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.
That Maine native Samuel Madore, DO, is practicing medicine in the state where he was born and raised is the result of two things: A bout of back pain when he was young – and the call of the wild. As a primary care provider at Waldo County General Hospital, Madore focuses on how a patients’ health relates to your nerves, muscles, bones, skull and spine. He is board certified in family medicine, neuromusculoskeletal medicine and osteopathic manipulative medicine. Dr. Madore is accepting new patients. To make an appointment, call Waldo County Medical Partners Primary Care at 207-505-4567. WCMP Primary can be found online here. To learn how Dr. Madore’s back pain led to a career in medicine, and how many of the state’s 4,000-foot peaks he has climbed, read on.
What or who inspired you to go to medical school?
In high school, I was always interested in biology, and chemistry and nature. I went to the University of Maine in Orono as an engineering major, which then changed into biochemistry/microbiology. I was going to get either a master’s degree or a PhD in some lab science. Then I started to have my own back pain in college. I saw a number of different physicians to try to get help with that. I finally found an osteopathic doctor who evaluated me in a way that I found ... useful. The experience helped me realize that I did not want to sit in a lab all day, I wanted to try to help people with pain. That put me on the path to becoming a doctor.
When a new patient expect when the comes in to see you for the first time?
Patients can expect me to ask about their diet, activity level and lifestyle as those things might pertain to their health. I’m always digging into people’s sleep, diet, exercise and stress levels as much as I can. I do my best to sit back and let the patient tell me their story. To me diet, sleep and movement are often the most important things to focus on. Our modern life just predisposes all of us to some ailments. If we keep putting our hands on a keyboard, on the steering wheel, on our phone, we’re always going to get tight shoulders and tight backs. I can make the patient feel better temporarily, but the real solution is the change to way we do these things.
What are your passions outside of the hospital?
I’m pretty outdoorsy. I like to fish, I like to garden, I like to trail run with my girlfriend and my dog and just kind of explore all the places I haven’t been yet in Maine even though I’ve lived here my whole life. I still want to canoe the Allagash and hike all 14 of the 4,000-foot peaks in Maine. I’ve hiked six of them so far.
Craziest outdoor adventure?
In California, we were hiking along the coast and we’re on this ledge, looked down, saw this beautiful beach, and decided we would spend the night down there. We had maybe two hours of light left and we bushwhacked our way down and got to the beach just as high tide was peaking and realized there was only a foot of sand left. So we had to bushwhack our way back up. At one point I was crawling on my stomach underneath shrubs. And then a couple of minutes later I was crawling over shrubs, not even touching the ground.
Nature holds many metaphors for poets. Does it hold any for medicine?
I think so. When you see a river that’s been dammed up for decades, and then it becomes undammed, like the Penobscot River, fish come back. Wildlife comes back. It may take a decade or two, but the habitat regenerates. It reminds us that patients really can truly heal. I think a lot of our chronic medical conditions are us living in a way that contrary to the pace of our evolution. Our way of life has changed drastically in the last 15 years with the internet, in the last 100 years with cars and processed foods. But we need to remember that we’ve been around for 299,000 plus years not living like that and our genes have not adapted. So when I see animals in their own state being healthy, as far as anyone can tell, having good communities and doing what they do best, it reminds me that they are in a place that’s well suited for their genes.
You were a Boy Scout. Did you earn a First Aid Merit Badge?
I earned the Lifeguard and First Aid merit badges and many others. I don’t know if there’s any more medical related ones. But that was a big piece of developing a love for adventure.
Our troop was, I don’t know, 30 kids. There was a lot of adult involvement. We went on canoe trips, hiking trips, biking trips. We got out there, and we did things. It was a great troop. But once you get to 16 years old, a lot of your friends leave the Boy Scouts and so you need a reason to stick with it. Earning Eagle Scout was my reason.
It seems so many young college graduates choose to leave Maine, but you stayed. Why?
My family and friends are here, and there is a big need for health care providers here. And there’s just a lot of fun things to do here. Even when it’s frigid out, I’ll go ice fishing. I’ve visited other states. Other than Northern California, nothing really spoke to me as Maine does.
Pop Quiz: How long does it take a native New Englander living in California to stop being a Patriots fan?
