Monument HEALTH Magazine, Issue 11, Summer 2023

FULFILLMENT

Life is a journey, not a destination. For Jacob Weasel, M.D., summiting Mount Everest is only part of the adventure.

Monument Health wants to keep all of our area athletes going higher, faster and farther. To prep our athletes and provide the best care to our communities, we’re offering free sports physicals.

www.monument.health

NEUROSURGERY

VISIT

From trauma to acute or chronic pain, we treat it all.

Low back pain | Neck pain | Spine trauma | Herniated discs

Glen Pollock, M.D. Kyle Schmidt, M.D. Jennifer Kang, M.D.

A WELCOME FROM

Paulette Davidson

President and Chief Executive Officer, Monument Health

Is there something that you’ve always wanted to do? Perhaps there is a goal you’re working to achieve or a dream you’ve had for years.

Or maybe there’s simply something that you already do on a regular basis because you believe it delivers value to yourself or the people around you.

When you accomplish that goal, complete your dream or provide that value to others it leads to a sense of fulfillment, and that’s what this issue of Monument Health Magazine is all about — fulfillment.

When you read our cover story, you’ll get to know Jacob Weasel, M.D., a Monument Health Trauma Surgeon who successfully climbed Mount Everest, the tallest mountain in the world.

As an enrolled member of the Cheyenne River Sioux Tribe, Dr. Weasel is committed to inspiring Native American youth and giving back to the community — learn how summiting Everest provided a way to do both.

Another story that you’ll want to read is about Norma Henderson. Born in 1931, Norma had an adventurous life, but one particular dream remained unfulfilled until the caregivers at Monument Health Home+ Hospice helped her take flight. It’s a heartwarming story that you don’t want to miss.

If you’d like a lovely reminder of just how important kindness can be, you’ll love reading about the caregivers from Lead-Deadwood Hospital who helped Wade and Ruth Strong check an item off their bucket list by arranging for them to complete their dream trip — a visit to Mount Rushmore National Memorial.

You’ll also have the opportunity to meet Barb Irwin, who cares for patients at Custer Hospital and Clinic. In addition to her clinical duties, she also cares for her fellow caregivers and physicians, cooking homemade meals for them every shift she is able.

We’re confident that these stories, and more, in this issue of Monument Health Magazine will leave you feeling fulfilled as well. If you enjoy our magazine, we encourage you to share your feedback, suggest stories and send your thoughts to us at magazine@monument.health.

HEALTH

Managing Editor

Melissa Haught

Editor

Stephany Chalberg

Senior Writer

Wade Ellett

Contributors

Karlee Baumann

Dan Daly

Jennessa Dempsey

Stephen Simpson

Anna Whetham

Art Director

Stacy Brozik

Layout

Terri Upward Photographer Bob Slocum

©Monument Health Magazine. All rights reserved. Reproduction of any part of this publication without the expressed consent of the publisher is prohibited. The information included in this publication is believed to be accurate at the time of publishing. Additional articles are available online at magazine. monument.health Monument Health Magazine is a free, quarterly publication distributed throughout the Black Hills. Follow us on Facebook and Instagram for updates.

CONTENTS

SUMMER 2023

In case you missed It

A roundup of all the latest news and happenings throughout Monument Health. page 4

What we're reading and listening to Monument Health caregivers share the books and podcasts they’re loving right now. page 8

Awareness months

Highlights of key health issues and medical staff. page 9

Hope

When a visit to the Emergency Room puts a bucket list trip in question, caregivers step up to make a patient’s dream come true. page 10

Ask the doc

An Emergency Medicine Physician for the last 30 years, Stephen Dick, M.D., answers questions about the Emergency Department. page 12

Norma takes flight

The sky's the limit for hospice caregivers who work to help their patient fulfill a lifelong dream. Read how the focus on living helps hospice patients face dying. page 16

H2Oh … I didn’t know that Summer dehydration is a serious problem. Understand how water keeps our brains and bodies cool enough to beat the summer heat. page 19

On top of the world

Trauma Surgeon Jacob

Weasel, M.D., who recently summited Mount Everest, shares how his path to the top of the world can serve as an inspiration to others. page 22

My space

The Project SEARCH team takes center stage with their work ethic, personalities and impact on the environment around them. Meet three caregivers who completed this unique program and have become a staple at Monument Health. page 28

Hometown care

More than two decades after getting involved in health care in the community where she grew up, Registered Nurse Barb Irwin is still as passionate as ever about working to help the people who mean the most to her. page 31

Growth and healing

Custer’s Healing and Wellness Garden is uniquely Custer. The garden is an oasis for all and a passion for those who live and work here. page 34

Volunteer profile

The role of a volunteer is never dull, and in the case of Kim Krull, it’s actually quite soft. page 35

Physician spotlight

Meet Kirstin Hockhausen, M.D., a Dermatologist at Monument Health Dermatology. page 36

APP spotlight

Meet Zach Petersen, PA-C, a Physician Assistant at Monument Health Hill City Clinic. page 37

Introducing

Get to know physicians who have recently joined Monument Health. page 38

Calendar

Upcoming events at Monument Health. page 39

Directory

Find a Monument Health provider near you. page 40

Monument Health surgeon performs 1,500th surgery using da Vinci Robotic Surgical System

Robert Santa-Cruz, M.D., a Urologist with Monument Health Rapid City Clinic, 5th Street, reached a major milestone in January, after he performed his 1,500th procedure using the da Vinci robotic surgical system. Intuitive, the company that produces the da Vinci robot, presented him with an award for this milestone achievement.

Dr. Santa-Cruz sees a lot of benefits to using the da Vinci robotic surgical system and has worked to expand the Monument

Health robotics program. He pointed to his ability to perform more procedures and help more patients. He said, “Now I can touch the lives of more people in a day than I ever could. That to me is one of the great advantages the robot gives us, that extra capacity and longevity.” He also highlighted shorter patient recovery times compared to conventional surgeries. He said the ability for patients to recover in their own beds with their families is significant.

Monument Health Spearfish Hospital listed in Top 100 Rural Hospitals

Monument Health Spearfish Hospital was listed in the Chartis Center for Rural Health’s Top 100 Best-Performing Rural and Community Hospitals. The annual

recognition program honors outstanding performance among the nation’s rural hospitals based on the Chartis Rural Hospital Performance INDEX.

Monument Health now offering ENT services in Rapid City

Monument Health began offering Ear, Nose and Throat (ENT) services to the Rapid City community in January. The addition of V. Richard Bowen, M.D., Mark Guy, M.D., Jay W. White, D.O., MS, HCA, Robert Burgess, M.D., Stacie Collins, CNP and Merrill Hill, AuD., brings years of experience to the health care system, and help to further progress Monument Health’s commitment to provide high-quality care to patients close to home.

The physicians who make up the core of the Audiology and ENT team have been practicing in the area for years and are working to become a state-of-the-art tertiary care referral center for the region in order to meet the needs of the area’s growing communities.

Monument Health returns to the Black Hills Stock Show & Rodeo Rapid City

Monument Health announces executive leadership changes

Patrick Woodard, MHA, M.D., joins Monument Health as the Chief Health Care Information Officer. Dr. Woodard is an innovative health care leader and board-certified internal medicine physician.

Special Rodeo breaks attendance record

Monument Health hosted its second Special Rodeo during the Black Hills Stock Show & Rodeo. The event is for individuals of all ages with disabilities. The free event allows rodeo champions an opportunity to ride a bucking machine, interact with therapy animals and participate in stick horse barrel races.

The next Special Rodeo will be held on Aug. 26, 2023 during the Central States Fair in Rapid City. For more information, visit monument.health/specialrodeo.

Monument Health Strategic Marketing and Communications team takes home eight ADDY Awards

In February, the Monument Health Strategic Marketing and Communications team won five Silver and three Gold ADDY Awards at the American Advertising Awards banquet hosted by the Black Hills Chapter of the American Advertising Federation.

Robin Zebroski, MBA, has been promoted to Chief Brand Officer. She has successfully led the health system’s strategic marketing, internal and external communications, community relations and philanthropic efforts over the last six years.

Tasha Frisinger, MSN, RN, CNML, has been promoted to Vice President of Nursing in the Rapid City Market. She began her career as a certified nurse aide and joined Monument Health as a staff nurse. Tasha has been with the organization for 24 years, working in various leadership roles.

Steven Maser, M.D., has been named Vice President of Medical Affairs of Rapid City Hospital. Dr. Maser is a board-certified orthopedic surgeon. He has been with Monument Health since January 2019 as Vice President and Executive Medical Director of the Monument Health Orthopedic & Specialty Hospital.

Monument Health hosted a Community Health Summit during the Black Hills Stock Show & Rodeo at The Monument. More than 1,100 free preventative screenings were provided during the 10-day event. Each year, Monument Health provides health education and free health screenings to promote health care in the community.

CONGRATULATIONS

FAMILY MEDICINE RESIDENCY PROGRAM

GRADUATING CLASS OF 2023

JUSTIN D. AVIGLIANO, D.O.*

DOMONIQUE J. CUNNINGHAM, M.D.*

LEE N. HOSLER, D.O.

MICHAEL J. OSTERHOLT, M.D.

