Lincoln slept here

Across the continent, some U.S. cities are proving they can keep faith with the fascinating past while they move into the roaring present - and the health care of the future.

By Eileen Lockwood | Live & Practice | Spring 2012

 

What makes a place historic?

A hard-and-fast definition is elusive, but here are some likely possibilities. Maybe an important event took place there, such as the turning-point battle in Gettysburg, Pa. Or maybe it was the starting point of a significant expedition, such as the three-year Lewis and Clark Voyage of Exploration that departed from St. Charles, Mo. Perhaps it’s America’s oldest continuous state capital (Santa Fe, N.M.), or the seafaring tradition of Mystic, Conn.

These are four examples of cities whose residents take pride not only in maintaining their historic ambience, but also in working to move into the modern world.

With the exception of Mystic, which has a walk-in clinic, each supports at least one state-of-the-art health care facility with frequent employment opportunities for physicians.

End of the trail: Santa Fe, N.M.

In 1821, a Missouri trader, William Becknell, packed merchandise onto the backs of mules and headed southwest to an area many pioneers to follow would define as “The Land of Enchantment.” This year, New Mexico marks its centennial of becoming the 47th state. However, in 2011, Becknell’s destination city, Santa Fe, celebrated the 400th anniversary of its founding by the governor of the then-Spanish territory. Today, it’s the oldest continuous capital city in the United States—and, at 7,260 feet, it’s also the highest. (In actual age, St. Augustine, Fla., surpasses it by 46 years.)

Santa Fe is here to stay, and so is its enchanting 1600s appearance. In more recent years, most new buildings have maintained traditional pueblo-style adobe façades, and since 1961, a determined preservation group has acted to save other historic properties.

The architecture, landscape and culture of Santa Fe attracted neurosurgeon James Melisi, M.D., who moved with his wife from the East Coast. He’s also found a chance to grow as an amateur photographer.

Almost two centuries after Becknell’s first trek, New Mexico became virgin territory to neurosurgeon James Melisi, M.D., and his wife. Melisi is one of four partners with CHRISTUS St. Vincent Neurological Associates, affiliated with the regional medical center. Their new location came as a surprise to both of the Melisis. He had lived, been educated and practiced in East Coast locations, most recently in the Washington, D.C., area.

“I had been in practice since 1986 and part of a neurosurgery (group). The rest (of the time), about 12 years, I was in a very busy solo practice,” Melisi says. “But neurosurgical practices have started to change their scope, and costs of running a solo practice have changed dramatically. I found it very difficult to financially run a busy practice and also to get coverage for it. So that was the impetus to start looking in other places. My wife and I looked at each other and said, ‘We don’t have to spend the rest of our careers and lives in a major metropolitan city.’”

He began looking around. “We got a cold call one day from the hospital in Santa Fe. They asked if I’d like to speak to someone there. I told my wife, ‘Hey, they want to take us out to Santa Fe. I think I need to look on the map.’”

The change between super-congested Washington and the expansive, mountainous terrain of New Mexico was extraordinary. “We landed in Albuquerque. As we drove closer and closer to Santa Fe, we said, ‘Wow! This is really kind of nice.’ The more we looked, the more we fell in love with the area.”

He joined the CHRISTUS St. Vincent family a year ago, and he’s still sold on the Land of Enchantment. “We fell in love with the architecture and with the landscape. The melding of cultures is what we also find so interesting.” Not to mention the pleasant people of Santa Fe itself.

It’s no surprise to Melisi that artists over the years have been drawn to the area by, as he puts it, “the different colors of the mountains, the blue, blue skies and the red rocks. There’s a lot for an artist to utilize.”

The area has been a magnet for painters since the early 1900s. New arrivals formed groups such as the Santa Fe-Taos Art Movement and The Santa Fe Program, with their works now featured in the New Mexico Museum of Art. One of the newest exhibition sites is the Georgia O’Keeffe Museum, opened in 1997. Exquisite art pottery from several of the state’s 19 Indian pueblo communities is ubiquitous, not to mention some 250 art galleries in the city. Probably most enchanting is the Indian market in the shady portal of the 1610 Palace of the Governors, which shares the main square with the magnificent Basilica Cathedral of St. Francis. The largest Hispanic art event in the U.S. takes place every July.

