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Changes and Constants in Health Care Delivery

In the winter of 1864, tugboat Captain Robert Noble’s legs froze during a stay on Washington Island. Gangrene developed and Noble desperately needed medical attention as his condition deteriorated. A physician, Dr. Farr, happened to be in Sturgeon Bay looking over mill property that he was considering for purchase. The visiting doctor was quickly summoned to the Cedar Street house on Third Avenue to care for Noble. Realizing an amputation would be necessary, Dr. Farr promptly sent for instruments to be retrieved from Green Bay and then borrowed a butcher’s saw to complete the procedure. Captain Noble came through the ordeal well and continued to serve as a prominent citizen of the period.dclv08i01-feature2-Bay-Shore-Hospital

Thankfully, times have changed and so too has the delivery of health care in Door County. Penicillin and surgical anesthesia would have certainly made things easier for Captain Noble, not to mention the availability of a medical clinic on Washington Island and helicopter service to the mainland. Door County residents and visitors now have access to several clinics serviced by a multitude of providers. Extensive emergency medical services are staffed year round, with helicopter transport available from even the most remote areas of the county. Our modern and expanding Door County Memorial Hospital in Sturgeon Bay is equipped with the latest technology and staffed with over 125 experienced physicians, with specialties including Pediatrics, Orthopedic Surgery, Neurology, Rheumatology and Oncology.

Door County history includes countless stories of those who practiced medicine in the area. Some quickly moved on, but others choose Door County as their permanent home and dedicated their career and much of their lives to serving the people’s needs. A sampling of these stories reveals what has changed and what has remained constant in the delivery of health care on the peninsula.

Photo courtesy of the Ephraim Inn.

Photo courtesy of the Ephraim Inn.

Dr. Edward F. Battershill was the first physician on record in Door County, arriving in 1850. In addition to working as a physician, he held the position of High Sherriff of Door County and he often treated patients from the sheriff’s office. In July of 1861, there was a feud between George Boyer and Charles Wilkins which led to a fight outside the Lee House Saloon at 218 Kentucky Street in Sturgeon Bay. Boyer stabbed Wilkins and fled. Wilkins went directly to Dr. Battershill to have his wounds treated and bound. Shortly thereafter, Sherriff Battershill started after the culprit who eventually escaped by rowboat across the bay.

Dr. Battershill departed in the early 1860s, and Door County remained without a resident physician until after the Civil War. Patients often traveled to Green Bay for treatment and sometimes their condition worsened considerably while awaiting transport. Following the incident of Captain Noble’s amputation in 1864, public demand for a resident physician heightened significantly. The Door County Advocate printed an article stating the desperate need in town for a doctor, as well as a lawyer, blacksmith and tinsmith.

Approximately one year later, villagers induced Dr. Pommier to come to the county by collecting a subscription fund of $1,000. He was replaced in 1867 by Dr. Despin, who established the county’s first dclv08i01-feature2-Egeland-Hospitalpharmacy. Dr. Young was the next physician to arrive in Sturgeon Bay, and the first to build a combined doctor’s residence, clinic and dispensary. Over the next 30 years, other physicians followed Young’s lead by turning their residences into Door County’s earliest hospitals.

Early Sturgeon Bay records indicate that dominant areas of medicine in the late 1800s included homeopathic remedies of the immigrant settlers, native American Indian remedies and spiritual healing. Residents also sought care from non-licensed providers, such as Betsey Henderschott, a widow and mother of 11 who arrived in 1855 and served as a midwife for approximately 25 years.

For these early caregivers, serving the needs of the county proved to be both time consuming and dangerous. In June of 1881, a Dr. Mullin is on record for traveling the 26 miles from Sturgeon Bay to Baileys Harbor in 2 hours and 15 minutes by horse and buggy, which represented a new speed record for the period. Such house calls could prove treacherous, and travelers occasionally suffered injury from accidents during their late night trips over the rough roads.

dclv08i01-feature2-Egeland-Hospital2In 1902, the first free-standing hospital was established on the Sturgeon Bay shoreline at what is now 1114 Memorial Drive. The facility was originally named Bay Shore Hospital but the name was later changed to Peoples Hospital. Not long after, Dr. Gustav R. Egeland established Egeland Hospital which was later owned an operated by his nephew, Dr. Daniel Dorchester. Meanwhile, Dr. Charles Leasum maintained Citizens Hospital with space for 12 to 15 patients, located in a three-story building on Michigan Street and Third Avenue. Each of these facilities was privately owned and they essentially operated in competition with one another. An addition to the Egeland Hospital was funded by the federal government in 1943, at which time the facility was established as a non-profit hospital organization named Door County Memorial Hospital.

