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By Taylor Sisk
Jerry Wolfe has spent the vast majority of his 91 years within shouting distance of Rattlesnake Mountain.
The mountain keeps watch over the Cherokee village, hub of the Eastern Band of the Cherokee Indians’ Qualla Boundary home, tucked into the Great Smoky Mountains of Western North Carolina.
Wolfe, a WW II veteran, grew up in Big Cove, just the other side of Rattlesnake. He remembers being told by the elders of a crystal buried somewhere there on the mountain – a crystal from the head of a great snake, believed to hold healing and other powers bestowed by “the different spirits that came out of the Great Smokies.”
The man who served as guardian of that crystal knew his remaining days in this world were few, but could find no one to entrust it with.
“So he took it up in the rock cliffs up there on that mountain,” Wolfe recounted, pointing skyward, “and every so often the mountain will glow, and the old people would say that the crystal was searching for its master.”
Today on a nearby knoll now stands another force of healing, this one with a different evidence base. Last Thursday – a postcard-perfect early-autumn morning, the brilliant sun inching past Rattlesnake – the Cherokee community welcomed some 500 guests to the ribbon-cutting of their $82 million, 155-000-square-foot Cherokee Indian Hospital.
The hospital was designed with input from the community and built entirely with tribal funds, rising as testament to a new day on the Qualla Boundary, one informed by a rich tradition.
The future of health care
Thursday’s festivities began with a Morning Song from a chorus of Cherokee school kids; a prayer from Vice Chief Richie Sneed and tribal council member Marie Junaluska; and a four-directional blessing by Wolfe, to Mother Earth and the Great Spirit.
Carmaleta Montieth, chair of the Cherokee Indian Hospital Governing Board, next provided historical context: initial plans to remodel the existing hospital, inspiration to aim higher and visits across the country to investigate successful building designs and models of care.
Casey Cooper, Cherokee Indian Hospital’s chief executive officer, prepared those assembled for their introduction to a “world-class facility … an illustration of how health care will be delivered in the future,” one that stands as a “monument to self-determination.”
Newly elected Principal Chief Patrick Lambert then gave his thanks to those who made it happen, citing by name several key players: carpenters, painters and clean-up crew members among them.
A ribbon was then snipped on the doorstep of “The Basket,” main entrance to the facility, a design based on the work of local artist Maddie Wildcat.
“It is no secret that health care in this country is experiencing a tremendous amount of destructive change,” Cooper said. “Hospitals across the country are tenaciously endeavoring to re-create themselves to provide greater value at lower costs. Unfortunately, too many people in this country lack health care, especially primary care.”
Native-American health care is critically underfunded, Cooper continued, at about one third the national per capita average.
He described for the audience how in 2002 the tribe took over the administration of its hospital from the federal Department of Health and Human Services’ Indian Health Service and created the Cherokee Indian Hospital Authority.
Under the auspices of the authority, an investment was made in improved health care, including, Cooper reiterated, a hospital “planned, constructed and paid for” by the Cherokee people.
“We are not here today because of the federal government’s commitment to Indian health,” he told those assembled. “Rather, we stand here today in spite of it.”
What the community wants
Cooper said the Cherokee Indian Hospital Authority committed itself to ensuring the hospital was “designed and constructed consistent with the desires of the community.”
Its governing board told the design team, he said, “‘First and foremost, make sure that you build us a building that accentuates the beauty of the environment that we live in,’” true to the tribe’s strong sense of place.
That spirit is embodied in a “River Walk,” the primary path through the hospital, infused with natural light and lined with scenes of Cherokee legend.
Lynne Harlan, public relations officer for the hospital authority, explained on a recent tour that the stories the scenes depict are intended to help “maintain the cultural continuum that gives people strength.”
“The story of how we came into being validates that we belong where we are,” Harlan said.
Planners held more than 20 community meetings and consulted with hospital and EMS staff to determine the hospital’s layout and the nature and range of services to be offered.
From a structural standpoint, priority number-one, said longtime community-health professional Jody Bradley Lipscomb, was a level parking lot. Visitors previously had to park on a steep hill.
The community also requested a drive-through window for the pharmacy, and got it.
The hospital’s approach to care, Cooper said, is founded on a commitment to greater patient and family involvement, each step of the way; prevention and management of chronic disease; and processes to ensure proper use of specialty care and medications.
Care is integrated. Patients are assigned a team of providers; a case manager, doctor, behavioral health specialist, nutritionist and pharmacist work together in one suite. Consultation rooms are adjacent to exam rooms.
Inpatient rooms are large and sun-filled, with mountain vistas, and there’s ample room for family members to stay close, either within rooms or just beyond, in a design modeled on hotel hospitality suites.
The hospital has a 20-station dental clinic and a mall-like eye clinic, with glasses out on display; offers massage therapy and acupuncture; and will be introducing chiropractic care.
Proof of excellence
“We believe that we provide a world-class health care system to this community,” Cooper told Thursday’s audience.
“But there is a perception that this community has not received world-class service,” he said, which he attributes in large measure to services that were “packaged in an outdated building.”
That’s now been rectified – one major step forward in a health care initiative, post-2002, that’s yielded a freestanding immediate-care clinic, expanded general and oral surgery and endoscopy services, expanded optometry services and increased access to pediatric and specialty care.
Customer satisfaction scores have climbed, Cooper said, and the hospital authority has won the Healthcare Information and Management Systems Society’s Davies Public Health Award for IT excellence, several Indian Health Service Director’s Awards and the Governor’s Award for Performance Excellence in Healthcare.
And, Cooper added, since 2002 the hospital authority has increased cash reserves from fewer than 100 days worth to more than 360.
The Cherokee Indian Hospital’s go-live date is Nov. 16. Friday, Nov. 13, will be a business-as-usual day at the existing hospital. Then, at 5 p.m., everything will be packed up and moved into the brand-new facility next door, with no interruption in services expected.
That Monday, at 8 a.m., a new day begins.