In the heart of eastern North Carolina, at ECU Health Edgecombe Hospital, my brother Kenneth and I have quietly built a legacy of service, scholarship, and synergy. As identical twins, Kenneth Gregory, DNP, FNP-C, and I, Richard Gregory, DMSc, PA-C, have spent more than a decade working side by side in the Emergency Department, where our collaboration feels as intuitive as it is impactful.

I have spent most of my life walking in step with my identical twin brother, Kenneth. From our childhood in eastern North Carolina to high school classrooms, to the U.S. Army, and eventually to ECU Health Edgecombe Hospital, our paths have rarely drifted apart. Working side by side in the Emergency Department for more than a decade has felt like a natural extension of the bond we have shared since birth, an unspoken rhythm and a quiet synergy. People often assume we planned it this way, but the truth is that we have simply always supported each other. That was true when I became a Physician Assistant and he pursued nursing. It was true again when we both decided to return to school to earn our doctoral degrees.

In 2025, we achieved a milestone that still feels surreal. Kenneth earned his Doctor of Nursing Practice from East Carolina University, and I completed my Doctor of Medical Science (DMSc) at A.T. Still University's Arizona School of Health Sciences (ATSU-ASHS), where I served as Vice President of my class. Even though our programs were different, our purpose was the same: to grow, to lead, and to make a meaningful impact. We pushed each other through long nights and demanding weeks. Our conversations were not always about assignments. Often, they were simple check ins about rest, burnout, or whether one of us needed a reminder of why we started.

We have always had an unspoken agreement that if one of us advanced, the other would not be far behind. My decision to pursue the DMSc came from a desire to expand my impact beyond direct patient care. With more than 25 years in healthcare, including 10 in family medicine and 15 in emergency medicine, I felt driven to strengthen my leadership skills and contribute more intentionally to evidence-based practice.

My doctoral research focused on the use of low dose ketamine for acute pain management in adults in the Emergency Department. With opioid stewardship in mind, I created a decision tree to help clinicians implement an already active protocol across the ECU Health system. It is work I am proud of. It aims to improve pain management while reducing reliance on opioids.

Kenneth’s doctoral project addressed the challenge from another angle by integrating transitional care for patients with opioid use disorder into the Emergency Department. We have always approached problems differently, he from a systems and operational standpoint and me from education and clinical practice. That complementary perspective is part of what makes our teamwork so effective. Even now, with our degrees completed, we still talk about the same things. How do we advocate for rural healthcare? How do we elevate the culture of excellence at ECU Health? How do we ensure that every patient encounter reflects compassion, innovation, and evidence-based care?

One of the most meaningful parts of this journey has been sharing it with my son Brendan, who is currently serving in the United States Coast Guard. I wanted him to see that determination and hard work can make anything possible, even when you are balancing school, family, and full-time clinical work.

When people ask for advice about pursuing advanced education, Kenneth and I say the same things. Kenneth always tells them, do not pursue a degree for the title. Do it to solve a problem that frustrates you. Purpose will carry you when motivation fades. For my part, I tell them, do it. Do not let fear get in the way. Advanced education will challenge how you think and ultimately make you a better clinician, communicator, leader, and advocate.

Our story is not about perfection. It is about perseverance, purpose, and partnership. It is about two brothers who chose to grow together, to serve together, and to build something meaningful at ECU Health Edgecombe Hospital, one patient, one project, and one milestone at a time.

Story written by Amy C. Dixon about Richard Gregory