UO > Community Profile > Little Rock, AR

Its midstate location, edged by the southwestern Ouachita Mountains and the eastern fertile delta, definitely puts the capital city near some of nature’s best places. A current tourism slogan, The Natural State, emphasizes Arkansas’ scenic beauty in its mountains, forests, and waters. Ozark and Ouachita Mountains are covered with 88 varieties of green vegetation. The state boasts 17 million acres of national forests, huge stands of pine, 58 lakes, and some 9,700 miles of streams, some known nationwide for their abundance of everything from sunfish, crappie, and catfish to walleye, bass, and trout. One Web site (www.littlerock.about.com) lists the state’s “Top 10 Fishin’ Holes.”

A big serendipity for David Mego, MD, an interventional cardiologist who relocated from San Antonio in 1998, is easy access to fly-fishing locales. As for Gerson, “Being a kid from New York City, I didn’t spend a lot of time fishing or boating on lakes and rivers, but I’ve become a big catfish fan. I now know 110 ways to prepare it.”

In the city, scenery gives way to a neighborly friendliness and traditional southern hospitality that impresses almost every newcomer. And the collegial spirit noted by Tanner also seems to exist among the city’s five general medical centers and the Arkansas Heart Hospital. Case in point: The city has three hospitals with cutting-edge heart-care capabilities—the Heart Hospital itself, Baptist, and St. Vincent Infirmary Medical Center. While the obvious competition might border on hostility in some cities, Vickie Wingfield, the community relations director at the Heart Hospital, credits the two counterparts for their heart-care capabilities and for ongoing upgrades in care, diagnostic equipment and research. “Unfortunately,” she says, there’s enough cardiovascular disease for all the hospitals to handle patients. Arkansas is number three in the U.S. in its incidence.”

One of the striking major “amenities” for a medium-sized metropolis in the center of a mostly rural state is the prevalence of cutting-edge hospitals that helped Little Rock quietly emerge as a sophisticated center for state-of-the-art medical care.

“Every facility is working very hard keeping up with the latest technology,” says the Heart Hospital’s Wingfield. “Within a 12-month period we all have the same level of equipment and the same care techniques.” But, she loyally adds, “The residents of Arkansas are getting better care because we raised the bar, and they caught up.”

The Heart Hospital is one of 13 cardiac institutions nationwide that are managed by MedCath, a North Carolina-based firm, but its attraction for physicians is that they’re part-owners, and have more control over clinical and building design decisions so they can ensure the facilities are geared for the most efficient patient care. “Administrative offices take up the equivalent of four small rooms,” says Mego, who practices there. “The minute I saw that, I knew I was in the right place.” Also, “it’s good to be a worker/owner.”

Mego moved to Little Rock after 12 years as an army physician at San Antonio’s Fort Sam Houston. “I think of Arkansas primarily in terms of being a good place to raise my family,” he says, but the professional hook was the opportunity to be involved in clinical trials and research, which was part of his work at the Texas military base. “The Heart Hospital provided that chance,” he adds. Not only that. “Since I arrived, four of my military friends have followed me.”

A preponderance of Little Rock doctors are state natives educated at the University of Arkansas for Medical Sciences, which also operates the UAMS Medical Center and Arkansas Children’s Hospital. The picture is changing, though. “Now we have a combination of born-and-bred Arkansans and (former) army recruits,” quips Mego.

With 58 cardiac specialists (the Heart Hospital has 50), Baptist more than holds its own in heart-related technology, including intracoronary radiation devices for in-stent restenosis, beating heart bypass capability, implantable cardioverter defibrillators, resynchronization therapy devices, drug-eluting stents, HeartMate devices to maintain heart function for patients waiting for transplants, and a heart transplant program.

The orthopaedics department has perfected a wide range of surgeries, including foot/ankle and back/neck procedures, plus the new unicompartmental (partial) knee replacement technique.

“You don’t think of Little Rock, Arkansas, as the Mayo Clinic,” says Doug Weeks, Baptist’s senior vice president and administrator, “but, when you think of the available services, we’re there.” The services he refers to include those of St. Vincent Health System as well as Children’s, UAMS and the smaller Southwest Regional Medical Center, once a hospital for railroad workers and their families and now one of 54 Health Management Associates (HMA) facilities in the U.S. Occupational medicine is still one of its specialties, but others include extensive neurosurgery and total knee replacements.

Opened as a 10-bed charity hospital in 1888, St. Vincent now operates two hospitals in Little Rock—St. Vincent Infirmary Medical Center and St. Vincent Doctors Hospital, one of whose standout components is a neonatal intensive care unit. Its specialties include the newly opened Jack Stephens Heart Center. It’s been a leader in positron emission tomography, which, among other uses, can diagnose Alzheimer’s Disease in the area’s sole memory center. A state first was an on-site cyclotron to develop radioisotopes for PET use.

Originally an offshoot of a children’s home finding society (aka orphanage) in 1912, Children’s Hospital has grown exponentially and currently is undergoing nearly $30 million in expansion projects. Added to the list of standard care capabilities, its programs include stem-cell transplants (it’s a member of the national Pediatric Oncology Group), a heart transplant program, nerve stimulation procedures for epilepsy patients, a neuroscience unit, and extracorporeal membrane oxygenation (ECMO) equipment for heart-lung bypasses that require extended time in surgery. Breakthrough research has been done on pain management for neonates and milk-protein nutrition which may prevent breast cancer in later life.

