Provider Q & A

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.

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.

Favorite filmmaker? 
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.

Tristen Ripley, MD, is the epitome of growing where you are planted.

Born and raised in Waldo County, Dr. Ripley attended local schools, including the University of Maine in Augusta, before entering Maine Track. The program is a unique partnership between MaineHealth and the Tufts University School of Medicine for students who want to practice rural medicine.

Now Dr. Ripley has joined Pen Bay Medical Center as a primary care provider at Pen Bay Family Medicine – a stone’s throw from his childhood home. He cares for patients of all ages by treating acute and chronic illnesses, providing routine health screenings and counseling patients on lifestyle changes to help prevent illnesses before they happen.

Dr. Ripley is accepting new patients. To make an appointment and to learn more about Pen Bay Family medicine, call 207-301-5900. To learn more about Dr. Ripley, read on.

What or who inspired you to go to medical school?
My sisters were big inspirations. When I was growing up, they were in school to become certified nurse assistants – so there were always medical books around the house. That piqued my interest. Sometimes they had the anatomy models so I could see the lungs and the heart and the arteries and veins. When I was very young, my grandmother was in the hospital, and I spent a lot of time there visiting her. So I was exposed to how hospitals run at an early age. That, in combination with the medical books, planted the seed, and then I just ran with it.

Can you tell me about any mentors along the way?
Susan Baker [a professor in the chemistry department at the University of Maine in Augusts] always pushed me to pursue my goals. She inspired me to volunteer at the greeting desk in the entrance to MaineGeneral Health in Augusta, and that led to a job being a patient sitter, which evolved into me reading telemetry strips at night. Susan’s little push to volunteer set me up for medical school.

She also got me into a volunteer relief trip associated with University of Maine-Augusta. We traveled to a medical clinic in the town of Cazale in Haiti to help deliver health care immediately after the 2010 earthquake there. I was able to experience what it was like to deliver care in the middle of nowhere with a minimum of supplies. This pushed me toward the rural medicine track.

You’re referring to Maine Track, the program run by Tufts School of Medicine and Maine Medical Center for students committed to rural medicine.
What appealed to me about Maine Track to me was the fact that I was able to come back to Maine for a lot of my training. I would spend a day or so with my parents, and then I would go to my rotation at Maine Medical Center. I didn't have to stay in Boston all the time. City life isn’t for me.

The administrators at Maine Track suggested that I become a primary care provider. I thought, that might not be exactly what I want to do. I thought I wanted something faster paced. But by the end of my third year in medical school, I was, like, “Oh, they were right. Primary care is a good fit for my personality.”

When a patient comes to you for the first time, what can they expect that visit to be like?
I like to keep it conversational but with a goal. I want to listen and learn as much about the patient as I can. Certainly I want to know their medical history. But so many other things impact their health, and it’s important for me to listen as they share the circumstances of their lives. If they were born and raised in the area, I try to emphasize that I’m from here, too. I get a lot of relieved sighs when I say, "Oh, I'm about 30 minutes away." They tend to relax a bit more when they know that.

Can you tell me something about yourself that might surprise me?
Well, I don’t know how surprising it is being that I’m from Maine, but I spend most of my free time in the outdoors, usually in the Jackman area. It's an area that is relatively untouched, but it's accessible enough that I can get there to enjoy time in the woods.

Why stay in Maine?
There's obviously the comfort factor of practicing in the place where I grew up. It’s good to be around friends and family and give back to the community that helped me more than I often admit.

There are those who lift weights for their health and wellbeing. And then there is Jason Green, DPM.

Dr. Green recently joined Pen Bay Podiatry at Pen Bay Medical Center. A retired U.S. Army officer, he served as chief of the podiatry clinics at several bases including Fort Riley in Kansas and Fort Eustis in Virginia. Closer to home, he also served as chief of the podiatry clinic at Eastport Healthcare in Calais.

Dr. Green is accepting new patients. To schedule an appointment and to learn more about Pen Bay Podiatry, call 207-301-5700 or go to pbmc.org. To learn why Dr. Green once carried a 70-pound stone more than two miles back to his car, read on.

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Who inspired you to go to medical school and enter health care?
My dad is a retired podiatrist. He actually had an office in our house, and I would see patients come and go. As I grew up, I got to see the ins and outs of running a private clinic, so I had a very thorough understanding of what I was getting into. You might say I grew up in the profession. When I was in medical school, my father advised me to shadow some other medical professionals to make sure I was aware of my options. I spent time in the ear, nose and throat specialty. I also explored pharmacy, physical therapy, and orthopedics. So when I chose podiatry, I knew what I was getting into and what I was passing up. My parents were really good about not pushing me one way or another. They just said, "Make an educated decision and go from there."

You said you dad was a role model. He was his own boss as an independent provider. Now you find yourself working for a larger organization. How's that transition going?
It's pretty smooth. I did my residency and most of my training in the military. Once you become a government employee, you learn what the challenges are in a big institution. Actually, I like working for a bigger institution. I like the comradery.

How many years were in the military?
I was seven years active, one year reserve. I joined as a captain. After about five years, I got promoted to a major and I moved around a lot. I was in five duty stations in Georgia, North Carolina, Washington State, Kansas, and Texas. It was good training, a good way of life, an honest way of life. To be part of that system gives you discipline, makes you humble. 
During my last year in the military, I was at Fort Riley in Kansas as an active-duty podiatrist. And I liked the hospital. I liked working there. It was a very new hospital. But my contract was up and I was preparing for civilian life when the hospital commander approached me about staying on as a civilian. So I stayed on, and it was basically taking off one uniform and putting on another one. Instead of wearing what is called a green suit, I started wearing a white coat and did the same work.