Santa Fe’s historic atmosphere has probably been a factor in the rise of what the Convention and Visitors Bureau cites as “a museum for just about everybody, toddlers and teens included.” The current total is 12, the newest of which is the New Mexico Museum of History, which opened in 2009. Near the edge of town, on Museum Hill, aficionados can visit four institutions devoted to Indian, Spanish colonial and folk arts, history and culture.

Rounding out the cultural scene is the now-famous Santa Fe Opera, a mainstay of summer activities. “To many minds, it’s second only to the Metropolitan in New York,” Melisi reports. He was surprised by another local advantage. “There are a lot of people who moved here from other big cities who demanded the culture but not the population. (For instance), we have hundreds of restaurants in this town of 100,000.”

But Santa Fe is hardly all arts and ambience. As Chamber of Commerce President Simon Brackley explains, “What Santa Fe really has going for it is quality of life, including arts, climate, culture—and recreation. This is a place where you can ski in the morning and play golf in the afternoon.”

It’s also a place where most people can find serious employment. The Chamber lists some 1,200 member businesses.

CHRISTUS St. Vincent contributes its fair share to the job force. It’s the umbrella for 380 physicians among a total of 1,450 employees.

Santa Fe Indian Hospital, the other, much smaller, general health care facility, has a physician roster of 19.

CHRISTUS St. Vincent is a descendant of the facility founded in 1865 by the Sisters of Charity as New Mexico’s first hospital. In 2008, it joined the CHRISTUS organization. It’s the largest hospital facility between Albuquerque and Pueblo, Colo. Last May, negotiations began for the purchase of the Hospital and Physicians Medical Center, which now coordinates services of ERs in the area. A new sports medicine program fills a 10,000-square foot complex.

Last June, the hospital foundation initiated a Healthcare Exploration Program, which gives high school students a chance to “develop their interests in the medical field.”

CHRISTUS St. Vincent serves some 300,000 residents of seven counties. Melisi became the fourth neurosurgeon on staff, which now allows the hospital to provide full-time coverage in that specialty. There’s an added plus, he says. “Because this is a relatively small town, we don’t have the competition of several major universities nearby, and as neurosurgeons, we really get to see a larger variety of patients. That’s extremely interesting from a professional standpoint.”

New Mexico has provided another, somewhat unexpected, outlet for Melisi’s creativity. “I could expand my amateur photographic abilities.” In fact, in January, “someone saw some of my photographs in my office and asked me to put them up in a coffee shop gallery. So I did. It was my first photo exhibit.” The outcome: “I had three sales on the opening day.”

Proceeding on: St. Charles, Mo.

They were two unlikely partners in a great adventure. One was a secretary to the president of the United States, the other a career military man. Together, in 1804, Meriwether Lewis and William Clark left from St. Charles, Mo., on one of America’s most fabled expeditions, charting territory destined to become nearly two-thirds of the land area of the United States.

Clark wrote that they departed with cheers from men on the bank, “and proceeded on…”

The two explorers are well remembered in this city on the Missouri River. Among “memorials” is Lewis & Clark’s Restaurant, not far from the shore where their group pushed off aboard a 55-foot keelboat and two pirogues (canoes hollowed out from tree trunks). The local population was 450.

The city itself has also proceeded on over the years. Founded in 1769 by a French Canadian fur trader, the first European settlement on the river became a thriving trading hub and outfitting center for westbound pioneers. Daniel Boone, the celebrated outdoorsman, lived nearby for the last 20 years of his 85-year life.

Today, with almost 66,000 residents, St. Charles is the seat of Missouri’s fastest growing county, the third largest city in the St. Louis metro area and home to thriving commercial and mixed-use developments, mostly along the feeder Route 370 from Interstate 70, Missouri’s major east-west artery.

Nevertheless, St. Charles still boasts the oldest and largest historical district in the state. “I think we have a nice mix of the old and the new,” says Wendy Rackovan, the Chamber of Commerce marketing/communications VP.

“The historic area is definitely our sweet spot,” says Carol Felzien, the Convention and Visitors Bureau communications director.

