As a teen, Tom Howerton had a job driving an ambulance around Durham, sometimes delivering passengers to a hospital and sometimes to a funeral home.
In the 1930s it was common for a hearse to double as an ambulance, as was the case at Howerton & Bryan Funeral Home. Howertons tenure working for the home was short, but it had a lasting impact.
Dad said he started thinking he wanted to be working with the living and make them healthy rather than work with the dead, said Tom Howerton Jr. of Smithfield, the oldest of his four sons.
The older Howerton, who died last month at 91, went on to become a top administrator at hospitals across the state. His most challenging and rewarding post was that of Durham Regional Hospital, originally called Durham County General Hospital and soon to be Duke Regional Hospital. Under his leadership, the citys black hospital and white hospital merged, and colleagues say that turbulent transition could not have been handled by a gentler soul.
Born and raised in Durham, Howerton was attending Duke University when his studies were interrupted by World War II. He joined the U.S. Army during his senior year and was stationed at a hospital unit in England.
He learned to appreciate the socialized medical system in Britain, and upon his return he focused his studies at Duke University on hospital administration. He soon embarked on a 40-year career that saw him leading hospitals all over the state.
Affordability and accessibility were big words with Tom, said Ed McCauley, a former colleague and longtime friend.
Howertons first job was with the N.C. Medical Care Commission, and in 1950 he became administrator of Moore Memorial Hospital in Pinehurst. A decade later he left to oversee the creation of Wilson Memorial Hospital.
His experience in building a hospital from scratch made him an ideal candidate in Durham, his family said that, and his status as a local boy.
Coming back to Durham was never really a hard sell for him, Tom Howerton Jr. said.
Back in the Bull City, Howerton became executive director of the Durham County Hospital Corporation, the entity responsible for merging Lincoln Hospital and Watts Hospital, Durhams black and white hospitals, respectively.
It was the early 1970s, and in the wake of the Civil Rights movement, neither hospital was particularly eager to join forces. There was not a significant disparity in care between the two, and both served as community hospitals catering to people within their respective parts of Durham. A merger meant some staff would be let go, but unless they integrated, state and federal funds would be withheld. So began the complicated process of incorporating the two into Durham County General Hospital.
McCauley, who worked under Howerton at this time as administrative director of Watts Hospital, said Howerton had many issues to deal with and people to keep happy and he did so with grace.
I dont think I ever heard anybody criticize Tom, McCauley said.
When a location north of downtown was chosen for the new hospital, Howerton had to manage the uproar from both communities. Some wanted Watts to expand its campus to absorb Lincoln. Many in the African-American community were frustrated there was no bus line running from the historic black neighborhood in which Lincoln sat to the north Durham site, across town. The location was ultimately chosen because it used land already owned by Durham County.
Howerton managed to assuage fears and anxiety without offending, colleagues said. Colleagues were in awe of his ability to be diplomatic but not pedantic, sensitive but effective. He was known for fairness in all things.
He was a calming influence in a time there was an awful lot of unrest in the community, said Richard Myers, a former Durham Regional CEO. He had the ability to work out problems by talking them through and reaching consensus. He really knew how to interact with people that really had strong opposing views.
Once the doors to Durham County General Hospital opened in 1976, Howerton became CEO. He managed the integration of staff from both hospitals, all while the health-care landscape was changing dramatically.
At the start of Howertons career, hospitals did less competing with one another and more supporting, Myers said, often lending supplies to one another and sharing staff during shortages.
That changed during his tenure.
If you didnt produce a surplus you would die, and if you werent careful the hospital across town would put you out of business, Myers said.
Howerton taught staff members such as A.J. Vericchia that providing service was the ultimate goal of a hospital. Howerton brought Vericchia from Wilson, where he had started out as an electrician and risen to chief engineer, to Durham, where he became vice president of operations and oversaw nine departments.
Vericchia said Howerton taught him how to be a leader and a gentleman. Howerton also encouraged Vericchia to seek additional training and education, offering to pay for professional enrichment.
I became president of a national organization, and it was because of all the things he did for me, said Vericchia, who at one point headed up the American Society for Healthcare Engineering.
Id run for President, but Im afraid Id win, he laughed. My self-confidence was built through Tom Howerton.
When Howerton retired from Durham Regional, he became a board member of the hospitals Foundation for Better Health of Durham. One of his projects involved improving access to medication for the elderly. He became one of six program developers of Senior PharmAssist, a nonprofit agency that guides geriatric patients as they obtain prescription medicines.
He definitely had a huge heart for people who werent as wealthy and who were struggling. We were called the City of Medicine then, and he felt rightly so that that should be for all people, said Gina Upchurch, founder and executive director of Senior PharmAssist.
Howerton was diagnosed with Parkinsons Disease about 10 years ago, and he lived out his final years at Durhams Hillcrest Convalescent Center. Until recently he was still eager to engage in conversations concerning the state of health care.
Ultimately, friends and family seem most struck by his relentlessly positive attitude toward all things.
No matter what, thats how he looked at life, said his son David Howerton of Greenville, S.C.
About 15 years ago, David Howerton competed in a bike race, and his father was there to watch him finish. It was a less than stellar showing for the athlete, but once David Howerton saw his fathers face he could not feel defeated.
You would have thought Id won an Olympic gold medal, the son said. Hes the type of person who made you feel like that.