EMILY L. URBANIAK, M.D.

ALI S. H. WEISS, M.D.

*Chief Resident

WHAT WE'RE READING AND LISTENING TO

Monument Health caregivers share what books and podcasts they’re enjoying.

Bed Number Ten

by Sue Baier and Mary Zimmeth

April Aldrich, RN, Lead-Deadwood Clinic, likes reading “Bed Number Ten.” The story chronicles a patient who is paralyzed with Guillain-Barre syndrome. It takes you through the 11-month hospital stay. April likes the book because it is a true story from the patient perspective.

Motorcycle Diaries, Notes on a Latin American Journey by Ernesto Che Guevara

A Quilting Life with Sherri McConnell and Chelsi Stratton

Focus on This with Courtney Baker, Mike Boyer and Blake Stratton

Jedediah Beadle, Medical Assistant, Rapid City Clinic, Flormann Street, likes reading “Motorcycle Diaries, Notes on a Latin American Journey.” “I like this book because I speak Spanish, and it is about two Argentinians taking a motorcycle trip through South America. They ride an old British bike, which has even inspired me to get a similar motorcycle,” Jedediah said.

Janine Medley, Patient Access Specialist, Rapid City Hospital, said her favorite podcast is “A Quilting Life.”

The podcast discusses quilting, fabric, inspiration, creativity and more.

Janie said, “The podcast feeds my inner artist. Quilting keeps me sane, for the most part.”

Jackie Dittman, Health Unit Clerk, Behavioral Health Center, said her favorite podcast is “Focus on This.”

The podcast boasts being the most productive podcast on the internet. Jackie said, “It’s all about being organized and efficient. It’s very entertaining.”

MONTH

Every September we honor our smallest and most vulnerable patients, and the physicians and caregivers who care for them, during Neonatal Intensive Care Awareness Month. The Neonatal Intensive Care Unit at Rapid City Hospital cares for premature and critically ill infants born throughout the immediate five-state area.

As a Level III healing environment, Monument Health’s NICU is the only one of its kind in western South Dakota and is capable of treating most neonatal medical problems. The NICU team is composed of neonatologists and neonatal nurse practitioners — the latter of which are in-house 24/7 to provide immediate care when needed.

August is National Immunization Awareness Month (NIAM)

Every August, we highlight the importance of getting the recommended vaccines throughout your life. Getting vaccinated is one of the simplest and most effective ways to protect yourself and family from preventable illnesses.

Are your vaccinations up to date?

During NIAM, we encourage you to talk to your doctor, nurse or health care professional to ensure you and your family are protected against serious diseases by getting caught up on routine vaccination.

As your children head back to school this fall, it’s important for you to work with your child’s doctor or nurse to get caught up on missed well-child visits and recommended vaccines.

Sepsis Awareness Month

Sepsis is a serious illness that can develop when the body’s normal infection-fighting reaction goes awry and can quickly become life-threatening. In severe cases, sepsis can weaken the heart, shut down other organs and may lead to death. Early recognition of patients with possible sepsis is critical for preventing severe outcomes. Sepsis currently affects more than 1 million people every year and the number of cases is on the rise, which is why September is Sepsis Awareness Month. Those at higher risk include people with weakened immune systems, infants, children and elderly people with chronic illnesses.

Pain Awareness Month

Nearly 100 million Americans suffer from chronic pain. September is Pain Awareness Month, which shines a spotlight on issues involving pain and pain management. Pain is meant to serve as a warning, indicating that the body has a problem that needs attention. Living with chronic pain, however, can become debilitating. Monument Health’s pain management team uses physical therapy, psychology and occupational therapy, and coordinates cognitive behavior therapy, surgical referrals, rehabilitative therapies and alternative therapies in order to treat chronic and acute pain.

HOPE

Written by Stephany Chalberg Photo by Dyllen Martin

Everyone has something that they hope for, that they look forward to. Holding onto a dream, of one kind or another, helps us stay hopeful. It makes the good times sweeter, and the hard times a little easier. However, when it feels like that dream starts slipping out of reach, it’s easy for hopelessness to start sneaking in. But sometimes a little kindness or an unexpected favor turns everything around, transforming a dream into reality.

Wade and Ruth Strong were visiting the Black Hills with the hope of fulfilling a bucket list dream — visiting Mount Rushmore. For those that live near the National Memorial, this may not seem like a challenge, but it was far from easy for the Strongs.

“My wife and I are in our late 80s, and we were on a bus trip from Pennsylvania,” said Wade. “We’d been having some issues and visited a few emergency rooms along the way.”

One of those visits was at Monument Health Lead-Deadwood Hospital under the care of Nurse Practitioner, Christine Duerksen.

“After his initial assessment I told him that I would do my best to get him feeling better so he could be on his way,” Christine said. “He looked at me and tears welled up in his eyes, he said, ‘I came here to see Mount Rushmore. It’s on my bucket list. I’m not sure I’ll ever get to see it now.’”

Christine wasn’t willing to let Wade miss out on his dream. Instead, she told him that she would do everything she could to help turn this dream into a reality. And that’s exactly what she and her team did.

“Everyone I work with here, we’re like one big family,” Christine said. “I come from a small town so when someone needs something, you just do what you can to help. I’m glad we could help.”

Christine and her team called every taxi and tour company they could think of, but kept striking out. That is, until Lead-Deadwood

Paramedic, Julie Martin, had the idea to call someone that she knew could help — her son.

“My mom called and she was like ‘do you want to do something?’” Dyllen Martin said. “I told her, ‘well, yeah, but you have to explain it first.’”

Dyllen, a 19-year-old college student, was home for the summer, but hadn’t yet started his summer job with Sturgis Fire and EMS. He listened as his mom explained how an entire team of caregivers was trying to help the Strongs get to Mount Rushmore. Julie asked if he would be willing to act as a tour guide for the day.

“When I first met them they were kind of in shock I guess. They were happy that I was there and they could see Mount Rushmore,” Dyllen said.

“He just made our day,” Wade said. “Dyllen took us out for maybe five or six hours.”

Mount Rushmore

“Mount Rushmore met all of my expectations — my bucket list was fulfilled,” said Wade. “When we got there, our bus tour was leaving. I was in a wheelchair and he pushed me up there. I would have never made it without him.”

Dyllen helped the Strongs tour through the memorial, pushing Wade’s wheelchair and helped the couple to the amphitheater to watch an educational video. After that, the adventure and Black Hills tour continued.

“I gave them a couple options after Mount Rushmore,” Dyllen said. “We took the Needles Highway drive through Custer, made a few stops so they could take more pictures and see the wildlife.” It was the trip of a lifetime and now, they have memories to share.

“They had an older phone that didn’t really take pictures, so I took a few and sent them to their grandson,” Dyllen said. “I did print out a few and mailed them as well.”

Thinking back on the eventful day, Wade said, “It was the most wonderful day I ever had.”

"I would have never made it without him."

WADE STRONG, ON DYLLEN'S HELP FULFILLING HIS BUCKET LIST

DYLLEN

MARTIN

EMERGENCY MEDICINE

JENNIFER MURRAY Director Emergency Department Rapid City Hospital

M.D. Emergency Medicine Physician Rapid City Emergency Services

Monument Health offers emergency medical care at its five hospitals in western South Dakota. These hospitals treated 71,087 patients in their emergency departments in 2022. Rapid City Hospital has the busiest emergency room in the region, treating more patients each day than any other hospital in a three-state region.

Stephen Dick, M.D., has spent over 30 years working in Emergency Medicine, and shared his experience answering some common questions about the emergency room.

What is emergency medicine? Emergency medicine is the medical specialty in which physicians are equipped to handle any emergency for any patient at any time. It sounds simple, but in practice it’s immeasurably complicated.

Nobody loves a visit to the emergency room, but everyone is grateful for emergency care when they need it.

What you need to know about

STEPHEN DICK,

Photos by Bob Slocum

As a nonprofit health system, Monument Health’s primary obligation is to its patients and its communities. That means our emergency departments are open to anyone, 24 hours per day, 7 days per week, 365 days per year regardless of ability to pay.

Emergency physicians are specialists who care for a wide range of injuries and illnesses, from minor to critical — and just as importantly, they have the ability to diagnose what seems minor but is actually a major problem.

When should someone seek emergency medical care?

The reality is, whenever someone is experiencing life- or limb-threatening issues or severe pain or distress, that is when you should seek emergency medical care. Typically these are new, non-chronic or sudden issues. However, in practice it’s difficult to define what is and isn’t an emergency — when patients believe they have a medical concern that needs timely attention, that’s when they should visit the nearest emergency room.

While it might be better for continuity of care if an individual saw their primary care provider for most issues, research has shown that four out of five people who called their family doctor about a sudden medical issue got the same advice, “Go to the ER.”

Are there problems that don’t warrant a visit to the ER?

Simply put, yes. However, emergency medicine is anything but simple. For many people who do not have access to primary care or preventative medicine, the emergency room is often the only place to safely receive care.