Patients come from the world over to Childrens’ Vascular Anomalies Center, one of three in the nation, where a high-level team of surgeons, otolaryngologists, oncologists, radiologists, dermatologists, and pathologists works to cure and remove birthmarks that are, in some cases, life-threatening. In another unusual achievement, the hospital’s James Aronson, MD, was the first pediatric orthopaedic surgeon to use a new bone-lengthening technique devised by Siberian professor G.A. Ilizarov.

Both the anomalies center and state-of-the-art orthopaedic work at Children’s were featured in a special three-hour Discovery Channel presentation on September 26th.

Besides training some 80 percent of the state’s doctors, UAMS, founded in 1879, has medical-related colleges of nursing, pharmacy, public health, and graduate schools. Its research programs spill over into the Medical Center. It has made the U.S. News & World Report list of 50 top geriatrics programs. Other focuses include three institutes for the eye, spine/neurosciences, and myeloma.

Medically speaking, Little Rock—as well as all of Arkansas—still has challenges to surmount. Looming large is the heavy rate of adult and childhood obesity. Recent surveys put Arkansas seventh on the list of “fattest” states.

The problem has not gone unnoticed, though. Last year the state legislature mandated a Child Health Advisory Committee which has ordered schools to remove student access to vending machines, give parents annual reports on student body mass indices, establish healthy lifestyle programs, and report on companies contracting to supply food products.

The fat-fighting army includes Children’s Hospital’s Obesity Center, plus anti-obesity programs at St. Vincent and Baptist. When other approaches fail, the latter two offer gastric bypass surgery, including the laparoscopic Roux-en-Y technique.

As for challenges still facing the city in general, Mayor Dailey has set ambitious goals beyond current downtown and neighborhood achievements. Encouraged by the opening of a monumental downtown headquarters and Global Village (a kind of living museum showcasing life in villages around the world) by the Heifer International Foundation and a new highrise for Winrock International, Dailey has declared his intention to turn Little Rock into a home for many more non-profit societies. Heifer oversees startup agricultural enterprises in the U.S. and some 120 emerging nations. Winrock is a similar economic-opportunity organization started by foundation funds from former Governor Winthrop Rockefeller to benefit the world’s disadvantaged. Their presence brings the current total of non-profits’ headquarters in Little Rock to four, including Lions’ International World for the Blind and CareLink, a regional agency offering eldercare services, including meals on wheels and in-home assistance. The Clinton School of Public Service is also a key component of the non-profit research dream, according to Carter at City Hall.

Dailey is also working with UAMS to expand the scope of its research into a 135-mile BioMedical Corridor stretching eastward to Memphis. The idea is to build on some 200 current UAMS patents in agricultural medicine, mainly using insertion of human protein into seeds for plants that can produce the ingredients for vaccines and medications, and possibly doing it cheaper than those on today’s market. So far, 12 related companies have been started, according to Timothy O’Brien, MD, the director of UAMS Arkansas Bioventures. Five will be profitable this year, and five more are in the pipeline. They should create jobs “that will offer more than double today’s average Arkansas wage,” says O’Brien, who believes the new “crops” can be cultivated on farms across the state. This would be a significant financial boost for agricultural communities.

Business, downtown, and neighborhood rebirth are all pluses for newcomers to Little Rock, and, so far, home prices have resisted ballooning. As Tanner testifies, “To replace my house (complete with land for his horses) in Santa Fe, for instance, would cost three to four times as much. We’ve also got the land—lots of space to build.”

Mego, a Pittsburgh native, appreciates the four-season climate. “One aspect of Texas that we got tired of was the constant heat.” He can’t help adding a note about the “friendly, courteous, neighborly” people and the patients who are “very appreciative for the care we give them.”

Things were not always so rosy in the capital where Bill Clinton spent 12 years in the classic Colonial Revival governor’s mansion. Long-time residents find it hard to forget that earlier governor, Orval Faubus, who called out the National Guard to keep black students from entering Central High School in 1957, three years after the U.S. Supreme Court mandated school integration across the U.S. Only the U.S. Army could get the doors open for the first nine courageous African Americans. Faubus retaliated by closing all the high schools the next year, but students, black and white, returned in 1959. All nine of the “pioneers” graduated and went on to college and successful careers.

Today, Little Rock’s public schools get mixed grades. Although Tanner is a public school graduate, his four children all attended a private academy. Still, he says the public schools “have gotten much better.” Central now has a strong college prep sequence as well as a regular-track program. Almost 60 percent of its students are scoring proficient or advanced on state tests, and it consistently produces 10 percent of the state’s National Merit Finalists.

In 1987, the “Little Rock Nine” visited Central and were greeted as heroes. By then the student body president was black and the mayor of Little Rock was a black woman. At a 40th anniversary celebration, President Clinton, Governor Mike Huckabee, and Mayor Dailey teamed up to hold the doors open for all to enter.

Now a special committee is planning a gala 50th event in 2007. And today, Dr. Roy Brooks, the superintendent of schools, is a black man. g