February 1, 2001
Seeley Swan Pathfinder
Seeley Lake, Montana
By Donna Love
OPEN HOUSE FEBRUARY 4, 2001
The new Seeley-Swan Medical Center will host an Open House for the public this Sunday, February 4, from one to five o'clock in the afternoon. The community can tour the new facilities, visit with board members and meet the staff. Door prizes will be given away. The main one is a wood carving by Jon West. Refreshments will be served.
Part 1 of this History of Health Care in the Valley appeared in last weeks Pathfinder. It told how medical care evolved from early settlement until the time that the first Health Center had its start. Two items from Part One need clarified.
First, the hospitals in Missoula actually started much earlier than the 1940's. St. Patrick Hospital started in 1873 as Sisters of Providence. Community Hospital started in the Bitterroot Valley in 1910 as Thorton Hospital, moved to Missoula in 1917 and became Community Hospital in 1947. Both hospitals underwent major building renovations in the 1940's after World War II that included providing ambulance service to outlying areas.
Second, Swan Lake was listed in the WICHE article as having 300 citizens. It may be that they were confused by the name SOS (Seeley, Ovando, Swan) so they included Swan Lake. Or they may have meant Condon and listed it as Swan Lake. The actual town of Swan Lake was never in the SOS Hospital District even though it was mentioned in their article. Thank you to those that read the article so thoroughly that you noticed.
In addition, Wilma Nickolson the Center's first and only "real" Community Health Nurse remembered that the hearse/ambulance was purchased from Geraghty Funeral Home in Missoula and Marion Brechbill was a nurse in the community that also helped out in the early days along with Helen Rich.
Now, Part 2 will continue from the summer of 1970 to present
(Part 1 is in the February 28, 2001 issue)
It wasn't possible to get a nurse for the summer of 1970, but after much work a Master's Level nurse on loan from the State Health Department came to the Valley on September 1. Considered a Pilot Project, the nurse worked in the Valley for ten months until funding could be obtained for a permanent nurse.
The Committee looked hard all summer to find suitable housing and facilities for the nurse. After much searching they rented a cabin in the Wapiti Motel behind the Elkhorn Restaurant about a mile north of Seeley Lake on Highway 83. (The row of connected cabins is now south of the Elkhorn.)
The cabin had five rooms according to an article published by The Western Interstate Commission for Education (WICHE) titled, "WALK IN and Meet the Country Nurse," published in 1973.*
The first room housed the waiting area where secretary sat at her desk with an "aging Remington electric typewriter, a few chairs and a grumbling gas heater."
The kitchen was in the same room as the waiting room. Two bedrooms served as examine rooms and the nurse lived in the third bedroom. One bathroom served all. The rent for the cabin over the ten month period was $700.00.*
Furniture was "begged or borrowed." The chairs were from the basement of Missoula's St. Patrick Hospital. The typewriter was on loan from the high school. The exam table was a maternity table donated by a retiring physician.
The first nurse was Elsie Toavs. Her $1000 a month wage was paid by the state. In addition, the community charged $4 per house call and $2.50 for each office visit to cover the cost of the facility, the secretary's wages and supplies. Two local nurses were also hired on a part time basis to fill in for Elsie when she was away.*
Elsie was an energetic and enthusiastic nurse that did much to help the communities of Seeley Lake, Ovando, and Condon. When her ten months were over she returned to Helena and went on to help other rural areas start their health care facilities.
A Spoon Full of Sugar
At the end of that time the State hired Wilma Nickolson, to be the Community Health Nurse. She was a (as the WICHE article put it) "sometimes crusty, always caring registered nurse" who "threw over a teaching job at Butte Vo-Tech Center to work alone as a community health nurse in the backwoods."
Wilma remembers that friends at the Department of Health asked her if she would like the position. She thought, "I might just as well," because she wasn't happy teaching and she would "only be there a year."
Wilma was the Community Health Nurse for the next 26 years. She chose not to live at the Center because she had a daughter in fourth grade.
The WICHE article describes Wilma and her first year with the Health Center this way; "full of grit and good humor, the new nurse began what she would later call the bloodiest summer of her life," because she "fielded injuries and death from two highway smashups."
Wilma recalls that those accidents involved young people from Great Falls, Mustang cars, alcohol and the winding road around Salmon Lake.
