Adventure

Mary Franck’s Destinations Transform Her Life

ADVENTURE // STORY BY LISA LUKECART // PHOTOGRAPHY BY BILL SITZMANN // DESIGN BY MATT WIECZOREK

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tsunami hit Mary Franck’s life. Her mother died. She lost her job. Her husband left her.

“I haven’t loved you for 25 years,” he said of their 27-year marriage.

All of it swept away in nine devastating months of 1998.

A newspaper ad for a summer job at Yellowstone National Park changed the flow of her life. The six-month gig with Xanterra Travel Collection seemed like it could be a healing adventure. She had nothing more to lose, especially since her children were grown.

When Franck arrived, the landscape reflected her soul. The fires of 1988, 42 of which were caused by lightning, left approximately 1/3 of the lush 1.2 million acres scorched. Blackened scars remained 10 years later. Fire, however, regenerates and rejuvenates. Pine cones, shattered open, exploded seeds from their shells. Lodgepole trees sprouted out of the ashes. Green bentgrass burst out of pockets and cracks near geyser basins. Yellow wildflowers shot up from the gloom.

She felt cracked open by her grief, but the revitalized environment made her feel hope.

“I knew this [was] where I was supposed to be,” Franck, then 44, recalled.

Franck, clean and sober from alcohol and drugs since 1984, didn’t relapse. She credits the experience at Yellowstone for pushing her through a difficult year. She kept busy working at Old Faithful Snow Lodge as a waitress, making “grocery sacks full of money.” Employees lived a dorm-style life and ate three meals a day in the dining room.

When she returned to Nebraska, Franck worked supplies with the Omaha Police Department. But the call of the wilderness returned. In summer 2006, she returned to manage Old Faithful Inn at Yellowstone.

Franck recalled how her mother always wanted to travel to Alaska, and after talking to other workers about their travels, she knew it was next on her bucket list. But her father’s dementia worsened, so she stayed home to take care of him, which enabled her to spend time with her grandchildren.

After his death eight years later, Alaska beckoned. Franck submitted her resume to Aramark in 2019, eager to land a job with Denali National Park and Preserve. The 65-year-old woman set out on her journey, deciding this time she would attempt the 10-day drive from Omaha to Alaska. She camped along the way, sometimes in the middle of nowhere, pitching her red and white tent next to her Subaru Outback, with nothing but trees sheltering her. It allowed her to see the country: a dazzling drive through the Black Hills in South Dakota, sleeping under the stars at Glacier National Park in Montana, and glimpsing frozen Lake Louise in Canada.

Soon, the spectacular view of Denali National Park loomed in the distance. One lonely gravel road, 92 miles long, leads in and out of the 6.1 million acres of vast wilderness and plentiful wildlife. The shadow of North America’s highest snowy peak, Denali, loomed over visitors as they hopped on a bus to head into the secluded park. But if one travels further down the stretch, wild animals ranging from bear to moose to wolves roam free.

It took a few days before Franck adjusted to the long hours of sunlight. Room and board cost $15 a day. She took down reservations at the bus and train depots, working 10-hour days four times a week at $20 an hour. It gave her three days to explore, kayak, or bike. Franck would throw on a long sleeve shirt and long pants to hike, since mosquitos are plentiful. The redheaded explorer even ventured up Mount Healy, an eight-mile journey up and back.

“I thought I was going to die,” she said. “But once at the top, it was breathtaking.”

Franck never let her age stop her. She practiced yoga, walked a sled dog, and talked to campers.

“I thought it was incredible. She’s a very genuine character to be around,” Denali’s reservation supervisor Chris Sloan, 27, said.

The work doesn’t come without its pitfalls. The wilds of Denali can create an isolated experience.

“Being alone is bittersweet. It’s beautiful, but sometimes you want your family and friends to share it with you,” Franck said.

She never felt scared except on the Cassiar Highway through Canada on her way back. “The Highway of Tears” has been dubbed the most dangerous stretch due to the number of unsolved murders and disappearances of women. Franck didn’t see another vehicle or person for hours at a time and cell reception was spotty.

“I think we shouldn’t put limits on us just because of our gender. There are more risks involved as a solo female than a solo male. I feel safer camping than in a big city,” said Alaina Anderson, Denali’s assistant manager of reservations.

