Morning Edition; Sarah Jane Tribble

It's morning edition on K-R-P-S. A new podcast from Kaiser Health News titled Where It Hurts focuses on health care in rural America. The first season, No Mercy, was released in late September. The story is reported on by Southeast Kansas native Sarah Jean Trouble, grew up in Parsons, on a 10 acre farm that her parents still live on today. No Mercy tells a story of mercy hospital in Fort Scott, Kansas, closing at the end of 2018 and the lives it touched. I spoke with Sarah last week and she first tells us how she came to create the Where It Hurts podcast. Right, so the podcast drops every Tuesday live on any podcast app that you use or on the website, The Where It Hurts Show. And we are partnered with St. Louis Public Radio where Mercy Company is based. The Mercy Health System in the Midwest is based out of St. Louis. They owned the Fort Scott Hospital as well as Independence Hospital in Independence, Kansas and they've closed both of those down since 2015. I went there first to report on the hospital closure in December 2018, a few weeks before the

Fort Scott Hospital closed and I had landed an interview with Rita Baker, the then president of Fort Scott Hospital. And my goal was to ride about a small town losing its hospital and to really kind of dig in and understand what that meant to the people of Fort Scott. When I made it back to DC and put my story into my editors, one, my written story was very long because I had met so many interesting people. I just wanted to include them in the story. And my editor came back to me and said, I think you should follow this town and this community and these people for a year and see what happens to them. And she asked if I could do a podcast and I've never done a podcast before, but I knew that these voices deserved respect and deserved to be heard. So I went back and said, yes, and I visited Fort Scott more than half a dozen times over the course of 2019. Yeah, and speaking of the voices that deserve respect, one of the things I love about your podcast

unlike others, I've heard a big honest with you is that each word is so powerful in each interview and each person you introduce us to, their narrative and their story. This isn't a story. This is their life. And you introduce us to Ralph Wheeler and Ralph, one of the things the main reason he went to Mercy Hospital was because he had to get dialysis. So Ralph Wheeler is a native of Fort Scott Kansas. He grew up in Fort Scott and he's a really kind and humble person who is in his 70s and is dealing with very bad emphysema. He, he, he and Pat, his wife, who is in her 60s, struggle financially. And they also struggle with chronic health problems that are common in southeastern Kansas. Southeastern Kansas has some of the worst health outcomes in the state of Kansas and is one of the most worrisome parts of the state for state experts. And those are things like emphysema from smoking or what we now call COPD, things like diabetes and obesity.

For Ralph, his emphysema is, is chronic and it's, he's also has heart problems, which is a condition that's common with COPD. And so he has been using Mercy, whether it be in Joplin, Missouri or back home for his heart problems for years. But Ralph and Pat used the dialysis center that was not part of Mercy Hospital in Fort Scott. It was next to the hospital and that dialysis center ended up closing months after the hospital closed in part for the same reason, not enough patience. Yeah, that's one of the things about your podcast is the, especially in Fort Scott that, they've really hit it home for me. The city is one thing and having a small business or or whatever close, that's one thing. But the hospital, it seemed like it was the center of the city and so many so many other things closed after the hospital closed. I didn't realize hospitals were such economic engines. Right. So every dollar spent by a hospital in a community, research shows it puts another $2.30 back into the community. So there's all sorts of research

and studies over the economic impact of a local hospital in small communities in particular, but also in large communities. Hospitals, if you think about it, are anchor institutions in towns. They have a lot of employment because of nurses and staff. So they're usually one of the largest employers in town, if not the largest, for years, Mercy, fit that bill. It had 400 to 600 employees at one time and when it close, it had more than 200 employees. But then also when you think about the jobs at that hospital, these are largely well-paid jobs, white collar jobs, nursing jobs, and their professional jobs. So the impact is not just the number of jobs lost, but the kind of quality of those jobs, both from an economic trickle-down standpoint with disposable income, but also from an education standpoint. These are often people who are leaders in a community, and they have influence over different organizations and small towns because they generally have college educations or some kind of higher level of educational degree. Yeah. And then in the

podcast, you highlight that one of hospital closes, it's not like a lot of those high-paying jobs. Well, those are gone, but the people who have them, they normally don't stay. They move on themselves. Right. Forrestka was lucky in one aspect because Rita Baker, the former president, was from the area or is from the area, and she wanted to make sure that Forrestka had some resources left in it that she thought were key for the community. So one of the things she did right off the bat was to call Christa Post-I, who leads the Community Health Center of Southeast Kansas. And she asked Christa and Christa jumped at the opportunity, that's the words that Christa used, to take that health center into Fort Scott. And Christa then negotiated contracts with most of the primary care doctors that were employed by the hospital. So many of the doctors ended up staying in some form in the community. However, I have heard many stories anecdotally about nurses and others who had to leave the community to find jobs, whether they transferred to Joblin, or they found jobs outside of the hospital in other areas of Southeast Kansas. But there were, there was

some people that began to commute. Many others also took early retirement, so they're no longer working. I think that Rita would say that she tried very hard to make sure all of her employees landed on their feet in some way. But on the other hand, that doesn't necessarily mean that those folks are still in the community, putting those dollars back into the community. Sarah Jane Trouble is a senior correspondent for K-H-N. She produced the podcast, Where It Hurts. The first season is called No Mercy. It's a collaboration with St. Louis Public Radio. I want to thank you for speaking to me this morning. Thanks. I hope everybody listens. You can hear this interview again at our news blog, krpsnews.com. And you can hear the complete first season of Where It Hurts on krps, Friday morning at 9, and Friday evenings at 6.30. Or you can download Where It Hurts wherever you get your podcasts.