Ackerman Family: May 2016

Sweet Elizabeth got stitches. This is our first set of stitches for our kids. Adaliah and Elizabeth went with Pete to his parents house for Super Bowl Sunday. Norah and I stayed home because Norah was getting over a bad cough and fever.

Elizabeth ran into a metal stool while playing with her little cousin Sophie. Pete could tell right away it needed stitches so he applied pressure quickly. Elizabeth cried when it first happened, but then didn't cry again. She was so brave at the doctors. The doctor gave her a popsicle and then a sucker. When he gave her the sucker she told Pete "I'm saving this and bringing it home to Norah"- and thats exactly what she did. She is such a little sweetheart.

In February my "nesting" kicked in and I got all the the kids bedrooms put together. I moved the girls down to the basement. Moved Norah to the girls old room, and got Norah's old room ready for Jimmy. It was a lot of work- especially while having contractions day and night but it helped me keep sain during the final stretch.

In February my Dad was given the "Family Practice Physician of the Year" award for the state of Utah. We were so proud of him. Anne surprised him and came to the special dinner that he was given the award.

Robert Armstrong is no ordinary family physician. He is currently one of 10 rural family doctors in a medical group that is divided between five clinics that cooperate to provide services to Sanpete Valley Hospital. Dr. Armstrong is located in Manti, 22 largely unlit and often treacherous country miles away from the hospital. He has made this trip countless times at every hour of the day and during every season of the year. It was because of the influence of Dr. Armstrong that I chose to make my home in Sanpete County and develop my career here. This topic came up at a recent medical staff partner’s meeting and many of the other doctors there related how Dr. Armstrong’s encouragement, support and enthusiasm led them to make the same decision. As Bob approaches the end of his career, it does not seem right to just stand by and watch him leave his full time practice without appropriate recognition. His influence has been far reaching and has helped to improve the quality and availability of medical care throughout the state. One of my own sons recently took a job as a medical assistant at the Kaysville Clinic. Before long, a conversation took place regarding Sanpete County and not unexpectedly two of the physicians there had spent time during their residency in training with Dr. Armstrong.

