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December 9, 2020

Making miracles

SHANE RHYNE STILL REMEMBERS A certain Wall Street Journal story about his town in 1980.

Promoters in Knoxville were drumming up exhibitors for the World’s Fair to be held two years later. More than $45 million was earmarked for a 70-acre site near the University of Tennessee - Knoxville.

But WSJ reporter Susan Harrigan was skeptical. "Not one major corporation has signed up for an exhibit here," she wrote, "and a mere handful of foreign countries have agreed to participate."

Then came the fightin’ words, according to Rhyne, the public relations director for the East Tennessee
Historical Society. Harrigan wrote, "Nevertheless, with visions of international exotica in their heads, leaders of this scruffy little city of 180,000 on the Tennessee River are . . . comparing Knoxville to such previous world’s fair hosts as Paris and New York."

Fact is, the projected 11 million visitors did come, and even generated a profit, unlike any North American counterpart before or since - a manmade miracle, in a way, but also a tribute to hardheaded perseverance packaged with a swig of mountaineer graciousness.

Knoxville history - and that of all east Tennessee - is a story of self-reliant, independent- minded settlers who literally climbed mountains to get there. Some say the resulting isolation instilled permanent differences from that "other" part of Tennessee.

Native Americans like Sequoyah, the Cherokee leader who created a written language from scratch and taught 96 percent of his people to read in three years.

In 1784, John Sevier led a group that set up the independent state of Franklin, later absorbed into Tennessee. During the Civil War the mountain men sided with the Union by a two-to-one margin.
Historian Bruce Catton labeled Knoxville "the most dissident of all Confederate cities." Wary of following the crowd even now, east Tennesseeans tend to vote Republican while the "westerners"
seem wedded to the Democrats.

The state constitution was written and signed in 1796 at the Blount Mansion, now a visitor attraction on a hillside not far from the University of Tennessee. Thomas Jefferson called Tennessee’s constitution "the least imperfect and most republican" of all its peer documents.

Thus, in 1980, "it became a badge of honor to be picked on by the Wall Street Journal," says Rhyne.

Defiant pride

The city’s central location (a third of the U.S. population lives within 500 miles), and three converging interstates helped draw visitors to the World’s Fair, says Rhyne. "We were able to play off on geography. People could be on their way to Disney World and say, ’Why not stop at the World’s Fair in Knoxville, too?’"

Today, in a kind of salute to a snub, a reporter’s offhand epithet has turned into an affectionate nickname. In fact, adds Rhyne, several businesses, such as Scruffy City Publishing, have used the name as a springboard to success.

The "S" word actually dates back to the late 1940s and a book, Inside U.S.A. Its author, John Gunther,
wasn’t content to stop at "scruffy." Knoxville, he added, "is the ugliest city in America."

Gunther’s punch in the belly predictably roused local pride. It became the inspiration for the
Dogwood Arts Festival, one of the city’s largest annual events. Residents began re-landscaping with the pink and white-blossomed trees, said to grow here bigger and better than anywhere else in known civilization. Today the festival fills the month of April, spotlighting seven "trails" and five "garden byways," plus myriad other activities from quilt shows to concerts and sports events.

Visitors to Knoxville during the World’s Fair found more reasons for the local pride. They were in a hilly city not only on a great river but nestled between the spectacular Great Smoky Mountains and two other national parks, surrounded by a scenic waterworld. Seven nearby lakes with  multirecreational opportunities are the legacy of the Tennessee Valley Authority, the 1930s federal corporation that built 20 dams on the Tennessee River and its branches to provide power for hundreds of communities in the South. One of the river branches, the Clinch, has become a mecca for trout fishermen around the country.

"For outdoor enthusiasts the region is a gold mine," says Nicholas Potter, PhD, who heads the Molecular Diagnostic Testing Laboratory of the Developmental and Genetic Center at the University of Tennessee Medical Center in Knoxville. Potter and his wife, Ilse Anderson, MD, a clinical geneticist
at the UT complex, moved here from Connecticut in 1991 and, as he says, "We have no desire to look elsewhere. The Northeast has a lot going for it, but we wanted to be able to balance our professional lives with our personal lives. There’s a slower pace of life, and the commute time is only 20 minutes
from a nice neighborhood."

Ambiance and climate are a special plus. "Knoxville is big enough for some cultural events," Anderson says, "but small enough that you can go somewhere and you will meet someone you know." And, she adds, "It’s so much farther south that you can put your garden in in April and it grows through October. You still have four seasons, but you’re not in that tropical zone where all you have is palm trees and dead grass."