Joseph Beckmann, M.D., agrees. The family medicine practitioner returned to his boyhood area last June when he joined SSM Medical Group, an arm of SSM Health Care in St. Louis. St. Joseph Health Center is SSM’s St. Charles affiliate.

Beckmann lives and works in the nearby town of St. Peters. “When I was growing up,” he says, “all of the area that I’m in now was farmland. Today the whole area is growing a lot, but the interesting thing is that you still have that nucleus of old-town charm. (Both) old-town St. Peters and old-town St. Charles are very similar to what they were before I left.”

Beckmann returned after a long hiatus during which he completed all of his education and specialty training in Missouri institutions. He then stayed on for 16 years as medical director of the rural teaching practice operated by the University of Missouri School of Medicine, with two more years practicing at the University Family Medicine Department in Columbia. At that point, he says, “I was ready for a change, although the biggest reason was to be closer to my mom and dad. They’re getting on in years, and I wanted to be able to help them.”

Then, almost out of nowhere, came a once-in-a-lifetime moment.

“My father was playing golf with my old high school principal and happened to mention that I was looking to get back to the area. (Later) the principal saw the guy who’s my current partner, who (said) they were looking to recruit somebody. And here I am. I told Mr. Buhlig that he was the best principal in the world. He was still getting me a job after 30 years!”

While St. Charles beckons with its old-time charm, SSM Medical Group glides along a cutting edge. The practice has almost completed an electronic system, MyChart, allowing patients to check their medical records online.

Beckmann says, “I think SSM is far ahead of the curve compared to my experience with the University (of Missouri) and really any other practices that I’ve seen.”

St. Joseph Health Center itself, in a $30 million renovation surge, has, among other projects, rebuilt, modernized and more than doubled its emergency department, upgraded its Family Birthplace, and created new ICU, OB and nursery, an orthopaedic floor and a 33-bed long-term, acute care “hospital within a hospital.” Even before its renovations, though, the SSM system in 2002 became the first of kind in the U.S. to win the highly prestigious Malcolm Baldrige National Quality Award.

In spite of St. Charles’ new developments, the still-thriving multi-block South Main Historic District offers an enticing cluster of eclectic shops, homes and “tourable” buildings.

It’s unlikely that St. Charles can be outdone when it comes to community celebrations, including the annual Fěte de Glace in January when participants carve sculptures from 260-pound blocks of ice.

But Christmastime festivities trump all others. Starting the day after Thanksgiving, the activities seem endless.

Costumed historic characters populate Historic Main Street. There’s a Las Posadas reenactment of Mary and Joseph seeking shelter, plus Christmas for Veterans, Candlelight Christmas Walk and the Santa Parade with Santas, elves, snowmen, Victorian carolers and other groups.

But hardly any can beat the lure of Santa’s North Pole Dash and Children’s Snowman Shuffle.
Adult runners and walkers purchase red shirts, hats, beards and “holiday spirit” bracelets by the dozen—and off they go.
The cheery reward afterward is free drinks at participating restaurants.

Two and a half minutes: Gettysburg, Pa.

On Nov. 19, 1863, President Abraham Lincoln delivered a speech at the Gettysburg Pa., battlefield that would resonate throughout American history.

The Union Army had won the victory that signaled the end of the Civil War, but had also cost 51,000 dead and wounded. Lincoln had come to dedicate a national cemetery. Contrary to persistent lore, he did not dash off those 272 words (10 sentences) on the back of an envelope, reports Carl Whitehill at the Convention and Visitors Bureau. The now-immortal speech was composed in Washington and refined at the home of a local attorney, David Wills, where Lincoln spent the night before delivering it and which is now one of several historic buildings open to visitors.

The main speaker that day was Edward Everett, a well-known scholar and politician. His talk dragged on for more than two hours. Lincoln followed him on the dais. Everett later wrote to the president, “I should be glad if I could flatter myself that I came as near to the central idea of the occasion in two hours as you did in two minutes.”

These are anecdotes that circulate as visitors—some three million every year—tour the famous battlefield and adjacent home of President Dwight D. Eisenhower. The onslaught dwarfs the resident population (7,620) with many more visitors expected during the Civil War sesquicentennial. Battle reenactments and activities at both the National Military Park and in connection with the Eisenhower house continue to attract devotees.

