Provider Q & A
Our patient-centered approach to health care thrives on trust, mutual respect and open communication between patient and provider. To foster that, we present a growing list of Q&As with our providers that look beyond their resumes and focus on what motivates them inside and outside their medical practices. Get to know your provider, and enjoy the improved health benefits that our patient-centered approach delivers.
In some ways, the midwifery career of Alison Engel, CNM, started when she was 5 years old. “I grew up in a family of women who were nurturers,” Engel says. “My mom was a cook and a caregiver, and my grandmother was a labor and delivery nurse. So it’s no surprise that I’ve been putting bandages and fake poultices on my friend’s booboos since kindergarten. “It was in my nature to be in health care,” Engel says. Engel joined Pen Bay Women’s Health earlier this year as one of five certified nurse midwives providing a full range of care for women of all ages, including birth control, annual checkups, pap tests, breast exams, sexually transmitted infection testing and treatment, preconception care, abnormal bleeding evaluation and menopausal care. “Alison is an experienced, thoughtful and compassionate caregiver, and we are fortunate to have her on our care team,” said Jennifer McKenna, MD, director of women’s health for PBMC and WCGH. To schedule an appointment with Engel, please call 301-8900. Pen Bay Women’s Health is located on the campus of Pen Bay Medical Center in Rockport: learn more here. To learn more about how Engel’s family shaped her choice to become a midwife, read on.
Why did you become a midwife?
I was born with the assistance of a midwife, as was my middle sister, and we grew up hearing our birth stories from my mom. This definitely influenced my decision to become a midwife. When I was 15 years old, my oldest sister had a baby with the assistance of a midwife. I was present for the birth, and it left a big impression on me. I really admired the way the midwife was so calm and quiet but also very involved and present. She wasn’t not there. She wasn’t not doing her job. She just wasn’t intervening and getting in the way of the process. She was there to support my sister in having her baby. There was a time I thought about medical school, but I decided that the principles of midwifery were more in line with who I am and the holistic care I want to provide. So I went to nursing school. After working for a couple of years as a nurse, I went to midwifery school. I was ultimately guided by the experience with my sister and her midwife to choose this career path.
Do you see midwifery in terms of pregnancy only, or does midwifery address a larger range of women’s health issues?
Popular culture associates midwives with pregnancy and birth, but historically midwives provided health care for the whole family. That piece of our profession got lost over the years, and we were put into the niche of providing just obstetric care. But we provide a full range of health care to women, from birth through menopause and beyond.
Some of my favorite people to work with are young teens. I find great satisfaction helping them get a good start in their lives by teaching them how to respect their bodies and treat them well. Menopause is another transitional time in life, with unique and amazing opportunities to learn about and have confidence in our bodies.
When a patient comes to see you for the first time, what can they expect?
First and foremost, they can expect to come into a safe space for their care. By safe, I mean two things. While we have always offered a clean space for patient care, we have taken extra precautions due to COVID-19. Women coming to my office should be confident that they are coming to a place that puts their safety first. I also mean safe in the sense that our care is non-judgmental and comes from a place of compassion and empathy. Women can expect an open conversation. I’ll start by asking them what’s on their mind and what I can do to help. I encourage women to participate in the decision-making process about their health. We, as midwives, work hard to make women feel comfortable talking about their health in ways that otherwise might be uncomfortable. Listening to women is the center of what we do.
Does listening come to you naturally or is it a skill you had to develop as a midwife?
A little bit of both. I’m not the world’s chattiest person, so I enjoy listening to people and hearing their stories. I feel privileged to be let into a patient’s life, to hear a person’s experiences. As a midwife, there are certain kinds of listening that you do where you pick up on little nuances of what somebody is saying. Those nuances can give me insight into their health and tell me how I can help them.
You grew up in New Hampshire?
I grew up there until I was 14. My mom was from the Newburyport area on the North Shore of Massachusetts. It is a beautiful seaside town. We moved back there when I was 14. I went to college in Boston and met my husband there. I went to graduate school in New Haven, Connecticut, and then practiced and worked in Massachusetts for the first six years that I was a midwife.
Why practice midwifery in Maine?
The town I grew up in was very small and probably had a lot more cows than people. And so I never felt quite at home in cities and suburban spaces. I wanted to settle and raise a family in a more rural setting. And my parents and my sister live in Freeport now, so I wanted to be closer to them. My dad’s family for generations has been coming to Maine in the summer. Maine was definitely a place that feels like home and offers more of the lifestyle that I want for my kids.
Outside of the women’s health offices, what are your passions?
I am a total midwife cliché. I love to knit and garden and do yoga and bake, all those crunchy things that you would imagine a midwife likes to do. I’m a total nester. I’m a homebody, but also we really enjoy the outdoors. We have a dog and two kids, and our favorite thing to do on the weekends is throw the baby in the backpack and hike with the dog and the 7-year-old. My husband is a musician so we sing and make music together as a family.
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The midwives at Pen Bay Medical Center are accepting new patients. To make an appointment with a midwife at Pen Bay Women’s Health, call at 301-8900. The center is located at 3 Glen Cove Dr., Suite 1, Rockport. To make an appointment with a midwife at WCGH, call Waldo County Medical Partners Women’s Health at 505-4332. The practice is located at 16 Fahy St., Belfast.
What happens when you mix a little bit of Vermont with a little bit of Cape Cod? Just ask Jude Stevens, DNP, APRN, AGPCNP-BC.
Stevens recently joined Pen Bay Internal Medicine, a department of Pen Bay Medical Center (PBMC) that focuses on adult health and wellness. Born and raised in Cape Cod, they graduated with a Doctor of Nursing Practice (DNP) degree from the University of Vermont.