With that in mind, for patients with chronic problems who do not have acute changes and are being monitored or treated by another provider, it is usually best to communicate with the specific provider who is familiar with your case before coming to the ER. Those who are seeking specific tests, labs,

Stephen Dick, M.D., FACEP, has been recognized for 30 years of Emergency Medicine Board Certification by the American Board of Emergency Medicine (ABEM). He is an Emergency Medicine Physician at Monument Health Rapid City Hospital and has previously served on the Monument Health Board of Directors and as the Director of the Emergency Department. For his initial certification, Dr. Dick completed medical school and specialized training in emergency medicine. This was followed by completion of an examination that covers the breadth of emergency medicine.

Board certification is a voluntary process and reflects a dedication to the specialty. Dr. Dick actively participates in a program of continuous learning to maintain his certification. The ABEM continuing certification process helps board- certified physicians stay up to date on current medical research and provides opportunities for practice improvement.

Although

VS URGENT CARE SITUATIONS EMERGENCY SITUATIONS

• Allergies

• Ear or eye infection

• Fever

• Cuts that may require stitches

• Possible broken bones or simple fractures

• Rashes and minor burns

• Severe sore throat

• Sprains and strains

• Vomiting/diarrhea

• Vaccinations

• Cold or flu symptoms

CTs or MRIs, should schedule those through their provider or specialist. When a person comes to the ER, even if told to come by another provider, they will see an emergency provider who will determine what tests are necessary to complete on an emergent basis. Many tests can and should be scheduled on an outpatient basis by primary care providers.

What are some of your most rewarding memories?

There certainly have been life-saving wins and emotional “thank-yous.” I’d have to say there is a daily reward when reflecting on the fact that what we do in emergency medicine matters. The “we” is also a rewarding memory in that many of those who have chosen to be part of the ER team have been an amazing extended family as we lean on one another in trust and understanding.

What are some of your most surprising cases/memories?

There are too many to even consider. I have had a 30-year career in emergency medicine in which I have seen several thousand patients. Having seen so much, the one that sticks with me would not be appropriate for public comment. The worst of the worst are the cases I most remember.

It’s worth noting that for most of those presenting to the ER, they are not having a good day. For many, it’s the worst day of their lives, and I have now become a permanent memory of that day. Over the years, I have gained self-awareness of this fact and have tried to be a positive in their experience — as much as one can be in these grave situations.

What changes do you see coming to emergency departments in the future?

Over three decades I have seen huge advancement in technology, changes

• Chest pain or squeezing sensation

• Difficulty breathing or shortness of breath

• Seizure or loss of consciousness

• Serious burns

• Severe or sudden pain

• Sudden paralysis or slurred speech

• Uncontrolled bleeding

and challenges to operational efficiency, 180 degree changes in management standards, medication usage and many new medications and interventions to heal.

As I see it, emergency medicine’s current primary challenge is the high rate of burnout — the highest of any medical specialty. As word has gotten out of the challenges of our profession, amplified by COVID-19, there has been a significant decrease in young physicians choosing to pursue emergency medicine. Until recently, it was one of the more sought after specialties, making it very competitive.

Locally, I believe we are going to continue to see our trend of getting busier as our community grows and access to care becomes more challenging for people. It is causing us to really look at our processes and be creative with how we handle the increased volume and acuity of people needing our services.

the emergency room is always there when you need it, it’s not right for every situation. For an illness or injury that isn’t a threat to life or limb, consider a visit to urgent care.

ORTHOPEAK RUN

SEPTEMBER 30, 2023

SHORT COURSE

2.5 miles

750 feet of ascension

LONG COURSE

7 miles

2,250 feet of ascension

FOR FULL DETAILS VISIT: monument.health/orthopeakrun

Presented by Monument Health and Terry Peak

NORMA TAKES FLIGHT

Written by Dan Daly

With help from Monument Health Hospice staff, a Hill City patient fulfills a lifelong dream.

Norma Henderson had a long, adventurous life filled with great memories.

Born in 1931 in Wessington Springs, she grew up wishing to be a pilot, and even asked her parents to allow her to take flying lessons. They said this wasn’t a proper activity for a girl, so Norma concocted other adventures.

After high school, she moved to San Diego, where she worked for an advertising and public relations firm. She took solo trips to Mexico and learned to sail. Later, an old beau from high school, a young lawyer named Frank Henderson, persuaded her to return to South Dakota and be his wife.

Together they had eight children. Frank practiced law, served as a Circuit Court judge and later served on the South Dakota Supreme Court. For a number of years they ranched and operated Pine Rest Cabins near Hill City. Frank passed away in 2012, and Norma remained at the ranch, which she loved.

John Henderson, Norma and Frank’s son, moved back home to take over the ranching operations and, as her health declined, cared for Norma. He reports that one day toward the end of her driving career, she “sneaked out” to take a helicopter ride around the Hills. Her passion for flight remained strong.

A few years later, by May 2022, Norma was gravely ill, receiving home care from Monument Health Home+ Hospice. During conversations with one of her nurses, Elizabeth, she confided that one item remained on her bucket list. She wanted to fly in a hot-air balloon.

“The whole Hospice team sat down and said, ‘How can we make this happen?’ and everybody worked together,” said Michelle Sieveke, Director of Monument Health Home+ Home Health and Hospice.

Elizabeth, along with John, his sister Andrea Henderson and the Hospice staff hatched a surprise balloon flight for Norma.

On May 15, 2022, John and Andrea took Norma for an early afternoon drive in the country. They ended up at Southern Hills

Golf Course in Hot Springs, where massive, colorful balloons were being readied for flight. Even then, Norma didn’t realize she would soon be boarding one of the balloons.

“When she found out she was going in the balloon, she was one happy little white-haired lady,” John said.

With help from her family and the hospice nurse, Norma scrambled into the balloon’s basket. She was joined by family friend Kristin Donnan – the only other one in the group who wasn’t afraid of heights. The afternoon was one of the Southern Hills Ballooning Association’s tethered events, so the balloon floated only several stories high during the flight. That didn’t matter to Norma – her smile grew wider with each foot the balloon ascended.

Later, Kristin compiled the photos from that day into a book, which the family signed and gave to the Hospice staff. “We just want to express our deep gratitude to the Hospice program,” John said. Norma passed away in October 2022.

Keeping the focus on living

While a balloon flight was a first for the Hospice staff, Director Michelle Sieveke said it’s not uncommon for patients to seek one last experience during care. When possible, the nurses and caregivers do everything they can to fulfill those requests. They’ve staged art shows, hosted baby showers and arranged a visit from a horse on the Hospice House patio. They even brought in an Elvis impersonator.

Other notable moments include:

• A few years ago, one hospice patient wanted to take a final motorcycle ride. With the help of Black Hills Harley-Davidson, the Hospice crew loaded her into a sidecar –they called it a bucket – and took her for a ride while blasting “Born to Be Wild" on the motorcycle’s speakers.

• Another patient, who was at the Hospice House in Rapid City, wanted to share one final anniversary with her husband. A nurse brought in her best china from home, the volunteer coordinator made them a Key lime pie, and the staff decorated the patient’s room. The couple shared a special candlelight dinner with soft music.

• One woman was completing her online doctorate program from a university, Hospice Nurse Manager Lisa Davis recalled. Hospice staff worked with the university to coordinate a ceremony, complete with cap-and-gown and an iPad video connection, so she could fulfill that dream.

“I feel like our staff really tries to capture things that are important to patients. They look at the individual and try to capture those moments,” Michelle said. “It really reflects what hospice is all about. We’re not focusing on dying; we’re trying to focus on living.”

H₂OH I DIDN’T KNOW THAT

Drinking an entire bucket of water could turn you pail, but dehydration is no joke.

Written by Stephany Chalberg

If you’re reading this, there’s a good chance you’re dehydrated — along with almost 250 million other Americans. Luckily, there’s something you can do about it, and it’s as easy as taking a sip.

Undoubtedly, you’ve heard the old saying, “You can lead a horse to water but you can’t make him drink.” Hopefully, what’s true of horses isn’t true of people as well. While a number of studies indicate that up to 75 percent of adults in the U.S. are chronically dehydrated, there’s still hope for meeting our hydration needs, and those of our loved ones. With a little more knowledge about H2O and the risks of dehydration, these hot summer months are the perfect time to improve hydration habits.

Water you doing?

Water makes up the majority of the human body — roughly 65 percent for men, and 55 percent for women. Because it’s such a significant percentage of the body, it’s crucial that people of all ages stay adequately hydrated. Every organ in the human body — and every cell, for that matter — requires water to function well. Without enough water, we can become confused, struggle to breathe, our hearts work harder, our intestines don’t function well and our kidneys become strained.

“Because water impacts every part of our bodies, dehydration can present with many symptoms,” said Sarah Fitzsimmons, PA-C at Monument Health Sturgis Clinic. “In urgent care, we frequently see dehydrated patients experiencing dizziness, headaches, fast heart rate and decreased urine output. If you are feeling dehydrated, start trying to hydrate yourself with cool liquids and get to a cool place. Seek medical care if you have concerns about dehydration or aren’t able to help yourself feel better relatively quickly.”

Dehydration doesn’t need to be extreme to have a detrimental effect. Physical and mental performance can be reduced when an individual is dehydrated by as little as 2 percent of their body weight, impairing decision making, motor function and the ability to maintain focus. Add heat into the mix, and you have a recipe for danger.

