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Community profile: Albuquerque, New Mexico

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It didn’t take J. Randle (Randy) Adair, MD, long to make up his mind. A “non-traditional” older student fresh from medical school after leaving a social work career in “an overstressed urban environment,” he was seeking a fresh place to live and work.

Albuquerque: One of the best-kept secrets

“I was close to signing with a lovely group in Phoenix when someone suggested Albuquerque,” he recalls. After interviewing at Presbyterian Hospital, New Mexico’s biggest medical center, he started exploring the area. “I discovered one of the best-kept secrets around.”

Now one of 27 physicians in the PMG Hospitalist Group owned by  Presbyterian, Adair has fallen under the spell of Albuquerque’s picturesque terrain. Also charmed by the still-thriving Spanish and Indian cultures in the city, he bought a 1920s adobe-style home a short mile-and-a-half walk from the hospital. “I’m in a safe, affordable, user-friendly neighborhood,” he says, “where I can also walk to a community grocery store or Starbucks or one of the finest restaurants in the city.”

Tom Rothfeld, MD, elaborates on the city’s expansive eating options. “We have everything from the ubiquitous chains to local places like a hole-in-the-wall Vietnamese restaurant that’s terrific,” he says. Rothfeld entered the University of New Mexico in 1975, completed medical education and residency at its medical school and hospital, and stayed on in Albuquerque. He recently started a new pediatric practice in a group with family practitioners, internists, and ob/gyns.

Rothfeld also has a warm spot for the local cuisine. “This is the only state to my knowledge that has an official state question:  ‘Red or green?’” That would be red or green chilies, which are not only the state’s number one cash crop but the ingredients that spark some of the hottest discussions among homegrown residents. Which of the little peppers tastes better in a given entree at any of the city’s numerous Mexican/New Mexican bistros? Rothfeld says it depends on what he’s having—red with tamales and posole, green with enchiladas, for instance. “When I’m indecisive, I get the Christmas—a little of each.” Rothfeld also says there are several seafood restaurants “like the coastal ones in Mexico.”

Adair says he’d feel unfulfilled without his nearness to the bucolic tranquility of nearby village of Corrales, where roads wind gently through country you’d swear is 90 miles from nowhere. In April, its cottonwood branches are thick with lime-green leaves. Homes, some luxurious, some more modest, sit back from the road. Horses graze behind white fences.

“I call it Critterville,” says Adair of the half-rural, half-urban community less than half an hour from the heart of the big city. “Corrales doesn’t have streetlights, so at night you can sit outside and see stars,” he marvels, adding, “I have never seen so many stars.”

The residential choice of some Albuquerque physicians, this village is a reminder of simpler days in Albuquerque itself, which was founded near the banks of the Rio Grande in 1706 by Francisco Cuervo y Valdez, an interim New Mexico governor. (A big tercentennial celebration is planned for 2006.) It was named Alburquerque, honoring the duke of a city in western Spain. Over the years, the first “r” in the name has disappeared.

Old Town, with its adobe shops, restaurants, galleries, and plaza dominated by the San Felipe de Neri Church, keeps the old culture alive.

Even in his own neighborhood, though, Adair says, “I can walk to the corner and look over the valley and see volcanoes on the horizon.” Many eons ago, the fiery cones provided “canvases” for ancient peoples who carved some 1,700 images into the residue lava rocks. The area, now protected as Petroglyph National Monument, edges the western part of the city. Writes historian Marc Simmons, “Probably no other American city can boast of so much native art preserved at its doorstep.”

In the 21st century, Adair and many another newcomer have discovered other reasons that 19th-century tradesmen from the Midwest saw New Mexico as a land of enchantment as they carted their merchandise along the Santa Fe Trail and the old Camino Real (royal road). Today, much of the north/south Interstate 25 still immerses travelers in the same fantastic swirl of red-rock outcroppings.

Two mountain ranges, the Sandia and Manzano, guard Albuquerque on the east. A year-round scenic thrill is the 10,378-foot-high view from the top of Sandia Peak, reached by the world’s longest tramway. From Albuquerque, roads lead north, west, and south to New Mexico’s 19 pueblos, long-inhabited Indian villages best known now for their fine art pottery and colorful festivals.

For Adair, a more practical enchantment, he says, is the fact that “in 15 minutes of local driving I can be at a trailhead in a state or national park and hike into the mountains, starting in desert and ending in snow.” High mountain peaks yield enough snow to sustain ski resorts during the winter months, but moderate temperatures and dry climate around the city mean golf is still in season most of the year as well.

Albuquerque history: From tuberculosis to space medicine

It was more than the scenic beauty that lured thousands of Americans here in the early 1900s. They were hopeful tuberculosis patients seeking a cure in Albuquerque’s clear, dry, high-desert climate. Soon so many small sanatoriums lined Central Avenue, the main street, that it was nicknamed “TB Avenue.”