Before joining PBMC, Stevens delivered primary care to adults, adolescents and older adults in rural northern Vermont. Other clinical interests include affirmative care for LGBTQI individuals and communities and integrative care.
Stevens is accepting new patients. To make an appointment, call Pen Bay Internal Medicine at 207-301-5800. To learn Stevens’ answer to what happens when you mix Cape Cod and Vermont, read on.
What drew you to a career in health care?
I knew for several years after finishing my undergraduate studies, in which I focused on health-related issues from a more social science lens, that I wanted to translate theory into practice. The nursing model in particular was something that always resonated particularly well with me. Certain experiences, like caring for my mother during her end of life and watching her team of care providers, including nurses and nurse practitioners, had a profound influence. I knew after that experience that I wanted to pursue the path of becoming a nurse practitioner.
Have you had an “Aha” moment that confirmed your decision to be in health care?
I can think of one patient in particular who had come to see me for primary care. They had not engaged with healthcare of any kind for many years. This patient was concerned about their level of alcohol consumption. We talked about that and developed a timeline for how we were going to address that on an outpatient basis while also connecting the patient to other sources of care, including the licensed alcohol and drug counselors.
We also started to work on smoking cessation. This patient also had lingering cough and some elevated white blood cells that we discovered via blood work. Through referral to hematology, we discovered lymphoma. That was one of my most impactful examples of teamwork with a patient. Even if we couldn't address all the problems that we had in a given day, let's address what we can and get you back. I think things really started looking up for this patient as we worked together over time.
What can a new patient expect when they meet with you for the first time?
I strive to create a comfortable, safe environment for people to talk about difficult things, to share who they are, to engage in shared decision-making. I am there to provide guidance, but ultimately it's the patient's goals and needs that drive our trajectory. I am particularly interested in preventive care and assisting patients with navigating systems of care to figure out how we can best meet their needs.
When patients come to see me, they can expect a safe environment to receive their health care. Our facilities are regularly sanitized and our care team members are educated on a daily basis about COVID-related developments in our community. We take our responsibility for patient safety very seriously. Before coming to PBMC, you worked at a rural health facility in northern Vermont.
What attracts you to providing health care in rural settings?
My most recent job was at a federally qualified health center in the Northwest corner of Vermont where we provided accessible community-based care to an underserved rural community rooted in the dairy industry. Prior to that, I worked as a registered nurse for three years while I completed my graduate studies at the University of Vermont. There is great opportunity to get to know your patients and your community in a rural setting. I think there is something incredibly special about being a member of a close-knit community which prioritizes knowing and caring for our neighbors.
What are some of your passions outside of the hospital?
I love being outdoors. I love hiking. I love swimming and finding new swimming holes off the beaten path. It is incredibly important for me to be outside on a daily basis regardless of the season or weather or activity. The simple act of engaging with the natural world in some way is joy-giving for me. I also love weaving with my floor loom, reading fiction, traveling and learning new languages, birdwatching, and caring for pets and animals – even if they aren’t mine!
I'm originally from Cape Cod where my mother’s side of the family goes back many generations. In many ways, Maine combines the things that I love most about Vermont, where I lived for the last 10 years, and Cape Cod, where I was born and raised. I yearned to be closer to the ocean for the last 10 years. . I come from a legacy of people who lived off of the ocean including fisherpeople and anglers. My grandparents and great-grandmother were well-known fisherpeople where I grew up. While I haven't gone fishing or clamming since I was a teenager, I hope to relearn some of these skills in Maine and have found many other ways to enjoy being on the water.
I visited Maine as a child and one of my grandmothers was born and raised in a community of recently-emigrated Greeks who settled in Maine. I've always felt an affinity for this place. It was while I was visiting Maine last winter that I decided to follow my interest and seek a position here. I soon discovered Pen Bay Medical Center which seemed like the perfect combination of a well-resourced medical system serving a close-knit rural community. Having maintained some social connections in this area over the years, I already knew what an incredible, vibrant community this is.
When it comes to his medical education, Karl Santiago, MD, considers his two children among his best instructors.
Dr. Santiago recently joined Pen Bay Pediatrics, a department of Pen Bay Medical Center (PBMC). He is a graduate of the Maine Track, a program of MaineHealth and Tufts University School of Medicine that addresses the shortage of doctors in Maine by training medical students who are committed to pursuing careers in rural medicine.
Pen Bay Pediatrics is accepting new patients. To make an appointment, call 207-301-5600. The practice recently relocated to the new PBMC Health Center at 15 Anchor Drive on the PBMC campus in Rockport.
To learn how Dr. Santiago’s children made him a better doctor, read on.
Who inspired you to pursue a medical career?
It was a set of experiences dating back to the 1980s. My mother is a nurse in a neonatal intensive care unit. Being around her and even getting to see her unit as a very young child made an impression. I did not entertain health care as a career until late in college. I was studying economics and seeing myself headed towards some kind of health care economics research-based position. At the same time, I was volunteering for a shelter for men recovering from substance use disorders. Seeing doctors work with the clients was the first impression that I had of how a physician can play such a critical role in a person’s life. From that point on, I knew that my career and calling would be working with people individually.
Does your early economics training carry over to your exam room?
Absolutely. My favorite professor at New York University always stressed that economics is not the study of money per se; it is a study of choices under conditions of constraint. He called it a lens for viewing the world. Scarcity, incentives, trade-offs – we all face those in our daily lives. I always consider the trade-offs and incentives that make it easier for my patients to take care of themselves and take care of their families. Economics has never left me.
When children and their parents come to see you for the first time, what can they expect?
