Dag Hammarskjold, an early United Nations secretary-general, believed that parents could leave their children only two things. "One is roots," he said. "The other: wings." Omaha seems to have inherited an abundance of both. This sparkling city on the Missouri River cannot be dismissed as merely part of what East and West Coast "sophisticates" call Midwestern "flyover" territory.
Hardy 19th-century pioneers and entrepreneurs laid the groundwork that made the city a transportation, insurance, and meatpacking hub. Successive generations took flight with grandiose ideas and accomplishments in varied ventures. Twentiethcentury merchandising genius Rose Blumkin masterminded the Nebraska Furniture Mart, an unparalleled sales empire, managing it well past her 100th birthday. An Irish priest opened a home for destitute boys; today Girls and Boys Town has branches across the U.S. Investment genius Warren Buffett catapulted the investment/acquisitions game into a multi-billiondollar enterprise.
As the city rocketed into the 21st century, riverfront transformation was in the works, sparked by a futuristic $291-million convention center and a $90 million glassy performing arts center overlooking both the Missouri River and the Gene Leahy Mall, a swath of green that sweeps west through the heart of downtown. Its waterfront neighbor is Heartland of America Park, with a spectacular fountain shooting 9,500 gallons of water 300 feet skyward every minute. One county official calls it "a majestic landmark to showcase the gateway to Nebraska and the West," a kind of western cousin to St. Louis’ Gateway Arch. In fact, Omahans have called their town The Gate City for a long time. Work began this spring on Lewis and Clark Landing, a new riverfront recreation site with a restaurant, walking and biking trails, a boardwalk, and an unusual footbridge to Council Bluffs in Iowa. "In the last five years the whole riverfront has been transformed," exults Kathy Schultheiss, the convention sales and marketing director. "Now people driving here are saying, ’Wow! Did I get off at the wrong exit?’"
Other city promoters say that Omaha, as a tourist destination, "is probably as good a depiction of ideal America as there is anywhere." That includes the historic "comfort zone" called the Old Market, an early harbinger of city renewal. Its downtown warehouses are now filled with loft housing, shops, pubs, and restaurants, most of them locally owned - not franchises.
Omaha has been billed as the city "where intellectual capital goes to work," but it also boasts nicknames like "silicon prairie" and "the 800 capital of the U.S.," thanks to a farsighted telecommunications infrastructure. Its medical systems are close technocousins. In fact, it would probably be hard for almost any city to match the futureworld activity that’s energized Omaha health care in the last 10 years. Fully digital hospitals, computerized information systems integrated among dozens of clinics and hospitals, bloodless surgery, robot pharmacists, robotic surgery, integrated diagnostic centers, centralized operating room controls, worldwide voice-andimage- sharing during surgery…it’s almost enough to strike awe in Captain Kirk.
But the high-tech systems are not enough to satisfy healthcare leaders working to bring old-fashioned tender loving care in line with space-age medical procedures. Administrators at Alegent Health, a regional system of seven hospitals and some 100 outpatient sites, have adopted the Planetree Philosophy, a humanistic approach incorporating homelike surroundings, pleasing colors, lighting and art work with calming lobby waterfalls, sleepover space - including computer ports - for relatives, pet therapy, and the "five-minute challenge." Staff members are encouraged to soothe patients by sitting with them for five minutes at the beginning of each shift. It’s a nicety that has touched ministry educator Mary Sue Sturgeon. "I followed a nurse after she spent time with my daughter, who was a patient. The nurse was really busy, and after she left the room she literally ran down the hall. But while she was with my daughter she was completely focused."
Transplant surgery has been a mainstay at the University of Nebraska Medical Center for 20 years, with an organ "inventory" now including livers, bone marrow, kidneys, hearts, bowels, pancreases, and stem cells. Today the program attracts patients from all 50 states and at least 17 foreign countries.
The quest for better care and results has hardly stopped there. In 2001, when laparoscopic gall bladder surgery was performed on a 40-year-old woman, UNMC became the eighth U.S. medical center to use the Storz 1 OR system, a robotic-technology combination devised by the Bausch & Lomb Co. that creates, as Dmitry Oleynikov, MD, puts it, "a seamless integration between man and machine."
Oleynikov could be a poster boy for the technological revolution, as well as for the city itself. Brought to the U.S. as a two-year-old when his parents left Russia, he grew up in New York City but began migrating west after his 1994 graduation from Albert Einstein College of Medicine. Involvement with video-endoscopic surgery in Seattle was a first step toward his current position at UNMC as director of the Training Center for Minimally Invasive and Computer Assisted Surgery - and an adjunct assistant engineering professor at the University of Nebraska - Lincoln.