Physicians of this time period were not like the sub-specialists of today. They treated all ailments and handled every aspect of their patient’s care, whether office visit, surgery or hospital rounds. It is no wonder that the family physician became intimately familiar with the details of their patients’ lives and often came to know them as well as their closest friends.

In 1935, a young physician named Hubert D. Grota settled in the county. Grota was employed by Dr.

Photo courtesy of WC Schroeder and the Door County Historical Museum.

Photo courtesy of WC Schroeder and the Door County Historical Museum.

Dorchester until January 1940 and then established his own private practice through which he became known as Doc Grota, or simply Doc. As recalled by Phyllis Gorectke, daughter of the late Doc Grota, her father treated generation after generation of Door County residents. “He knew not only the patient’s history but their family history.” Grota commented in a 1996 interview, “It was a family affair. We would deliver the baby, become well acquainted with the family, and go back to treat the kid for colds, appendicitis, whatever.” In his memoirs, Grota wrote, “I was the young doctor in Door County, so I suppose that is why the young people came to me. I delivered about 250 babies a year for 20 years.” This was the baby boom generation, and Grota delivered approximately 90 percent of the babies born in the county during that time period, most in the families’ own homes.

One of Grota’s late-night deliveries occurred during a brutal snowstorm in the winter of 1936. The mother lived near Newport so Grota arranged to meet the woman’s husband at Anderson’s store in Ellison Bay. From the store they set out by foot across two miles of woods and open fields. Grota was soon wet and cold and covered with snow. Seeing that he was shivering, the pregnant woman invited him into her bed for warmth and promised to wake him when the baby came. Several hours later, they baby was delivered successfully. Grota bathed the baby and cared for the mother, then packed his bags and hitched a ride back to the store on a passing snowplow.

This story represents just one of many late-night house calls. “He would get out of bed and leave without anyone knowing,” recalls Gorectke. He would often arrive at the breakfast table with his white collared shirt on over his nightshirt, a tell-tale sign that he’d been called out during the night. Sturgeon Bay’s

Photo courtesy of the Door County Historical Museum.

Photo courtesy of the Door County Historical Museum.

shipyards were very busy in the 1940s, employing up to 7,000 workers. Grota would sometimes make two or three nightly trips to the shipyards to stitch up a cut, fix an abrasion or pull a metal sliver out of an eye.

What was the price of care in those days? As Grota established his practice in the 1940s, the charge for an office visit was $1, a home call $2 and a baby delivery with pre/post-partum care was $25. During hard economic times, patients didn’t necessarily have the means to pay. In Grota’s words, “A lot of them didn’t pay or couldn’t pay, but nobody died because they couldn’t pay. Over the years, we wrote off a lot of debts.” There were unique methods of payment as well. Grota was offered chickens, plumbing work and other trades as compensation. Tokens were required to purchase rationed items during World War II and some patients would offer their gas tokens in payment. This served a second purpose, ensuring that Grota would have enough gas to get to them if necessary.

Thinking back on her father, Gorectke explained, “The old time doctors worked 24/7. He did medicine all the time. Every conversation, every outing included an encounter with someone who was seeking medical advice. Work often intersected with home life.” Gorectke tells of a time when a man appeared at Grota’s front door with his hand wrapped in a towel. He had sliced off his finger and was bleeding profusely. Grota’s wife Carrol answered the door and by the time Grota arrived on the scene she had passed out, unable to tolerate the sight of blood.

Patients at the door weren’t the only trial Grota’s wife endured. There was more than one occasion

Photo courtesy of the Door County Historical Museum.

Photo courtesy of the Door County Historical Museum.

where she would be dressed up and ready to go out, but was left waiting because her husband just didn’t come home. Knowing that he was busy caring for someone somewhere, Carrol eventually traded her evening gown for a nightgown and went to bed. But did the sacrifices he and his family made ever cause him to question his course in life? “Not for a minute,” says Gorectke, “he loved the practice of medicine.”

As the years went by, the medical needs of the peninsula were primarily managed by a small handful of physicians. Among these were Dr. Edward Farmer who practiced on Washington Island for 25 years before moving his practice to Sister Bay. Dr. Sneeburger ran his practice in Ephraim at what is now The Ephraim Inn. Dr. Hirshbeck was based in Forestville. Dr. John Muehlhauser and Dr. Frederick Huff worked in Sturgeon Bay, and Dr. Edward Konop in Sawyer. Construction of a new Door County Memorial Hospital building began in 1962, financed through federal grants and local fundraising efforts. It was completed in 1964 on the site of what is now the Dorchester Nursing Center.