First, they will see that we have adopted procedures and policies to keep our young patients, their caregivers and our care team safe during the COVID-19 pandemic. Parents should feel comfortable maintaining wellness appointments and vaccination schedules for their children. Then, I try to be an ally of the parents and caregivers – they are the experts on their child. I seek to give them the best and safest advice that I have and try to work with them to implement that advice based on their values or the constraints that they face. I also try to understand what goes on at home, in school and in the community, because they are going to spend 99% of their time in those settings and maybe 1% of the time with me in the office. The more I understand those situations, the more parents and I as a team are going to succeed in keeping their kids healthy.
You have two children at home. Does being a parent shape the way you think about pediatrics?
Actually, my children have been some of my best teachers! Medical school doesn’t teach you the lessons you learn from parenthood. When I had my first child – my oldest is now 4 years old – I became a different kind of doctor. Now I can relate to the experiences that my patient’s parents are going through. I can anticipate their questions and anxieties because my wife and I have had similar experiences raising our own children. I don’t think it’s possible to ever completely put yourself in another parent’s shoes, but my role as a father definitely helps me to meet families where they are at.
Doctoring is largely science-based, but you also have a creative side. Where does that comes from?
When I was a kid, fidgeting in the back seat of a long car ride or in the waiting room at my doctor's office, my parents would hand me a pencil and a pad of paper. They would say, "Here, occupy yourself," and I would. Thankfully, I have had opportunities to foster that and to express myself in various ways from early childhood with painting, drawing and illustration, and then in high school and college with filmmaking. So I’ve had a lot of practice in design, graphic design, illustration, trying to find ways of evoking emotion, evoking thought, portraying an idea in the most straightforward and accessible way possible. It is a way of seeing the world.
Do you still work in film?
When I do, it is usually to make educational material. My last project was for a health care education conference, and I helped create training videos. I enjoy both the creative side and the technical side of filmmaking. Those two things, when combined, get me excited no matter what field they’re applied to.
Steven Spielberg. I hear the argument that early Spielberg is a lot different from Spielberg over the last two decades, and that is true. I think my enduring admiration comes from so much of my childhood being spent in front of a brightly lit screen watching a movie that he directed.
How about on the design side?
I am passionate about the role of design in health care. How we craft the office visit experience and the materials that we give to patients to educate them about their health have a huge impact on whether they absorb the information we give them and act on it. Good design improves health care and health outcomes.
When you signed up for the Maine Track program, you committed to learning how to practice rural medicine in Maine. Any regrets?
None. Maine has been really good to me, from being accepted by the Maine Track program and receiving my medical education from some of the best doctors in Maine, to a pediatrics residency at Maine Medical Center. Both my daughters were born at Maine Medical Center, and it's been a blessing to be able to raise them in a place like this. The beauty here is incredible. The mission of the Maine Track program is to train doctors who will practice medicine in Maine. I look forward to making good on the mission.
Kimberly Spectre, FNP, has come home. Again.
After a stint working at rural health care provider in Vermont, Spectre returned to Belfast to join the team of providers, nurses and support staff that opened Waldo Country General Hospital Walk-In Care. Their goal is to expand affordable, same-day access to a health care provider for those whose urgent needs do not require a visit to the emergency room.
Walk-In Care is located in the Biscone Building at 119 Northport Ave, Belfast. Visit wcgh.org/walkin to learn more. For more information, call 207-505-4567. To learn more about the many places Spectre has lived and why she keeps returning to Belfast, read on.
What inspired you to pursue a career in health care?
I was in the nursing program at the University of Maine, but I transferred to wildlife biology because I just wasn’t sure at the time that nursing was for me. After college, I did field work as a wildlife biologist for 10 years, and then my husband was diagnosed with cancer. Seeing how all of the nurses and doctors cared for my husband got me thinking about health care again and I realized it was something I really wanted to do. I had just had my second child, and medical school didn’t seem possible at the time. So in 2001 I started nursing school. Later, a colleague at WCGH encouraged me to earn my advanced nursing degree, which I did in 2014.
You’ve been providing primary care to patients for six years …
Actually, it wasn't until three years ago, when I was managing the PBMC and WCGH EDs, that the emergency department medical director asked me, “Would you be interested in filling in as an ED nurse practitioner?” I really loved it, but it was difficult to be both a department manager and a nurse practitioner. I will always remember a conversation with Dr. Clark (Kent Clark, MD, chief medical officer of WCGH) about trying to balance the two roles. He said, “You can do both, but you can't do them both really well. At some point, you’ll have to decide whether you want to be a clinician or a manager.” That's when I decided to focus on being a nurse practitioner. I did a one-year emergency medicine fellowship in Vermont. Now I’m really excited to come back to Belfast to help establish Walk-In Care.
You worked in emergency departments for a most of your career. Is it hard to move on?
I am through and through an emergency nurse. I breathed it for the last 15 or more years. But I also love primary care. Coming back to WCGH to help launch Walk-In Care appealed to me because urgent care is a good mix of both. Similar to working in the Emergency Department you never know what's going to come through the door, and there is the ability to make a difference in the lives of people struggling with health issues.
When a patient comes in to see you, what can they expect?
Patients can expect to be screened for symptoms of COVID-19 and required to wear a mask. Those are just two of many measure we’ve put in place to make sure that we provide a safe place for patients to come for their health care. When I enter the exam room, I’ll be wearing a mask and goggles for both their safety and mine. Then they can expect a compassionate and non-judgmental experience. We will discuss why they came in, and I’ll do a great deal of listening to better understand how I can help.
I want to return to your background as a wildlife biologist. Tell me more about that.
