Chapter 4 Transcript
Editor’s Note: If you are able, we encourage you to listen to the audio of Where It Hurts, which includes emotion and emphasis not found in the transcript. Transcripts are generated using a combination of speech recognition software and human transcribers, and may contain errors. Please use the transcript as a tool but check the corresponding audio before quoting the podcast.
[Segment 1— 0:08]
SARAH JANE TRIBBLE: The year is 1886. Two nuns, one a superior and the other a novice, are traveling south across the Great Plains.
Their destination is Fort Scott, Kansas, a former military outpost that has become a busy trading center at the edge of our nation's new frontier. Their journey is chronicled in the book "Mercy in the Heartland."
It reads …
Voice actor: Fort Scott in the late 1880s was fertile land for care of the poor, sick and ignorant. The purpose for the existence of the Sisters of Mercy.
SARAH JANE TRIBBLE: The nuns hoped to open a Catholic school for the town's children. But Fort Scott's business leaders were worried about their workers.
Voice actor: The town had become a hub of railroad activity, and a hospital was needed to care for those injured in railroad accidents. Statistics of the day showed that 5,000 railway employees were killed and 26,000 maimed annually in the United States.
SARAH JANE TRIBBLE: The local Catholic church pastor and some parishioners meet the two nuns as they step off the train.
[Choral music]
The town really needs a hospital. And these nuns have nursing experience. Fort Scott and the surrounding countryside are home to about 30,000 people. Men work long hours in the train yards, shuffling freight cars and moving cargo loads, or they're at the railroad repair shops.
If not there, they're at the glassworks, brickyards and door factories — all of it hard labor that causes grisly injuries.
The Sunday edition of the Fort Scott Daily Monitor runs a story in November 1886 with the headline "Glad Tidings."
Voice actor: Glad tidings helped the good cause along. The Sisters of Mercy, who recently arrived in our city, have concluded to remain and open a hospital. The hospital is not for Catholics only. Persons of any religious denomination will be received and kindly cared for.
SARAH JANE TRIBBLE: He's asking Fort Scott's residents to donate household goods that the nuns need to have a home and start a hospital. Any furniture, bedding, dishes and pieces of carpet they can spare.
Voice actor: It is to be hoped that the citizens of Fort Scott will show by their interest in the matter that they really desire the sisters to remain.
SARAH JANE TRIBBLE: This is the beginning of the Mercy Hospital story in Fort Scott. And the sisters did stay, for 132 years. But now there is no Mercy. I'm Sarah Jane Tribble. This is Where It Hurts, a new podcast from KHN and St. Louis Public Radio.
Mercy Hospital and the people of Fort Scott have a long history. And Mercy is more than just a faceless health care company to the people here. To understand what Fort Scott really lost, we need to take a step back and learn from the past.
[Segment 2 — 3:32]
The day I meet Fred Campbell, he greets me at the door with a wide smile.
[Knock on door]
FRED CAMPBELL: There we are. Come in, sit down and … wherever you want to sit. Usually that's the visitor's chair, or this can be the visitor's chair.
SARAH JANE TRIBBLE: Fred’s a big guy. He's leaning on a cane, wearing a button-down polo and suspenders. We pick our seats and I quickly realize he's a storyteller.
FRED CAMPBELL: I am a veteran teacher. And I'm out to pasture now.
SARAH JANE TRIBBLE: Fred's nearly 90 years old and he has strong, broad shoulders. He played a lot of basketball and football as a kid in Fort Scott. He was born here in 1930, at the beginning of the Great Depression. When Fred was young, Fort Scott was a railroad town.
FRED CAMPBELL: Used to be you could get on a faster train in Fort Scott, be in Kansas City within two hours, get on a streetcar, go downtown and go to the Forum and eat and go… go to the zoo and get on, like, on a train at 5 o'clock, be back at home at 9 o'clock at night and never have to get an automobile. It was a wonderful situation. We didn't do it often, but we did often enough that I have fond memories of it.
SARAH JANE TRIBBLE: I'm sort of jealous as I listen to Fred. I'd heard stories of people taking the trains for fun, but it seemed like something that just happened in the movies. My hometown, Parsons, is about an hour away. As a kid, my grade school took a field trip to the local Katy railroad museum, and I remember being so proud that my grandpa had worked on the trains. I tell Fred about my grandpa and we talk trains for a bit.
FRED CAMPBELL: There was the Katy and the Missouri Pacific and the Frisco …
SARAH JANE TRIBBLE: Fred tells me that at one point, 13 railroads were expected to go through Fort Scott.