She called Franck for advice when driving by herself from Steamboat Springs, Colorado, where she worked that winter, to Denali for her summer session.

“You can make a life traveling around. I met people like Mary—the brightest person I ever met—[whom] I would never have had the opportunity to meet,” Anderson said.

Franck mentioned people shouldn’t dwell on the “what-ifs.” If Franck didn’t take a chance, she would never have seen the northern lights. She plans to walk the Camino de Santiago pilgrimage trail in Spain for her next venture.

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oday, almost every industry is using AI to improve performance and make better business decisions. One of those industries is health care—and the impact is profound.

According to Michael Ash, M.D., executive vice president and chief transformation officer at Nebraska Medicine, AI is making big changes in how health care is delivered in a number of ways, including quality, safety and delivery of care, provider and patient satisfaction, costs, regulatory requirements, research, education, and security.

Artificial intelligence refers to the use of machines to carry out tasks in a way that mimics human learning and thinking. Machine learning is a part of AI that applies the simulation through the use of data to develop algorithms to help predict outcomes and/or find patterns and associations. Also referred to as “smart” systems, machines are programmed or automated to process data to achieve a specific task, such as predicting the risk of certain conditions or diseases. The more data they receive, the smarter and more accurate they become over time, growing their knowledge and capabilities so that they are essentially learning for themselves. By adding a feedback loop, the machine can learn by being told whether its decisions are right or wrong, allowing it to adjust its methodology in the future.

Nebraska Medicine is realizing the critical role AI can play in improving quality and safety of care through the use of clinical decision support models and predictive modeling (using data to develop algorithms to help predict outcomes and/or find patterns and associations). “With the use of clinical decision support, we can more effectively identify people at risk for sepsis and begin interventions sooner to prevent it or reduce its severity. This has allowed us to significantly lower our rate of sepsis mortality, propelling us to a ranking that puts us among the top 15% of academic medical centers in the country in terms of safety.”

Early determination of deterioration is another area the hospital is actively working to improve with the help of AI and predictive analytics. This entails identifying which hospitalized patients are at greatest risk for developing life-threatening incidents like arrhythmias, heart attack or pulmonary embolism. Armed with this information, providers can begin preventive interventions earlier to thwart such events.

“We’ve been working on it for several years,” Ash said. “Developing these types of predictive models can take years and years depending on the complexity of the condition. It’s a collaboration of data scientists, physicians, pharmacists, and analytic experts using data and algorithms to find patterns and gain insights so we can develop predictive models. These are then tested repeatedly for safety, accuracy, and making sure interventions are effective.”

Nebraska Medicine recently became one of the first hospitals in the country to adopt the voice recognition technology called Dragon Ambient Experience to transcribe doctors’ notes into electronic health records as they evaluate and visit with patients.

“This technology improves patient care, as it allows the doctor to focus on the patient, instead of a computer screen,” Ash said. “It

“Over the past five years, the synergy of robotics and AI technologies combined with our clinical expertise is providing us more efficiencies and capabilities and is allowing people to regain function more quickly and restore quality of life.” -Megan Potter, P.T., DBT

“These tools are streamlining the clinical process by quickly getting large amounts of information to our providers at the point of decision-making so they can make more informed decisions,” Ash said. “This is huge for doctors, who must constantly sift through large mounds of data when making health care decisions about a patient.”

He explained that one of the big challenges in health care is that, while at times a patient can have symptoms that are predictive of a disease, a lot of times patients have subtle changes that are difficult to detect. Artificial intelligence and predictive modeling can help detect those subtler changes and take proactive measures.

Case in point: sepsis. Nebraska Medicine has been using this tool to lower their sepsis rates—the number one cause of hospitalized deaths worldwide. And the results have been dramatic.

“Sepsis can be difficult to detect and a delay in therapy can be deadly,” Ash said. also saves our doctors an enormous amount of time that they normally would have to spend entering and organizing their notes. This system does it for them, parsing out what’s most clinically relevant. Eventually, the goal is that this technology will also be able to make suggestions for diagnosis and treatments and provide providers with the most cost-effective choices.”

