Simply put, most people who live in the Upper Valley area of New Hampshire and Vermont consider themselves to be thoroughly spoiled. The region is rich in everything you’d ever want: small-town life, lots of four-season outdoor activities - summer’s hiking trails become winter’s cross-country skiing trails - a surfeit of culture, great food, unique shopping possibilities, intellectual stimulation, and last but not least, friendly people. Quaint little towns and old-fashioned general stores dot the region, heralding a view to a bygone agricultural era that’s still alive and kicking.
The towns that make up the core of the Upper Valley - Hanover, Lebanon, Lyme, and Enfield on the New Hampshire side, and Norwich, Hartford/White River Junction, Thetford, and Hartland in Vermont - vary widely in terms of real estate, culture and population. For instance, Hanover is home to many Dartmouth College professors, so there’s a real intellectual air that permeates the town, but come fall weekends, football fever predictably reigns. Though it’s right next door, Lebanon has more of a melting-pot feel to it demographically speaking. It’s also the one town in the region with the most national retail chains, on Route 12A in West Lebanon, which parallels the Connecticut River. Lyme boasts to numerous horse farms and second homeowners while Enfield is generally regarded as suburban.
The differences don’t stop on the Vermont side. Norwich is one of the wealthiest towns in the state, while Thetford to it’s immediate north has a more laid-back rural feel. South of Norwich, the town of Hartford is made up of numerous villages including White River Junction - an old railroad town that’s now a gritty arts community with a top-notch theatre company, a funky clothing store/espresso bar, and a martini lounge with live music nightly - and Quechee, home to a sprawling second home community and a gorge that is one of the most popular tourist attractions in the state. To it’s south, Hartland is similar to Thetford.
Small high-tech companies abound in the area, and many of the companies with main headquarters located here - Hypertherm, TeleAtlas, Dimatix, and Creare - got their start as a mere glimmer in the eye of some Dartmouth professor.
Dartmouth Hitchcock Medical Center in Lebanon, New Hampshire, is the largest hospital in northern New England - with 329 beds - and is home to Dartmouth Medical School.
In addition to Dartmouth Hitchcock Medical Center - better known as DHMC - physicians can find work at the Veterans Administration in White River Junction and Alice Peck Day Memorial Hospital in Lebanon. In fact, many Upper Valley MDs shuttle between at least two of the hospitals; there’s a lot of career cross-pollination, especially due to the presence of Dartmouth Medical School.
Indeed, in some ways, it sounds too good to be true. Of course, there exists what some people consider to be a downside, but we’ll get to that later.
The local music and art scene is alive and well in the Upper Valley, with many restaurants hosting live music several nights a week - the Canoe Club on Main Street in Hanover boasts live music 363 nights a week (Christmas and Thanksgiving being the exceptions.) World class performers passing through town to perform at the College’s Hopkins Center; in the last year, luminaries including Wynton Marsalis and Kevin Bacon graced the stage. The Lebanon Opera House also hosts top national acts like Hot Tuna and Garrison Keillor. William J. Rosen, MD, associate professor of ophthalmology at Dartmouth Medical School is well-versed in the local music scene; besides his day job, he also plays jazz guitar in ensembles at some of the local restaurants.
Rosen first discovered the Upper Valley in 1993 when, after finishing med school and residency at UC Davis, he came to DHMC for an interview. He was charmed by the Upper Valley, and though he had already been offered a job in Augusta, Georgia, he accepted a position at DHMC and never looked back.
"The Upper Valley has a small-town college atmosphere with good schools and cultural events, and it’s a safe place to raise a family," he says.
Around the Upper Valley, some residents prefer the atmosphere of a small hospital instead of the teaching-hospital environment at DHMC, and some physicians feel the same way. With over 6,600 employees, DHMC is by far the Upper Valley’s largest employer, akin to a small city, while Alice Peck Day Memorial Hospital (APD) - with 440 employees and 50 beds - has more of a small-town feel.
David Kroner, MD, FACS, is a general surgeon at APD and appreciates the neighborhood feel of the hospital. "I get to practice in a place where I know everyone from the CEO down through nursing, maintenance, and housekeeping, though as a physician, the access to DHMC for referrals and continuing education is a wonderful plus," he said. After completing his surgical training in San Antonio, his stations included Michigan, Virginia, Maine, and Alaska, among others, along with a stint as the commander of a Rapid Deployment Force hospital. In 1985, when it came time to settle down in one place, Kroner’s wife, Connie - who had loved the years they spent in Maine - put her foot down and insisted they live in New England. The first time they drove around to explore the Upper Valley, they both felt a sense that they were in God’s country and had found their home.
"We have the best of both worlds here," he said. "Whatever you need, it’s not too far away. If you need the big city, Boston is only two hours away while rural is right out your back door." And for downhill ski enthusiasts, resorts such as Stowe and Killington are about an hour’s drive from Upper Valley towns. While hospital food usually ranks right down there with airplane cuisine, according to Kroner, the chefs at APD are particularly gifted. "This is the only hospital where I’ve worked that I actually sometimes order take-out from the cafeteria because the food is that good."