“Getting Well in Friendly Land” was a poster slogan for one of the “sans,” as the institutions were called. It worked for two sufferers who recovered, then stayed on to make health-care history.

The Rev. Hugh A. Cooper arrived in 1903, and after recovering from the “White Plague,” he became pastor of the First Presbyterian Church. Visits to ailing communicants convinced him of the need for a sanatorium, specifically located in the “Duke City” because it “most nearly approaches perpetual sunshine and…has the driest atmosphere in New Mexico, while the altitude, 5,000 feet, is the ideal medium—high enough to secure the pure thin air and dryness and not so high as to put too great a tax on the heart and lungs.”

To start, in 1908, a committee bought a five-room cottage with two large porches, located on a hilly dirt road later to become part of America’s historic Route 66 (which would coincide with Central Avenue.) Southwestern Presbyterian Sanatorium also took some non-TB patients, but dramatically changed course —and nicknames, from “The San” to “Pres” (pronounced Press)—to become a full-fledged general hospital after modern drugs conquered TB in the 1940s. Today, Presbyterian Hospital is the state’s largest health-care facility, with some 2,000 employees, and its umbrella institution, Presbyterian Healthcare Services, encompasses seven hospitals throughout New Mexico, including Albuquerque’s Presbyterian Kaseman Hospital, plus its own health insurance operation and 29 primary, specialty, and urgent care sites.

This year an independent study published by Modern Healthcare magazine rated Pres the ninth most integrated health-care system in the U.S. Its fast-growing medical group hired 50 new physicians in 2002 and is still looking for “a few good men and women.”

Nine years after Cooper’s arrival, another cured TB victim, William R. Lovelace, MD, moved his practice from Fort Sumner, about 150 miles east. Edgar T. Lassetter, MD, also a TB “alumnus,” joined Lovelace in 1922 to open a Mayo-like group practice that would mushroom into today’s Lovelace Sandia Health System.

Last year, Ardent Health Services of Nashville bought and consolidated Lovelace with St. Joseph’s, the city’s first general hospital. St. Joseph’s was founded in 1902 by the Catholic Sisters of Charity with “special provision” to treat the then “growing ranks of tuberculosis patients.”

The system now includes four acute care facilities, the Rehabilitation Hospital of New Mexico, and 15 neighborhood health-care centers in Albuquerque, Santa Fe, and suburban Rio Rancho. Lovelace’s Northeast Heights Medical Center opens this fall as the state’s first hospital exclusively for women. At least 330 physicians are employed in Lovelace-owned groups, and the system also operates its own health insurance plans—commercial, Medicaid, and Medicare.

Over the years, Lovelace Sandia has pioneered various treatments, such as installing the U.S.’s first cobalt teletherapy unit in 1953. In 1954, Lovelace teams worked with the U.S. government on shelter design and physical protection concepts related to atomic testing, a subject close to home, since the first atomic bomb was developed and tested in northern New Mexico by the Los Alamos National Laboratories. One of Albuquerque’s largest employers today is Sandia National Laboratories (7,700 employees), with an impressive list of science, engineering, and security projects.

You could say Lovelace’s nephew, William Randolph (Randy) Lovelace II, MD, had his eye on the sky. In 1942, he made a 40,200-foot jump to prove that parachutes were safe for emergency bailouts from stratospheric altitudes. He brought his international reputation for achievements in aviation medicine when he joined his uncle in 1946. This was the reason the Lovelace Clinic was selected as the site for the early astronaut medical tests so graphically portrayed in the film The Right Stuff. Randy was named NASA’s Director of Space Medicine in 1964, a job cut short when he died in a plane accident the next year.

Lovelace initiated New Mexico’s first free-standing approved residency programs for pathology, internal medicine, and surgery. Most recently, its Gamma Knife Center in the Albuquerque Regional Medical Center joined the rather exclusive group of only 80 such facilities nationwide. “It has exceeded all expectations for all procedures in the first four months alone,” according to public relations director Anne Monson.

Albuquerque’s medical community

In recent years, health system administrators have increased concentration on cancer and heart care, but the competition in the latter became intense when the Heart Hospital of New Mexico opened in 1999.

“We treat more than 8,500 heart patients a year,” says Martha England, the Heart Hospital’s business development vice president. These include “800-plus actual heart surgeries, many of them requiring highly specialized techniques, such as implanting bi-ventricular devices, electrophysiology mapping and ablations and mitral valve repair.”

All of the above was enough to lure Paul Levy, MD, now the surgical director, from his position as a cardiothoracic surgeon in the Toledo, Ohio, area. Levy had also considered moves to Detroit and to Chicago, where he trained more than 13 years, but chose the new Albuquerque venue because “professionally I thought it would be a good move for my family and me.”