At least two factors clinched Oleynikov’s decision to relocate in Omaha. "I had known Dr. Bud Shaw, the Department of Surgery chairman, for many years, and I knew he had a vision for increasing efforts to bring advanced surgical technology research to the university." He was also swayed by the spirit behind the Storz installation: a "generous donation" from philanthropist Charles Durham, who "has truly given smartly. He earmarks his donations for research in new and exciting ways of treating illness."
Omaha itself has been a comfortable fit for Oleynikov and his wife, Sonja, an ob/gyn. "People in the Midwest are very nice and very welcoming." He was impressed that "a standard suburban home" was big enough for his family, which includes two small children, an aunt and a grandmother. "The neighbors greeted us right away, and we’ve become wonderful friends." It doesn’t hurt that housing prices - and the cost of living in general - are more than 10 percent below the national average, although taxes are considered high.
As a culture lover, Oleynikov subscribes to both the Omaha Symphony and Opera Omaha, a mere sample of possibilities that include eight musical organizations, seven choruses, and four dance companies. The opera and symphony both perform in the grand old Orpheum Theater, built in 1927 and twice renovated since 1974. In addition.
there are 18 theater companies, including the Omaha Community Playhouse, established in 1924 and billed as America’s largest community theater.
"We don’t have the Chicago Cubs down the street," says Mark Oberlies, MD, a general internist who served internship and residency in the Windy City area before coming to Omaha two years ago. "But it turned out when I lived there I could never go to the games anyway."
There are alternatives, though, such as the Triple A Omaha Royals, arena football, and two auto raceways. Oberlies says he makes it a point to attend the College World Series, which brings 200,000 aficionados to town in mid-June. "[It’s] reasonably priced [with an] excellent family atmosphere." Oberlies also attends occasional local college hockey, basketball, and baseball games. On fall weekends it seems most of Omaha migrates to Lincoln to cheer on the very husky University of Nebraska Huskers, whose win-loss record, until recently, was nearly unmatched. Options for sports "do-it-yourselfers" are many - 36 golf courses, ice arenas, indoor and outdoor pools, tennis courts, softball and soccer fields, a riding trail and even a skateboarding park.
The real lure of Omaha for Oberlies, however, had more to do with the professional promise of Alegent Health’s new Lakeside Hospital, scheduled to open next summer as the area’s first totally digital, "paperless" facility from the ground up, thanks to an alliance with the Siemens Corporation.
Technology began blending with amenities several years ago. For the last two years, Alegent has been cited as one of the nation’s "most wired" health systems. Eventually, functions from bedside registration and charts to diagnostic imaging and prescriptions will be electronic and linked to all facilities, says Ken Lawonn, the vice president for information technology. One highprofile component, a robot pharmacist, went into action in April 2002 at Alegent affiliate Bergan Mercy Medical Center. As of this writing, it had not yet made a mistake.
Says Oberlies, "In so many ways, hospitals and physicians (across the U.S.) are behind in the way we carry out our (mission), but one of the neat things about Alegent is that they are very forward- thinking." A promotional brochure describes it this way: "The new campus is designed to create an entirely new kind of healing environment, one that promotes the emotional, spiritual, social, and physical health of patients and their families." In fact, the word "Alegent" is derived from "allegiance" and "is intended to indicate strength, stability and comfort," according to physician recruiter Kathy Nikunen.
Administrators have been putting these pieces together since 1996, when Catholic and Lutheran hospitals came together to form Alegent Health, an interesting ecumenical exercise in itself. "Each organization maintains its way of worshipping," says Nikunen. But, most important, "All employees are evaluated on how they’re living out our mission statement." Schedules for religious services are listed on Internet sites available to staff, patients, and their families. Lutheran associates participate in mission work, such as a longterm partnership with hospitals in Latvia and Tanzania.
Also in the past decade, Creighton University Medical Center, affiliated with the School of Medicine, has done some pioneering of a different sort. Approached by representatives of Jehovah’s Witnesses in 1994, the Jesuit institution agreed to start a "bloodless surgery" program. Now the only one of its kind in the region, it incorporates various techniques such as laser-induced coagulation, arterial embolization, and hemodilution to eliminate the need for transfusions that violate the Witnesses’ religious principles.
The timing couldn’t have been better, says Ed Finan, the hospital communications and public relations coordinator. "Now there’s a shortage of blood. But beyond that, we’re finding that more and more people - of all faiths - do not want transfusions."
Timing was everything in October 2001, too, when some members of a high school band critically injured in a bus accident were brought to the hospital - only two weeks after brain oxygen monitoring equipment had been installed. For at least one victim, it was literally a lifesaver, says associate administrator Chris Hyers.