It must have been bad too, for Wilma had served as a nurse during the Korean War. Stationed at Hickam Air Force Base in Honolulu, Hawaii, she was part of the Evacuation Unit for war casualties returning to the states.
The Nurse's Station
Wilma's main duties as the Community Nurse included seeing patients at the Health Center, making home visits and being on call 24 hours a day.
She also served as the school nurse providing services for preschool roundup, athletic physical exams, dental screening and "brush-in," vision and hearing checks, immunizations and first aid.
In addition she was the nurse for Pyramid Lumber Company and held adult screening clinics such as Blood Pressure checks in Ovando and Condon. Later, she could no longer serve in the Ovando area because it was in a different county, but folks from there still used the Health Center because it was closer than Deerlodge or Missoula.
One of the first things Wilma did was find a "real" ambulance for the community. She drove to Idaho to retrieve it. In 1987 it became the responsibility of the Volunteer Fire Department and QRU (Quick Response Unit).
She was also glad that Seeley Lake had a pharmacy, which was opened in 1962 by Nels and Edna Newgard. Not only did they provide supplies and fill prescriptions the presence of the pharmacy was one of the State's stipulations for allowing a nurse to work in the community.
A summary of what the Health Center did during its first four years appeared in a 1977 WICHE publication titled, 'Innovation in Community Health Nursing, A Solo Practice in Rural Community Health." The Center had 4,798 office visits, 557 home visits, referred 271 patients to a physician and took 44 ambulance calls.*
The only thing Wilma wouldn't do was deliver babies. "When the Health Center Board hired me I told them at our first meeting that I absolutely would not deliver babies," and with a chuckle she told this story, "It wasn't but three months later the chairman of the board, Bob Border, called me one night to say that his wife was in labor and needed to get to the hospital fast. We had to stop at a turn out on Salmon Lake and deliver that baby. I just wrapped the baby up, laid it up on the mother's chest and said, Drive! I didn't get over that for three months."
That was the only baby she ever delivered. She explained, "They all knew by the time the story got around town that nobody else had better even ask!"
This Will Only Hurt
Sandi Doucett, the Secretary for the Health Center remembers those early years. She remarked that Elsie and Wilma were "both very knowledgeable and caring people" who gave their all to the communities.
As for her job, she did everything from paying the bills to being the ambulance driver "when there wasn't anyone else available."
During the first few years funding was always a problem and since they operated on grants they were always writing grant applications. "Wilma worked hard for those grants," Sandi said, adding, "If she didn't get it from one angle, she went at it from another."
Their hard work paid off and over the first four years they received many grants, including those from the WICHE Mountain States Regional Medical Program, the Taylor Foundation, the W.K. Kellogg Foundation and the Montana Bicentennial Administration.*
Along with the grants they also charged fees of $5 for an office call plus supplies and $8 for a home visit plus supplies. That still wasn't enough so they held bake sales, auctions and worked booths selling hot chocolate and coffee at celebrations to earn money for the Center.
In 1973 the SOS Committee formed a Hospital District to allow the Center to obtain mill levy support gathered in the form of taxes. The Center operated with a mill levy that the community voted on every two years. In other words, the communities had decided to tax themselves to pay for a new Clinic.
In 1974, with the mill levy and a grant from Revenue Sharing from Missoula County a new Clinic was built on land donated by the late Thelma Carnes, who lived in Seeley. Her attorney, Hugh Kidder, who handled the land transfer said she was quite concerned for the citizens in the Valley. He recalls her exact words, "These lumberjacks get hurt."
Architect, Shirley Hautzinger, whose husband, John, was a Forester with the Forest Service in Seeley Lake, designed the Clinic. It was located on SOS Lane off Morrell Creek Road and was called the Thelma Carnes Memorial.
"It was a grand day when that Clinic opened even if its halls were too narrow for a gurney to easily pass through," Wilma said. But she never had any problems with the building though some of the ambulance drivers had a hard time getting the stretchers in the doors if they didn't do exactly what she "told them to do."
Take Two Aspirin and
Call Me in the Morning
After the Clinic was built a succession of doctors worked off and on there. "And," Wilma laughed, "every one of them called me boss."
In 1974, Dr. Walter Peschel, a physician from North Dakota just starting a practice in Missoula, approached the Clinic and asked to work there to build his practice. He paid rent for the use of the building and an "appropriate salary" to Wilma and Sandi for their services. His only request was that the Clinic provide a properly shielded room to house a used x-ray machine that he owned. The Board agreed.
