BUILDING TRUST IN PRIMARY AND RURAL HEALTH CARE
Paul and Dr. Emily Bray have put their trust in East Carolina University to further rural primary health care training and provide care for underserved patients in the region. The couple’s gifts foster the memory of their daughter, Dr. Katherine (Kati) Bray-Strickland and honors their deep passion for rural primary care.
The Brays created the Maine Farm Trust in support of ECU through a Flip Charitable Remainder Unitrust (Flip CRUT). The trust was created with a unique property in Maine that functioned as a wedding venue and bed and breakfast destination. The property was transferred to the ECU Health Foundation and the proceeds established a CRUT. The trust earns interest and will grow over time based on the market and is set up to distribute quarterly payments to the Brays. At the end of their lives, the remaining balance will come to ECU.
“We felt like we were privileged, and we would like for future generations to have the same opportunities to give back,” Emily said. “It is rewarding to see our savings help the institution continue to support program that we believe in.”
The Brays were “recruited to ECU” and moved to Greenville with their daughters, Kati and Josie, in 1999 to work at the Brody School of Medicine and in rural health care management in eastern North Carolina.
“They (ECU) were looking for a family doctor who delivered babies,” Emily said. “We both decided it was a good time to make a change.”
Emily has served as assistant residency director and a clinical associate professor in ECU’s Department of Family Medicine. She specialized in family medicine, training future physicians in primary care, obstetrics and geriatric medicine. Emily retired from clinical teaching in 2024 and continues to do some administrative work at Brody.
Paul is co-director of the Eastern Carolina Association for Research and Education (E-CARE), a network of clinicians formed to ask and answer clinical and organizational questions central to primary health care. Through E-CARE he manages a diabetes self-management education and support program at 11 eastern North Carolina clinics. He also serves as an assistant research professor in the ECU department of family medicine and coordinator of diabetes quality initiatives.
“It’s a very important job in eastern North Carolina, especially,” he said. “It’s really a very hand-in-glove relationship with the primary care physician.”
Emily and Paul have a first-hand understanding of what’s expected of a medical professional who accepts rural residency and potentially a more
rural lifestyle than being a metropolitan area. The two attended state universities with the lowest tuition they could find – the University of Illinois and Southern Illinois University – allowing them to complete their education with minimal debt. They are proud they can make a similar opportunity possible for future ECU students.
“We both came from pretty modest families,” Emily said. “Our families helped us the best they could. We both worked in high school and college and we both had the benefit of some scholarships.”
Because of their low debt, they were able to follow their desire to providing health care to vulnerable populations, which started out in inner-city Chicago and then in rural Maine. For the first 20 years they were able to make their professional lives work on average salaries, because they didn’t have a huge burden of debt.
“That experience has been really forefront in our thinking with our investments,” Paul said. “The whole notion is helping medical professionals, both physicians and nurses, to end their study with a lower debt [load], which would allow them to serve in communities where their salaries would not be as high.”
RURAL RESIDENCY
During their years in Maine, Emily attempted to start a rural residency program. She visited Greenville to learn about the Brody School of Medicine because of its mission to increase the supply, quality and training of primary care physicians in the region and state. While the idea did not take shape in Maine at the time, Paul and Emily were impressed with ECU and the health system and the leaders at Brody remembered the Brays.
“Everyone was really sincere in the mission,” Paul said.
Emily echoed the sentiment, describing the focus on rural health care as the most genuine of any place they’ve worked. “Here at ECU, we have programs that are focused on the most vulnerable populations. There is a credibility in our mission statement. I’m proud of our graduates and I’m happy with the general way we train people.”
Acting on the needs of the state’s rural residences also drew their daughter, Kati, to attend Brody after graduating from the University of North Carolina – Asheville.
“Part of her choosing to come back for medical school at ECU was because of the focus in ECU of primary care and of rural health in general,” Emily said. “That was very important to her and has really been very important to us. I guess she listened to us enough at the dinner table about people’s needs. She had a heart for rural medicine.”
Dr. Katherine Bray-Strickland was a family medicine resident at ECU when she died in 2010 at only 27.
“When she passed away, we were grief struck and we also really appreciated the support that she and we as a family had from the whole ECU community,” Emily said. “I don’t think I could have been happier with how, for instance, my boss and the whole department plus the whole medical school really helped to support her in getting through medical school and all sorts of challenges she had multiple times in the hospital.”
When the Brays began to consider how to honor their daughter and support the future of primary care, ECU felt like the right place to see their vision come to fruition and grow.
“It seemed right for us to try to establish a way for people to remember her. So, basically I did that through payroll deductions for a number of years to the point that it grew to the point of an endowment,” Emily said.
Over time the Brays were able to fine-tune how the endowment was worded, and now the endowment provides a scholarship to those who hope to do “the kinds of things we thought Kati would do if she had been able to go into practice. She was taking care of people who were underserved,” the Brays said.
The couple said they didn’t recognize the depths of Kati’s passion for rural health care until after she died as they heard so many people talk about how amazingly supportive Kati was in their struggles.
“I guess, you know, sometimes you don’t see it right under your nose. And of course, maybe you over dramatize people who die as to being more of a saint than they were,” Emily said. “Turns out, everyone else saw her as the same as [we did].”
Funds from the Maine Farm Trust will allow Kati’s endowment to grow. The Brays said when they learned that they could give property to the foundation to create a trust, focused on their prioritites, it made complete sense.
The Brays decisions to build the trust will continue two traditions that have been important to their family – rural health care and a family farm and wedding venue in Maine.
The new owner of the Maine property has been connected to the property for generations and is fulfilling a life-long dream to return to the farm. His grandmother also was a caregiver for the Bray’s daughters when they were young.
“Our daughters did not want to leave Maine, so on a whim, we decided that rather than sell it, we would see if we could rent it,” Emily said. “Over time it became a family event venue; and eventually we gutted the barn and turned it into a wedding venue.”
“Kati hated to leave [Maine], but once she got here, she loved it,” Emily said. “She met the love of her life, David Strickland, and thrived.”
FURTHERING RURAL HEALTH CARE
Their gift also created a smaller endowment in memory of a friend that will provide funds for nurses to do continuing education in diabetes care.
“She was a nurse in post op here at ECU Health (Vidant) and she also had Type 2 diabetes,” Paul said. “I think we’ll have memories of two very good people in the system that will continue on.”
“It’s kind of a win-win,” Paul said. “Assuming that ECU continues to be true to the mission for the rural areas, this is ideal if we can start to build that endowment that’s going to be, you know, not necessarily something we’ll see in our lifetime, but some years from now.”
