Keith D. Gray ’90, MD, MBA, FACS will speak at NCSSM’s 38th Commencement ceremony honoring the Class of 2019 on Saturday, May 25.

The summer heat in the tobacco fields near Snow Hill, North Carolina, is stifling at 6 in the morning. They come to the fields early — 15 year-old Keith Gray, his devoted younger brother Kendrick, and the adult laborers — to get a jump on the blistering sun yet to rise. But the previous day’s heat has never really left, having simmered in the night between long rows of tall, still tobacco.

Keith sweats in the dawn next to Kendrick as they ride the tobacco harvester, his hands tacky with the residue of tobacco leaves that won’t come off for weeks even after he starts back to school. They will be out here until 6 in the evening, a 12-hour day in the fields and curing barns for the rest of the summer. Keith will do this every summer until starting his sophomore year of college at Wake Forest.

This wasn’t Keith’s idea, cropping tobacco. Absolutely not. This was the doing of his parents. It wasn’t reckless parenting nor punishment for some youthful transgression. It was a decision made with Keith’s future in mind, a life lesson in the value of hard work and a foundation for the appreciation of life’s later luxuries. And it was history and tradition, too, these tobacco days, handed down like DNA in his blue-collar community where everyone ended the day the same — hot and sweaty and tired.

Thirty-two years later, Keith Gray — Dr. Keith Gray, surgical oncologist and Chief Medical Officer at the University of Tennessee Medical Center, Knoxville — wouldn’t change any of it. “Not one thing,” he says with absolute certainty. “It was the most impactful time period in my life.”

Something incredible happened in those endless green tobacco rows, something beyond the overlooked valor of the working class. A surgeon was formed — or the ambition of one — and that would soon lead Keith to the North Carolina School of Science and Mathematics.

“I want to be a surgeon”

Thousands of times each summer, at each tobacco plant, Keith reached around and behind the stalk, then drew his hands toward himself as fluid and graceful as a confident swimmer. Each stroke drew a handful of yellowing tobacco leaves into his grasp like playing cards. Onto the harvester by his brother went the leaves. And then came the next stalk. And the next stalk. And the next.

Keith liked it. Not the early morning awakenings, of course. Not the burn of sweat in his eyes or the gummy, sticky mess of his hands. But he liked that sweeping motion as he collected the leaves, the feel of something in his hands, the understanding that his muscles, his arms, his hands and his fingers were precision tools capable of changing the environment around him.

He liked something else, too, something some might have considered surprising for a teenaged tobacco cropper and school baseball and basketball player. Keith liked anatomy and physiology, part of an advanced biology course he had taken with Mrs. Vera Russell during his just-completed 9th-grade year at Greene Central High School. In the years ahead, and until she passed away, Mrs. Russell would continue to send Keith notes of encouragement as he achieved milestones in his academic and professional career.

“Anatomy made sense to me,” Keith says. “It spoke to me. You know, if you think about how the bones and the muscles and the tendons and the ligaments and all that stuff work together, it’s physics. It’s a series of levers and lever arms and pulleys and all this other kind of stuff, and so it made sense; it was predictable, and it was just fascinating. It just made sense, man.”

As Keith and his brother kept their hands busy in that thick-hot tobacco field, their brilliant and curious young minds wandered. They talked across the row of tobacco about the previous school year, plans for the summer. And then Kendrick asked his older brother that inevitable question: What do you want to be when you grow up?

My hands, my mind, Keith thought. Anatomy and physiology. “I think,” Keith said, “I want to be a surgeon.” It was a simple thing and sudden, this declaration.

The tractor plodded along. The snap of another leaf pulled. Another drop of sweat shed. The rest of the day lay before them — the rest of their lives. More than 30 years would pass before Keith and Kendrick (who’d become a dentist) discussed together the trajectories of their professional lives.

That evening Keith told his mother of his plan as she stood at the stove preparing the family dinner. Mrs. Gray exemplified the ethics Keith would emulate. Though working full time for Pitt and Greene Electric Membership Cooperative (where she advanced through the ranks before retiring after 40 years as Director of Office Services), raising two young boys with their father, and managing the home, she had also just begun taking college courses in accounting, a track she would follow as time and energy allowed, until finally receiving her degree 18 years later.

“Kendrick and I were talking today and I think I’ve decided what I want to do,” Keith said.

“What’s that?” she replied.

“I think I want to be a surgeon.”

Mrs. Gray stirred the sauce pan of food, adjusted the heat. “How about surgeon general?”

“There was no turning back”

The North Carolina School of Science and Mathematics made a brief appearance in Keith’s life when an admissions officer visited his school when he was in eighth grade. Keith couldn’t imagine trading his friends, his family, his community, and his position as an accomplished student in his home school for a distant school filled with strangers. No way. But it was out there now, this idea of becoming a surgeon. It had passed Keith’s lips and was alive and real.

His mother suggested he revisit the idea of NCSSM. He applied, was accepted, and enrolled, a big step for the small-town family boy, the first step toward realizing the dream formulating within him. And it got off to a rocky start.

“I was as homesick as I’ve ever been,” Keith says. “I missed my brother more than anything. But after the first six weeks I kind of got the hang of that thing, made some friends, and there was no turning back. I loved it. I absolutely loved it.”