I did a lot of field work gathering data for biologist with more advanced degrees. They used the data mostly in population studies. As a wildlife biologist, you can do anything from working in the private sector or a nonprofit organization to working for state or federal agencies. Ornithology was something that really interested me, and I was fortunate to work at both the Manomet Observatory in Plymouth, Massachusetts as well the Massachusetts Audubon Society. I really got into identifying birds by sight and sound. In the end, I realized that I needed to earn an advanced degree to further my career as a biologist. Ultimately, I opted to enter health care and in the end health care is where I was meant to be.
Do you miss being outside that much?
I love being outside, but I can enjoy it on my own. There's never been a day that I regretted the change that I made to enter health care. I feel like it's a win-win. I get to be in health care where I can help people, and then I still have my wildlife biologist friends to talk to outside of work.
Outside of the office, what are your passions?
I'm driven by travel. I don't do it as much as I would like. And of course, right now during the pandemic I'm not doing any, but travel is what drives me. I just love the idea, even if I can't actually do it. Just reading about places I might go to excites me. New Zealand and Australia have always been an interest of mine. Otherwise, my perfect weekend is just being home, enjoying family, going for a hike or a run or just sitting with my husband by the fireplace.
Why have you decided to stay in Maine to pursue this career and raise your family?
I grew up in Massachusetts until my parents decided to move to Maine when I was 13 years old. After we got married, my husband and I thought a lot about what it would be like to live somewhere else because we were both from the mid-coast area. We moved to Washington State where I worked for Skagit Valley Community College teaching an entry-level wildlife biology class. When we moved back to Maine, we ended up in Belfast which, honestly, is where we were meant to be. It's just funny that it took us moving 3,000 miles away to learn that. When the driver for the moving company showed up in Belfast with our stuff, he looked at our rental house over-looking Belfast Harbor and said; “This looks like the town where I picked up your stuff.” That's when it hit me. You spend your whole life thinking that things are better somewhere else, and that’s not always the case. We are so fortunate to live in Belfast.
It seemed inevitable that Louisiana native Helen Cassou, FNP, would have an alligator story to tell.
After a few detours, Cassou has traveled the Acadian Highway north to join the team of providers, nurses and support staff that opened Waldo Country General Hospital Walk-In Care. Their goal is to expand affordable, same-day access to a health care provider for those whose urgent needs do not require a visit to the emergency room.
Walk-In Care is located in the Biscone Building at 119 Northport Ave, Belfast. For more information, go to wcgh.org/walkin or call 207-505-4567. To learn about the role alligators play in Cassou’s life, read on.
What or who inspired you to enter healthcare?
My first career was in industrial hygiene and environmental consulting for a small firm in Louisiana, which is where I’m originally from. The job required me to go to different industrial facilities and perform plant-wide assessments on the workers’ exposures to different elements in the workplace. I became increasingly interested in the health aspect of the job. When the company lost a big contract and I got laid off, I applied to LSU School of Nursing in New Orleans and have since dedicated myself to health care.
You continued your education to become a nurse practitioner. What inspired you to do that?
During the different rotations I did in nursing school, one of my instructors encouraged me to pursue a career as a critical care or emergency room nurse, but I didn’t think I’d be good at that. Months later, I was going out to eat at a restaurant in New Orleans. When I pulled up, there was a crowd gathered around a woman on the sidewalk who was turning blue. She was choking. I just instinctively got behind her and did the Heimlich maneuver. Then I gave her CPR, and she recovered. It was her 76th birthday. A few weeks later I was surprised when an executive from the American Red Cross came into our class and presented me with the Heartsaver Hero Award. I found out my instructor had called the Red Cross. She approached me after class and said, “See, I knew you would be a good emergency nurse.” I took a job as a nurse tech in an emergency room just to see if it would be a good fit. When I graduated nursing school, I worked as an RN in different emergency departments. It was fulfilling, but as time passed, I began to notice a link between the lack of primary care and the cause of overuse of the emergency department for routine health needs. I developed a desire to help increase access to primary care. That desire is what drove me to pursue a degree in advanced practice nursing.
When a patient comes in to see you, what can they expect?
As we continue to navigate the COVID-19 pandemic, patients can expect a safe space to come for their health care. We require patients and all staff to wear masks, practice good hand hygiene and maintain appropriate distancing. My priority when I walk into a room with a patient is to determine if they are in the correct place. Should they be here, or do they need to be in the emergency department? Then I comfort and reassure the patient and make them feel safe.
You are part of the team that launched Walk-In Care as a new service at WCGH. What is it like to help start something that is so important to the health of the community?
This clinic is an incredibly important way to improve the health of our community. This is the second clinic that I have been a part of opening here in Maine. I initially came to Maine to help launch a sleep clinic for another health system. What I’ve learned from both experiences is that you have to be flexible. You have to communicate. You have to be able to adapt. There are going to be things that work and things that don’t work. You have to learn how to switch gears quickly and with grace and ease. I think everyone on this team has the ability to do that.
Outside of Walk-In Care, how do you spend time off?
I love to hike. I am not a fan of the gym, but I find solace in exercise. I lost 80 pounds this past year after I started hiking. I go almost every weekend, at least three to five miles. My goal is to hike all the peaks on the Appalachian Trail in Maine before I’m 50. I’ve got a few years to go!
I’m also passionate about photography. When I moved to Maine, I was thrilled with the clarity of the night sky. I bought a camera and started doing astrophotography – taking pictures of astronomical objects such as the moon, planets and the Milky Way.
I was born in New Orleans, but my dad was in the Marine Corps, so I moved around a lot as a kid. I’ve lived in Cuba, Japan, Virginia, Tennessee and Wyoming. I’ve been to a lot of places in my life and I can tell you, the people here in Maine are refreshingly genuine. My favorite food is lobster. Down in Louisiana, we’re all about seafood: crabs, crawfish, shrimp. I love blueberries and all the foods that are indigenous to Maine although I have yet to try fiddleheads! I like rural areas. My first nurse practitioner position was in Wyoming. I’m attracted to rural areas because I’m passionate about bringing health care to people who otherwise struggle with access.