Whitehill says that 2013, “the 150th anniversary of the Gettysburg battle and the Lincoln speech, will be our absolute big year.” Special events are planned throughout the year, including reenactments of the speech. “In Gettysburg, we celebrate it every day.”

Orthopaedic surgeon Kyle Messick, M.D., and family enjoy the historic battleground at Gettysburg.

Kyle Messick, M.D., can back up that statement. “I am interested in history,” he says. When he was a student at Penn State Hershey College of Medicine in the nearby chocolate capital, “whenever I had free time, I would often take the drive down (to Gettysburg) and wander around the battlefield. Since I’ve been practicing here, I’ve been learning more about the battle and getting a little more into the history. It was definitely a part of why I was looking into this area and why it appealed a little more.”

He also discovered a more modern and unexpected kind of history: World War II reenactments. “You’re not going to have any (authentic) place to reenact those battles here in the States,” he says. “So with the Eisenhower connection here, I guess it makes sense. But it’s funny to see people driving around in Jeeps and some of the old tanks.” But there’s something even more strange. “One of the things I’ve never quite gotten used to is seeing a bunch of Civil War reenacters and ladies in period dress with hoop skirts getting out of a minivan.”

Messick moved to Gettysburg in 2008 and is a surgeon in the city’s office of WellSpan Orthopedics, which is part of Gettysburg Hospital.

The hospital itself dates to 1921 but is now a WellSpan partner to the nearby and much larger York Hospital. It’s been cited for high-quality care in several areas. An $18.1 million emergency department expansion and modernization is expected to be completed this August.

Messick’s personal evaluation of the area is that it’s also “close enough to family (in New Jersey) but a nice small town and a nice environment. And housing is very, very reasonable, especially when compared to other places in the Northeast.” Philadelphia, Baltimore and Washington are also close enough for sports and entertainment getaways—and it’s not hard to get out of town. Several historic roadways converge at or near the town, including US 15 and 30 (the Lincoln Highway), making it a hub for Adams County.

The Chamber of Commerce lists more than 3,000 member businesses, including light aircraft manufacturing, commercial printing companies and the 2,500-student Gettysburg College. The county also encompasses more than 1,250 farms, whose apple crops make it the fifth-largest producer in the U.S.

The ubiquitous fruit—some 54 varieties—has, of course, spawned related industries, especially in nearby Biglerville, headquarters for the venerable Musselman’s applesauce company, now part of Knouse Foods.

Spring blossoms and fall harvest events attract thousands of visitors who visit many of the farms and taste not only apples, but seemingly every other apple-related product.

It would seem that Adams County might be the home of the old adage about an apple a day keeping the doctor away.

This isn’t necessarily true for Messick and his two partners. One reason is the sheer number of visitors.

“From a practice standpoint,” he reports, “it’s very interesting because you get to take care of people who come from all over the country, including international patients from England, Ireland, Belgium, Brazil, Italy… They twist an ankle or break a hip and need surgery while they’re here, so we spend a lot of time of them. There’s nowhere I would have that for a practice in a town of this size.”

A river runs through it: Mystic, Conn.

There are several misconceptions about the charming geographic entity generally known by outsiders as Mystic Seaport, at the far eastern end of Connecticut and on the Mystic River, which flows into the Atlantic Ocean.

Its residents—about 4,000—are proud of where they live and of its seafaring tradition. The shipbuilding industry is still alive and well in the area, with a major facility where General Dynamics manufactures submarines. They’re proud of its historic homes and buildings and today’s harbor with marinas and some 6,000 slips and moorings for boats along the river. They’re proud of their tradition as an arts community and of two superb, sea-related museums that attract thousands of visitors every year. And they’re proud that their town still prospers.

But they’d like to set the record straight on a few misconceptions.
1. The official name of the place is not Mystic Seaport. It’s simply “Mystic.”
2. Although it was homeport to some whaling ships, New Bedford, Mass., was actually the thriving center for that industry.
3. Mystic is a village, but is not now nor ever has been an actual incorporated city or town.

For U.S. Census Bureau purposes, it’s a CDP (Census Designated Place). For postal service purposes, it’s 06355. The CDP reasons are dense, but include such facts that the population at the time of the designation was too low for cityhood and that Mystic is actually part of two other cities. The latter is still true.