In research, decision support models are helping providers identify and match patients with the most appropriate clinical trials, resulting in a 20% jump in clinical trial participation. In education, AI is helping professors develop smarter tests that do a better job of determining clinical competency in specific areas as well as the development of better teaching models and approaches to improve learning.

Cybersecurity is another area in which AI is making waves. “Instead of waiting for the cyberattack to happen, using predictive modeling, we can look at patterns of activity that might be suggestive of a virus or cyberattack and intercept it much earlier,” Ash said.

The use of AI to drive new and exciting rehabilitative technologies at Omaha’s QLI, an intensive inpatient rehabilitation center for catastrophic injuries, also has been a game changer.

“The rehabilitation process for someone who has sustained a catastrophic injury can take weeks to months to even years,” said Megan Potter, P.T., DBT, coordinator of Physical and Occupational Therapy at QLI. “Over the past five years, the synergy of robotics and AI technologies combined with our clinical expertise is providing us more efficiencies and capabilities, and is allowing people to regain function more quickly and restore quality of life.”

One of those technologies is the Eksobionics exoskeleton, a robotic-powered device designed to help individuals with lower-limb extremity paralysis or weakness due to spinal cord injury, traumatic brain injury, or stroke. The device is worn like a backpack with an attached body suit and helps an individual relearn the physical movement patterns necessary to walk. Artificial intelligence assists by providing predictive information about the person’s step length and step height once they begin walking and then determines how much support they need to maintain optimal gait mechanics. The exoskeleton technology is also helping those who have impairments that cause unpredictable and erratic movements by working to normalize it.

“These technologies have drastically changed the rehabilitation process,” Potter said. “Repetition is the bedrock of getting someone back to independence. More repetitions result in better outcomes such as greater functional ability, and ultimately, independence. Before the exoskeleton and similar rehab technology, gait training was very laborious. It could take up to three therapists plus a body weight support system to hold a person up and help them take a step. With the exoskeleton, the volume of steps we can achieve in gait training can be 500 to 1,000 steps per session compared to 30 steps without it. This allows us to get our patients back on their feet much sooner and is helping reduce length of stays.”

For patients with upper extremity impairments, QLI employs the ArmeoSpring, a sensor-based technology that provides support and resistance to promote motor relearning while also building strength. The device allows patients to complete tasks utilizing a game on its computer screen to target movement in all planes. It encourages movements that simulate everyday tasks like eating, brushing teeth, and putting on clothes, moving them closer toward independence.

continued on pg. 65

STORY

scott stewart

PHOTOGRAPHY

bill sitzmann

DESIGN

matt wieczorek

Four Children, Five Minutes

[ONE TENACIOUS COUPLE ]

Life is scary sometimes. Some moments define the direction a person takes in life, such as landing a dream job, saying “I do,” or learning of the loss of a loved one. Good or bad, change means uncertainty.

But sometimes those life-altering milestones aren’t contained to moments. The uncertainty can linger... and linger...and linger.

The birth of a child—or, in the case of Maria and Joseph Sawaged, four children in five minutes—is one of those moments. Facing the challenge of infertility, which the Sawageds did for five years, also preceded the joy, prompting a series of more difficult moments.

They stayed hopeful through 13 rounds of fertility treatments, unwavering in their commitment to grow their family, no matter how long it took.

Maria and Joseph first met at Metro Community College in 2009.

“I still remember she denied me the first time,” Joseph said. “I think it was the day after that she said I may as well take a chance on this guy.”

[T]

hey married in 2014, and both wanted children. Maria wanted to start trying sooner, but Joseph wanted to make sure they had a good financial foothold first.

“When we were thinking of getting ready, my first thoughts were ‘I didn’t know the expense of a baby,’” Joseph said.

He wanted debts paid off and to move into their forever home together.

About six years ago, Maria said he had a surgery—nothing too serious, but enough to question where they were in their lives.

“At that time, we decided we were going to start trying,” Maria said.

After a couple months, they started a simple fertility treatment. It didn’t work.

That would become a recurring theme for the Sawageds. They tried, and tried, and tried, working with a specialist who cautioned them that fertility treatments could eventually do more harm than good.

The treatments were also expensive. They would try for a month and then take a couple months off to relax and save up money.

“It was on and off for five years that we tried,” Maria said. “It just wasn’t working.