Creighton physicians have pioneered laparoscopic techniques and webcast surgery. There’s a phone line providing 24-hour EKG interpretive services for patients of more than a hundred rural hospitals and clinics. The medical school is one of three National Institutes of Health osteoporosis research centers in the U.S., and there has been international recognition for its affiliated sports nutrition program.
That pioneering spirit has deep roots. Omaha was a mere 14 years old when, in 1868, Sisters of Mercy boarded trains to solicit pennies from rail workers to build St. Joseph’s Hospital, which became the primary teaching hospital for Creighton and was recently renamed for the university. It’s the area’s oldest hospital in continuous operation. "Ironically," says Hyers, "the first patient (in 1870) was a trainman who had donated a nickel. He had taken an arrow in the eye."
Medical care in the area actually dates back to an 1819 army hospital at nearby Camp Missouri. The first civilian institution - and the second - burned down in 1866 and 1869, paving the way for St. Joseph’s. These were rough-and-tumble times in Nebraska Territory. One physician, Charles A. Henry, killed a man in a land squabble. He was never brought to trial because he was the only doctor in town. And he later became a respected community leader.
Nebraska Methodist Hospital came into being in 1891 to meet a need perceived by the national church hierarchy. In the 20th century, it would accumulate a string of firsts: Nebraska’s first tumor registry, linear accelerator, chemical dependency unit, MRI unit, and lithotripter. It is now making a name for itself with its new Spine Rehabilitation Clinic and its highly specialized vascular care.
Children’s Hospital and Methodist have both incorporated high tech components and state-of-the-art care, but historically they stand out for another reason - an unusually creative solution to severe financial and management problems that arose in 1971. With finances in disarray, Children’s Hospital’s leaders sought help from Methodist, which had closed its pediatric department to avoid competing when Children’s opened in 1948. The solution was to consolidate many operations (eventually 36 departments), saving some $10 million in building and equipment costs.
The ultimate move to togetherness came in 1979, when a second tower - for Children’s - was erected next to a new Methodist Hospital building. Bridges on all floors connect the towers, including one linking Methodist’s obstetrical department in the South Tower to Children’s newborn nursery in the North Tower. A June, 1982 article in Modern Healthcare magazine noted that the two hospitals "have taken the concept of shared services about as far as possible without actually merging."
The partnership continued until Children’s moved into its third home three years ago, a 142-bed facility combining
ultra-modern care with colorful, reassuring decor that’s across the street from Methodist.
With two medical colleges in the city, you’d expect most Omaha physicians to have trained at either the University of Nebraska Medical Center College of Medicine or the Creighton University School of Medicine. Although this has been the case for a long time, according to Nikunen, the Alegent recruiter, the city is drawing physicians from larger markets. "We are always looking for people with ties to Omaha or the Midwest and people who want to come back here. It’s been a case of not wanting to put a square peg in a round hole." But physicians are beginning to trickle in from other areas.
The high-tech possibilities at the Nebraska Medical Center lured Oleynikov from Seattle. Montanaborn Angela Fischer, MD, a family practitioner, followed her fiancé, a South Dakotan, to the Gate City, but, she explains, "The reason we decided to try Omaha is that we’re both professionals, and we wanted to go somewhere where we can both have professional opportunities." Not to mention that "Children’s Hospital has pretty much anything you need for really sick children."
Oberlies, who grew up in Rochester, New York, followed by education and residencies in Buffalo and Chicago, had lived in Omaha 10 years ago while dating his wife, a native Omahan, but says, "I became more infatuated with the city after I left. My wife had family ties, but I was actually the one more interested in getting back, both for personal and professional reasons."
On the professional side, the hospital atmosphere gets high marks. "When you’re in health care," Oberlies says, "you’re used to the status quo. You may feel like the way patients and their families are treated is lousy, and you don’t feel you can do anything about it. But doctors here are certainly getting the message that this is our hospital and we have a chance to shape it for our future."
A paperless hospital also gets high grades from Oberlies, who says, "Anything you can do to improve the work system is just a Godsend to doctors. For example (with computerized systems), patients shouldn’t have to tell their stories to ten nurses and doctors over and over. It should be captured once, and then easily reviewed by all medical staff going forward.
"Of course, we’re also very hopeful that it’ll reduce medical errors and improve efficiency, both of which will help improve patient outcomes, which is, of course, what we’re all about."