Mystic is actually a presence in cities on both sides of the river: Stonington on the east side and Groton on the west. They’re connected by a revered bascule bridge linking the two sides of Main Street.

Mystic itself has no government, but it does have a chamber of commerce, which lists as members Amarin, an international pharmaceutical company, and Easy Meeting, a video conferencing company. It also promotes Mystic’s historic downtown as a “fantastic retail” location and the area’s “wonderful beaches.” Its convention and visitors bureau recently separated from the regional tourism district and adopted the title “Mystic Country” to better promote the smaller area.

Although there’s no hospital, at least five specialists make regular stops for appointments at the Mystic Medical Center. Several other physicians have practices there, and two doctors staff the Seaport Walk In Medical Center. The Harvard Medical School also operates one of 34 research locations of its Joslin Diabetes Center. For more extensive care, patients can check in at Lawrence & Memorial Hospital, a short 20 minutes away in New London, a long-time—and state-of-the-art—fixture in the area. It celebrates its 100th anniversary this year. L&M also maintains an outpatient facility in Stonington.

Ken Donovan, M.D., a hospitalist who grew up and lives in Pawcatuck, Conn., another “CDP” nestled in the middle of Stonington, wears three medical director hats. He divides his time among Palliative Care Service at L&M, IPC Hospitalists of New London and IPC Hospitalists of Westerly, R.I. His job travel actually amounts to less time than if he were practicing in a large city, he says. “New London is 20 minutes away, and Westerly is 10 minutes away.”

Donovan offers kudos for his specialty. “I have practiced as a hospitalist since 2000,” he says, “and have found it very rewarding because of the acuity of illness we treat on a daily basis. Also, the intense nature of the patient interaction leads to strong bonds that form quickly.”

The good news for professionals seeking new challenges: “There’s certainly room for additional physicians in my specialty.” That goes for the palliative care field, too.

After leaving home for college, medical school and internships/residencies, he, with his wife and two children, decided to return to the coastal area in 2004. He quickly summarizes the reasons: “The Southeastern Connecticut area has wonderful communities (Mystic is one of them) in which to live, great public and private schools, close proximity to the beaches and shoreline and affordable real estate.” Not to mention “many unique attractions,” including the Mystic Seaport museum and Mystic Aquarium. As for sports, he’s recently joined a local country club and become an avid golfer. As for spectator sports, he’s a Red Sox fan, and he’s in luck—Boston is a mere hour and a half from the Mystic area; New York City not much further.

One item missing on his leisure CV is a boat. But the deficit may not last too long. “My kids are trying to change my mind on this one!”

Mystic, Conn., offers some 6,000 boat slips along the river. Residents and visitors also enjoy a museum, aquarium, and learning about the area’s seafering traditions.

Mystic may be a mere CDP on the government’s books, but it’s home to two five-star attractions. Founded by three residents in 1929, Mystic Seaport (hence the town name confusion), subtitled The Museum of America and the Sea, is now one of the foremost nautical museums in the world. Visitors can become immersed in multiple exhibits with some of the museum’s 2 million artifacts, but the main attraction is the restored 1841 Charles W. Morgan, the world’s sole remaining wooden whaling ship. In its 80-year career, it garnered more than $1 million for its owners. The ship also takes visitors on brief trips.

There’s never a dull time at the museum itself. A special exhibit, Treasures from the Collection, opened in March. Spokesman Dan McFadden says it contains “about 200 of the best, coolest, most notable things that we have.”

The Mystic Aquarium and Institute for Exploration offers up-close encounters with some of the more unusual sea creatures. Oceanographer Dr. Robert Ballard plays an active role in the museum and has initiated special hands-on learning programs. A blockbuster new exhibit, “Titanic—12,450 Feet Below,” almost literally takes visitors down below to share the experience of Ballard when he discovered the sunken Titanic in 1985.

Mystic residents are also proud of their long-time connection with painters who settled along the shoreline.

Mystic Country spokeswoman Karin Burgess sums up the appeal of her town: “When people come here, they want to feel history and quaint. They want a place that’s a little different from where they live.”

Eileen Lockwood is a frequent contributor to PracticeLink Magazine.

 

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