“As we move into the summer months, we worry about our patients who have dehydration combined with high heat exposure. If you have been out in the heat and start feeling confused, have body aches, have a fever or start throwing up, please seek medical care right away,” Sarah said.

Am I dehydrated?

Two of the biggest warning signs of dehydration are thirst and urine — if you’re thirsty and your urine is a darker yellow, you’re probably dehydrated. “As a general rule, when you're well hydrated your urine will be pale and odorless. You should also be going to the bathroom regularly,” explained Sarah. “Thirst, while not always a sign of dehydration, is a good indicator for most people, and it’s a built-in reminder to take a drink of water.”

Other symptoms of dehydration include dry mouth, lips and eyes; headache; dizziness; light-headedness and tiredness or fatigue.

HYDRATION FOR ALL AGES

Although good hydration matters at every stage of life, how we stay hydrated can vary depending on age. Here are some helpful guidelines for every age.

INFANTS

The percentage of body weight made up of water is actually higher in infants — up to 78 percent, dropping to about 65 percent by the time they’re 1 year old. Even so, babies don’t need to carry around a Stanley Cup or wear a CamelBak. Unless a doctor or provider makes special recommendations, babies younger than 6 months old only need breast milk or formula. After 6 months of age, babies can begin sipping on water with meals. Keep in mind that infants can overheat easily, so try to keep them out of the hot sun and don’t dress them in more layers than you would want for yourself. Unless your health care provider has specifically recommended it, your baby does not need juice or electrolyte drinks.

KIDS

Kids should have unrestricted access to water at all times. Many families find reusable water bottles helpful for this. Remind or help your kids to fill their bottles regularly; they’ll stay more hydrated if they can drink easily. Juice and electrolyte drinks can be fun snacks but should only be an occasional treat. Most are full of sugar and artificial flavors that can contribute to obesity and dental problems. Help your kids develop a taste for plain water now, and you could help them avoid bigger problems later.

TEENS

Active teens need consistent hydration. If your teen is working outdoors or participating in warm weather sports, have a plan to keep them hydrated. If they are going to be sweating a lot, this is a situation where electrolyte replacement beverages may be helpful. Otherwise, water is best — make sure your teen is drinking enough water and discourage consumption of caffeine and energy drinks.

ADULTS

As adults, we can use indicators from our bodies to know if we are well hydrated. If you are not urinating regularly or if your urine is very dark, you need more water. Rather than getting hung up on drinking a specific amount, aim for clear to straw-colored urine when you go to the bathroom. Give yourself access to water all of the time. Any time you feel thirsty, start to get a headache, feel tired or want a snack, take a drink of water before you do anything else.

PREGNANT WOMEN

Pregnancy comes with increased water needs — moms-to-be are drinking for two, after all. Dehydration can cause significant problems in pregnancy, including early labor. Unless an OB/GYN has recommended otherwise, pregnant patients should drink lots of water, especially as the weather warms up.

THE ELDERLY

Older individuals may struggle to maintain adequate hydration. Some medical conditions require limiting daily water intake, and specific recommendations from a doctor should always be followed. Many older individuals may not realize how low their water intake is, or how much coffee they are drinking. Water bottles can be helpful to drink greater amounts of water, but if you don't like bottles, try to set out glasses at the beginning of the day to help remind yourself to drink. Aim for a full glass of water when you wake up as well as at and after each meal. You will know you are well hydrated when your urine is clear to straw-colored.

Flat, sparkling or fruit-infused

Flavored water is big business. A trip to most stores shows an overwhelming number of options. You don’t need to spend money on any of them to stay healthy and hydrated — tap water in a reusable bottle is your easiest, healthiest option.

However, if you truly dislike the taste of water, try gradually weaning yourself toward healthier options. Start by avoiding anything with high fructose corn syrup, which is very calorie dense and can be bad for teeth.

Carbonated or sparkling water provides another zero-calorie, zero-sweetener alternative that often comes with a light, refreshing fruit flavor. Double check the ingredients to make sure that there are no hidden sweeteners or sodium, but these can help break a soda habit and make the transition to drinking more water.

“Remember, plain old water is the best option for hydration, but if you really crave something with more flavor, your healthiest options will avoid sugar, fructose, sucralose and artificial sweeteners,” Sarah said.

H2Oh yeah!

Good hydration significantly impacts the way your body works. If you don’t have good water drinking habits, now is the best time to improve. Grab your water bottle or fill a glass, and take a cool, refreshing gulp. You’re already one step closer to being healthier and better hydrated.

1% DEHYDRATION can lead to a 5% decrease in mental performance

2% DEHYDRATION can lead to decreased physical performance, impairment to attention span, decision making and motor function

5% DEHYDRATION can decrease performance by 30 percent

WASH YOUR REUSABLE WATER BOTTLE AFTER EVERY USE.

This will help to prevent buildup of bacteria and mold. Be sure to read the manufacturer’s instructions to determine if the water bottle can be cleaned in a dishwasher or if it needs to be washed by hand. Avoid filling it with sugary drinks — sugar can provide a food source for bacteria and mold, something nobody wants a swig of! If you do put milk or juice in your water bottle, rinse it out thoroughly after each use. Likewise, if you share your water bottle with others, be sure to wash it after each use.

ON TOP OF THE WORLD

Written by Wade Ellett

At almost 22,000 feet of elevation, climbers on Mount Everest ascend Lhotse Face toward Camp III. What starts as a flat walk leads to an icy incline, where climbers will clip into fixed lines — ropes that are permanently in place to facilitate climbing — in order to ascend what is essentially a 4,000 foot icy slide. Ice and rock, dislodged by climbers moving above, careen downward.

As Trauma Surgeon Jacob Weasel, M.D., approached the Lhotse Face, one of those rocks, roughly the size of a billiard ball, hit him on the left side of the chest. His experience and medical knowledge told him that while the impact hadn’t broken any ribs, it had caused severe bruising. But there’s only one thing to do on Mount Everest — just keep going.

“In the aftermath, after I’ve come back down from the mountain, I know how crazy that is,” said Dr. Weasel. “A foot higher and four inches to the right, it impacts my heart and I’m dead. If it had hit me in the throat or face, I wouldn’t have come off the mountain alive. Instead, I just continued on to Camp III.” It’s a long way to the top

Everyone knows that it’s a challenge to climb Mount Everest, but they may not grasp just how complicated it can be. It’s a multistage process that can take up to two months. The first step is getting to Everest Basecamp — a one- to two-week journey in and of itself. From there, it takes an average of 40 days to reach the summit of the tallest mountain in the world.

The route up Mount Everest, for those braving the climb, is broken up into four camps,

not counting Basecamp. A process of ascending, acclimatizing to the thinner air, descending and then climbing again is the only way to prepare for the final push to the summit from Camp IV. Finally, if weather and timing cooperate, climbers can make a bid for the summit, which can take anywhere from eight to 16 hours.

Dr. Weasel departed Rapid City on April 10, and summited Everest on May 17, 2023 — close to the average time to complete the feat.

You may have seen photos of lines of people leading up Everest. These may make it look like immeasurable amounts of people have reached the summit, but if you were to amass a group of everyone who had been to the top of Mount Everest, you’d have a relatively small club. By the end of the 2023 climbing season, the total number of climbers who have summited since Edmund Hilary and Tenzing Norgay became the

At some point, everyone has felt like they’re on top of the world. Jacob Weasel, M.D., has actually been there. And he’s just getting started.

first confirmed summiters in 1953, sits at around 7,000. To put that in perspective, that is less than one tenth of one percent of the current world population.

“This is an opportunity that few people get,” said Dr. Weasel. “I’m grateful for it.”

Why Mount Everest

There are a lot of reasons why people climb Mount Everest. Some need the biggest challenge they can find, others are seeking thrills. For some, the mountain is laden with meaning and significance. Dr. Weasel loves climbing mountains, but Mount Everest was never on his metaphorical horizon. That is, until he realized how he could use the mountain to do good.

“It’s important to me to give back. That’s why I took a position serving as an Assistant Dean for Diversity and Inclusion at the University of South Dakota Sanford School of Medicine,” Dr. Weasel explained. “One of my goals is to try and recruit and encourage native kids to pursue careers in health care and related fields.”

The Everest trek provided the physician with additional avenues for helping others. He hoped he could set an example for native youth, to show them that they are equally as capable as anyone. “Whether we’re talking academics, the professional world or yes, climbing Mount Everest, I want all native people to know that they’re capable of accomplishing anything.”

Dr. Weasel has developed a solid resume of mountain climbing before summiting Mount Everest (29,032 ft). His first experience mountaineering was climbing Mount Rainier (14,411 ft) when he finished his undergraduate degree. Since then he has tackled 14ers — mountains reaching 14,000 feet above sea level — in Colorado, as well as Cloud Peak (13,171 ft) and Grand Teton (13,775 ft) in Wyoming. He traveled to Ecuador to climb Cotopaxi (19,347 ft) and Chimborazo (20,549 ft) and to Tanzania to summit Kilimanjaro (19,341 ft).

