This physician decided
This physician decided

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Community profile: Charleston, South Carolina

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The Porcher-Simonds House, at 29 East Battery Street, was built in 1856.
The Porcher-Simonds House, at 29 East Battery Street, was built in 1856.

For Steven Shapiro, MD, make-believe isn’t good enough. He’s happy to be in a genuine historic city rather than one of those recent retro remakes that appeal to some Americans. In 1974, the New Jersey native, now vice-president of medical affairs and chief medical officer at Roper St. Francis Healthcare (RSFH) in Charleston, moved to the city whose slogan is “Where History Lives.”

Charleston: A unique American city

Shapiro considers this nearly 350-year-old South Carolina coastal enclave “one of four or five unique American cities, such as New Orleans and San Francisco.” His main incentive for the move, of course, was a job offer, but he says, “When I got here, the lifestyle just seemed to fit my personality.” Charleston exudes the quintessential South, but its plunge into modern times is also hard to ignore. Adds Shapiro, “This has become a cosmopolitan, eclectic city where we have everything from high arts to huntin’ and fishin’, all within a few miles’ radius of where anyone lives.”

For golf addicts, South Carolina boasts more than 380 courses “from the mountains to the sea,” with almost 25 public and private links in the Charleston area. The list almost multiplies if not-far-away Hilton Head Island and Myrtle Beach join the mix. But Shapiro begs to opt out of the club-swinging crowd. Instead, he looks forward to water-related outings when his professional obligations give him a break. Besides his administrative duties at the hospital, he’s the principal physician with Low Country Genetics.

“When I lived in New Jersey, we would go to the shore, but it would take four to five hours for a 20-mile trip” thanks to the oppressive traffic. “Here we can get to the beach in 15 minutes almost any day of the week. We really enjoy being on the water, especially if we can sail or be on motorboats”.

Leisure use, including a growing cruise ship business, is a rather recent addition to the city’s large – and bustling- harbor area, but water has defined wealth in this distinctively southern city since its founding by an English proprietary company in 1670. Shipping soon became the colony’s honey and cake as well as its bread and butter. “Merchandise and trade were the foundation stones of most, if not all, the great fortunes in South Carolina,” wrote historian Edward McCrady.

Charleston, South Carolina Statistics
Charleston, South Carolina Statistics

The unsinkable southern city

Throughout the centuries, rags-to-riches cycles seem to have been a Charleston theme song. Economic downturns followed enemy occupation during the Revolutionary War and the double whammy of Union takeover and port blockade during the Civil War (a.k.a., in these parts, the “War of Northern Aggression”), whose first shots were fired in the assault on Confederate-occupied Fort Sumter in 1861. The mix of misfortune has included five major fires, the Great Earthquake of 1886, and several others. Hurricane Hugo devastated the city in 1989, but it wasn’t the first catastrophic storm to hit. Water rose to the second floors of buildings in a 1699 catastrophe, and a 1911 cataclysm finished off the prosperous rice industry once and for all. But, in every case, gritty citizens refused to be defeated.

Now, just as sailing fleets once crowded the seaport with such cargoes as indigo, rice, and cotton, thousands of container ships come and go to worldwide destinations.

In the 20th century, a huge shipyard and U.S. Navy base continued the water-oriented tradition, leaving a large dent in the economy when they closed. But they’ve been replaced by, as Chamber of Commerce spokesmen put it, “a very significant military presence” —quite an understatement. The “presence” provides 22,000 jobs and includes the Atlantic Space and Naval Warfare Systems Center (SPAWAR), a Naval Weapons station and nuclear power training command, and a research facility for armed forces communications systems. The military mix also includes Army, Air Force and Coast Guard installations.

The military and heavy port activity are two buffers against recession woes plaguing so many other U.S. cities. Spokesman Karen Kuchenbecker, at the Charleston Regional Development Alliance, notes a mix of several successful businesses, but singles out two other “economic pillars”—the 10,000-strong Medical University of South Carolina campus, medical complex, and research arm that attracts at least $200 million in annual research funding, and the travel/tourism industry, which can thank those lucrative early businesses for its gargantuan success.

