It’s fabled nickname is Big Sky Country. On a fine day, the massive blueness surrounds you like a great cocoon. In fact, in Montana everything seems to be under a giant magnifying glass—big land, big rivers, big game, big fish, huge mountains, and more.
“The Montana of my youth was a world with dew still on it, more touched by wonder and possibility than any I have since known.” The words reflect the spirit of Norman Maclean’s book, A River Runs Through It. The book was, in effect, a love story about his home state, its pristine beauty, and fly fishing as a metaphor for life.
It’s a mere introduction to the unspoiled wonders of outdoors — hiking, biking, rafting, kayaking, mountain climbing, skiing, and more. “There’s hiking in every direction but east,” says Kevin Stiffarm, the CEO of Pioneer Medical Center in Big Timber. And, he adds, “Depending on the season, there’s something to hunt all year long.” A short list: elk, bear, deer, antelope, and wild turkey. He and other townspeople are proud to point out that the 1992 movie version of Maclean’s book, complete with spectacular fly fishing scenes, was filmed on and near the Boulder River just south of Big Timber.
There is a flip side. “Gigantic” comes to an end with population statistics and cities, and, as Stiffarm can testify, hospitals and medical practices. This could be a clue that the state still holds opportunity for adventurous physicians.
Pioneer combines 25 acute care beds with a 52-bed nursing home in a town of 1,600. Its single hospital-employed practitioner moved to Georgia this fall. Stiffarm, luckily, found a replacement by November, a physician who had done some part-time work there and who was attracted by the facility and the fact that “we are making some moves toward initiatives.” Those include a recently purchased building for more space, a radiology system upgraded to digital capability for Internet transmission to specialists in larger cities such as Billings (65 miles east), a trauma receiving facility designation last June, and possible expansion of physical therapy services. The latter, adds Stiffarm, “has become a very valuable service to our community. More people are becoming aware of its benefits.” There’s one other physician in town, an independent practitioner.
An independent spirit
Although Stiffarm is in the process of moving to another city himself, this time in Wyoming, where there are “greater opportunities for my family” and a larger salary, a number of medical professionals are finding permanent fulfillment in Montana. William C. Anderson, MD is one of them. “When I moved out here my blood pressure dropped to normal,” he jokes. That was 25 years ago.
In Forsyth, population 2,500 and 100 miles east of Billings, there is a small hospital, but Anderson chose to set up an independent practice. To some, that would seem like an automatic trigger for a 200/150 systolic/diastolic reading. Anderson’s diagnosis is different. “There are pluses and minuses,” he says. “You don’t make as much money. You work longer hours, but you are not subject to the vicissitudes of local politics. That’s a big deal, as it turns out. In a small town everybody has equal legitimacy, and anyone can jump on your case. It helps to be somewhat of a loner. You don’t depend on external validation. If you live for compliments, you die by the criticism.”
Not all was roses, of course. Anderson had grown up in Fargo, ND, but attended high school in Forsyth and worked briefly on the railroad after that. However, he graduated from the medical school at the University of North Dakota and completed a residency in Kalamazoo, where he met the girl he expected to marry. “We came out here to look at this place,” he recalls with a bit of a grimace. “We came at night. As soon as the sun came up, she walked to the front of the hotel, looked at the town, and that was the end of our relationship right there.” In other words, “There’s a big divide when it comes to who practices medicine (here) and who doesn’t. It’s got to be a lifestyle. That’s a big order. You don’t have the abstract professional relationship you would have somewhere else.”
Many of Montana’s residents are here because the open spaces, the sense of freedom, and a lifestyle where neighbors know each other seeps into their blood and captivates their sensibilities. As Norman Maclean put it, “The setting and the scenery seem to inspire a passionate devotion to place.” Anderson is probably a poster boy for this mind-set. He and his wife, who grew up on a ranch north of Livingston, MT, now live on acreage about two miles out of town. “I haven’t taken two weeks off more than once in 25 years,” he says, “but there’s more natural environment around me at home than at a camping site in the mountains. It’s quieter here with nobody running generators and watching TV in mobile homes. (At my home) there are wild animals all over the place.”
Not everyone at the homestead shared the thrill of the wild. “When we did vacation,” he admits, “the kids loved going to the Mall of America and Disneyland.” But, “my kids grew up with the values of these people.”
The four, now ages 18 to 25, attended schools that are “fine and totally adequate,” and grew up with skills they might never have developed in big cities. “You have a familiarity with different personality types. There are no cliques (because there aren’t enough kids to form them) so you have to get along with everybody.”
Anderson does note, however, that “the kids (who grow up here) all leave.” There’s good news, though. “They usually come back in their 20s and 30s with skills or abilities. If those are marketable here, they’re pretty happy. More kids are coming back than used to because they’re making decisions based on lifestyle.”