John Neff, MD, takes a scientist’s more cautious approach. "I go for the job, not necessarily for the ambiance," he admits. The job that lured him to Knoxville 10 years ago was that of chairman of the pathology department at the UT Medical Center and medical director of University Hospital Laboratories (now Dynacare-Tennessee).

Having lived and practiced in Ohio, Missouri, and New Hampshire, he assesses his current home as "a good university town and a medium-sized city with a bright future." And he hasn’t failed to notice the influx of "a lot of very fine restaurants" in the last several years.

He’s softened his attitude toward the outdoor life, too. "I am very much the city kid," he says. "I’ve never been impressed by dirt and bugs." But he now owns a country place in Townsend on the edge of the Great Smoky Mountains National Park and about 25 miles from Knoxville.

"Family life. That’s why I’m here," says Scott Stevens, MD, who was recruited as a general surgeon 10 years ago. He’s now one of a trio of UT vascular surgeons setting the curve with state-of-the-art techniques such as inserting fabric-covered stents through laparoscopic incisions. Soon this vanguard group will be clustered with other cardiology specialists in the new $16-million Heart, Lung, Vascular Institute, one of a number of new facilities emerging from a recent building flurry by all the Knoxville hospitals.

Stevens, the father of four, adds, "This is a great place to be a kid. I think the fact that people come back here to raise families is a windfall from the University of Tennessee."

Some of the returnees are famous, such as Pat Ryan, a former UT football standout and ex-New York Jets quarterback. "He’s my son’s Little League coach," says Stevens. Pat Summit, 25- year coach of the perennial championship men’s basketball team, is also "very accessible," he adds. She’s one of a select number of inductees in the strikingly designed new Women’s Basketball Hall of Fame.

Cutting the edges

Stevens’ group represents only one of the ’medical miracle’ projects among various Knoxville  hospitals in the last decade. Other advanced studies at UT Medical Center include detecting abnormal
light chain production and deposition in kidneys and other tissues, growing vein-replacement cells, and detecting causes behind the breakdown of artery walls.

Potter’s laboratory has been in the forefront of molecular diagnostic testing in the Southeast for more than a decade. The group has been involved in identifying several rare neurological disorders that are clinically similar to Huntington disease.

Fort Sanders Parkwest Medical Center enrolled the first American patient in an international clinical trial to evaluate the use of implantable cardioverter defibrillators (ICDs) to prevent sudden death in high-risk heart-attack survivors.

Just this July, Kelly Blair, MD brought his endovascular expertise in specialty stent grafts, several of which he helped develop at the National Institutes of Health, to Baptist Hospital. Besides his NIH work and a year at the University of Chicago’s Department of Vascular and Endovascular Surgery, nine years of highly specialized experience at Vanderbilt University have qualified him for every kind of surgery from traditional to all the latest minimally invasive procedures. "I have the training for one-stop shopping for everything, including diagnostics," he says.

What lured a cosmopolitan, quadrilingual person with life experiences as diverse as overseas  education  and White House advisory roles to a mid-sized, mid-America city? And what made him decline offers from medical facilities at Harvard, Dartmouth, Emory, and Northwestern in favor of Knoxville? "I saw endovascular surgery as an emerging field and wanted to be at a facility where I could play a role in this new discipline," says Blair.

He quickly discovered the need for his services. "There were 10 endographs performed at Baptist last year. I had four referrals in my first week here," he marvels. Just as quickly he ticks off other pluses: "1. No traffic. 2. Superior education at public as well as private schools. 3. Low crime rate. 4. No state
income tax. 5. Low cost of living. 6. Enjoyable, respectful people."

Potter and Anderson endorse all of the above. "Financially speaking, this is a very attractive place to live," says Anderson. He and his wife paid $160,000 for a 3,200-square-foot home in Knoxville. "Here you can do a lot of things you want to without being beholden to your mortgage," he says.

Besides the nonexistent state income tax, property taxes are low, although there’s a six percent levy on dividends and interest from stocks and bonds, and the legislature recently voted to an increase the sales tax to 9.75 percent.

Steadfast economy

The bottom line for Blair and his wife: "We plan on staying here forever." That should be plenty of time to savor not only Knoxville’s outdoor and cultural features (symphony, opera, chamber orchestra,
two ballet companies, and a respected children’s dance company), but historical and entertainment sites in the surrounding area as well.

Pigeon Forge, complete with bright lights and big entertainment, including Dollywood, is 33 miles southeast of Knoxville. Gatlinburg, the hub of mountain crafts with more than 440 specialty shops, is 40 miles east. Sixteen miles north, the Museum of Appalachia in Norris spreads over 65 acres with
three dozen old-time log structures and some 300,000 historic artifacts from life in a simpler century.