Shipping was the springboard for one of America’s most attractive cities, recently cited by Condé Nast Traveler as readers’ second most popular American tourist destination. One offshoot: Countless couples have chosen the city as a charming setting for the increasingly popular destination weddings. In fact, the Convention & Visitors Bureau now publishes a thick booklet with complete information about every wedding-related service in the area from license bureaus to wedding group transportation, not to mention honeymoon havens.

This iron gate is typical of those that grace hundreds of private and public properties around Charleston.
This iron gate is typical of those that grace hundreds of private and public properties around Charleston.

Historic charm and elegance

What better way to show off success than with the elegant mansions and gardens that would become the stuff of visitor delight three centuries later? According to the South Carolina Historical Society, “The cityscape of modern Charleston is one of the most historic in America.” No fewer than three preservation-related societies keep tabs on many of the 2,000 historic buildings, a good number dating back to the early 1700s and 1800s, in the city and its suburbs. Several homes are open each year for ever-popular spring and fall tours. The Charleston Preservation Society began in the 1920s to save and restore threatened buildings. The mission of the Historic Charleston Foundation, according to communications director Leigh Handal, is “restoring the fabric of otherwise decaying neighborhoods.” Started in 1947, the foundation identifies distressed homes, purchases them, and finds buyers who restore them to their original status.

All of the above represent a permanent source of pleasure for Shapiro and his wife, whose South Carolina family ties date to around 1680. (“We joke that if you’re here for any number of generations, you’re related to everyone else,” he laughs.) His wife’s specialized hobby is searching for old pottery, glass, clay pipes, weapons, and other artifacts from varied generations of residents, occupying Revolutionary and Civil War armies and even the notorious pirates, including Blackbeard, who frequented the area. Among the “treasure chests,” are the 16th, 17th and 18th-century dumps, long covered over, on James Island, where the Shapiros live. It’s one of at least 18 islands clustered around the city roper on its peninsula.

Charleston’s “icing on the cake” for Michael Kilby, MD, is that his 12th-floor office overlooks the harbor, the ships, bridges, and a waterfront cluster of handsome historic homes. Driving over the Cooper River on the spectacular new Arthur Ravenel, Jr., Bridge from his home in suburban Mt. Pleasant is a special pleasure, he says. Opened in 2005 to replace the picturesque but decaying Cooper River Bridge, the Ravenel is North America’s longest cable-stayed span. (An egocentric joke among native Charlestonians has it that the two rivers flanking their city, the Ashley and the Cooper, come together to form the Atlantic Ocean.)

Historic waterfront homes can be found along Charleston Harbor
Historic waterfront homes can be found along Charleston Harbor

But, for Kilby, who relocated a few months ago from Birmingham, Ala., and is planning to build a home, the city’s scrupulous historic homes protectionism can sometimes go too far. “In a town like Charleston that is very much about history and neighborhood planning, it can be quite an adventure to get all the approvals to build a house. There are rather strict rules about what you can build.” The good news: “I think we’ve jumped through all the hoops so far.” Permit problems aside, the Kilbys are delighted to be on the fringe of a large city while in an area “just filled with wildlife. It’s like living in a nature preserve,” he says.

Besides observing animals and birds au naturel, the flat territory and natural beauty has made Charleston “a great place to jog,” he adds. Another pleasant discovery: “The restaurants are famous for fine food; not just the upscale, expensive establishments, but many neighborhood bistros.”

Schools are a plus, too. “A lot of cities have reputations for bad ones, but in Mt. Pleasant we’ve been very happy with them,” especially because of the music programs, he reports. His sons, 12 and 15, play piano and guitar, and both are drummers in marching bands.