Dr. Weasel’s nonprofit, the Wopila Project, is currently raising funds to build a playground at Lakota Homes, a housing community in Rapid City that serves the local Native American population. The plan includes surrounding the playground with informational displays of each of the seven traditional Lakota values; Prayer, Respect, Wisdom, Compassion, Honesty, Generosity and Humility. Once completed, the next goal is to construct sustainable women’s health clinics in Nepal in order to provide obstetric and gynecological care to help the disparity related to women’s health in the rural areas of the country. To learn more about the Wopila Project, visit www.wopilaproject.com.

Leading up to his departure for Nepal, Dr. Weasel created a nonprofit called the Wopila Project. Wopila is a Lakota expression of gratitude for everything that life offers, for existence and for the blessings in every moment. “The goal is to cultivate gratitude, to inspire hope and to work together to create a tangible impact in people’s lives,” he said. “My hope was that I could use my Everest climb to raise awareness of our current projects and get people involved. I’m happy to say that there has been positive feedback, and I’m excited to keep the momentum going.”

A view from the heavens

After arriving at Camp IV, Dr. Weasel and his Sherpa, Lhakpa, took a rest day. They ate and hydrated, and tried to rest and sleep as best they could. They stepped out of their tent at 10 p.m. the next night, to perfect conditions — clear skies with no wind.

Despite the evening start, there was already a line of people, but Dr. Weasel and Lhakpa passed climbers and pressed onward. “The mountain just keeps going. It goes on and on and on. It never seems to end and you just keep climbing,” said Dr. Weasel. “And I kept occasionally looking at my watch, asking myself, ‘when is the sun going to rise?’ Because I was freezing cold, and wanted nothing more than to see the sun rise.”

In May, the average temperature at that elevation is -13 Fahrenheit. It can get much colder, and wind chill can lower that temperature significantly. Luckily the air was pretty still for Dr. Weasel. While the rising sun wouldn’t raise the temperature significantly, every degree counts on Mount Everest, and the psychological benefit of sunrise would have a dramatic effect.

Dr. Weasel explained, “You just keep climbing and then you get to the point where the sun finally starts to peek out. And it is breathtaking. That was probably the most beautiful thing I've ever seen in my life. It is amazing watching the sun rise over one part of the valley and then look to the other side and

seeing the perfect pyramid of Everest’s shadow being thrown onto the valley. And you cry because it is that beautiful. Then your tears freeze to your face, but it is literally amazing.”

You might expect a similar sense of awe at the summit, but for Dr. Weasel, the experience was somewhat muted. He said that the view was incredible — from the top you can see 200 miles of the world spreading out beneath you. Across the valley to the northwest is Cho Oyu, which is the eighth-tallest mountain in the world. Looking Southeast you’ll see Makalu, the fifth-highest, and closer still is Lhotse, the fourth-tallest.

That last view, of Lhotse, is partially responsible for Dr. Weasel’s more muted response to the summit of Everest.

“The summit was good, but I was there to climb two mountains,” Dr. Weasel said, explaining his plans to climb Lhotse following his completion of Everest. “When I stood on the summit of Everest, I didn't fully appreciate it because I was so disciplined at that point that in my mind, I was only 25 percent done.” Mentally, he was already working on the descent back to Camp IV, from which — if things went according to plan — he and Lhakpa would then summit Lhotse the next day before beginning the trek back to basecamp.

Unfortunately, a number of considerations conspired against the two men, and in the end the second climb didn’t happen. One of

the reasons likely being the amount of time Dr. Weasel had spent in what is known as the Death Zone.

The Death Zone

As a general rule, human bodies work most efficiently and effectively at sea level. At high altitudes, bodies become less and less efficient. For those that want to summit Mount Everest, they have to enter — and stay in — what is known as the “Death Zone.” At this elevation, above 8,000 meters or 26,247 feet, the air has so little oxygen that the human body will begin slowly dying, one cell at a time, even when using supplemental oxygen.

“Making it to the top is everyone’s goal, but once you do you’re not done. You still have to descend safely,” said Dr. Weasel. And while it may seem like it should be easier to come down from the world’s highest peak than it was to go up, more accidents occur during the descent. A combination of exhaustion, hypoxia, a caloric deficit and hypothermia — combined with the inherent risks of avalanches, falls and other injuries — make coming down a challenge unto itself.

As climbers’ brains starve for oxygen, their judgment and decision-making skills get progressively worse. As the lungs struggle with oxygen deprivation, the risk of heart attack and stroke increase, as does the likelihood of a high altitude pulmonary edema. This happens

as the body produces additional hemoglobin in an attempt to compensate for the lack of oxygen. As it thickens the blood, it can also cause an accumulation of fluid in the lungs that comes with shortness of breath, a sense of impending suffocation and persistent coughing.

Likewise, if the brain doesn’t get enough oxygen, it can cause swelling which leads to high altitude cerebral edema. Symptoms include nausea, vomiting, impaired judgment and difficulty thinking. At worst, it can lead to delirium in which climbers may not remember where they are, begin destroying clothing and gear or speaking to people who aren’t there.

Most climbers are advised to not remain in the Death Zone longer than 24-48 hours. Dr. Weasel estimates that he spent about 63 hours, between his arrival at Camp IV, summit and descent.

“I recognize that with that much time in the Death Zone, at any point my body could have just said, ‘no,’ and given up,” he said. “I could have just collapsed and died.”

Although he returned safely, that doesn’t mean that the Death Zone didn’t take a toll on the physician. “I definitely hallucinated on the way up and on the way down. I heard voices of my team members on the way up,” he said. “On the way up, and even more pronounced

“I have always found there to be a lot of similarities between surgery and mountaineering. In both cases you have a plan, but your plan never goes exactly as you anticipate, so you have to be agile and flexible enough to recognize and adapt to the situation as it's presented to you. There’s always a balance of risk and reward — you're trying to minimize the amount of risk and to provide the best possible outcome. Sometimes when you're on the mountain you’re dealing with life or death decisions. Those are high stakes, and they are similarly high during a surgery.”

on the way down, I saw the faces of my children, when they were younger, and the face of my wife coming out of the rock.”

Hallucination is a common, and temporary, symptom of hypoxia. It’s something that most climbers will have to endure on Everest, and after descending into a more oxygen-rich altitude, the symptom goes away.

“I didn't consider the actual physiological effects of what was happening. I knew I was hallucinating, and just thought, ‘Hmm, that's interesting.’ And I just keep working my way down the mountain.”

The man on the mountain

It may seem odd that someone who had just summited the tallest mountain in the world would feel disappointed, even angry, that he was turned back from the fourth-tallest. Especially after experiencing hallucinations in something called the Death Zone. But Dr. Weasel has a self-described stubborn streak. While that streak leads to disappointment when he’s turned back from a goal, it’s the same quality that empowers him to climb mountains — and to reach where he is in life now.

Dr. Weasel, an enrolled member of the Cheyenne River Sioux Tribe, knew from a young age that he wanted to become a surgeon. “When I told people that I planned to become a surgeon some people told me that there’s no way that that’s ever going to happen, that it’s not even possible,” he shared. “But the more that people would tell me that something wasn’t possible, the more that it spurred me towards accomplishing a certain thing.”

That stubborn streak would propel him up mountains like Cotopaxi and Chimborazo, where he experienced conditions he described as horrendous, including white out visibility and 50 mile-per-hour winds that pelted his face with ice which he likened to being in a sandblaster. Even before that, it spurred him on through his undergraduate education, medical school and surgical residency, an experience he likened to training for mountains.

“Surgical residency was super helpful for mountaineering. It was probably the best training that I could have had, learning

how to operate with little sleep, learning how to operate mentally and physically on very little food and just taking a beating and having to come back and keep going,” he explained. “When you’re working 80 hours a week in residency and you still have a family, and you still have to read and prepare and do all those things — having experienced that kind of mental exhaustion on a long-term basis is super helpful when you’re on a mountain.”

There’s always another mountain

After climbing the tallest mountain on earth, you might think Dr. Weasel would hang up the mountaineering goggles and retire his crampons, but that isn’t the case. He said, “I love mountains, and so climbing them will be a part of my life for as long as I’m able.” He’s already working on his next great challenge — becoming the first enrolled member of a Native American tribe to reach the top of the Seven Summits. This entails climbing the highest mountains on each of the seven continents: Mount Everest, Aconcagua, Denali, Kilimanjaro, Elbrus, Mount Vinson and Puncak Jaya.

He’s already checked Mount Everest and Kilimanjaro off the list, and is looking forward to returning to Mount Denali in Alaska, the highest peak in North America, with a summit elevation of 20,310 feet above sea level — he almost summited in 2022 before his guide turned him around due to dangerous weather.

“I might as well save Mount Vinson in Antarctica for last, and then ski to the South Pole,” he said with a smile. “Because then, if I do that, I’d have to do the North Pole, making it an Explorer’s Grand Slam.”

Less than 100 people have completed this assemblage of summits and treks, and it’s easy to think of the challenges and adversity and ask, “Why?”

Maybe, as George Mallory said of climbing Mount Everest, “Because it’s there.”

Or perhaps, as Dr. Weasel said, “There’s an opportunity to inspire and help others while doing something that I love. That’s gratitude coming full circle.”

In SEARCH of Caregivers

There’s one thing that’s true of these three Monument Health caregivers and graduates of Project SEARCH — they each take their roles very seriously.