That didn't happen. But the railroads were big. Back in the 1940s and '50s, when Fred was younger, the trains dictated town life. He told me how the St. Louis and San Francisco Railroad — known as the Frisco — had a repair shop in Fort Scott.
FRED CAMPBELL: They had a giant chimney and they produced their own electricity and steam. And every Monday they would, what they called “blow the stack.” And when they did, they shot steam up through that chimney. And it was very, very tall. And it blew this black cloud all over the city. And women who washed on Monday and knew that they were going to blow the stack got their washing out early and in because by afternoon there was chunks of fine coal. And that went on every Monday for I don't know how many years.
SARAH JANE TRIBBLE: In Fred's memory, Fort Scott sounds industrial and prosperous. Honestly, that's pretty different from the sleepy town I've come to know. Today's Fort Scott takes just a few minutes to drive around. Most streets don't even have lights. You can slide through the intersections with a rolling stop. And the past is easy to see here. The post office, the swimming pool, football stadium and the grade school where Fred later taught history — they were all built as public works projects during the Depression. It was all New Deal construction. Fred's eyes smile when he tells stories about growing up here, and he talks most vividly about two things: trains and the Sisters of Mercy. Fred says the nuns who ran the hospital helped keep the railroad workers healthy and on the job.
FRED CAMPBELL: Mercy has been part of our DNA, part of our structure — who we were. That we always had the Mercy Hospital.
SARAH JANE TRIBBLE: Mercy Hospital would not have stayed open without the community's contributions. Local doctors and leaders were generous with the railroad hospital. If the hospital needed electricity, a donation was made.
The first X-ray machine was another donation. And there's even a story about the businessmen of Fort Scott giving the nuns a new Model T Ford. And the nuns, they gave back to the town, too. Fred says people felt the sisters were merciful. And he shared this story about his parents during the Depression.
FRED CAMPBELL: They had a hospital bill for these two surgeries, about $400. They were … they were serious surgeries. And there was no way they could pay that bill. So the Sisters of Mercy arranged a monthly payment, and then they reduced it.
SARAH JANE TRIBBLE: The first time Fred needed the nuns, he was 12 and had broken his arm.
FRED CAMPBELL: Well, I had never, ever been in a hospital. And here came these ladies in flowing robes and white bands around their faces. And I was scared to death. But it wasn't long till I found, that first thing I know, they had some iced Coca-Cola.
I can still remember them putting their hand on my head to see if I had a fever. This may have been 2 o'clock in the morning.
SARAH JANE TRIBBLE: Iced Coca-Cola was a special treat in the 1940s. And a treat he didn't really expect.
FRED CAMPBELL: They almost looked like Batman coming down the hall. But boy, when they came time to treat you, they knew how to take care of people. Especially children.
SARAH JANE TRIBBLE: Everything Fred describes seems different than what a kid would experience at a modern hospital. Fred stayed with the nuns for two or three days. In today's world, you wouldn't even stay the night for a broken arm.
But staying many nights used to be very common. And in 1956, the nuns raised money and opened what was a huge hospital for the time. It was 167 beds. The opening was a big event for Fort Scott. The town called it Operation Moving Day. National Guardsmen were there to move patients and equipment.
FRED CAMPBELL: They built what we then called new Mercy Hospital, and it had the sign on it: "Dedicated to Suffering Humanity." There was a big strip of marble. And it was carved in letters a foot high. When you walked in that main door, you're going to see it as you went in. And that, of course, became our mantra, our slogan or whatever we thought for our hospital.
SARAH JANE TRIBBLE: In the decades that followed, the sisters joined business operations with the nuns in St. Louis, and eventually they formed a formal corporation. This company tore down that hospital and built another hospital in 2002. It was the new-new Mercy Hospital. That's the one that closed and brought me to this story. There was no sign or mantra over that entrance. Fred has questions.
FRED CAMPBELL: I wondered what happened to Mercy's mission. At what point did they put the dollar over service? Something happened with the Sisters of Mercy and the Mercy corporation that seemed to doom hospitals like ours.
SARAH JANE TRIBBLE: It's all very painful for Fred. We spoke for more than an hour, and you can tell he's been turning the closing over in his mind.
FRED CAMPBELL: One of the hardest parts of it all, too, is to drive by and see the trucks backed up, loading out the equipment to take to other Mercy hospitals as they clean this one out of any- and everything they could.
SARAH JANE TRIBBLE: Near the end of our visit, I can tell Fred still has some hope. He knows southeastern Kansas is a tough place for any business to thrive. But ...