A foray southwest takes you into a world of early textile and knitting mills, complete with museums, and to the reconstructed Fort Loudoun, where costumed interpreters tell lively stories of life and action at the first British outpost in the region.

Back in Knoxville, the World’s Fair lives on as an "unseen legacy," as Rhyne sees it. In the last decade or so, a good number of companies and corporate headquarters have been relocated to the region, some to attractively restored former warehouses and department store buildings in one of three once-thriving-and-now-reviving downtown districts.

The first tangible legacy was the 53,000-square-foot Knoxville Museum of Art, built on the  fairgrounds themselves soon after the exposition. The most recent, the half-million-squarefoot
convention center, opened in July.

Besides the main grounds themselves, World’s Fair organizers also beefed up an overlooked boat-launching area on the Tennessee River, turning it into the Fair’s entertainment district. Today,
Volunteer Landing is a pleasantly landscaped cluster of attractions and restaurants, with a hotel and marina for the tour-ship Star of Knoxville as well as private and rental boats.

Lately, other downtown restoration projects have followed. Venerable department store buildings and warehouses are being developed into Class A office space, attractive condos, and a large number of loft apartments. The glitter has been restored to two grand theaters, and vigor has made a comeback to Market Square, another historic center of activity. The city helped move the projects along with incentives, such as waiving permit fees.

The downtown renewal efforts, according to Tom Ingram, have been more of a shot in the arm than a rising from the dead. "Three major institutions insulated us from real economic downturns," says Ingram, the president and CEO of the Knoxville Area Chamber Partnership (formerly the Chamber of Commerce).

One is the university. On Saturdays during football season, "The city turns orange," as one Knoxvillian puts it. Neyland Stadium fills with some 102,000 fans, and the river nearby fills with boats of the "Volunteer Navy," the Knoxville equivalent of a massive tailgate party. It’s just one indication of the
staying power of UT. (The "Volunteer" nickname stems from the fact that overwhelming numbers of men volunteered to fight in the War of 1812 and in the1840s Mexican War. In May of 1846, the governor called for 2,800 men; 30,000 responded.)

The other two pillars of the economy, the Tennessee Valley Authority (TVA) and the Oak Ridge National Laboratory, inspired the World’s Fair theme, "Energy Turns the World."

Once World War II ended and its topsecret research was no longer in demand, many people thought Oak Ridge, 20 miles east of Knoxville, would deteriorate into a ghost town. Instead, the onetime "secret city" may now be home to the nation’s largest multipurpose federal research and development center, the Oak Ridge Laboratory. And it’s about to become even bigger with the building of the Spallation Neutron Source. The Neutron Source’s central element, a linear particle accelerator the
size of nine football fields, will make it possible to break down every organic and inorganic substance in the world into its most minute components. Potential uses of this technology include development of an almost limitless cadre of new products from drugs to paints and plastics, according to the  project director, Carl Strawbridge. The Oak Ridge Laboratory is a U.S. Department of Energy facility, operated under contract by UT-Battelle, a company formed by the University of Tennessee and the
Battelle Memorial Institute.

Difficult vision

The Oak Ridge laboratory was also a major factor in the establishment of the UT Medical Center, but only after a long squabble among the medical players in the city.

Private homes and doctors’ offices served as makeshift hospitals in Knoxville until 1886, when Eastern State Hospital opened. It had limitations, though, according to John M. Burkhart, MD, a city native and hobby historian who has been in family practice for 22 years. "Nobody but the city-appointed doctor or the sheriff could admit patients," he says. "There was a white men’s ward, a white women’s ward, a colored men’s ward, and a colored women’s ward."

Starting in 1902 with Knoxville General, other facilities opened as needs arose: Fort Sanders in 1920, on the site of the city’s brief and only Civil War battle; St. Mary’s in 1930, after a severe bed shortage prompted an appeal to the Bishop of Nashville (unusual because the area population was and is
largely Protestant and mostly Baptist); East Tennessee Children’s in 1937; and Baptist in 1948.

After World War II, deteriorating conditions made it clear that something must be done about  Knoxville General. The need to address this situation coincided with the University of Tennessee’s need for a student infirmary and the government’s need to find peaceful uses for Oak Ridge’s nuclear leftovers. A fourth star in the alignment was the 1947 Hill-Burton Act, passed by Congress to spur new hospital construction. City and university leaders proposed a UT medical center that would combine isotope research with a student care facility.