Tina Foster, MD, MPH, MS, also ended up in the Upper Valley - at DHMC - after an equally circuitous route. After graduating from med school at UC/San Francisco in 1984, she did her residency in OB/GYN at San Bernardino County Medical Center/Loma Linda University in southern California. She then earned an MPH at the Harvard School of Public Health before getting a VA National Quality Scholars fellowship, where she landed at the VA in White River Junction. After finishing the fellowship, she stayed on at DHMC, starting there full time in 2002.
She first came to Vermont in January 2000, and she was anxious about driving on ice or snow. As it turned out, she didn’t have to worry about snow, but found it bitterly cold when the thermometer fell below zero and got stuck for awhile. "Everyone kept telling me that it was never that cold. I now know they were not being entirely truthful," she adds wryly. Foster initially thought that the Upper Valley seemed pretty far away from everything, and once she relocated she planned to visit Boston and New York as often as possible for a dose of culture. That soon fell by the wayside, however, due to the rich cultural offerings in the area. "I actually spent more time in New York when I lived in LA than after I moved to the Upper Valley," she says.
"It’s incredibly beautiful here," she adds. "I feel lucky every day on my drive home, even in the winter now, and it’s really safe. I’m in a community, but I’m not hemmed in by it. There’s plenty to do if you like being outdoors or indoors, but I’m not sure I would love it here so much if the college weren’t here."
Jennifer H. Judkins, MD, an otolaryngologist, joined APD in 2006 after spending six years in practice in Providence, Rhode Island. She attended the Medical College of Ohio in Toledo, Ohio, and split her residency between Burlington, Vermont, and Brooklyn, New York. When she decided to leave Rhode Island, she specifically looked for a rural community so she could start a small farm. She picked New Hampshire after considering Colorado, Wyoming, and Wisconsin.
"I’ve been so happy here," she says. First she bought a small farm so she could keep her two horses at home instead of boarding them, and she’s since added four more horses along with two goats and fourteen chickens. Judkins also grows some of her own food and is involved in a grassroots organization that promotes animal-powered farming. She loves that there is so much to learn. "As a physician, it’s so important to have a passion at home that allows you to decompress from your practice, which helps prevent burnout," she says.
Like her colleague David Kroner, she loves the small-town feel of the area. "I know all my neighbors, and we all watch out for each other and help out without being asked," she says.
Margot D. Stephens, MD, has been a family practitioner at APD since 2002. After completing medical school and a residency at the University of Massachusetts in Worcester, Massachusetts, she knew she wanted to head north. In 1995, she landed first at Springfield Hospital in Springfield, Vermont, just south of the Upper Valley, before looking further north in part for her children. The Dresden School District - a bi-state district for the towns of Hanover and Norwich - boasts some of the best schools in both states, and the sports and educational facilities played a role in Stephens’ decision, along with being closer to the opportunities at Dartmouth College.
"We wanted to raise our children in a place that had a little slower pace, yet still had plenty to offer both in outdoor recreation and culture," she said. "But as our children grew older, we wanted to be closer to the great schools this area has, as well as some of the recreational opportunities.
"The presence of Dartmouth College and the medical center means that there are many highly educated people living in the area, and in fact, many Dartmouth graduates and DHMC physicians retire here, so we have a population that is quite a bit more urban and well-educated than might otherwise be expected at this distance from a major city," says Stephens, whose husband works in the high-tech industry. They’ve both been impressed at the number and range of small creative firms in the Upper Valley. "There are so many interesting companies in this area, many with international ties, and you’d never know it because it feels like you’re out in the country," she adds.
If it all sounds too good to be true, it just might be. One big negative for many people is the weather. Hands-down, if you don’t like long winters and cold weather - or at least can’t learn to tolerate it - then you’ll have a tough time adjusting to life in the Upper Valley.
In addition, physicians who are relocating with families tend to have an easier time here since the area is more suited towards families than singles. "If you like big cities and lots of restaurants and young people, then this isn’t the best place," says Rosen. "If you want to maximize earning potential, this isn’t the place unless you plan to enter private practice."
There are growth concerns for residents and businesses. Commercial land for office space in the core towns of Hanover and Lebanon - and Hartford on the Vermont side - is limited and as a result, some businesses are priced out of the market. Residential real estate prices can be high in Hanover and Norwich, with median home values in some of the adjacent towns up to two-thirds lower.
And good jobs for non-physician spouses can be lacking. "My situation is unlike many others in that I didn’t have a family to move and no significant other to consider, so I didn’t have to worry about other jobs or schools," says Foster. "There are only so many jobs around here, and it seems to be hard to find something suitable for both halves of a couple."
But for others, like Judkins, the downside is minor. "There are no bad points to living here," she says, "unless you want Chinese takeout at two in the morning."
Maybe she should just plan ahead and get some takeout from the APD cafeteria. UO
Lisa Rogak lives and writes in Charleston, South Carolina. Her next book, Haunted Heart, The Life and Times of Stephen King, will be published in January.