FRED CAMPBELL: My thinking gets back to “Dedicated to Suffering Humanity.” 'Cause these who are left will certainly be suffering.
SARAH JANE TRIBBLE: This gentle giant of a man doesn't want to believe that the nuns who cared for him and so many others wanted to leave. I ask him, what would he ask Mercy if he had the chance?
FRED CAMPBELL: Are you getting out too soon? That'd be my question. With our, our history as a community and supporting your efforts. Mercy corporation, can you stay with us longer and see if we ourselves can't be sustainable, with your help?
SARAH JANE TRIBBLE: Sitting there in the visitor's chair, I promise to find a nun and ask what happened.
[Segment 3 — 11:49]
The Sisters of Mercy left Fort Scott slowly. Over decades. They're gone now, except for the tombstones at St. Mary's Cemetery on the west side of town. About 80 nuns are there. And up until the early 1980s, a dozen nuns ran Mercy Hospital. There was the foundress, Mother Mary Teresa Dolan. Sister Mary Xavier Landers was in charge in the 1950s, and the last nun in charge was Sister Mary Trinity Jackson. I can't find any nuns actually living in Fort Scott to speak with. But Reta Baker, the president who closed down Mercy Hospital — she was trained by the nuns and can tell me about them.
RETA BAKER: And what were the nuns like? They were actually just like everyday people, except that we kind of put them on a pedestal, and there was a lot of nuns when I started working at Mercy. In fact, Sister Trinity was the CEO when I started here at Mercy, and my head nurse, when I started as a staff nurse, was a nun, Sister Annrené, who wrote the book.
SARAH JANE TRIBBLE: The book is “Mercy in the Heartland,” the one I've read so much that it's like my own little bible to the Sisters of Mercy. And it turns out that the author was Reta's boss and maybe a mentor.
Anyway, they keep in touch.
RETA BAKER: Sister Annrené still lives in Independence. And we communicate at least weekly. And she's a delightful, delightful person.
SARAH JANE TRIBBLE: There's my connection! I need to talk with Sister Mary Annrené Brau, the woman who wrote "Mercy in the Heartland."
I actually had reached out to Sister Annrené while researching this story. She didn't want to be interviewed. So I'm doing what I almost always do when people say no to me on the phone or email. I get in my car and drive there. Boots on the ground. Often this has worked for me. Surprised by a friendly, smiling reporter at your door, you're more likely to say something.
SARAH JANE TRIBBLE: I find Sister Annrené in Independence, Kansas. She lives in a modest one-story house on the wealthier side of town, near the country club. There's a small religious statue near her door.
I'm not sure anybody's home.
Somebody is opening the door.
SISTER MARY ANNRENÉ BRAU: Hi.
SARAH JANE TRIBBLE: Hi, I'm a reporter.
SISTER MARY ANNRENÉ BRAU: Pardon me?
SARAH JANE TRIBBLE: I'm a reporter.
SISTER MARY ANNRENÉ BRAU: Uh-huh.
SARAH JANE TRIBBLE: I am Sarah Jane Tribble. I emailed you in April. Um, I'm doing a series of stories on the closure of Mercy Hospital in Fort Scott, and I'm doing audio as well. I wanted to interview you. So I drove over here today.
SISTER MARY ANNRENÉ BRAU: No. No.
SARAH JANE TRIBBLE: This is why I'm playing the audio, because I thought you might say no immediately. Why not?
SISTER MARY ANNRENÉ BRAU: Thank you.
SARAH JANE TRIBBLE: Thank you.
My mouth is still open — trying to find the right thing to say. But Sister Annrené, politely, closes the door in my face. I walk slowly back to my car.
OK, so I'm disappointed.
Sister Annrené was wearing a pair of jeans and a T-shirt. And I know from public records that she's 81 years old. She must know so much about what happened to Mercy Hospital.
I didn't have a chance to ask her the most important question, which is what she thinks of the Mercy Hospital closing in Fort Scott.
So I'm back on the road and heading back to my parents' house.
A few days later, sitting at my desk in Washington, D.C., I open an email. It's from one of the media relations people at Mercy Health System.
It says: "Sarah, I had a conversation with Sister Annrené Brau this morning and understand you went to her home over the weekend to attempt to interview her. She was distressed to have a reporter surprise her at home."
I don't want to upset a nun. But I do want to pose Fred's question to a sister.
So I called up the corporate media rep again. And if not Annrené, is there another person available to talk about the hospital closing?