If he had a wish list of amenities, Oberlies would haul in "beautiful mountains and freshwater lakes," but the social topography makes up for any lack of geography. "People are very friendly and down-to-earth." And, he says, "there are great restaurants here, and you know what? You can get into them and you can park in front. This is 2003, and we have great chefs here who were trained all around the world, but they can’t charge New York prices. To me it matters that at the cleaners, drive-throughs, and grocery checkouts, people here are still personable and friendly. I generally haven’t experienced that elsewhere, so I’m really enjoying it."
Internist Hank Sakowski left Denver for the Creighton medical school, planning on a short stint in Omaha, but his wife, a native-born Omahan, wanted to stay here. "In fact," he says, "we lived for a long time on the same street with her mom, brothers, sisters, an aunt, and a grandmother." When they decided to move to a new neighborhood, "for her it was like moving to California. She was worried about maybe snooty neighbors. I was ready to get psychotherapy.
"But she was wrong. The neighborhood is alive with people out walking and with their families, and kids playing in the park and in the middle of the street…. It took forever to move in because people came up to talk to us - and brought food. In fact, we still have an unknown person I call ’the grandmother of the neighborhood.’ She keeps putting boxes of doughnuts in our doorway."
Pediatrician Kent Kronberg, whose medical education was at the University of Nebraska Medical College, knew a good thing when he had it. "My family’s been here more than a hundred years," he says with pride. "It was just quite natural for my wife and me to find jobs here. Now I would never consider leaving." he insists. "I have great partners," he adds, "a dedicated children’s hospital, and two medical schools in this small city that provide the whole spectrum of care that any child could need. I don’t think it could get any better."
Two important developments have occurred since he set up practice in 1983, most recently the addition of hospitalists to the staff of Children’s (as well as the Alegent group). "They seemed like a threat at first," he remembers. "Private physicians thought the in-house docs would take over their work, but we’ve found it’s better for an in-hospital person to take care of all the patients’ needs and coordinate back with us. If I have one patient in the hospital and have to drive eight miles to see him and then drive eight miles to the office, that’s inefficient care."
A second burnout preventative is the Pedi-call service. Qualified nurses take phone calls throughout the night and, with the top 500 most-asked questions available on computer, are authorized to call in prescriptions and/or send patients to emergency rooms. Physicians receive summaries each morning, and the service is free to patients.
Omaha was laid out as a town in 1854, but the real population boom began in 1858 when gold was discovered in Colorado. The new Nebraska town became the outfitting and equipment center for westbound miners. President Lincoln sealed the city’s importance when he signed legislation in 1863 making it the eastern terminus of the first transcontinental railroad.
Omaha’s rail identity continues today as the corporate center for the Union Pacific Railroad. Union Pacific is one of five Fortune 500 companies located in the city - that’s "more than most markets our size," according to Sharon Brodkey, the Chamber of Commerce’s marketing and communications director. Two others - ConAgra Foods and Mutual of Omaha Companies - date back almost a century. Kiewit Construction was founded in 1940; Warren Buffett bought control of Berkshire-Hathaway in 1965.
World War II brought the Martin Aircraft Corporation, which produced B-29s, including the two that dropped atomic bombs on Hiroshima and Nagasaki. In 1946, Offutt Air Force Base became home to the Strategic Air Command (SAC), renamed STRATCOM in 2002. This year the Department of Defense moved SpaceCom from Colorado Springs to become part of STRATCOM, a victory for city leaders, who had feared the whole operation would leave town. Offutt is now the area’s largest employer. (Alegent is second.)
An offshoot of the fusion is the Strategic Air & Space Museum, one of Omaha’s most popular destinations, along with the Henry Doorly Zoo, which boasts America’s largest rainforest exhibit, world’s largest indoor desert dome and - new this year - the world’s largest nocturnal exhibit. Equally captivating are the Joslyn Art Museum and the Durham Western Heritage Museum housed in the restored Union Station. Joslyn’s collection covers antiquity to the present, with emphasis on 19th and 20th century European and American works.
Meanwhile, civic and business interests had created Allied Information Management, (AIM), a non-profit group that helps develop employees for high-tech jobs. In August, the Gallup Organization will move most of its Lincoln operation to Omaha’s riverfront, including Gallup University, its executive leadership program, which, says Brodkey, will bring some 5,000 topnotch business people to town every year. "When those people start going back and telling businesses and friends about us," that could be nothing but good news for the Gate City, she says.
Outsiders and national magazines have cited the city as "a model of cooperation" between public and private sectors, the fifth hottest domestic market to do business in, and "one of the top eco-cities in America." None of the accolades surprises Brodkey. It’s a tribute, she says, to the "vision and ambition, persistence and tenacity" of a string of city administrators, plus "an engaged, passionate private sector. It almost makes you look bad if you don’t get on board."
Eileen Lockwood is a free-lance travel writer based in St. Joseph, Missouri.