JP, Berkley and Cody all have a deep understanding that the time they spend as caregivers is making a difference. Every day.

Written by Stephen Simpson Photos by Bob Slocum

JASON "JP" PLOOSTER Environmental Services Technician

BERKLEY KOLKMAN Guest Services Specialist

When you walk into Monument Health Rapid City Hospital, you might find yourself receiving one of the friendliest greetings you’ve ever experienced. If that’s happened to you, then you’ve probably met Jason Plooster, better known as JP to his friends — and everyone is his friend. Because of his warmth, friendliness and positive energy, it’s no surprise that JP is a star at welcoming people. What may be surprising is that it isn't even his job. He’s an Environmental Services Technician, and while he’s great at his role, he’s also great at making people feel welcome. He loves coming to work. “I just get to high five people. It’s awesome,” he said enthusiastically.

Project SEARCH

JP, like many caregivers at Monument Health, is finding meaningful employment through a partnership with Project SEARCH. The program’s mission is to train people with developmental disabilities to have fulfilling employment through internships and through developing the skills necessary to join and thrive in the workforce.

Project SEARCH is a national organization that connects its graduates with several employers in the area. Monument Health is the largest employer of Project SEARCH graduates in western South Dakota. The program works with young people on practical job skills but also focuses on soft skills like communication, professionalism and ways to connect with people.

The program is a success. It’s great for the Project SEARCH graduates who find jobs for which they’re an excellent fit, it’s great for Monument Health because they find incredible caregivers and it’s great for patients and community members because they have the opportunity to interact with caregivers like JP.

Patients who interact with JP always walk away with a smile, but he also lends his signature sunshine to doctors, nurses and senior leadership — anyone who encounters him receives authentic, friendly encouragement.

“I like working here,” JP said, directly but enthusiastically. “It’s awesome.”

Warm welcomes

JP isn’t the only Project SEARCH graduate who makes sure patients feel welcome. As a Guest Services Specialist, Berkley Kolkman makes it a priority to make patients, visitors and caregivers feel as comfortable as possible when they come to Rapid City Hospital.

In many ways, Guest Services caregivers act as ambassadors to Rapid City Hospital, providing guidance, direction, information and comfort to

CODY BROWN Patient Transporter

patients and visitors alike. Berkley, a kind and gentle individual, is a perfect fit for this role and enjoys helping patients feel more at ease. “It can be hard coming to the hospital,” she said. “We give out things like neck pillows and activity books — stuff like that.” Berkley loves spending time with patients and said that she’s had the privilege of meeting some of the funniest and kindest people while on duty. She also enjoys being part of a team, and her fellow caregivers bring joy to her job as well. “I like my co-workers a lot,” she said. “All of them are really nice and supportive.”

Getting where you’re going

Moving around a hospital isn’t always easy, especially as some patients may need wheelchair assistance. Knowing where to go is only part of the challenge — when a patient needs to get from one area to another, for treatment or services, they’ll meet a Patient Transporter like Cody Brown.

Cody’s role is to ensure patients get where they need to be, when they need to be there. And it’s a duty that Cody takes seriously. “Safety is my goal,” he said matter-of-factly. He knows what is important, and he enjoys what he does, because every day brings a new experience. He can always count on two things remaining constant in his role: getting to meet kind people every day, and always hitting his step goal. “I get 15,000 steps most days,” he said with a smile spreading across his face.

The SEARCH is never over

These three caregivers are excellent representatives of Project SEARCH and show just how well the program’s graduates do as Monument Health caregivers. In fact,

you’ll find graduates making a difference in Monument Health facilities across the region. And with each Project SEARCH class, new, unique and valuable skills and perspectives are sure to be brought to the Monument Health team of caregivers.

“Our Project SEARCH graduates are woven into the fabric of Monument Health. Each caregiver brings their passion, personality and whole heart to work each day,” said John Pierce, Rapid City Market President. “I truly love walking the halls of Rapid City Hospital and seeing our caregivers serving others.” Often, you’ll see John sharing a fist bump or smile with JP.

In fact, JP has built a rapport with John. The two have nicknames for each other: JP1 and JP2.

“JP1 has an equal love and respect for all those he works with,” said John. “You’ll see him treat physicians and executives with the same friendly demeanor as anyone else. Because JP sees us as all his friends. It's something we can all take away and learn from JP.”

HOMETOWN CARE

More than two decades after getting involved in health care in the community where she grew up, Registered Nurse Barb Irwin is still as passionate as ever about working to help the people who mean the most to her.

Story and photos by Bob Slocum

Deep roots bear rich fruits; that is nature’s way. Barb Irwin’s career with Monument Health in her hometown of Custer has developed in much the same manner. Her ties with the hospital and clinic and the community have deepened over the decades through shared experiences and dedication, reaping meaningful rewards along the way. She has served Monument Health in various roles throughout her life, but a calling to care for the health of her neighbors drew her to nursing. More than two decades later, she is not unlike the ponderosa pines that line the Custer horizon: unwithered by the storms and better off for them.

Finding her place

Raised on a ranch near Custer, Barb was always right at home working in her local health care system. She has been with Monument Health continuously since 1997, when she started as the director of assisted living. She eventually stepped down from that role, remaining as a medication aide while she began her nursing school prerequisites.

“I went to nursing school during the day and worked nights,” she reflected. Barb became a nurse in 2005 and has been a constant presence throughout Custer Hospital and Clinic ever since. “If you want to really go back, when I graduated high school, I cooked for the hospital and collected bills at night,” she continued with a laugh.

Helping at home

Much like life on the ranch, a small town hospital is rarely boring. That’s one of Barb’s favorite aspects of the job. “What I like most about working in Custer is the variety,” she said. “If you work in a large hospital, you work in one area. Whereas in Custer you see patients in the emergency room at their worst, you see them on the inpatient side, all the way to discharge. You get to see that you have made a difference; that you have been a big part of helping them get back to their best self.”

A connection with her patients comes easy to Barb, especially since they are frequently acquainted. That’s another reward of her role.

“It’s your grandparents, your best friends’ parents, their entire family,”

Barb said. “One moment you’re responding to an emergency, and the next you’re helping with end-of-life care and supporting the family.”

Barb said she is proud to work alongside the Custer physicians and caregivers to provide health care to the community.

“For a small town, we have exceptional nurses and doctors. I mean, our doctors do it all. Their specialty is anything that comes through the door. Our team of

“I just love patient care,” Barb said. “We touch so many lives here.”

nurses and aides are a talented group of people, and they are all here because they love our community.”

Caring for caregivers

One thing about Barb that her patients may not know is that she channels her energy into caring for her team, as well. She frequently cooks a meal during her shift and serves the staff in the galley.

“I've probably done it the whole time I have worked here,” Barb said. “It depends on how busy we are — I try to cook every shift, but sometimes it’s too busy and I don’t have time.”

From freshly baked buns to soups from scratch and pot roasts of her own local Hereford beef, Barb’s culinary exploits have made her beloved by her coworkers. Recently, she was bestowed special recognition by her teammates. Debbie Risser, Manager Nurse at Custer Hospital, organized an informal gathering of staff earlier this year to show appreciation for Barb.

“You take care of us, you feed us, you

just don’t quit. Your work doesn’t go unnoticed,” she told Barb.

Joy Falkenburg, M.D., stated that she believes Barb lives by a western code of devotion to her values. “I think she truly understands how health care is about the human being; taking care of the patient. Barb is a shining example of that dedication.”

During the presentation, Dr. Falkenburg recalled how when her mother-in-law was ill, Barb helped care for her. “That is the kind of person Barb is. She shows up for people, in the hospital and outside of it as well.”

No one comes and works in a ranch community without being fed and recognized — it’s part of the culture and lifestyle. The people are a part of your family because they are working beside you, so you treat them and take care of them as such, Barb explained. "I just feel like it’s part of my job every day. It’s not something I consider going above

and beyond, it’s just what you do for your family.”

Western living

The culture and values of western living have informed Barb’s choices inside and outside the confines of Custer Hospital. It is still part of her life and her reprieve from what even she will admit is a difficult profession at times. As far as she’s concerned, there’s “no better way to live” than the western way near Custer, where she said the “friendly and giving” people should be prized as much as the beautiful locale.

“Ranch life is the best. It’s 24/7. Your work is your reward. If you don’t work, your animals won’t survive and you won’t have a flourishing place. There is a lot of that to take and apply to nursing,” she said.

“Everything is your job. Everything that keeps it going is everyone’s job. There’s no saying, ‘that’s not my job.’ You work as a team and the end result is always better than if you’re flying alone.”

UNIQUELY

CUSTER:

Healing Garden an oasis for all

Custer’s Healing and Wellness Garden is an asset to caregivers, patients and community members alike. Nestled along the side of Custer Hospital, the healing garden spans 10,000 square feet and a trip around the therapy walking path reveals one surprise after another.

When Monument Health and the city of Custer opened the doors on the new $21.7 million hospital and clinic in April 2018, the vision was to make the best use of the new facility as a healing center. An outdoor space was part of that shared vision, and the healing garden began to take shape once local patron Delmer Brown was identified as the initial donor for the project. Other individuals and organizations have since made valued contributions to the project.

