Chapter 8 The Case of Barnesville, Indiana

Welcome to the completely fictional county of Brock County, Indiana.  This is a small county.  It has a population of 7,000 making it just a little bit bigger than Indiana’s smallest county, Ohio, which has a population of 6,128. (U.S. Census Bureau, 2018).  Brock County is located in western Indiana between Indianapolis and Terre Haute.

Dr. Ranjit Souri was originally from Madras, India, which was renamed Chennai in 1996.  Dr. Souri moved to the Brock County seat, Barnesville, in 1976.  He had left Madras, studied medicine at New York University and became a cardiologist.  He moved to New York City after med school with his wife and three young children to begin his practice.  He and his family hated New York City.  It was too rough, too noisy for their tastes.  They decided to move back to India.  Before they left, however, they decided to travel the United States.  They packed up the station wagon and headed west ultimately catching I-70.  Just past Indianapolis, kids will be kids, they started to fuss needed a food and bathroom break.  It was fall.  Barnesville was beautiful and happened to be where they stopped.

Sarah Gracyzk owned and operated Sarah’s café where the family stopped for lunch.  Sarah is a lovely lady and personally saw to the Souri family’s needs that day.  A mother herself, she recognized the look of weary children.  Sarah got the kids settled, gave the parents a break, and struck up a conversation with the family. The Souri’s shared their story.  Sarah shared the town’s story.

Being small and stuck between Terre Haute and Indianapolis, Barnesville struggled.  There was no medical care to speak of and little interest from big city doctors to relocate there.  Being a small town and county, a lot of the residents were related by blood or marriage.  As such, this area had created an interesting medical case situation. There was an abnormally high incidence of hypertrophic cardiomyopathy in the area.  Hypertrophic cardiomyopathy is a condition in which the muscles of the heart thicken and must work very hard to push the appropriate amount of blood through the heart (University of Ottowa Heart Institute, 2020).  The town received its medical care from Doc Brown whose main office was located in Terre Haute.  He came to Barnesville every other Friday for well-baby checks and non-emergent care.  Emergency cases were transported to either to Terre Haute or Indianapolis.  With the very high incidence of hypertrophic cardiomyopathy and resultant cardiac emergencies, the mortality rate for this area is unnecessarily high.  The town held no appeal for big city doctors, the town was unable to locate a replacement which the population so desperately needed.

Perfect –the Souris loved the place, Dr. Souri needed a place to call home and decided not to return to India.  It was love at first sight for both parties. Dr. Souri saw an opportunity to practice in a quiet, beautiful place, create the clinic that served the town’s needs as well as his interests, and allowed him to also do some general practice.

Dr. and Mrs. Souri raised their three children in Barnesville.  It was a beautiful 30-year relationship for both the Souri family and the town residents.  The care and attention he gave the residents helped to decrease the county’s mortality rates due to cardiac incidents as well as decreased its morbidity rates with the preventative care he provided.  It’s now time for Dr. Souri to retire.  He plans to move back to Chennai after all of these years to give back to his birthplace.  His oldest daughter, Rashmee, was also a cardiologist who dabbled in general practice.  She is going to go to Chennai with her father when he leaves.

The residents of Barnesville are devastated.  They have had the care of an excellent cardiologist for three decades with the potential promise of Rashmee’s services as well.  Dr. Souri would leave family meals, holiday events, and so on to care for these people. With the very common hypertrophic cardiomyopathy, this town really needs a good cardiologist as well as a general practitioner.

What is Barnesville going to do?

The county commissioners of Brock County are trying to seek out solutions for this dilemma.  A few members of the town have appealed to you, the CEO of IU Health for help.  You have a very real connection to this case.  You are from Barnesville, still have relatives in the county and town.  You see the need and the potential for IU Health. Make a case for the IU Health Board of Directors to allow you and help you bring healthcare delivery to Barnesville, Brock County, Indiana.

As guidance here are a few topics to help guide your research:

• Desire of medical doctors to practice in this type of service area
• The potential of a research study of a common but unusually high prevalence of a specific disease
• The access to health care needs of small communities. What does Ohio County do for healthcare services? For that matter, how does the Indian Health Services recruit medical personnel.

Reference

University of Ottowa Heart Institute. (2020). Cardiomyopathy.  Retrieved from https://www.ottawaheart.ca/heart-condition/cardiomyopathy