With those experience as a backdrop, what can a local patient at PBMC expect when they come to see you for the first time?
I think they can expect to see someone who is pretty low key and a good listener. I want a patient to feel comfortable discussing their health plans and their lower extremity issues with me. I want them to have the mindset that there is no bad question to ask. My ultimate goal is to give them my professional opinion through an educated answer and treatment plan.

What are your passions outside of the hospital?
One of the biggest passions outside of work for myself is to travel. I have lived in 10 states. As a prior active duty Army podiatrist, I moved around based on the needs of the government. I came to embrace this lifestyle and to enjoy every place that my wife and I moved to. I love to see new areas domestically and internationally as well to understand how different areas live and interact. Some places having a very different way of life and at the same time very similar as well. The end of the day though I'm always happy to be at home.

Tell me something about yourself that might surprise me?
One of my main hobbies is to collect fossils through field work. I grew up with a father who had a passion for academics as well as collectibles. He would take us on different outside excursions in Virginia where I grew up to search for sharks teeth and other fossils found in the area. My brother and I continue that passion and I enjoy being out there, getting a little bit of exercise and potentially finding something with a unique story to it. I have a pretty big collection from around the country. My largest specimen was a 70 pound ammonite I found in Texas and had to carry about two miles back to my car. It's a conversation piece and, for me, a good memory. Even if sometimes I don’t find anything collectible, being out in nature is relaxing and peaceful.

Why practice in Maine?
I have roots in Maine. My father had a Podiatry practice in Saco Maine when I was very young in the early 1980s. Throughout the years we would come and visit Maine and I've always had fond memories of the people in the area. I like the way of life here and the opportunity to enjoy the beauty of the land and the hospitality of the people. My wife and I are excited to come back to this area and be a part of this community.

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.

Why Maine? 
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.
 

Elizabeth Hutton Lykling, MD, came to Maine to watch her garden grow. Literally.

Dr. Lykling recently joined Waldo County General Hospital and its team of primary care providers seeing patients out of offices at 16 Fahy St. in Belfast. Before joining WCGH, Dr. Lykling recently served as an Assistant Medical Director of the Primary Care group at MaineGeneral Medical Center.

Dr. Lykling’s past experiences include caring for patients in an underserved rural settings as an attending physician in Boonville, N.Y., and Hamilton, N.Y. She earned her medical degree from Albany Medical College and served her residency at Tufts Medical Center, with a concentration in Integrative Medicine.

Dr. Lykling is accepting new patients. To make an appointment and learn more about primary care services at 16 Fahy St., call 207-505-4304. To learn about Dr. Lykling’s love of gardening and the role the Maine Organic Farmers & Gardeners Assoc. played in her decision to move here, read on.

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What or who inspired you to a career in health care?
I grew up in rural upstate New York. My mom was a public health nurse and very connected to the community through her work, and I saw the good that she did. She helped people obtain access to healthy food, made sure kids were involved in education and connected moms to resources in the community. She showed me the breadth of what it means to be a health care provider.

My mother also had some chronic medical conditions and we spent a fair amount of time at our rural community hospital, Mary Imogene Bassett, in Cooperstown, New York. The team of people there helped her to remain as healthy as possible and live a productive life. So, health care was an important part of my life growing up. Health care workers were some of the kindest and best people that I interacted with as a young person and I wanted to follow in their footsteps.

When do you think you made that decision to enter health care?
Medicine was a passion even before high school. When I was a kid, I took care of animals. In high school, I focused on preparing for college and thinking ahead to medical school.

When a patient comes to you for the first time, what can they expect?
I think an open conversation with my patients the most important thing. Certainly I want to review their records, but I also want to hear about who they are as a person and about their health care goals. Then 
we create a plan together that may include routine screenings and medical treatments, but also lifestyle choices and habits to reach those goals. 

How about outside of work? 
My first priority in life is my family. My husband, daughter, and I are all interested in organic farming and gardening. So, actually, MOFGA [Maine Organic Farmers and Gardeners Association] was a big influence on our decision to come here. We are interested in ecology and in protecting the environment. We also hike, swim, kayak and generally interact with the coast as much as possible. I love cooking and baking, I love to craft and crochet. I love to read. I will take on home improvement projects for better or worse. I like to be active and always learning.

So MOFGA was actually top of mind as you were making your decision?
Absolutely. My family's passion is organic farming and gardening and mine is medicine. When we looked for a place to be, Maine, particularly the greater Belfast area, offers community with both. I think that being active outside, consuming healthy foods, and finding the elusive work/life balance are important. Access to hiking and walking trails and other opportunities to be active are so important not just to us personally but the health of a community. Having excellent access to local farms was also a major draw, and MOFGA provides support to those interested in growing, allowing for a more dense collection of farms here than other places we looked.

Is there anything that you can tell me about yourself that might surprise me?
I am usually a gentle person, so it might surprise you that I played rugby in college. It was a great physical outlet. 

This isn’t your first time providing health care in rural setting. Can you tell me more about your past experiences?
I have worked in rural places like Boonville and Hamilton in New York. I also worked as a physician caring for military families out in Washington State. I have worked at a clinic for Exeter Hospital in New Hampshire. So I've had a variety of experiences, but I keep being drawn to what feels like home.

I grew up in Mohawk, New York, which is in the foothills of the Adirondacks. It is a combination of farmland valleys, groves of trees, and the Mohawk River. It gets to be mountainous and wild pretty quickly. So here in Maine, the geology, the forest architecture, even the plants are familiar. It's just that we also have the coastline, which I love.

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. 

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.