Do I hear a little Louisiana in your voice?
Yes, sometimes it comes through. My mother is full Cajun. My grandmother was born on the Bayou and lived with 14 brothers and sisters like sardines in a little bitty boathouse. She just recently passed. She lived to be 87 years old. My mom is now living in her house. She posts videos of herself on Instagram feeding the alligators in the backyard. I told her, “Momma, if you keep feeding those gators, they’re going to start coming after you!”
A Midwesterner at heart – and a devoted fan of the Nebraska Cornhuskers football team – Anthony Floreani, MD, has nevertheless fallen for the charms of the Maine landscape and the people who inhabit it.
Dr. Floreani is a pulmonologist at Waldo County General Hospital. Pulmonologists diagnose and treat disease of the respiratory system, including the lungs and other organs that help a person breathe. They are also called on to care for patients in intensive care units who need life support and mechanical ventilation.
A native of Nebraska, Dr. Floreani attended the University of Nebraska College of Medicine and completed a fellowship and a residency at the University of Kansas School of Medicine.
Dr. Floreani is accepting referrals. To learn more about how he might help you, call his office at 207-505-4674. To learn how the Maine landscape and its people differ from his native state of Nebraska, read on.
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Who inspired you to go to medical school?
When I was a young boy, I had a mild operation. In the hospital, I saw these young doctors walking around in their white smocks with stethoscopes hanging around their neck. I thought what they were doing was pretty neat, particularly since they were very nice to me and allowed me to have ice cream while I was in the hospital, which was a big treat. As a kid, I was also influenced by some television shows that were about doctors. I probably went through some phases where I wanted to be an astronaut or a firefighter or a cowboy, but in the end I always wanted to be a physician.
What steered you to specialize in pulmonary medicine?
When I was doing my residency, I did a rotation in pulmonary medicine, which involves a lot of work in the intensive care unit. It was a busy intensive care unit. Very early on, it was apparent that the people who did pulmonary critical care were kind of like the firefighters in the hospital. They were called on to put out a lot of fires, so to speak, and cared for a lot of different patients. I found it very interesting. I also had a supervisor, what we called a supervising resident, who was going into the field and he talked about it in a positive way. I think that when someone talks enthusiastically, it makes you enthusiastic, too. It did for me.
When a patient comes to your office for the first time, what can they expect?
The first thing they will notice is how much work we have put into making sure they are coming into a safe space for their health care. Even before COVID, WCGH put patient safety first. We have only heightened our diligence during the pandemic. Once here, patients can expect that I will listen to them, and sometimes that’s the most important thing a physician care offer. It has been said that our job is to “cure sometimes, relieve often and comfort always.” This quote recognizes that much of what we see is not curable. I have always found those useful words to remember because it really tells you what we should be doing.
In your years of practice, has there been a specific experience that confirmed your decision to practice medicine?
During my residency, I did a rotation at a hospital in a rural part of Kansas. A very young couple came in distraught because a dog had bitten their young child on the face. I examined the jagged laceration on the boy’s face, and I told them that I thought that they should go to a nearby community about 60 miles away that had a plastic surgeon. They said, “No. We're farmers. We don't have that kind of money, and we don't have insurance. Could you just please do the best job you can.” Well, interestingly, I had always known about sewing since I had parents that were tailors and owned a clothing shop. More importantly, when I was in medical school, I worked in an emergency room and helped the plastic surgeons sew up lacerations that came in. These plastic surgeons saw that I was interested and taught me some very basic things about how to debride those lacerations and how to sew them up. So I worked on this child for a long time and did the best I could. When the parents and the child returned later to have the wound checked, I was nervous. We took the bandaging off. God had been so kind and had guided my hand, so to speak, because the wound healed with very little scaring. The mother baked me a peach pie to thank me, and I thought, wow, this is incredibly cool.
Will you tell me something about you that I'm not likely to know but would be interested in?
My wife and I like to hike and to travel. I like to read, I like to paint. I come from a family of artists, and I have to say that I'm the least talented of the family – but I still like to dabble. And that's what we do.
Why have you chosen to practice medicine in Maine?
We love Maine. I come from a prairie state in which trees are few and far between except when they've been planted across river valleys and river beds and creek beds. And so I appreciate the natural beauty of this state and all the forest. I had read that Maine is the most forested state in the United States and I can believe that. When I was in high school, we had summer reading assignments. One summer I read “The Last of The Mohicans” and “Deerslayer” by James Fenimore Cooper. From that I developed a highly romanticized vision of what new England was like. And it hasn't disappointed. I have found Mainers to be very polite, direct, which is also the way people in the Midwest are, but also very friendly.
As a young teenager, Shannon Axelson, CNM, was inspired to a career in health care while helping a local veterinarian deliver puppies. As an adult, she is inspired by far more human concerns.
Shannon recently joined Waldo County General Hospital (WCGH) as one of a team of certified nurse midwives providing a full range of care for women of all ages, including birth control, annual checkups, pap tests, breast exams, sexually transmitted infection testing and treatment, preconception care, abnormal bleeding evaluation and menopausal care.
WCGH has put in place a number of additional measures to ensure the safety of staff and patients during the ongoing COVID-19 pandemic. All patients are strongly encouraged to maintain regular appointments and routine screenings such as mammograms, where early detection can minimize the risk of such life-threatening diseases as breast cancer.