Joy Falkenburg, M.D., is the curator and caretaker of the healing garden. She says the space was designed to utilize sounds, sights, smells and textures to bring people into the

present moment as a form of healing.

“We felt like an outdoor space was really important for the vision of Custer as a healing center,” said Dr. Falkenburg. “It’s next to the hospital so that patient rooms look out onto the garden, and patients can sit and even do rehabilitation out there.”

Dr. Falkenburg and other providers’ healing approach to medicine finds many practical uses for the garden. This includes convalescence and solitude, activity, sensory opportunities and spiritual respite.

“We have several unique plants that smell and feel different, so those can be used for stroke patients or patients with sensory abnormalities,” Dr. Falkenburg said.

On the far side of the garden, around back, a door from the hospice suite opens into a large circular area.

“It’s not uncommon that people want to die in nature and with the sunshine on their face,” Dr. Falkenburg said. The garden helps these individuals stay close to nature as they come to the end of their lives.

The first year the garden was planted, a major hailstorm wreaked havoc, but the garden has been re-planted each spring in what has become an annual event for clinic staff and community members. During this year’s planting in June, vendors, caregivers, children and community volunteers worked together to revitalize the space for another season of restorative connections with nature.

Some of the of the garden’s most special features include:

• Several seating areas, including a semi-circle pergola area.

• Two different water features.

• A children’s playhouse.

• An intention hut in which visitors can quietly reflect.

• A “wind phone” is available for people to express their grief, concern or anything else in their heart, leaving it “on the wind.”

• Five raised garden beds for growing vegetables.

• Sculptures and art throughout the garden.

• A variety of foliage from trees to shrubs and flowers meant to attract birds.

Scan QR code to learn more about Custer's Healing Garden

What are your main responsibilities as a volunteer?

Right now my focus is to make blankets for patients. This is something I can do at home on my own time, which means I am still making a difference for patients while having time to care for my 92-year-old mother. When I need supplies, I come to Rapid City Hospital, pick up fleece and take it home. Then, I cut it to size, tie it into blankets and return them. Over the years I have tied hundreds of blankets. I have also returned to in-home hospice volunteering as my schedule allows and I'm so thankful the restrictions of COVID-19 have finally been lifted. Hospice volunteering is truly a rewarding experience, getting to know and visit with patients as they near the end of their lives.

What surprises you about volunteering?

Just the sheer number of opportunities available for the volunteer. Of course, it’s fun meeting and working with the other volunteers, and it also gives me a feeling of accomplishment. It’s about doing something for someone else and hopefully brightening their day during a difficult time.

What do you most look forward to on the days you volunteer?

We have a really fun group on the auxiliary board of directors, and I look forward to our meetings and conversations. It is also exciting to see just how much money the auxiliary has been able to donate to various needs within the hospital. Giving $250,000 to the Cancer Care Institute over a five-year period as well as annually donating to CMN, just to name a couple! It's possible to have such an impact because of the volunteers' support and commitment. I truly work with an amazing, selfless group of men and women who volunteer their time and energy for a much larger goal. I am proud to be listed among their ranks!

Kim Krull began volunteering in 2015 and has worked in many areas including in-home hospice, the Rapid City Hospital volunteer desk, patient rounding, hand massages and wayfinding.

Kim Krull

A hospital

stay can

be physically, mentally

and emotionally

challenging.

Volunteers like Kim help bring patients a little bit of comfort in the form of a handmade blanket.

Volunteer Auxiliary Board President, Rapid City Hospital

Kirstin Hockhausen, m.d. Dermatologist

Her husband’s leukemia diagnosis was a driving force for Dr. Hockhausen, ultimately leading her to pursue a career in medicine. Eventually, she found her passion in dermatology.

I am a general medical dermatologist with Monument Health. My job is to be prepared for any skin condition that walks through the door. I take care of patients of all ages from newborn babies to adults. I also perform skin cancer surgeries and provide cosmetic services. My team and I treat a wide variety of skin concerns from common conditions such as, acne, eczema and psoriasis to more rare or complex skin diagnoses and skin cancers. Skin conditions often exist alongside other medical issues, and I work collaboratively with primary care providers and other medical professionals on a daily basis.

When I was a medical student, I had the privilege of working under Dr. Allen Nord here in Rapid City. With every patient he would say, "What can we do to help this patient today?" I have learned to carry this question with me into each patient encounter. My goal is to use my expertise and experience to help in every way I can, every time. Each patient is unique, and I am dedicated to providing high-quality dermatologic care that is individually tailored to the needs of the person sitting across from me.

My Passion

I am passionate about my community and my patients. I always want to be the physician who patients confide in, who encourages them through difficult treatment protocols and is excited to celebrate with them once we have fully treated the skin cancer, cleared up the acne or got rid of their child's rash. Through patient education, skin cancer screenings and up-to-date medical management of skin conditions, my team and I deliver high-quality dermatologic care. Rapid City is my home, and I could not be more honored to be able to use my training, skills and knowledge to serve this wonderful community.

Dr. Hockhausen comes from a passionate medical family. She joins her father, Samuel Huot, M.D., a retired family medicine physician, and two brothers, Christopher Huot, M.D., an ophthalmologist, and Michael Huot, M.D., an anesthesiologist, in providing health care to the Black Hills region.

Advanced Practice Provider (APP) refers to physician assistants (PA-C), certified nurse practitioners (CNP) and certified registered nurse anesthetists (CRNA). Because of their advanced training, APPs can do many of the same things a physician does. Patients benefit from having both their physician and their APP working together on their care.

I really enjoy teaching the next generation of PAs and CNPs. I had tremendous preceptors when I went through PA school, and I try to pay that forward any chance I get. As the APP field continues with tremendous growth, we all have an obligation to be certain that quality does not suffer. Lastly, I try to be a voice for my fellow APPs. I am one of 11 members on the Monument Health APP council. I will continue to advocate for the issues that matter most to APPs at Monument Health.

Zachary

My Role

I am a Primary Care Physician Assistant at Monument Health Hill City Clinic. I provide annual wellness visits, diagnose illnesses and prescribe medications. More importantly, I act as a counselor, educator and advocate for my patients, helping them manage their health conditions, many times without the aid of specialists.

My Goal

My goal is to build trust and ensure access to quality health care for all, regardless of financial or social status. I am dedicated to improving the health and well-being of my patients in the Hill City community. Dr. Terry Graber, who is retiring this year, and I are the face of Hill City medicine, and I do not take that responsibility lightly.

My Passion

Preventive medicine, fitness, teaching and advocacy are my passions. In college as a certified personal trainer and bodybuilder, I found great satisfaction in helping individuals reach their fitness goals through proper nutrition and resistance training. As a cardiovascular and diabetes care specialist with Pfizer and Novo Nordisk, I learned from the top thought leaders in the country. This forged my strong conviction in preventing disease with a sharp focus on aggressive early disease management to improve life span, but more importantly health span.

This is how I approach clinical medicine. About 15 percent of my practice is lifestyle medicine focused on prevention, weight loss and exercise. I am humbled by the constant influx of referrals from all over the Black Hills. It is gratifying to witness these huge transformations and the self-confidence that ensues knowing that they are no longer prisoners in their own bodies.

Petersen, pa-c

Primary Care, Hill City

Preventative medicine, fitness and diabetes management are among the most fulfilling facets of working in primary care for Custer’s Zach Petersen.

Welcome our newest physicians

AUDIOLOGY

Merrill Hill, au.d., is an audiologist at Monument Health Rapid City Clinic, 4150 5th Street. He chose audiology because of his interest in neurological disorders and balance dysfunction. He enjoys being able to make significant improvements in the quality of people's lives which allows them to communicate with their families and participate in many activities that most people take for granted. Most patients have anxiety, depression or isolation due to hearing loss or balance trouble and it's great to be able to let them know that there is treatment and that they're not alone.

Vaughan Bowen, m.d., is an Otolaryngologist

(ENT) at Rapid City Clinic, 4150 5th Street with over 20 years of experience. He is a Fellow of the American Academy of Otolaryngology-Head and Neck Surgery, a Fellow of the American Academy of Otolaryngic Allergy (AAOA) and a Diplomat of the American Academy of Aesthetic Medicine. Outside of clinic, Dr. Bowen enjoys spending time with his family, golfing, hiking, reading and hunting.

Robert Burgess, m.d., is an Otolaryngologist

(ENT) at Rapid City Clinic, 4150 5th Street. He was born in Deadwood and grew up in Rapid City. He attended the University of South Dakota then obtained his medical degree at the University of Iowa in Iowa City, where he graduated with honors. He trained at the top ranked ENT residency in the country and practiced in Montana before returning home to Rapid City. Dr. Burgess enjoys all aspects of the specialty and sees both adults and children. He has special interest in pediatrics, ear surgery and tumors of the head and neck. He enjoys skiing, hiking, running, fishing and hunting.