But politicians and medical turf-protectors soon got into the act. The book Miracle in the Valley, chronicles the ensuing row. Supporters of Knoxville General opposed its closing to make way for the new facility. The Academy of Medicine (the city’s medical society) balked because its members wanted exclusive privileges - and worried about academics running a hospital. Politicians wrangled.

In Memphis, administrators at the state’s official medical college feared being overshadowed - or put out of business. Nursing school administrators fretted over a diploma program versus a degree
program. The city demanded $75,000 credit toward indigent care in exchange for outdated equipment from the old hospital.

Somehow, diplomacy prevailed, with perhaps a dose of heavenly providence. Knoxville’s largest medical complex now treats more than 203,000 patients a year from the city and surrounding
counties, supports a creditable number of advanced research efforts, and is East Tennessee’s only teaching hospital.

Children’s Hospital, whose annual statistical report includes the numbers of teddy bears given away (4,411 in 2001), popsicles eaten (56,160), and diapers used (373,928), along with traditional figures such as patient visits (111,131 last year), is in the middle of a $47.5 million expansion and renovation program. Its facilities include a specialized emergency department and a neonatal intensive care unit, plus labs for such subspecialties as pediatric neurology and gastroenterolgy. Its Lifeline hospital-tohospital vans ("intensive care units on wheels") serve the city and 16 surrounding counties. It also provides critical pediatric care nurses for delivery rooms at one other hospital and is working on expanding the service to others.

St. Mary’s recently became the first hospital system in East Tennessee to incorporate a computerized medication system. As part of its mission for preventive care, it also operates an extensive fitness center and a comprehensive 12- week weight-loss program.

UTMC was not Knoxville’s only health-care center whose problems were ’miraculously’ solved. According to Nancy Siler, in 50 Years of Hope, Healing and Compassion, when Knoxville Baptists asked for funds to build the original  Baptist Hospital in 1948, Tennesseans statewide pledged more than the requested $1 million, only to have the hospital committee discover they’d grossly underestimated costs. Although it would contribute to hospital support for years afterward, the state Baptist Convention turned down pleas for extra building funds. That was when the builder himself came to the rescue. According to the historian, "he refused to take one cent of the $75,000" he had
originally contracted to receive as payment for his services.

Now, Baptist Health System is constructing two separate entirely new hospitals, one exclusively for women, the other in an underserved area of town. Among Baptist specialties today are eye, heart, pain, and sleep institutes, a diabetes treatment center, and a corporate health program including pre-employment physicals and worker care.

Parkwest Hospital opened in 1973 as the city’s first for-profit health-care institution. After two ownership transactions, the now-named Fort Sanders Parkwest Medical Center and the older Fort Sanders Regional Medical Center are owned by the not-for-profit Covenant Health. Fort Sanders
Parkwest lists several "firsts" in its resume: first in the Southeast to use the Cutting Balloon tool in angioplasties, first in the state to implant a gold-plated stent, and first in the city to implant the
nation’s smallest single-chamber heart pacemaker.

In addition to its other acute care services, Fort Sanders operates the Patricia Neal Rehabilitation Center, named for the Knoxville native and actress who fought her way back from three devastating
strokes. An unusual feature is its Rooftop Therapy Park, a landscaped skyscraper- style oasis complete with therapeutic elements for ambulation training, plus a gardening area and a putting
green. As the hospital literature describes it, this is "where science meets nature to promote healing - physically, spiritually, and emotionally."

One of the most successful healthcare companies in the region - and one of the city’s largest employers - is Team Health, a nationwide outsourcing business that currently staffs all but one
emergency department in Knoxville hospitals. Company president Lynn Massingale, MD was one of two founders, both emergency room physicians, who started the organization in 1979. It now has a presence in 42 states.

With 4,000 employees and 2,500 independent- contractor physicians across the country, Team Health set up corporate headquarters in Knoxville, according to marketing vice president Tracy
Young, largely because "this is a hightech city with a good employee base and a good cost of living."

Soon after the infamous Wall Street Journal article, the Rand McNally and Pierce Surveys took note of Knoxville and have ranked it one of America’s most livable cities ever since. Besides that, the Places Rated Almanac, in its millennium edition, gave the city a blockbuster accolade: "Best place to live in
the U.S. and Canada" among cities of less than 1 million population, and 13th among U.S. 343 metro areas of all sizes.

Susan Harrigan, now a financial reporter for Newsday on Long Island, hasn’t returned to Knoxville since 1980. If she ever does, though, Rhyne will be more than happy to show her how his "scruffy" metropolis is doing these days: Very well, thank you.

Eileen Lockwoodis a free-lance travel writer based in St. Joseph, Missouri.

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