To learn more about midwifery services and schedule an appointment with Shannon, call Waldo Medical Partners Women’s Health at 207-505-4332 or go to wcgh.org. To learn about what turned Shannon’s focus from puppies to humans, read on.
Who or what inspired you to enter health care?
My neighbor, where I grew up in Northern Vermont, was a veterinarian. I used to help her when she delivered puppies, and I became fascinated with birth through that experience. In fact, I thought about going into veterinary medicine. Then, as I aged and became more aware of women having babies, I became more fascinated with human birth. I knew pretty early on that I would go to nursing school when I finished high school. After that, midwifery school seemed inevitable.
The strong women in my family were a big influence, too. My dad’s mom is 96 years old, and my mom’s mom is 93. They both still live on their own. They have both had their share of struggles throughout their lives, but persevered nonetheless. I always knew, as a woman anything was possible growing up with their influences.
Given how focused you were at such a young age, do you think of midwifery as a calling?
I don’t know if I would describe it that way, but I knew that I wanted to help take care of people and I wanted to empower the next generation of women. I grew up in a very small town, and many women took on specific roles in the home. I wanted women to see how much opportunity they have and encourage them to do whatever they set their mind to. I also recognize that having a child is one of a few experiences during our lifetime that stays etched within us. Most women remember what they ate that day, when they showered, and how hard they worked for the birth of their child. It is a gift to be able to a part of this process.
What is the scope of care that a midwife can provide?
In addition to caring for patients through their pregnancies, we provide gynecological care for all women. I always ask my patients if they are taking enough time for themselves, because a lot of times we put ourselves on the back burner. It’s really important for women to recognize that we become better at our jobs, more present for our children and our families if we spend some time taking care of ourselves as well. I have patients that I’ve been caring for long enough that I now see their children as patients. I care for women through the whole life cycle, which is part of the beautiful thing about being a midwife.
When a new patient comes into your exam room for the first time, what can they expect?
I make the environment as welcoming as possible. I want them to know that it’s a safe space for them to ask any question they might have. But I think a lot of it is guided by the patient in terms of figuring out where they’re at and what they need at that time. I think we as health care providers all have our standard questions. But then it moves further into, “Individually, what’s going on with you?” It really is about building a trusting relationship between the patient and the midwife.
Has COVID-19 forced you to change or rethink the way you work as a midwife?
Yes. Patients have many more questions. Do they get vaccinated when they’re pregnant? What happens if they get COVID while they’re pregnant? And people continue to struggle with the isolation created by the need to maintain social distance. I usually lead centering groups, which is prenatal care provided in a group setting. We usually meet for two hours and talk in depth about pregnancy, breastfeeding and birth. We discuss questions like, “What do you envision your family to be like?” “What was it like for you to grow up in your family?” “What are some things you want to bring forward with you?” “What are some things you don’t want to bring forward with your family?” Studies have shown that these groups produce better pregnancy and birth outcomes. COVID has changed the dynamics of that. We tried to do it as Zoom meetings for a while but it was just not the same. It’s hard for a group of strangers to bond and build trust virtually.
What are your passions outside of work?
I’m very passionate about being physically active. I love biking. I ride a recumbent, have a Peloton bike and I’ve been fat tire biking for a number of years now. I cross-country ski, too. I enjoy spending time with my husband and our son. We have two dogs that we love to bring out in the woods with us while we’re playing in the outdoors. I love reading and puzzling. Before COVID, I was certainly very social. That’s been challenging, as it has been for everyone. These days I focus on the journey of trying to guide our 16 year-old son through the pandemic.
How did you come to be in Maine?
I’ve been in Maine since 2002 seeing patients as a midwife in the Waterville/Augusta area. Before that, my husband and I both worked in New Mexico for the public health service at Gallup Indian Medical Center on the border of the Navajo Nation. It was a great place to work. The midwives did all of the deliveries, so I was very busy. And then 9/11 happened and we couldn’t get back East very easily to our families because of travel restrictions immediately after the attack. In that moment we realized we wanted to be closer to family and water! As soon as we could, we moved back East and ended up in Maine, which made sense because we had spent a lot time here skiing, camping, and hiking.
Some people doodle. When Sara Valente, MD, sketches, it is with purpose.
Dr. Valente, an urologist who joined MaineHealth in March, sees patients at Pen Bay Medical Center. Urologists are surgical specialists who also treat certain conditions affecting the prostate, testicles, kidney and bladder in patients of all ages.
A graduate of the University of Massachusetts Medical School, Dr. Valente has published in several academic journals and presented at a number of conferences. Her volunteer work is wide ranging and has included time with Teach For America and in the neonatal intensive care units at UMass Memorial Medical Center and Brigham & Women’s Hospital.
To learn more about the urology department at PBMC, go to www.pbmc.org. To learn exactly what—and where – Dr. Valente likes to draw, read on.
Who or what may have inspired you to pursue the path that you did?
Mine was a little bit of a convoluted path. I studied business management as an undergraduate at Boston College, where I learned about a program called Teach For America during my senior year. Teach For America is a program that attracts recent college graduates to teach in underserved communities. I was drawn to their mission of educational equity and inspired by their goals. My mother was elated, as she is a teacher. So I applied, got in, and was assigned to teach 8th grade in a community in Arizona.
I saw such gross disparity, not just in educational opportunities for these kids, but also in health care. I struggled for some time trying to determine how to tailor my lessons for one of my students to best help her understand, only to ultimately finally realize that she understood perfectly well, but couldn’t see the chalkboard because her family couldn’t afford to get her new eyeglasses. I expected to be the one doing the teaching, but the experience was educational for me in a way I could not have predicted. At the same time, I injured my back. I just happened to have a doctor who picked my brain in a way that I’d never had a physician do before. He was really interested in the idea that my background was in business management, and yet I was teaching. “What about medicine?” he suggested. No one in my family worked in health care. In fact, if I say the word ‘blood’ around my sister and aunt they get queasy. We have to refer to blood as, “the B word!” So, my initial reaction was, “Medicine? No, that’s crazy.” It took years of hard work, continued support and encouragement from my husband and family, sacrifice, and dedication...but that doctor put the thought into my head and here I am.