Weeks later, I'm at a nondescript office building outside of St. Louis, Missouri. Mercy has arranged for me to meet Sister Roch. She's 85 years old and still keeps an office at the Mercy Health System.
SISTER MARY ROCH ROCKLAGE: Sister Mary Roch Rockledge, and I serve on the board and in the sponsoring body. And I joke — you don't want to leave this in there — I help where needed.
SARAH JANE TRIBBLE: Sister Roch has short-cropped hair and a sweet smile. But I'm not fooled. This woman is a powerhouse. She changed the Catholic health care world. Sister Roch led the creation of the Mercy Health System in 1986, consolidating the behind-the-scenes operations of Mercy hospitals across the Midwest and South. She said she did this to keep up with changes to Medicare. It was cutting payments to hospitals.
SISTER MARY ROCH ROCKLAGE: It was very turbulent. All the new laws were coming out, and we felt that we had already put things together, or structures — that the best way for us to be safe — not safe — to be strong and be a permeating process in the future is we needed to come together as a system. Truly integrated in many ways, and have a vision of what we want it for.
SARAH JANE TRIBBLE: Sister Roch tells me you can't help people if you don't make enough money to stay open.
SISTER MARY ROCH ROCKLAGE: We always have in mind that we care for women, men and children who are poor, sick and in need of education or wounded by contemporary society. That we have to do, but we also have to be a business. We're not … if we have no money, the doors close. And if we don't take care of the poor, then we ought to close the doors.
SARAH JANE TRIBBLE: Mercy has closed a lot of doors over the years. The health system started in seven states, but now it's only in four. After Fort Scott closed, corporate executives told me Mercy closed the hospital in Fort Scott because there weren't enough patients and they were losing money. They sent me a chart of the hospital's finances. It showed that Mercy Hospital Fort Scott lost $2.3 million in 2018. It lost another $2 million the year before and another half-million in 2016. The chart also showed that fewer patients were going to the hospital every year since 2015. So I know the financial numbers before interviewing Sister Roch, but this meeting is the first conversation I'm having with top Mercy executives. Roch is joined by Brian O'Toole. His title is executive vice president over mission and ethics at Mercy. I ask him:
Have you announced any more hospital closures at Mercy?
BRIAN O'TOOLE: Not really. We have a situation in El Reno.
SARAH JANE TRIBBLE: Brian explains that Mercy has a lot of rural hospitals like Fort Scott. They have hospitals in Missouri, three in Arkansas and more in Oklahoma. He says there's a lot to consider before closing a hospital.
BRIAN O'TOOLE: So a lot depends on all these factors. Are people able to use it? Do we have enough revenue? Can we staff it with physicians? Those are all key challenges in each of these.
SARAH JANE TRIBBLE: This all makes sense to me. But when I'm in Fort Scott, the people there don't ask me about whether Mercy was losing money. They want to know what the nuns think. Would the nuns have closed Mercy Hospital Fort Scott? Our interview lasts well over an hour. Brian and Sister Roch patiently respond to all my questions, but I'm not quite sure I'm getting what I'm after. I tried to ask Fred's question every way I know how. Sister Roch deflects, changes the topic. She tells me the nuns have a problem that we haven't even talked about.
SISTER MARY ROCH ROCKLAGE: We're down, like, to 5,000 sisters-plus in the United States.
SARAH JANE TRIBBLE: Why? Why is that?
SISTER MARY ROCH ROCKLAGE: We don't … the sisters are dying. You know, we're elderly. Our mid age would be about in the 40s, I guess. Younger people are not coming in. In the United States this year, as far as I know, there's one young woman coming, and she's in St. Louis. And this year we had, throughout the United States, I think we had eight make their perpetual vows. And so that's nine people. And we probably have lost 40 in death. So people are not coming into religious life like they have in the past.
Sister Roch says she realized that there weren't going to be enough nuns to keep operating the hospitals. So in 2008, she asked the Vatican in Rome for help. Roch wanted to know if the nuns were allowed to hand off the health system’s management to laypeople.
SISTER MARY ROCH ROCKLAGE: And we were the first to ask for that permission. And they gave it.
SARAH JANE TRIBBLE: So you're basically saying, “We need to be able to trust laypeople to operate the health system.”
SISTER MARY ROCH ROCKLAGE: Basically right. That the future would not rest with the religious community, but that who we are, our charism, why we are would pass on and the footprint of Mercy would continue. And they approved that.