Another man who would make Door County his home and dedicate over 35 years in its service was Family Nurse Practitioner and Surgical Physician Assistant Mike Flood who joined the community in 1976. Flood was hired by Door County Medical Center with the intent of creating an outreach clinic in

Photo courtesy of Door County Historical Museum.

Photo courtesy of Door County Historical Museum.

northern Door County. Many county residents had become accustomed to traveling to Algoma for care, and there was a recognized need to reestablish the resident population’s relationship with the Sturgeon Bay facility.

Flood saw several physicians come and go. He suspects that they became frustrated with the workload and lifestyle associated with practicing in a small, close-knit community. As Flood explains, “Things are a bit different here. People don’t see you as a medical provider. You are a community leader and a friend.”

Flood continued to run the clinic for Door County Medical Center until 1981. He then built his own clinic which he and his wife owned and operated for 20 years. During that period, Flood estimates that he conducted over 11,000 patient visits per year. With so many hours spent working, Flood made every effort to avoid talk of medicine when away from the office. Still, he says, “There were many times I was called upon for off-the-cuff advice. It goes with the territory.” His Sister Bay practice was sold to Aurora health care in 2005 and Flood continues to serve a large number of patients at the Aurora Nor-Door clinic location.

Despite the many advances in medical treatments and technology, Flood faced some of the same difficult realities as the earliest physicians in the county. He was on call every night and every weekend for 25 years and essentially filled the roles of coroner and EMT, in addition to his role as primary care provider.

The only ambulance for a long time was a privately-owned hearse, still used in that service. In addition

Photo courtesy of the Door County Historical Museum.

Photo courtesy of the Door County Historical Museum.

to the black curtains, there was a parlor shade displaying a red cross that could be drawn when transporting a patient. A significant step forward in the availability of emergency care resulted from Flood’s efforts. He and Dr. John Herlache established a paramedic training program, one of the first rural programs in the U.S., for which Flood served as the training supervisor. With teams of paramedics in place, the medical teams are now somewhat relieved of the 24/7 pressure.

Why did Flood choose to stay when so many others had left? Quite simply, he “likes the area.” “My four kids grew up here, we did well here, we like the people, we have close friends,” he explains. Flood came from a small town where “everyone knows everyone,” and he continues to feel comfortable in that environment.

A more recent arrival to Door County’s medical community echoes some familiar themes when sharing his impressions. Dr. Phil Arnold joined Door County Memorial Hospital (DCMH) in 2006, and works as a family doctor and sports medicine specialist based at the Fish Creek clinic. As he sees it, Door County is “a place where you know everyone and your neighbor is your patient.” Arnold embraces opportunities to connect with the community; you might see him at a high school sporting event sitting with parents of the young athletes he treats. Arnold comments on the breadth of services he and his colleagues provide, stating, “In a small town versus a large city – doctors simply do more.”  dclv08i01-feature2-HD-Grota

Arnold realizes that some residents and visitors may be skeptical regarding the level of care in a rural community and points out, “We [physicians] all have the same training and take the same board exams. There are highly qualified people here delivering the care most needed by the community. At the end of the day we are all here because we choose to live here.” Arnold also indicates, “DCMH is way ahead of the curve on EMR [electronic medical records] and has been recognized as one of the more advanced connected hospitals in the region. This is part out of necessity and part due to the vision of the administration.”

Door County’s health care professionals remain realistic about what is best treated elsewhere and a system has been established to facilitate referrals outside the county when necessary. “We consult with other physicians and specialists every day,” comments Arnold, “and tertiary care is just a chopper ride away.” Meanwhile, DCMH continues to expand the services offered. A new surgery center opened in 2003, a Cancer Center in 2005 and a Women and Children’s Health Center in 2007. Further construction is underway, with a 31,080 square-foot addition due for completion in late 2010.

Consistent through the centuries, Door County’s medical professionals have recognized that working here demands flexibility and breadth, acceptance that work will intervene in the off-hours and a commitment to work above and beyond the expectations of their contemporaries. Today’s residents and visitors can feel confident in the extensive level of services available. Many limitations of the past have been eliminated, but fortunately the patient-caregiver bond unique to a small town environment still remains.

Resources:dclv08i01-feature2-sturgeon-bay-book

Stanley Greene Collection of Special Subjects – Medicine; 1999.6.6; courtesy of the Door County Historical Society.

“You just had to get up and take care of them,” by Joe Knaapen, Door County Advocate, March 8, 1996.

“Hospitals of Door County,” by John L. Herlache, published in The Peninsula, Vol 14, 2007-2008, Door County Historical Society.

Photos for this article were taken from Images of America:  Sturgeon Bay, written by Ann Jinkins and Maggie Weir for the Door County Historical Museum in Sturgeon Bay.