How did your mom respond when you told her you were going to be a doctor?
She was surprised. I think she was hoping that one of her kids would be a teacher and she would have been thrilled if that had been me. She always supported any avenue I wanted to go down, but I think she was hoping that I would stay with teaching.
Has there been a mentor who was especially important to your career?
I’ve had so many good teachers along the way. When I was a medical student at UMass, I met a urologist named Dr. Robert Blute at St. Vincent Hospital in Worcester, Massachusetts. He got me interested in urology. He’s such a welcoming person, friendly and funny. He always made patients feel like he had all the time in the world to give them. Even though he was really busy and his waiting room was overflowing, he never made anyone feel rushed. He had patients who he had followed for years, even patients whom his father (also a urologist) had seen before him, and I was drawn to the continuity in those patient-doctor relationships. I credit him for my focus on urology. After that, pretty much every urologist that I bumped into said, “Oh, hey, you’re interested in urology? Come with me.” The urologists I met as a student had diverse interests, were kind and humorous, and seemed happy. They say that, as a medical student, you have to find your people. I never really understood what that meant until then.
So what can a patient expect when they come to you for the first time?
I talk just the way that you and I are talking right now. Some people prefer a more formal environment, and I will try to adjust accordingly. I reassure them in a friendly tone that they will receive individual care tailored specifically to whatever concern brought them to my exam room.
These days, people are understandably anxious about going to the doctor’s office in the middle of a pandemic. As I toured Pen Bay Medical Center during the interview process, it was clear that they have taken all the precautions recommended by the U.S. Centers for Disease Control to ensure a safe space for patients to come to for their health care. I think it’s important for people to realize that delaying care is unnecessary and can in fact harm their health.
Both my husband and I are from New England. Maine has always been special to us. We eloped and married here 8 years ago. We have family nearby. We are also very excited to be close to the ocean, as we both love the water. My husband grew up on Cape Cod and I grew up on a lake in central Massachusetts. As soon as I could walk, my mom had me on water skis. My mom was pretty disciplined about making me get up every day to waterski with her. My grandparents also lived near the ocean and I have so many childhood memories with my Gram that involve the sand and waves, the sun and the ocean air. My husband knows how to sail. His parents taught him when he was little, just like my mom taught me to waterski. He really wants to teach our daughter to sail and to swim. We want her to know and feel that connection we feel to this beautiful environment.
I’m also really excited about the libraries here. It was exciting to learn that Rockport just built a new one. I saw it for the first time while out with a real estate agent. I was giddy when we drove by. I said, “If that’s a library, can we pull over?” Now I’m revealing my nerdy side, but who doesn’t love a good library?
Can you tell me something about yourself that I might not otherwise guess?
I have an almost 2-year-old. Every day I get to see the world through a child’s eyes in which every single thing is a new experience. We are grateful to be back near our families and watching her now get to know my nephew, who is the same age, and her grandparents is exciting. My biggest pride is my daughter.
Oh, and I still like to teach. At work, I draw on everything. I especially like to draw on the paper covering the exam table to help explain something to a patient. When I’m sitting with a patient, I will often draw the relevant anatomy, particularly if we are discussing kidney stones or bladder tumors. If I can look at a patient’s CT scan and then illustrate for them in a drawing that the miserable kidney stone they are dealing with has passed 75% of the way, then they can better understand what they’re going through and perhaps that helps them manage the pain. All of my colleagues at my previous job got used to seeing my drawings scattered around. I am not an excellent artist, but I think my drawings helped patients understand their anatomy. I think my mom would like that.
Dayton Haigney, MD, always wanted to be a doctor. And he's always loved fly fishing. But it took time for him to discover how the two intersected. Dr. Haigney joined the Physical and Integrative Medicine practice in Searsport at Waldo County General Hospital (WCGH) earlier this year. As a physiatrist, he has spent more than 40 years treating a wide variety of chronic pain conditions affecting the brain, spinal cord, nerves, bones, joints, ligaments, muscles and tendons. Before joining WCGH, Dr. Haigney served as chief of physical medicine and rehabilitation at the Togus Veterans Administration Medical Center. For more information about Dr. Haigney, contact his office at 548- 2475 or visit online. To learn how fly fishing keeps his medical skills sharp, read on.
What inspired you to go to medical school?
There was no family member or anything like that pushing me into a career in medicine, and yet I wanted to be involved in health care in some way, shape or form from an early age. We had a family physician who was a good role model, but otherwise I was self-motivated to pursue this career.
Do you recall a moment when you said to yourself, "This is why I went into medicine"?
Part of what attracted me to physiatry was the fact that it takes an integrated, holistic approach. We don't just look at the abnormalities that might be revealed by an x-ray but at other factors that might be contributing to a person's chronic pain, like sleep patterns and diet. So when I got exposed to physiatry, I realized that, "Oh, this is something that makes a lot of sense to me. This is the way I want to practice." I've been very happy with my decision. I've been out of medical school for 41 years. Every day since then I've had an experience that has confirmed that I made the right decision.
What will a patient experience when they meet with you for the first time?