The hidden gems of Charleston

One of many quaint alleyways
One of many quaint alleyways

“Charleston is a great town to walk in,” says Steven Shapiro, MD. “We find all these little hidden gems—architecture and gardens and little alleys…” All of the above contribute to the historic charm that’s been attracting visitors for decades. At least eight architectural styles are part of the city’s ambiance, and several of the homes, gardens, and nearby plantations are open to the public. Special homes tours are part of the scene, and four major garden-related festivals are also held from January through October.

Charleston was the early and undisputed center of drama and theater in the colonies. Its culture included the first theater (Dock Street, still in operation) and the St. Cecilia Society, known as the first musical organization to support a paid orchestra. Its numerous concerts are still eagerly attended as are concerts by the Charleston Symphony, which brought strains of Beethoven and Bach to residents 24 years before New York Philharmonic’s first concert. In fact, Charleston’s musical reputation was what attracted Europe’s first “immigrant” composer, Carl Theodore Pachelbel, son of the famed Canon in D composer, Johann. Today the drama and all genres of music are still part of city life.

Meeting Street
Meeting Street

Museum lovers can almost overdose themselves on Meeting Street, a major thoroughfare since colonial days and now designated Charleston’s Museum Mile, complete with six museums (including the Gibbes Art Museum), five historic houses, four scenic parks, five significant churches, and six historic public buildings.

Gibbes Art Museum
Gibbes Art Museum

But history didn’t come to a halt sometime in the mid-1800s. The city abounds with enticing visitor sites of a more modern nature. You can sit in Pew 43 at St. Michael’s Episcopal Church where George Washington worshiped and visit graveyards with “celebrity” tombs and designer headstones, but many other attractions await, such as the South Carolina  Aquarium, three water parks, the “heroic” World War II aircraft carrier USS Yorktown (star feature of a huge naval museum), the Charleston Hanger Skateboard Park and, surprisingly,  the Carolina Ice Palace.

January-February 2009 The Best of Two Worlds Charleston SC USS Yorktown
USS Yorktown

There are baseball, soccer and hockey games to enjoy, historic forts to inspect, untold varieties of fish to catch, ecotours, shells to find, dolphins to watch, and wildlife refuges to tour.  And there are mouthwatering crab cakes, shrimp, oysters, and near-sinful southern cuisine waiting in elegant—and everyday—dining palaces, the perfect ending to a day on the town.

Professional possibilities in Charleston

As for career opportunities, Kilby admits he was a hard sell at first. “I was happy in Birmingham and had a good job in charge of an HIV clinic. It was also a nice circumstance for me to be in, in terms of the research that I do.” But recruiters at the Medical University of South Carolina (MUSC), founded in 1824 and the South’s oldest medical school, were persistent. After four or five visits, he was persuaded that he’d be happy as the university’s director of the Division of Infectious Diseases, with time to treat patients as well. Another tempting aspect of the move was that it brought him closer to much of his family still living in North Carolina.

In a city immersed in family lineage, defeating dread modern epidemics seems to follow a genealogy of its own. Kilby and his associates are crusading against acute HIV and other 21st-century scourges, as their predecessors fought the 18th and 19th-century monsters of smallpox, yellow fever, and cattle plagues.
Other MUSC research projects, some in conjunction with a University Health System Consortium, cover such varied areas as epilepsy, delirium, gender factors affecting women’s health, the relationship of garlic in treating brain cancer, and a wound-healing peptide gel that generates new tissue instead of scar tissue. The research can be put to practical use in the associated 576-bed MUSC hospital, some of whose specialty areas are arthritis, bariatric, digestive disease, and bone and joint centers, in addition to heart/vascular and cancer centers. The hospital has been cited as a leading U.S. transplant facility, with special commendations for its kidney, liver, and pancreas procedures.

As soon as finances permit, the unit will be looking to hire more research physicians, Kilby says. A 6.7 percent population growth from 1990 to 2000 in the tri-county Charleston area has been increasing the need for other practitioners as well.