Jay Warren White, d.o., is an Otolaryngologist

(ENT) at Rapid City Clinic, 4150 5th Street

Dr. White has more than 25 years of experience and focuses much of his practice on pediatric ear, nose and throat conditions. Dr. White takes a thoughtful approach to the care of many chronic nasal problems including allergies, sinusitis, nasal airway breathing issues, congestion and drainage. He also treats a full spectrum of ear and throat disorders, such as voice dysfunction and chronic cough. He earned his medical degree from Des Moines University in Des Moines, Iowa in 1997 and completed his post-graduate training at St. John's Health System in Detroit, Mich. Dr. White practiced in the Cincinnati, Ohio area for eight years before returning to his home state of South Dakota.

EMERGENCY MEDICINE

Deanna Lassegard, m.d., is an Emergency Medicine Physician at Monument Health Spearfish Hospital with privileges at Rapid City, Sturgis, Lead-Deadwood and Custer Hospitals. Dr. Lassegard began her career at Monument Health as a paramedic and then as a registered nurse. She went on to attend medical school at the University of South DakotaSanford School of Medicine in Vermillion and completed her residency in Emergency Medicine at East Carolina University – Vidant Medical Center in Greenville, N.C. in 2018. In addition to her role as an emergency medicine physician, she also serves as the current EMS Medical Director for Black Hills Medical Direction, the National Forest Service, Black Thunder and Coal Creek Mine, Nolan Independent Management, Campbell County Memorial Hospital’s Sexual Assault Nurse Examiner team, Campbell County Health EMS and Campbell County Fire Department.

FAMILY MEDICINE

Brittany Bearstail, m.d., is a Family Medicine Physician at Monument Health Spearfish Clinic, North 10th Street. She grew up in North Dakota, and later moved to Eagle, Butte, S.D., where she graduated high school. Dr. Bearstail completed her Family Medicine Residency at the University of North Dakota Center for Family Medicine and earned her Medical Degree from the University of North Dakota School of Medicine & Health Sciences. She enjoys the full scope of primary care, particularly women’s health and pediatrics. In her free time, she enjoys spending time with her husband and three children, traveling, reading, trying new food and being physically active.

GENERAL/TRAUMA SURGERY

David Godbe, m.d., is a General Surgeon at Monument Health Rapid City Hospital. Dr. Godbe received his medical degree from Loyola University of Chicago – Stritch School of Medicine and completed his residency at the University of California – Irvine Medical School in Orange, Calif. in 1993. He has been practicing in Rapid City since 2003.

NEUROSURGERY

Glen Pollock, m.d., is a Neurosurgeon at Monument Health Neuroscience Center in Rapid City. He earned his medical degree at the University of South Florida, his neurosurgery residency at the McGraw Medical Center of Northwestern University, followed by training at the University of South Florida. He then completed his Endovascular and Cerebrovascular Fellowship at the Cerebrovascular and Stroke Center of New Jersey Capital Health. Dr. Pollock is a member of the American Association of Neurological Surgeons and the American College of Surgeons. When he isn’t working, Dr. Pollock is an avid outdoorsman.

EAR, NOSE AND THROAT

August 18-26

Monument Health Health Screenings at Central States Fair

August 26

Monument Health Special Rodeo at Central States Fair

September 9

Patriot Day Celebration

September 9

Little Black Hills Battles 5K Walk

September 16

Black Hills Heart Walk

September 30

OrthoPeak Run

September 30

Mammo or Bust Run 5K

DIRECTORY

We’re near you

HOSPITALS

Custer Hospital

1220 Montgomery Street

Custer, SD 57730

605-673-9400

Lead-Deadwood Hospital

61 Charles Street

Deadwood, SD 57732

605-717-6000

Rapid City Hospital

353 Fairmont Boulevard

Rapid City, SD 57701

605-755-1000

Spearfish Hospital

1440 N. Main Street

Spearfish, SD 57783

605-644-4000

Sturgis Hospital

2140 Junction Avenue

Sturgis, SD 57785

605-720-2600

CLINICS

Belle Fourche Clinic

2200 13th Avenue

Belle Fourche, SD 57717

605-723-8970

Buffalo Clinic

209 Ramsland Street

Buffalo, SD 57720

605-375-3744

Custer Clinic

1220 Montgomery Street

Custer, SD 57730

605-673-9400

Family Medicine

Residency Clinic

502 East Monroe Street Rapid City, SD 57701

605-755-4060

Family Health Education Services

930 N. 10th St

Spearfish, SD 57783

605-642-6337

Gillette Clinic

20 W Four-J Court

Gillette, WY 82716

307-682-1204

Hill City Clinic

238 Elm Street Hill City, SD 57745

605-574-4470

Hot Springs Clinic

1100 Highway 71 South, Suite 101

Hot Springs, SD 57747

605-745-8050

Lead-Deadwood Clinic

71 Charles Street

Deadwood, SD 57732

605-717-6431

Rapid City ClinicFlormann St.

640 Flormann Street

Rapid City, SD 57701

605-755-3300

Rapid City Clinic5th St.

2805 5th Street

Rapid City, SD 57701

605-755-5700

Rapid City Clinic -

4150 5th Street

4150 5th Street

Rapid City, SD 57701

605-755-5700

Spearfish ClinicNorth Ave.

1445 North Avenue

Spearfish, SD 57783

605-644-4170

Spearfish ClinicNorth 10th St.

1420 North 10th Street

Spearfish, SD 57783

605-717-8595

Sturgis Clinic

2140 Junction Avenue

Sturgis, SD 57785

605-720-2400

Wall Clinic 112 7th Avenue

Wall, SD 57790

605-279-2149

URGENT CARE

Custer

Urgent Care Services

1220 Montgomery Street

Custer, SD 57730

605-673-9400

Lead-Deadwood

Urgent Care Services

71 Charles Street

Deadwood, SD 57732

605-717-6431

OrthoExpress

Walk-in Clinic

1635 Caregiver Circle

Rapid City, SD 57702

605-755-6180

Please call your local clinic to schedule an appointment. Monument Health is also offering extended services through video and telephone visits with your provider.

Rapid City Urgent Care

Jackson Blvd.

2116 Jackson Boulevard

Rapid City, SD 57702

605-755-2273

Rapid City Urgent Care

Lacrosse St.

1303 N. Lacrosse Street

Rapid City, SD 57701

605-755-2273

Spearfish

Urgent Care Services

1420 North 10th Street

Spearfish, SD 57783

605-717-8595

Sturgis

Urgent Care Services

2140 Junction Avenue Sturgis, SD 57785

605-720-2600

SPECIALTY & SURGICAL CENTERS

Assisted Living

432 North 10th Street Custer, SD 57730

605-673-5588

Behavioral Health Center

915 Mountain View Road Rapid City, SD 57702

605-755-7200

Care Center

949 Harmon Street Sturgis SD 57785

605-720-2400

Cancer Care Institute

353 Fairmont Boulevard Rapid City SD, 57701 605-755-2300

Dermatology

550 East Colorado Boulevard

Spearfish, SD 57783 605-717-8860

Dialysis Center

955 East North Street

Rapid City, SD 57701 605-755-6950

Dialysis Center

132 Yankee Street Spearfish SD 57783

605-722-8110

Heart and Vascular Institute

353 Fairmont Boulevard

Rapid City, SD 57701

605-755-4300

Home+ Home Health and Hospice 931 E Colorado Boulevard

Spearfish, SD 57783

605-644-4444

Home+ Home Health

224 Elk Street

Rapid City, SD 57701

605-755-7710

Home+ Home Medical Equipment

1800 N. Haines Avenue

Rapid City, SD 57701

605-755-9000

Home+ Home Medical Equipment

1635 Caregiver Circle, Rapid City, SD 57702 605-755-6150

Home+ Home Medical Equipment

911 East Colorado Boulevard

Spearfish, SD 57783

605-717-8930

Home+ Hospice House

224 Elk Street

Rapid City, SD 57701 605-755-7710

Home+ Infusion

224 Elk Street, Suite 100 Rapid City, SD 57701

605-755-1155

Home+ Pharmacy

353 Fairmont Boulevard

Rapid City, SD 57701

605-755-8184

Home+ Pharmacy

1420 North 10th Street, Suite 1

Spearfish, SD 57783 605-717-8741

Home+ Specialty Pharmacy

725 Meade St. Rapid City, SD 57701 605-755-3065

Neuroscience Center 677 Cathedral Drive

Rapid City, SD 57701 605-755-5276

Orthopedic & Specialty Hospital

1635 Caregiver Circle

Rapid City, SD 57702 605-755-6100

Orthopedics and Sports Medicine

2449 East Colorado Boulevard

Spearfish, SD 57783 605-644-4460

Rehabilitation

2200 13th Avenue Belle Fourche, SD 57717 605-723-8961

Rehabilitation 220 Montgomery Street Custer, SD 57730

605-673-9470

Rehabilitation

61 Charles Street Deadwood, SD 57732 605-717-6370

Rehabilitation

2479 East Colorado Boulevard Spearfish, SD 57783 605-644-4370

Rehabilitation

2140 Junction Avenue Sturgis, SD 57785

605-720-2570

Rehabilitation Center 1050 Fairmont Boulevard Rapid City, SD 57701

605-755-1230

Sleep Center 2929 5th Street Rapid City, SD 57701 605-755-4000

Sports Performance Institute powered by EXOS

1635 Caregiver Circle Rapid City, SD 57702 605-755-6683

Surgery Center 1316 North 10th Street Spearfish, SD 57783 605-642-3113