The Hispanic and Native American population is in great need of cardiac care, Levy notes, and that, “unfortunately,” contributes to “a disproportionately high incidence of heart disease, high blood pressure, diabetes, etc., in the area.” Add the growing number of retirees finding New Mexico a great place to retire, and the Heart Hospital is poised to “become the premier cardiac care facility in the region,” Levy says.

Although there’s some controversy over for-profit specialty hospitals, Richard Gerety, MD, the former surgical director, likens general and specialty hospitals to that between department stores and boutiques. “Once you focus attention on a single business line, you tend to do better at it,” he asserts. At the Heart Hospital, every room is fully equipped, including beds for family members, so that patients don’t have to be moved from room to room as recovery progresses. The hospital is one of 13 cardiac institutions nationwide that are managed by MedCath, a North Carolina-based firm.

The University of New Mexico, another long-time Central Avenue landmark, now incorporates a medical school and large teaching hospital. The University of New Mexico Health Sciences Center can boast of its own accomplishments, such as selection as one of the top 15 major teaching performance improvement hospitals by Solucient, a leading provider of health-care business intelligence. UNM also operates the Children’s Hospital.

UNM research involvement includes studies on cerebral palsy at its neuro-imaging facility and work on the protein genome, but a big source of pride, especially in a rural state, is the School of Medicine’s ranking for the 10th time by US News & World Report as the number two school for rural medicine, out of 144 medical and osteopathic schools. Going hand in hand with that designation are high ratings for the College of Nursing midwifery and family nurse practitioner programs.

These programs can translate into health services for a great number of Native American residents who receive care at eight New Mexico clinics funded by the federal Indian Health Service. The need is great, laments director Maria Rickert at the Albuquerque Service Unit. “We beat the rest of the population in almost everything—heart disease, diabetes, obesity, alcoholism, suicide. And now cancer is approaching white levels.”

This year, after working with UNM physicians, an Albuquerque man published a practical Spanish dictionary for health professionals. Both Adair and Rothfeld believe such a tool is invaluable. Physicians not fluent in languages of their patients are mandated by law to hire interpreters at their own expense. “Knowing Spanish here also enlarges your perspective and social opportunities,” adds Adair.

Linguistic disparities bring challenges

Linguistic disparity is only one difficulty for practitioners in the land of enchantment, though. “I don’t think it’s easy to recruit anywhere, but I think it’s harder here,” says England, even though good research facilities seem to be a plus in attracting cardiac specialists.

Many physicians take a financial hit because state administrators were too conscientious about keeping down costs in the past. Today, Medicare payments are based on the old cost structure which, in New Mexico, is lower than most other states. Typically high malpractice premiums compound the dollar discomfort, and a state gross receipts tax adds insult to injury. This tax on services as well as goods is not reimbursed by insurance companies or Medicare.

The good news for hospital-employed physicians like Adair and Rothfeld is that the employer picks up the tab for most of these expenses. Also helpful is a recently passed bill allowing income tax deductions for gross receipts taxes on services involving managed care contracts for negotiated rates of reimbursement. It’s not total exemption, but it is like going from a pain threshold of eight to four.

Albuquerque sunset wonders

Nevertheless, there’s still some truth to “the old joke about getting paid in million-dollar sunsets,” England comments wryly.

For Adair, the “sunset” is “one of the nicest climates I’ve ever experienced. This is also one of the nicest places in the sense that it’s got charm and it’s got culture, but the culture isn’t overwhelming.” It’s almost as if he’d read a paean written long ago about the city’s healing powers:  “Albuquerque is one of the cities of the west that is so openly, so rampantly healthy, so gloriously deluged with vivifying sunshine and purified with healing breezes that it invites with open arms the sick and ailing to enter its portals.”

Closer to home, and especially appealing to outdoor lovers, a bike trail runs through the entire city along the Rio Grande, which itself is the object of renewed interest from residents. Also near the water is the Albuquerque Biological Park, incorporating a botanical garden and aquarium focusing on fish life as it varies from headwaters to the Gulf of Mexico. The new park complements the venerable 77-year-old zoo not far away.

The Duke City is awash in more “civilized” forms of culture, too, among them art galleries, symphony, chamber music, Broadway shows, and several theaters, including the historic KiMo, a venue for ballet, opera, and Hispanic and contemporary theater. “It’s the most intimate and aesthetically beautiful theater in the state,” says its manager, Craig Rivera. “And [it’s] probably the city’s longest-lasting building still used for its original purpose.”

Major league addicts won’t see Shaquille O’Neal, Bret Favre, or Derek Jeter, but they can watch UNM college sports, the New Mexico Scorpions (pro hockey), New Mexico Storm (pro soccer), and the Albuquerque Isotopes, a Triple A baseball team.