SARAH JANE TRIBBLE: So to answer Fred's question, I can say Mercy corporation lost too much money to keep the doors open. And the nuns can't keep the hospital open in Fort Scott because they aren't in charge anymore. But what I really want to know is how she feels. So I decide to play a bit of Fred's tape for her.
FRED CAMPBELL: That was the logo, "Dedicated to Suffering Humanity." We always felt that meant come hell or high water, you're going to be with us and you're not going to abandon us.
SARAH JANE TRIBBLE: She pauses before responding.
SISTER MARY ROCH ROCKLAGE: Well, we'd like to have a visit with him sometime, you know. But you can't really change him. He's hurting and he's grieving. And he evidently always counted that “they'll be there to care for us.” We're not physically there anymore. Hopefully, what we left there and the spirit will go forward.
SARAH JANE TRIBBLE: Sister Roch says she feels badly for him. And Brian responds, too. And then Sister Roch joins in.
BRIAN O'TOOLE: Years ago, we used to have people say it's not the same as when the sisters were in charge. We haven't heard that in a long, long time. So the recording that you played is one that we would have heard years ago. And it's an assumption that only the sisters would keep this a ministry. The laypeople or the corporate office would only be interested in the finances. And we don't hear that anymore.
SISTER MARY ROCH ROCKLAGE: You don't want this on here, but most of them have never met a sister. They wouldn't even know we were sisters walking down the hall because we don't have a habit on. You know, so that … we got to take that into consideration as well, you know.
SARAH JANE TRIBBLE: No. No, I don't know.
I just played them the voice of a man who feels abandoned. And their response is to say they don't hear this anymore? And Sister Roch tells me that nuns don't wear habits anymore? I'm trying to figure out, what do I take back to them? They're staring at me. So I take a deep breath and try again. I'm still hearing the comments in Fort Scott. I was just at the local historical society when a guy walked in.
A guy walks in. He looks at me. He goes, they would be rolling over in their graves if they knew what happened in Fort Scott. So I feel an obligation to represent that and say: Would they be rolling over in their graves? The assumption is they would be, that the sisters would regret making it corporate.
SISTER MARY ROCH ROCKLAGE: Yeah, I don't … I don't think the sisters — they would be sad from the standpoint or the emotional thing that what we had been involved in, what we've done is no longer existing that way. But we don't regret what's done because it was done in good faith, and good will come from this if we’ll all work together for it. And we'll be amazed at what takes place. What can we as a country do? Not just on the sisters, nor in Fort Scott.
SARAH JANE TRIBBLE: Sister Roch ends the interview, saying she does not think every small town needs a hospital. Instead, she says, they need the appropriate health care in the right setting.
Now, the people in Fort Scott are beginning to figure out what that means.
Next time, we meet a cancer patient who drives hours each week for chemotherapy treatment.
KAREN ENDICOTT-COYAN: Hi. How are we, ladies?
WOMAN AT DOCTOR’S OFFICE: Wonderful, how are you?
KAREN ENDICOTT-COYAN: We're good. Well, I say we're good. I … I went to the emergency room Tuesday.
WOMAN AT DOCTOR’S OFFICE: Aww.
KAREN ENDICOTT-COYAN: I got … I was dehydrated. I had the pukes.
WOMAN AT DOCTOR’S OFFICE: Oh.
SARAH JANE TRIBBLE: Still, she wears diamond earrings and powers through.
A special thanks to Ken Lyon and Robin Hixon. They are volunteers at the Old Fort Genealogical Society of Southeastern Kansas who took the time to respond to my many questions and guide me through reams of documents. And to former Fort Scott Mayor Jeanie Parker, who drove me on a tour of Fort Scott that convinced me I needed to meet Fred. This season of Where It Hurts is hosted and reported by me, Sarah Jane Tribble. Tarena Lofton is our production assistant. Taunya English is managing editor and managing producer for the podcast. She sends big thanks to Timothy and her husband, Gordon Washington, for their faith and laughter. You need both when you're trying to create something new.
Greg Munteanu at St. Louis Public Radio is our sound and design engineer. Diane Webber, national editor for broadcast, and KHN's editor-in-chief, Elisabeth Rosenthal, are editorial liaisons to the show.
Thank you to Dan Weissmann, host of "An Arm and a Leg," another podcast in the growing family of KHN podcasts. He and Robert Peterson offered early feedback on this episode.
Season one, “No Mercy,” is dedicated to my older sister, Maggie. The podcast is a co-production with St. Louis Public Radio and Kaiser Health News, a nonprofit news service about health care in America.
KHN is an editorially independent program of KFF.