Keith’s shaky transition to NCSSM was tempered somewhat by the fact that he joined there two other students — Brent Goff ’90 and Beth Krodell ’89 — from his home high school in Snow Hill. He made life-long friendships with students new to him as well, students like Tim Evans, Derrick Hines, Amy Sigmon, and Michael Armstrong, all Class of 1990.

All these years later, Keith is struck most by his classmates’ humility. After every extended break, Michael Armstrong’s mother sent cake back to school with him. Keith would join him and others for all-night cake eating and study sessions. And while Keith tried to stay awake, studying and eating cake, Armstrong, who Keith says was “so super bright he didn’t have to study very much,” continually fell asleep.

“The guy turned out to be a Morehead scholar, played football at [UNC] Chapel Hill, and today practices as an OB-GYN,” Keith says. “Tim went on to Harvard and now practices Native American law, and Derrick went to Morehouse and is a psychiatrist. Amy is a District Court judge.

“These people had so many gifts and talents,” Keith continues, “and yet there was just this sense of equality and humility at the School of Science and Math. There was no arrogance. You could [just] be yourself. That’s what stands out.”

Keith graduated from NCSSM with a copy of Ben Carson’s book “Gifted Hands,” a present from his mother. Though Keith’s own family and environment were stable and supportive, he still found inspiration in Carson’s story of struggle and achievement. If a young man of color could rise from the depression of inner-city Detroit to become a renowned neurosurgeon, then Keith could certainly find his way from the tobacco fields to a surgical unit.

“I don’t really know how to do this,” Keith recalls his mother telling him as she presented him with the book, “but let’s just do what he did.”

Keith entered Wake Forest University as an undergraduate that fall, and then later gained acceptance into the Wake Forest School of Medicine. Though studying in a city synonymous with North Carolina’s tobacco industry, he would never again snap a leaf of tobacco from its stalk.

“A celebration for all of us”

In the winter cold of January and February 1998, with medical school complete, Keith set out for a tour of residency programs in the southeast. Not particularly fond of flying (“If it’s six hours away or less by car, I’ll drive it”) he climbed into the 5-speed Nissan Altima he and his brother had once shared to visit schools in North Carolina, Kentucky, Tennessee, and Florida. He asked his father, a quiet, hard-working man who spent 30 years of his life building tires at the Bridgestone plant in Wilson, N.C., to come along on the out-of-state trips.

Fleeting moments, they would be, and precious. Off they went, father and son, a man with hands strengthened by manual labor alongside another with hands becoming skilled at medicine. Gainesville, Louisville, Nashville, and Memphis all loomed in the distance, then receded in the rear-view.

Smoothing the highway were the sounds of soul, rhythm and blues. Another of his father’s influences. The Manhattans and Teddy Pendergrass – especially Teddy Pendergrass – played over and over and over through the car stereo.

In Memphis, they settled into a spot at B.B. King’s Blues Club. On stage the Boogie Blues Band tore through songs Keith and his father both loved. “I’ll never forget it,” Keith says. “I remember it like it was yesterday. We just had a blast.”

In Nashville, they toured Vanderbilt University. Having heard Keith talk so fondly of him in his interview for the residency program, the program director, Dr. John Tarpley, asked if he could meet Mr. Gray. Keith introduced them. The doctor shook the tire-builder’s hand and said, “We want your son here.”

“Man,” Keith recalls. “My dad was so proud.” And that’s when it creeps in, the slightest of shifts in Keith’s voice that says there may very well be a tear in his eye, a tingly sensation in the tip of his nose. “It was,” he finishes, “a celebration for all of us.”

“NCSSM taught me that I could”

The next several years became a blur of accomplishments. After residency at Vanderbilt, Keith continued his career at MD Anderson Cancer Center, then joined the staff at the University of Tennessee Medical Center as a surgical oncologist where, during his original job interview in September of 2006, his future mentor, Dr. John Bell, pushed a blank sheet of paper across the table and said to Keith, “You decide how you want your career here to look.”

Today, that career has a new look. Keith is now the chief medical officer and senior vice president at the University of Tennessee Medical Center. He assumed the position March 1st.

“[NCSSM] taught me I could be as good as anybody else,” Keith says. “It taught me that I could run with the big dogs. Can I do it? Can I hold my own? It taught me that I could. It got more challenging as I went along, the stakes kept getting higher and higher and the competition kept getting stiffer, but I still was able to hold my own, and I attribute that to the confidence I gained at NCSSM.”

Despite his new position, Keith won’t hang up his scrubs. Half his time will be spent in the administrative role, and the other half will be right there in surgery with his patients. But that small-town fellow raised up in tobacco fields is still there. The first picture to hang on Keith’s new office walls was a family photo. The second was a painting of a Snow Hill tobacco barn created by a hometown artist.

Before every surgery, Keith meets with his patients to discuss the procedure, then asks if he might pray with them. As a man of Christian faith he draws strength from his religious convictions.

Never has a patient said no. In fact, quite often, they now ask him for a prayerful moment together.

As the moment for surgery arrives, Keith steps to the sink to scrub in. That’s when he sees it again. In a room overflowing with intellect, achievement, ambition, and advanced equipment, there’s tobacco gum in Keith’s memory, in his past.

He scrubs a little bit harder, preparing for the present, polishing the past.

More information about 2019 Commencement

Update: Watch a video of the 2019 Commencement ceremony including Dr. Gray’s address.