More than 30 years, if Paul Krivitsky, MD, is counting. A board certified surgeon, Dr. Krivitsky recently joined the Ear, Nose and Throat (ENT) department at Waldo County General Hospital after more than 30 years in private practice in California. ENT treats diseases of the ear, nose and throat including speech and swallowing problems, reconstructive surgery and head/neck cancer. Dr. Krivitsky is accepting referrals. For more information, call his office at 207-505-4367 or visit online. To find out if his allegiance to the Patriots ever wavered during his time in California, read on.
What or who influenced you to pursue a career in medicine?
I have always been interested in medical related things. As a kid, I was a very active model builder. I made hundreds of models. Cars, ships, airplanes and stuff. I also made this model called the Visible Body. It has a clear body and you could see the organs inside the skeleton. I even made a model of a nose, believe it or not. My mother was a big influence on me, too. She had two uncles who were physicians. One was a family practice doctor in Massachusetts and the other was an anesthesiologist. They probably had a small influence on me, but it was my mother steered me in that direction.
Have there been mentors that have shaped you as a physician?
When I was doing my surgery rotation in medical school, I became good friends with one of the chief residents, and he suggested that ENT would be a great specialty. He had a lot of influence on me. As a result, I chose the chairman of the ENT department at Boston University Medical School to be my medical school advisor. There was never any question in my mind that I would be a surgeon. But what kind of surgeon? These mentors are the ones who influenced my decision to specialize in ENT.
What can a patient expect when they meet with you for the first time?
The way I approach patients has been developed over many, many years. I try to make a good impression with a patient on a personal level. I want them to be comfortable. I spend a lot of time getting to know them and understand why they are here. During the exam, I’ll explain what I think the issue is and why I think that and what the next steps are. When they leave my office, I want them to feel that I’ve listened to them and that we have a plan to address their particular situation.
How long have you been in Maine?
About three years now. After medical school in Boston, where I grew up, I did my training in California. I was in private practice in Orange County for 30 years before moving back to New England. My family is still in the Boston area, and I wanted to be closer to them. My grandfather was in the shoe business, and I remember coming to Maine with him to visit shoe factories in all these little towns.
What sparks your interest outside of the hospital?
I am not really the kind of traditional outdoorsman that might want to move to Maine. I don’t hunt, I don’t fish, I don’t really camp. My two main hobbies are bicycle riding, which I do avidly, and motorcycle riding. I also snowboard. In California, my motorcycle buddies and I were sport riders in the canyons and mountains above Los Angeles. We rode in the San Gabriel Mountains in an area called Angeles Crest, at 5,000 to 7,000 feet above sea level. There are very few cars on the mountain roads, and the roads were all curves, nothing straight. These days, I’ve given up the sport bikes and ride a cruising bike. It’s set up so I can still have some fun.
After 30 years on the West Coast, do you find yourself rooting for California teams?
No, I have always been a big Patriots fan and Red Sox fan. Bruins and Celtics, too. I have enjoyed reconnecting with my teams. Even in California, I watched most of the Red Sox and Patriot games – which you might imagine did not go over well with my California friends.
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.
When Joseph Noonan, MD, fractured his femur during a college hockey game, little did he know that the road to recovery would lead him to a career in medicine. Dr. Noonan provides experienced specialized care in sports medicine, diseases of shoulder and elbow, as well as general orthopedics as part of WCMP Orthopedics and Sports Medicine at Waldo County General Hospital. WCMP Orthopedics and Sports Medicine offers services from minimally invasive treatments to total joint replacements using the latest technologies. The goal is to provide pain relief, increase function and help patients get back to doing what they love most. Dr. Noonan is accepting referrals. To learn more about Dr. Noonan, call his office at 505-4398 or click here. To learn how a sports injury influenced his career choice, read on.
Is there a person or a circumstance that inspired you to consider medical school?
Yes, I was a freshman hockey player at Williams College and fractured my femur in a game when I was 19 years old. Dr. Arthur Ellison took care of me, and he inspired me. He was an orthopedic surgeon in North Adams, Massachusetts. Then, going through the rehab process to get back to playing strength led me down the road to medicine and to orthopedics specifically. For unrelated reasons, I transferred to a new school after that and played three years of college hockey in Saint Paul, Minnesota at the University of St. Thomas. I was an all-conference player when I was a senior.
Does that experience influence the way you work with patients now?