They will quickly realize that I ask a lot of questions about their life in general, what's working, what's not working, what other factors could be contributing to their pain, everything from diet to mental health issues. In chronic care, there are all these other contributing factors that we have to unearth. For instance, is there stress at work or at home? Do you get a good night's sleep? What's your diet like? Is there depression, anxiety, mood swings? Then we talk about functional improvement in terms of the patient's ability to perform their job or their functions as a husband, wife, a parent. When I address chronic pain, I address the whole person to help them get back to doing the things that are most important in their lives.
What are your interests outside of the office?
My wife and I are birdwatchers, and I like to fly fish. I tie my own flies. Being out in nature is important to me. It's the way I recharge my batteries. We relocated from southern Maine to Midcoast Maine about four and a half years ago, and it's a delightful place to be, I think. We like the four seasons. We like the people here, so we're content.
Where do you fish?
I have pretty much fished all over Maine, from the Rangeley area, the Androscoggin River area, Moosehead Lake, the Moose River, the Kennebec River. I fish the St. George River over in Hope and Appleton. And I've done a lot of saltwater fly fishing in southern Maine. Sure, I like catching fish but really it's about getting outside and just trying to be aware of all that you're seeing. That's the reward.
Do you find any lessons in fly fishing that you use in your exam room, or vice versa?
When I'm out in nature, from birdwatching or watching the seasons change, it's just being aware of all of the subtleties because they add up to the big picture. I try to be very observant with my patients and actively listen to them. If they know they've been heard, then I've succeeded.
After your stint at Togus, why did you chose to remain in Maine?
We've been here since 1985. We love the geography. We love the seasons. We love the lifestyle. I think that the pace is appealing. I don't think we ever considered leaving Maine. This is where I wanted to be from a very early age. I had an uncle that lived on Peaks Island. I've been coming to Maine my whole life.
Wherever she has traveled, India Pappas, MD, has always felt best when she comes home to Maine.
Dr. Pappas recently joined the Women’s Health and Obstetrics department at Pen Bay Medical Center. The department’s team of medical doctors and midwives provides comprehensive care to women at all stages of their life.
Born and raised in Harmony, Maine, Dr. Pappas attended the Tufts University School of Medicine as part of the Maine Track program that prepares doctors to practice medicine in rural settings. She did her residency at Maine Medical Center, including an away rotation at PBMC.
Dr. Pappas is accepting new patients. To make an appointment, call the Pen Bay Women’s Health Center at 207-301-8900. To ensure patients receive the best and safest care, PBMC has put in place additional safety measures during the ongoing COVID-19 pandemic. To learn more about how we have created a safe space for patients, go to mainehealth.org/coronavirus-covid-19/safe-appointments.
MaineHealth encourages everyone to get vaccinated against COVID-19 as the best way to end the pandemic. Vaccinations are available at The Pharmacy at PBMC, PBMC Walk-In Care, WCGH Walk-In Care, and from our primary care providers. To learn more about Dr. Pappas, read on.
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What or who inspired you to pursue a career in health care or go to medical school?
My father inspired me to become a doctor. When I was really little he said to me that I needed to become a doctor so I could take care of him when he got old. And I said, "Okay, I can do that." And it just stuck with me. Eventually, I told my dad that I wanted to focus on caring for women which, of course, meant I wouldn’t be taking care of him. He was still proud.
Any other early influences?
In high school, my guidance counselor set me up with shadowing opportunities. I was shadowing a neonatologist at Eastern Maine Medical Center when I saw my first delivery. Neonatologists get involved in high risk deliveries. He said to me, "Make sure you just sort of stand in the corner and kind of keep quiet and if you feel like you need to step out at any moment, just go ahead and step out." I was like, "Oh, my goodness, what's going to happen? Am I going to pass out?" I had no idea what to expect.
As I was watching this baby be born, I felt this smile come across my face and I was like, "This is the coolest thing I've ever seen. This is exactly what I want to do."
When a patient comes to see you for the first time, what can they expect?
They'll get a smile. Of course, I’ll be wearing my mask, but they’ll see my smile in my eyes. I like to listen to them tell their story to better understand who they are, where they're from, what they do in this world and what their goals are for the visit. It’s also about reading their body language and how comfortable they feel and trying to create a safe environment for them to be able to talk to me. Then I do a comprehensive review of their medical history. It's absolutely a partnership all the way through.
Our women's health practices here and at Waldo County General Hospital are unique because we have such a breadth of knowledge and different types of practitioners. We have medical school trained MDs. We have certified nurse midwives. We have wonderful nurses and medical assistants who know the different types of care that our patients need. And we have a counselor. All of this allows us to provide incredibly comprehensive care for women right here where they live. I feel privileged to be a part of this team.
What are your interests outside of the hospital?
I have an almost six-month-old son, Niko. He is pretty much the center of my life outside of the hospital. My husband, Alex, and I very much enjoy outdoor activities – so coming to the Rockport-Camden-Rockland area was perfect for us. We like to go on hikes with Niko and are excited to go to the Snow Bowl this winter.
Would you tell me something about yourself that would surprise me?
All my siblings are named after places.
So you're named after India?
Yes. Sometimes people assume because of my name that I’m from India. I say no, my father just thought it was a beautiful country.
What are the other place names for your siblings?
I have an older brother, Dakota. I have a younger brother, Montana, and I have a younger sister, Chyna.
Did your parents travel to all those places?
They did not. The short answer is, my parents were hippies and they decided to be a little unique.
You were born and raised in Maine. You went to college in Maine and completed your medical training at Maine Medical Center. Now you’re here at PBMC. What keeps you here?
I've traveled quite a bit, and no matter where I go, no matter how beautiful it is or how exciting, I always feel so much better when I come back home. I enjoy traveling the world, but I love Maine – I’ve said that after almost every single trip I've taken. Maine is where I belong.