Dr. Peschel worked one day a week at the Clinic for about a year until, according to Wilma, his practice in Missoula grew so much that "he could no longer work in Seeley because he lost money on the day he was here."
After a while, Wilma called Dr. Herman Schreiber, a retired doctor from Florida who had recently moved to Condon to ask if he'd like to help. Wilma reached his wife by phone and she said, "He'd love too."
Dr. Schreiber began working two days a week at the Clinic in 1980. Over the next six years the caseload increased and in 1986 he began working a four-day schedule.
Wilma described Dr. Schreiber as a "fabulous" doctor whom she "enjoyed working with." After nearly ten years with the Clinic Dr. Schreiber retired for good.
Left without a doctor and a large patient load the Board decided that it was time to seriously recruit a doctor. Several doctors were interviewed and the Board chose Dr. Robert Nelson from Great Falls who was hired in 1990. Dr. Nelson worked full time for the clinic until 1996.
In 1990 Wilma suffered a heart attack. In 1996 she needed knee surgery and her house on the lake had burned down. She retired and moved to Missoula to be near her daughter and grandchildren.
Wilma said she loved every minute of her time in the Valley. Along the way she "got to know every doctor in Missoula and some in Kalispell." Nobody ever refused to help her and she was treated so well by the medical community and folks that it made her "job for all 26 years easy."
Wilma just had her other knee operated on and she hopes to return to part time nursing in Missoula as soon as she can.
An Ounce of Prevention
During this time other changes in Health Care were taking place. Helicopter Ambulance service from Kalispell was available in 1980 and from Missoula in 1981. By 1981 an office visit cost $20. Computers were added to the Clinic in 1986. Two nurses and two secretary/bookkeepers were needed to keep up with the demands.
Things were getting complicated and so was financing.
By 1997 the Hospital Board was $106,000 in debt to Missoula County. "Faced with the option of closing the Clinic or seeking an outside alliance," Board Member Mary Ann Morin explained in a letter to the Editor, which appeared in the September 7, 2000 issue of the Pathfinder, "the Board chose the latter" and contracted with Caron Corporation, a subsidiary of St. Patrick Hospital in Missoula for the daily operation of the Clinic.
Caron Corporation hired Ben Lindemen, a Physician's Assistant, and Cindy Gallea, a Nurse Practitioner to work part time at the Clinic. Family Practitioners from the Western Montana Clinic in Missoula served as doctors on a rotating basis.
The Board learned that they could gain additional funds by being designated a Rural Health Clinic. To do this the building had to be upgraded to meet the requirements of the Americans With Disabilities Act. It was possible to do at the old clinic, but would cost just about as much as a new facility. The Board decided to build a new one with higher visibility on Highway 83.
The Board applied for and received a $400,000 zero interest loan from Blackfoot Telephone Cooperative in Missoula to build the new facility. The loan is to be paid back in ten years. The Chutney Foundation in Ovando awarded the District a $150,000 grant. The sale of the old Clinic provided $75,000. All that totaled $650,000, but that was still $135,000 short the cost of the new facility.
The Board simply stepped out in faith and asked the community for donations. The Chutney Foundation gave another $50,000 and the community responded with overwhelming support and commitment. They achieved their goal in one year with donations from the community and friends from all over. "And, all at no extra cost to the tax-payers," beamed Board Chairperson, Tim Love, proudly.
Land for the new facility was purchased in January of 2000 from Dave Stewart. Construction started in June of 2000. The new Health Center boasted a helicopter pad, emergency procedure room, three examine rooms, a x-ray lab and nurses' station and room to expand. The new Seeley-Swan Medical Center opened its doors in December of 2000 at 350 Highway 83, between the Valley Market and One Stop. The official Open House is this Sunday.
Wilma wishes she could attend, but she is still on crutches from another recent knee surgery so she will only be there in spirit. Nevertheless, she is "just thrilled" for the citizens of the Valley and sends her greetings to all.
If you would like to be at another monumental moment in the history of the Valley be sure to drop by the new Seeley-Swan Medical Center on Sunday. The staff and Board will be happy to show you around.
*Data complied with help from Anita Richards. A book titled, The First 25 Years of the Seeley-Swan Medical Center is being published by A Butterfly Publication by Anita M. Richards in which the Minutes of the SOS Health Center and other related information is compiled. It will be out in the near future.