2008 Writing D e s e r t E x p o s u r e
September
2008
Small-Town Heart Sutra
Buddhist cardiologist Scotty Smith is the only heart specialist in our rural corner of New Mexico.
By Richard Mahler
Tens of thousands of human hearts are beating in our corner of New Mexico, millions of times each hour. Only one doctor specializes in their care.
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Dr. G. Scott Smith, the only cardiologist
for miles around, in his backyard. (Photo by Richard Mahler) |
"My wife and I came here looking for a great adventure," sighs G. Scott Smith, our local cardiologist, with a bemused grin. "Well, we found one."
The man is laughing, sky-blue eyes kindled. He grasps a cold beer in one hand and, in the other, a tortilla chip hovers above bean dip. For a moment, there is a mental disconnect. One might expect Scotty Smith to just as easily be crying. Or tearing his hair out. Or checking the want ads. Instead he is ticking off a list of things that attracted him and his wife, Connie, to Silver City.
"For us it was a combination of the downtown charm, small university, art scene, pleasant climate, access to wilderness and geographic isolation," recalls Smith, who relocated with his spouse from Colorado Springs two years ago. "Since arriving, we've also been astounded by the breadth of people we've met."
But "starting a cardiology practice was only part of why we came to Silver City," emphasizes the doctor, whose long-limbed physique and receding gray hairline suggest a younger version of self-help author Wayne Dyer (Your Erroneous Zones) or British actor Patrick Stewart (Captain Picard in "Star Trek: The Next Generation"). "We really do love this town."
Being the one and only heart specialist in southwestern New Mexico, excluding Las Cruces, would be a tough job under any circumstances. But there is heightened difficulty here, as reflected in some troubling statistics. The ratio of cardiologists to people in our region — including Las Cruces — is said to be less than half the national average of one per 16,000 potential patients. Meanwhile, our rates of heart disease are at least double US norms. Contributing to this is an elevated incidence of diabetes, widespread obesity, poor eating and exercise habits — and alarmingly high numbers for cholesterol, hypertension, smoking and stress. In addition, New Mexico has a large percentage of uninsured and underinsured residents, many living at or below the poverty level.
"It's pretty exhausting," understates Smith, whose wife, a nurse, joins six other staffers in running their Silver City practice. "Tomorrow we're seeing 29 patients, including eight or nine for the very first time. That's fairly typical. I feel like I'm holding my finger in a leaky dike."
At the moment, our sole cardiologist doesn't look like a man charged with such a daunting task. Instead, the 50-year-old appears preternaturally serene. Smith smiles broadly as he kicks back this balmy evening in sandals, shorts and a Hawaiian-print shirt on the shaded patio of his modest adobe-brown home. A swath of green hillside and budding ocotillo fence separates his spacious backyard from the Western New Mexico University campus. Hummingbirds zip around multiple feeders, competing for overnight calories as a setting sun floods the portal with canted apricot light. Smith looks more like a laid-back Buddhist meditator than a hard-charging disciple of pioneering Texas heart surgeon Michael DeBakey.
It turns out Smith is both — and he has the zafu and thermal atherectomy device patent to prove it.
"I got into Buddhism on February 22, 1993," Smith explains. "I happened to watch the popular series of interviews Bill Moyers did on public television with [mythologist] Joseph Campbell. The ideas they discussed really struck a chord with me."
One segment unspooled archival footage of the Dalai Lama's Tibetan palace in Lhasa being bombarded by an invading Chinese army. The attack on this religious monument was devastating. Yet, according to the program's narrator, the Buddhist leader expressed empathy and compassion rather than anger or a desire for vengeance. "The very next morning," recalls Smith, "I went to a bookstore and bought a 1910 book called The Buddhist Catechism." He has been studying Buddhist philosophy and meditating in the Vipassana tradition ever since.
"I think Scotty and Connie being here might have something to do with their being Buddhists," observes Alan Spragens, who with his wife, Nan, is a good friend of the couple. "They have an appreciation of contemplative life in a small town. I don't see them being seduced by the speed and glamour of modern [urban] life. They enjoy a place that's less harried."
Spragens points out that the Smiths arrived only two days after he and Nan, fellow Buddhists who own the Seedboat Gallery on Yankie Street, moved to Silver City. He adds, "Scotty and Connie have a great appreciation for the arts community and actually helped us set up our gallery." Since then, the two men have taught introductory classes on Buddhism though the Western Institute for Lifelong Learning, each bringing slightly different perspectives to their discussions of spirituality.
"I'm very interested in meditation's effect at the quantum level," Smith explains, adding that "the physics of consciousness" have long fascinated him. The doctor also has past associations with Dean Ornish, a cardiologist and bestselling author who promotes meditation's benefits to heart health, and Jon Kabat-Zinn, a microbiologist whose eight-week Mindfulness-Based Stress Reduction program is employed by hospitals worldwide. "Jon once asked me to 'translate,' as needed, during a week-long meditation retreat for a group of neuroscientists," recalls Smith, "none of whom had meditated before. Now that was an amazing experience."
Oh yes, about that patented invention: It was developed by Smith with two other physicians and is a computer-assisted gadget that heats up and loosens plaque inside blood vessels. "Some of the parts we bought at Radio Shack," the doctor chuckles, "but it worked."
The son of a real-estate investor, Smith grew up in the Kansas City area and earned a degree in Molecular, Cellular and Developmental Biology at the University of Colorado before returning to Kansas to obtain his medical doctorate and open a practice. From 1991 to mid-2006 he worked in Colorado Springs, where he and Connie raised two girls, now in their twenties and living on their own.
"So tell me more about this great adventure," I ask, bringing the conversation back to where it started — and smothering yet another chip with red chile salsa. Smith responds with furrowed brows and a pensive pose. He gathers his thoughts before telling the story of how he came to this place.
"We'd raised our children," he begins, gazing past flapping Tibetan prayer flags in the direction of Santa Rita's Kneeling Nun. "I had been working for nearly 13 years at a cardiology center. Connie and I figured it was 'now or never' to try our little experiment."
This experiment — alternately labeled "a final adventure" — was to try being an independent heart specialist in a small town, more than 100 miles from the next cardiologist and beyond the shadow of a large tertiary-care hospital. As far as Smith could tell, no one in the intermountain West had done it before.
"We are plowing new ground," he says of his Silver Cardiac Associates, "and, yes, it has been harder than expected." He has nothing but praise for his staff, whose professional standards are high, but the workload they face is tremendous. "We still don't know if [such a venture] is sustainable, but we will be glad we tried, however it turns out."
Cardiologists — whose aggregate numbers reached a plateau about 25 years ago — are in high demand, so they can be choosy about where they live and work. None had chosen Grant County. Or Luna, Hidalgo, Sierra, Otero or Catron counties, for that matter. Smith counts a mere eight practicing in Las Cruces, New Mexico's second-largest city. All of rural America is in this kind of fix when it comes to medical specialists. That's risky business.
"When you have a specific health problem, it's very good to have someone who knows how to diagnose and treat it," notes Melvin Gelb, a local public-health specialist in diabetes for the New Mexico Department of Health. "It's vitally important to have a cardiologist, but in most small towns someone like this would be in general medical practice as well."