I never tell patients about this experience but it does help me empathize with not just the athletes but with all my patients. I can better relate to how important their care is to them. I have a strong sense of what it would mean to them to lose physical function because of an injury.
I understand that you worked with several professional sports teams. Tell us more about that.
I did a shoulder fellowship at the Carrell Clinic in Dallas, and the clinic took care of many of the orthopedic needs of the Dallas Cowboys, the Dallas Stars and the Southern Methodist University Mustangs football teams. That experience helped me get a position as a sports fellow at Penn Orthopedics in Philadelphia. This gave me the opportunity to work with the Philadelphia Eagles, the Philadelphia Flyers and the Philadelphia Kixx soccer team. I was the onsite physician at two Eagles training camps, and I evaluated players at the NFL combine for two years.
What is it like when your exam room is the sideline of an NFL team?
It was really exciting to be at the games, but that comes with a lot of responsibility. It changes the way you watch the game. You don’t enjoy the game as entertainment because your too busy watching for the mechanism of injury. The Eagles had two doctors on the sidelines. If somebody was hurt, one of us would take the player into the locker room and do an exam and the other would stay on the field. The main question was, can he go back into the game? And if not, when is he going to be able to play again? And you better be right about it.
Does anything from that experience help you provide better care for patients at WCGH?
No doubt. When I was working with professional sports teams, I was fortunate enough to work with and learn from one of the best sports surgeons in the world. There are 56 players on a football team and 80 players in training camp. To be able to evaluate them day in and day out, I had to develop good skills and habits. You learn how to communicate, and you learn better diagnostic skills. You learn how to come up with a plan and to implement it. Of course, there is a big difference between that population, which has youth on its side, compared to many of the elderly patients that I see at WCGH that have degenerative problems. To me, it’s just as rewarding to help one of my patients be able to reach in the cupboard and get a glass from above. Or to help them sleep better because they don’t have shoulder pain at night. I find satisfaction in improving the quality of their lives.
When patients come into your office for the first time, what will they experience?
I think it’s my job to treat not just whatever is physically ailing my patient but to try to figure out who that person is, what makes that person tick, what kind of a sense of humor they may have, what kind of language they may respond to. To develop some type of a trusting relationship with them goes beyond just taking care of what happens to be wrong with them physically. This means I listen a lot. Of course, you are limited in how much time you can spend with a patient so you learn how to figure out quickly what motivates them, what you may have in common with them.
What has inspired you to practice medicine in Maine?
In some ways it’s like returning home. My family moved to Portland in the early 1960s when my dad got a job here. We moved around the East Coast following his work, and eventually moved out to St. Louis in 1971. I was 15. I went to Deerfield Academy in Massachusetts and then, as I said, Williams College for a year and a half. With six kids in the family, the cost was too much, so that’s when I transferred to St. Thomas. Out of medical school, I practiced in Connecticut and Rhode Island. I moved back to Maine to take a position at Franklin Memorial Hospital in 2016. I’ve been here ever since. I really like the coast. People are kind here and very accepting of dogs, which is important to me.
What are your passions outside of the hospital?
My son is a college hockey player, and I try to watch his games. He plays at a Division III school in Providence, Rhode Island. I’ve always liked going to my kids’ competitive events, regardless of the sport. Both of my kids were soccer players. I never played soccer in my life, but you learn about it so you can support them along the way. That’s been important to me.
I have a dog at home, and I like spending time with her. Her name is Lucy and she’s a Black Mouth Cur. They’re bred as hunting dogs, although I don’t hunt. I never knew the term before, but she’s what is called a treeing dog. The dog in the Disney movie “Old Yeller” was a Black Mouth Cur. Just like in the movie, they’re fearless. And yet Lucy doesn’t have a mean bone in her body. She just loves people and other dogs.
Will you tell me something about yourself that I might not otherwise know?
My faith is very important to me and has been since I was a kid. My family is Irish Catholic, two Irish Catholic parents and six kids. We used to take up an entire pew in church. Faith is a struggle. So much stuff happens in the world and you wonder why, but you keep fighting every day. I say the rosary almost every day. I pray for the patients that I take care of. I pray on my way to work, when I have surgery, that I do well that day for the sake of my patients. I know it’s not popular these days to talk about your faith, which is why I’ve hesitated to mention this. I’m not fanatical. I just try to do my best for my patients and hope there is someone else above me who is on my side.