before her retirement. She remained an active member of the centers board, and he saw her advocate continuously for people in need.
One way she did this was by encouraging those she thought would benefit from public housing. Nichols served many years on the Durham Housing Authoritys Board of Directors. As a housing authority tenant in the late 1960s she had gone as far as to sue the entity for its ability to enter units without due process. She took that case to the U.S. Supreme Court and won, her husband said.
She was also engaged politically, volunteering much of her time since retirement for candidates such as Durham Mayor Bill Bell.
She just insisted that she wanted to be involved, Bell said of his campaign last year, during which she was undergoing chemotherapy. Once she sent her mind on doing something, she did all she could to follow through with it.
And in the past two years, Nichols co-founded the Lincoln Community Health Center Foundation. The goal of the foundation is to secure funding so the nonprofit will be less dependent on mercurial funding sources such as government agencies and grants.
Nichols fellow board member, Carolyn Henderson, said the word that comes to mind when she remembers her friend is warrior.