One example: Shanon Honney, MD, reports that her practice, Charleston Internal Medicine, recently took on a new partner. Her return in 1992 after a hiatus in San Francisco was a homecoming, not to mention a true change of pace. Like Shapiro, she operates under the aegis of Roper St. Francis Healthcare, which comprises Roper, opened in 1829 as the Carolinas’ first community hospital, and the 1882 Bon Secours, South Carolina’s first Catholic hospital. Increasing demand for services has sparked plans for add-on facilities and two more locations as well. One is slated to open in 2010. Both institutions have installed state-of-the-art equipment. Roper has special concentrations, among others, in eye surgery, neurosciences, stroke, joint replacement, and spinal injuries.

St. Michael's Church, the oldest church edifice in Charleston, is well-known as a place of worship for President George Washington in 1791.
St. Michael’s Church, the oldest church edifice in Charleston, is well-known as a place of worship for President George Washington in 1791.

Charleston’s third largest provider is Trident Health System, with a family of hospitals including Trident Medical Center in the city proper and, in two adjacent towns, Summerville and Moncks Corner Medical Centers. Among the health system’s partnerships with nationally recognized programs are its Human Motion Institute, Spirit of Women, and h2u. Honney’s route to the medical profession was circuitous, starting with journalism school and work with a major advertising agency. Then a year in nursing school ignited interest in the MD path, which finally gave her a chance to practice in a city where, as she puts it, “everybody knows your mama. It’s funny,” she smiles. “I went to high school here in Charleston and probably half of my graduating class went to medical school so I either went to high school with half the people I work with now—or with their brothers or their sisters.” Her three children may be repeating the cycle in their own way. Two attend charter baccalaureate schools; the third is in a Baptist grade school.

Professional conviviality goes far beyond old-school ties, though. Honney praises specialist colleagues for their ready cooperation when she needs them. “I don’t think I’ve ever needed a specialist and not been able to find even some really bizarre expertise.” Not only that. “They’re very communicative. If I send a patient to any of them, they’ll call right away and let you know if there’s something going on.”

Charleston, she adds, offers more than a mere comfort zone for natives. “You can’t beat the weather, the beach is close, the city is wonderful. It has great restaurants, there are a lot of cultural events here—and we have the Spoleto Festival every year.”

This blockbuster festival is an offshoot of the 1957 annual event founded in Italy by composer Gian Carlo Menotti. Menotti pitched the American counterpart to Charleston, but it was the leadership of Mayor Joseph P. Riley, Jr., that brought the extravaganza of the arts to life in 1977. The wildly popular Piccolo Spoleto (little Spoleto), showcasing local artists of all genres, is now part of the festival mix.

Today, Riley, first elected in 1975 at age 32, may be the country’s current longest-serving mayor. In a masterpiece of understatement, historian Robert Rosen writes, “The Riley administration has been a whirlwind of activity.” The cyclone of civic achievement in the last 33 years has included such tangible examples as a new convention center and hotel, rejuvenated central business district, new waterfront park, and housing rehabilitation programs. In promoting “a new age of tolerance, harmony, and creativity,” Riley brought more minorities and women into city leadership positions, and, in an especially intriguing move, appointed Reuben Greenberg, probably the nation’s first and only Jewish black police chief.

Greenberg is a modern addition to a long line of Charleston “firsts.” A few samples: Middleton Place, oldest U.S. landscaped garden, 1740; first U.S. Reformed Judaism synagogue still in use, 1749; oldest U.S. museum, 1773; first municipal chamber of commerce, 1773; site of first submarine warfare (the recently excavated Hunley is now on display), Feb. 16, 1864; first historic district zoning ordinance, 1931.

And, perhaps a harbinger of today’s breakthrough medical research at MUSC, historian Rosen reports, “Physicians were the first professional men to arrive in Charlestown (the city’s original name, for King Charles II).” Besides treating patients, one of them, Dr. John Lining, conducted the first studies in the colonies on “non-infectious diseases.”

That was in the 18th century. Who knows what important breakthroughs will happen, thanks to local medical research, in the 21st? Charleston physicians in are excited to do their part.

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

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Eileen Lockwood

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