And for true poetry afloat, no self-respecting Albuquerquean ever misses the chance to marvel at a skyful of color during the city’s most famous event, the International Balloon Fiesta. The October event, which includes two magical nighttime light shows, has ‘ballooned’ from 13 participants in 1972 to more than a thousand, some 300 of whom live in the area year-round. The city’s high-flying tradition dates back a century or more, when a local bartender literally got high piloting a “gasbag” 14,000 feet over the center of town. Scientists later figured out why he did so well:  The weather, mountain formations, and wind characteristics make this the best place in the world for the sport.

A new event will greet next year’s attendees—the opening of the long-awaited Anderson-Abruzzo International Balloon Museum.

Albuquerque culture

Currently, the newest museum on the block is the ¡Explora! Science Center, where children can enjoy learning why wadded-up foil floats in water, how opposing air pressure streams hold floating beach balls in place, and how zeroes and ones are manipulated to make computers “know” the difference between A and Z.

¡Explora! has several companions in an area roughly known as Museum Row, including the Museum of Natural History & Science, the Museum of Art and History, and the National Atomic Museum.

Two other cultural experiences enhance the everyday Native American and Hispanic presence throughout the city. The National Hispanic Cultural Center safeguards that culture’s artistic and performing heritage. The Indian Pueblo Cultural Center, with live presentations and extensive exhibits featuring each of the 19 New Mexico pueblos, offers an introduction to the civilizations that pre-dated the 16th-century Spanish explorers. The pueblo peoples fought off the conquistadors for a long time but eventually came to terms with American settlers. Today, most of the pueblos themselves, from the spectacular “Sky City” of Acoma to Taos in the north, welcome visitors who want to learn about their cultures and view their unique arts. Several of them have added casinos for the bells-and-lights crowd.

Still, not all is hearts and flowers in the Duke City. Life’s persistent question for long-time resident and columnist V.B. Price is:  Will what he calls “a city at the end of the world” survive the onslaught of too many newcomers with no commitment to preserving the historic charm and natural wonders of the area? Just as it was considered a frontier zone “remote beyond compare” by 17th-century Spanish bureaucrats in Mexico City, Albuquerque, according to Price, is set in the middle of a true natural wilderness and still geographically isolated from the power centers of the world. This in spite of the fact that the area has been a trade center since the Camino Real was established in the early 1600s, and that outsiders have been rampant for 60 years at Kirtland Air Force Base, the area’s largest employer (6,500 military; 18,000-plus civilians) and for almost as long at the Sandia National Labs.

Fearing the worst—unfettered, homogenizing urban sprawl—Price grieves that Albuquerque has become “a city with amnesia—fascinating past and almost no collective memory.” And he berates city government for lack of leadership and failure to maintain a “unified urban image.” He worries about the great water well in the ground running dry from over-demand, although Gov. Bill Richardson cleared the way in July for Albuquerque to secure its water future at least for the next 50 years by diverting surface water from the Rio Grande. And he weeps over the one-style-fits-all new houses in northwest Rio Rancho, which is home to most of the 5,500 workers “imported” by the more recently arrived Intel Corporation.

Nevertheless, thanks to an energetic former mayor, Jim Baca, some $450 million in public and private money is being pumped into a 10-year rejuvenation plan for architectural gems in Old Town and “New Town.” (New Town is the part of the city built up after the railroad arrived in 1880.) Some 120 new housing units in a restored bank and high school are already occupied, with 180 people on a waiting list to fill soon-to-be-completed apartments in a once-abandoned gymnasium. The facelift also includes restaurants, theaters, shops, offices, five new museums, an expansion of the Albuquerque Art and History Museum, two retail corridors, and Tricentennial Park. “Our mission is to creatively plan, manage and develop downtown Albuquerque into the best mid-sized downtown in the U.S.A.,” says Brian Morris, spokesman for the Downtown Action Team, the group coordinating the work.

If there’s a lack of urban unity, that’s news to Rothfeld, the pediatrician and 29-year-resident. Although he knows doctors who live in such areas as the North Valley and closer to the river or the mountains, and some in bigger, newer homes, he, like Adair, has chosen the university neighborhood, where “I still run into people I know wherever I go,” he says. “In fact, my boys say, ‘Dad, it takes us so long to go shopping because you stop to talk to everybody!’”

“Urban sprawl is a real issue,” says Adair, “but people are verbalizing about not letting it happen. We’ve had some neighborhood fights over bond issues concerning water, and neighborhood meetings on rapid transit issues. I’ve never been anywhere that they have done those things.

“This,” he says with pride, “is a very active community looking forward and not backward.”

Eileen Lockwood is a freelance writer based in St. Joseph, Missouri.

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Eileen Lockwood

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