One of the newest physicians in our medical group, Dr. Brooks Thompson, observed that Dr. Armstrong “exemplifies the personal character, professional dignity, dedication to patients, and passion for rural medicine that has won the respect of the community and professional colleagues. He is one of a rare and diminishing breed of family physicians whose long and successful career has made such an impact on members of his community and young physicians in training that for all who know him there is no doubt that he merits the honor of Utah Physician of the Year.”
In the earlier years of practice, there were only 4 physicians in all of Sanpete County (excluding Gunnison). These dedicated doctors divided the work of Sanpete Valley Hospital by working one regularly scheduled 24 hour shift each week and one Thursday morning to Monday morning shift each month. On other days, they kept their own clinics open. In those days, there was no reimbursement for being on call, no physician lounge and no food or sleep room provided. Nurses who worked during those years report that despite the circumstances, Dr. Armstrong was always kind, compassionate and funny. They were never afraid to call on him in the middle of the night or ask a “dumb question”. They recall fondly how on Christmas or other special days, he could be found visiting patients in their hospital rooms while at times playing his guitar and singing to them. He never treated nurses like they were inferior. He was always their champion, helping many individuals to develop their skills and careers.
One nurse related how Dr. Armstrong counseled and comforted her when her mother died. He shared with her his personal feelings and experience from when his own mother died. Later, this nurse had some testing done that revealed a diagnosis of cancer. Dr. Armstrong called her immediately and helped her through the process of dealing with the diagnosis, understanding treatment options and getting set up with an appropriate specialist for the needed surgery. It might be easy to assume that the close working relationship that exists between doctors and nurses was a big factor in this supportive situation, but in Dr. Armstrong’s case, that is not so. He routinely gives as much attention to any patient.
Dr. Armstrong’s wife, Beverly, has observed that over the years she has seen many doctors who seem to find it necessary to distance themselves from the emotional needs of their patients just for the sake of self-preservation, but her husband has not done so. Even though at times he feels frustrated by non-compliant and often needy patients, he never turns away from anyone. Whether shopping at the local Walmart, at church or any other public place, he reaches out to those he sees there to give a kind greeting, a word of encouragement or to answer questions. He particularly enjoys recognizing the many kids and adults that he delivered. He recently delivered a 4th generation baby – he had delivered the mom and had cared for the grandparents and the great-grandparents.
Korinne Fuentes, a nurse from the hospital, was seeing Dr. Armstrong for her prenatal care. Korinne’s baby was well overdue and labor was induced. Not the first baby for this mom, she progressed to be fully dilated and should have been ready to deliver. Dr. Armstrong recognized that the baby was in distress and instead of encouraging this mother to push, he rushed her to the operating room and performed an immediate cesarean section. The abdomen was opened just in time to see a developing uterine rupture. The baby was safely delivered and Dr. Armstrong was then able to control the massive hemorrhage that quickly ensued. Later, this nurse went on to become a certified nurse midwife. Dr. Armstrong, in keeping with his usual style, provided mentoring and supervision making it possible for her to practice locally.
Another mother, Corinne Olsen, who also came to Dr. Armstrong for prenatal care had a couple of young children, but her last pregnancy had resulted in a devastating stillbirth. A couple of years later and with much anxiety, she was preparing to deliver again and a cesarean delivery was required. In the operating room, the infant was delivered. The child was pale and floppy with no respiratory effort. The doctor called for a bulb syringe, but the nurse fumbled with the device and was not able to get it to him quickly enough. With his own mouth he sucked the thick secretions from the baby’s mouth and spat on the operating room floor clearing the airway and allowing for resuscitation. When the horrified nurse exclaimed, “What is he doing!” the grateful mother quietly responded, “He is saving my baby’s life.” And that is just what he did.
Lisa Johnson was one of Dr. Armstrong’s first obstetrical patients when he started practicing medicine in Sanpete. After a seemingly normal pregnancy her first baby, a girl named Trina was born. At a six-week checkup, Trina was not breathing normally. Dr. Armstrong sent her directly to Utah Valley Hospital in Provo where she quickly deteriorated into a full respiratory arrest. She was diagnosed with an unusual heart condition and spent days and then months in and out of Primary Children’s Hospital. Dr. Armstrong kept in touch with the family at least weekly. By the time the child turned 2, it was certain that she was dying. The mother, Lisa, carefully planned the child’s funeral and selected speakers including Dr. Armstrong. She could not bear the thought of turning her little girl over to a mortician after she died, so she asked Dr. Armstrong if she could give the child to him instead. That day came and Dr. Armstrong met the Johnsons at the hospital where they brought the body of their precious daughter. He sat with them, cried with them and they each held her one last time. The parents wrapped their baby in a quilt and finally handed her over to their friend and doctor. He took the little body to a quiet room to wait for the mortician to pick her up. He watched over her all the while making sure to keep the light on because he knew that she had been afraid of the dark.
While the beginning and end of life are very important, Dr. Armstrong has never forgotten to make the most of the time in between. For 30 years or so, Bob has been deeply involved in Boy Scouts. He has held many leadership positions and has been recognized for his work as he helped and encouraged numerous boys through this program. As the father of seven children, he was also concerned about giving similar opportunity to the girls in the community. He has generously given his time and resources in support of his wife, Beverly, who has dedicated years of effort to providing leadership in the local Girl Scout program. He is well known for his dynamic story-telling during overnight camps and at the end of long hikes. This is just one talent that has enabled him to reach out to each individual youth and help them feel involved. Not long ago one little girl with several physical challenges was determined to try to complete a hike. Her feet and legs were weak and tired after just a mile or so. Bob at first carried her knapsack but then ended up carrying her piggyback to the base of the rock cap. That was as far as she wanted to go. Every time she sees him she thanks him for carrying her and helping her. It meant a lot to her to be able to do what the other girls could do.
Five years ago, a 14-year old girl wanted to have more opportunities for outdoor activities than the Girl Scout program provides. Dr. Armstrong was able to get Sanpete Valley Hospital to sponsor a Venture Crew that provides outdoor experiences with opportunities for young people ages 14-21 to gain skills in first aid, survival, safety and good citizenship. He has continued to be an avid outdoorsman who loves hiking, backpacking and snowshoeing. He is a Trainer with the Leave No Trace outdoor ethics program. He has attended several courses at the Philmont Scout Training Ranch in New Mexico and even attended the Boy Scout World Jamboree in 2011. He shares his knowledge and enthusiasm with all the youth and adult leaders that he is able to work with.
Robert Armstrong first received his ham radio license when he was 12 years old. He used to stay up late at night to “phone patch” messages from sailors aboard ships who would make contact from their ships through ham operators who would then make long distance collect calls to their families and patch them through so they could talk to them. He has talked to other ham radio operators in almost 200 different countries. He has been part of the Emergency Communications network for Sanpete County and has used his radio operations to send and receive information during emergencies in other countries from his home in Manti. One of his recent experiences with ham radio support was during the 2011 earthquake in Japan. Dr. Armstrong, who speaks some Japanese, was able to send and receive messages to people affected during that disaster and to patch them through to those they needed to reach.
Dr. Armstrong has been equally enthusiastic in promoting training for family doctors. He assisted in founding the Utah Valley Family Practice Residency (now the Merrill Gappmayer Residency) in Provo, Utah. For years he traveled to Provo on a weekly basis to mentor and assist with the program. He has continued to provide a rural training opportunity for each of the residents in that program. This rotation allows them to come to Manti to work side by side with him in clinic and hospital experiences. Unlike other training situations, Dr. Armstrong has included these new doctors in administrative and other staff meetings providing important exposure to help them better appreciate how influential they can and should become.
Dr. Armstrong has spent much time over the years providing chart reviews for the Hospital Association of Utah. He would receive hospital records when a patient had some sort of a bad outcome relating to medical care and review the course of events. With this information, he was able to identify situations where standardization of optimized care processes may have resulted in a better outcome. These reviews allowed him to become acquainted with the practice patterns of many different physicians. He has worked diligently to promote the use of guidelines to help standardize patient care. One example of this is in his work with Dr. Kim Bateman some years ago to develop the first pneumonia protocol for hospitalized patients. This continues to be the foundation of a standardized practice model that results in quality treatment for patients with pneumonia no matter where they receive care in Utah.
Dr. Armstrong has worked tirelessly to improve patient care processes and resources at Sanpete Valley Hospital. He has also invested a diligent long term effort toward improving physician relations with the hospital and also with each other. Being a great doctor is about more than what you know; it is about what you do with what you know. It is about who you are. It involves caring, listening and giving of yourself according to the needs of others. Dr. Armstrong has earned the trust and respect of his patients, peers and others because at every level he is truly a great doctor.

Pete got to get out on his snow shoes multiple times in February. Ben and him even did an over nighter in the snow. He was as excited as a little boy when he got home, telling me about his adventures. Karen was an angel to come and stay with me over the weekend when he was gone just in case Jimmy wanted to make his grand entrance a few weeks early. Luckily, he stayed put while Pete was out of cell range.