Joseph described feeling “just as bad as you can get.” Every time, it didn’t work. Every time, more disappointment, a little more doubt.

“You get really down,” Joseph said, not wanting to revisit the agony of those moments.

Still, he said they didn’t assign blame. They were told it was unexplained infertility, a frustrating diagnosis faced by up to a third of women seeking treatment for infertility, but one that still means pregnancy is possible.

“To this day, there’s no reason why,” Joseph said. “It’s just what our bodies were born with. There is nothing that we did on purpose that had done this.”

They decided to seek out a new doctor with Methodist Health Systems to explore new options. “We would have [gone] to any length to eventually get there,” Joseph said.

Eventually, they got there. After 12 unsuccessful rounds of treatments, they were told the intrauterine insemination finally worked, and the moment would soon come when they welcomed their first child into the world.

The Elkhorn couple knew going into fertility treatments that a multiple pregnancy was a distinct possibility. Maria is a twin herself, so it didn’t come as a huge surprise when they learned they were going to have more than one child.

“I thought I was going to have triplets when I got pregnant,” Maria said. “I just didn’t expect four.”

Since Joseph couldn’t accompany Maria to the appointment due to COVID-19 restrictions, she recorded the conversation with the physician, who started out by saying “Don’t be alarmed.”

The catastrophizing began. What’s the worstcase scenario? Maria played it cool with her husband. Then the doctor’s recorded voice said: “There are four babies.”

The quadruplets arrived on April 30, 2020, via cesarean section. They were the first set of quads at Methodist Women’s Hospital since 2017.

The Sawageds had three boys and one girl: Luca Samuel (3 pounds 11 ounces, 15 ¾ inches), born at 10:36 a.m.; Julianna Sophia (2 pounds 12 ounces, 15 ¾ inches), born at 10:38 a.m.; Barrett Eli (3 pounds 11 ounces, 17 inches), born at 10:40 a.m.; and Tychus Cole (3 pounds 7 ounces, 16 ½ inches), born at 10:41 a.m.

The quadruplets spent time in the hospital’s neonatal intensive care unit. Barrett and Tychus went home May 23, followed by Julianna on June 2 and Luca on June 4—all prior to Maria’s due date of June 25.

Methodist maternal-fetal medicine doctor Andrew Robertson specializes in high-risk pregnancies and worked with Maria nearly weekly during the early stages.

He said quadruplets only happen in about 1 in 10,000 naturally occurring pregnancies. Assisted reproductive technology has made it more commonplace.

Quadruplets average about 28 weeks of pregnancy, Robertson said. Maria made it a little past 32 weeks, avoiding complications associated with first-time pregnancies.

“She beat the odds,” Robertson said, attributing that to her “determination and her ability to carry pregnancies.” He added: “We didn’t have to deliver her because she got sick, which is a very common reason we do have to deliver some women preterm.”

Robertson has been part of about 3,000 sets of multiples over almost three decades.

“It is very rewarding to see a successful outcome,” he said.

Now more than 1 year old, the quadruplets are starting to have their personalities shine through. Luca loves food and to watch everyone around him. Julianna is talkative and likes to be heard—and is willing to be loud. Barrett wants to be held all the time, and Tychus is pretty much always happy.

Looking back, Joseph said he believes their initial delaying was a mistake, but he’s quick to point out that it worked out perfectly in the end.

Maria also spent a month in the hospital before the babies were delivered. “There are some women that would find that very difficult or impossible to do. She wasn’t doing anything other than sitting around and helping these kids grow.” -Dr. Andrew Robertson

“There is nothing wrong with having to go through treatments. It is sad, and it is hard, but it’s nothing to be ashamed of to have to have help to get pregnant.”

-Maria Sawageds

They both said that those facing infertility should seek professional assistance. “There is nothing wrong with having to go through treatments,” Maria said. “It is sad, and it is hard, but it’s nothing to be ashamed of to have to have help to get pregnant.”

In the end, “having a baby trumps all of the process that it takes,” Joseph said.

Of course, there is a financial cost, too. Fertility treatments generally aren’t covered by insurance, and, in the U.S., they range from a couple hundred to several thousand dollars per round.

The Sawageds said they are blessed with well-paying jobs. They both work in sales at Nebraska Furniture Mart and can work from home—something they did before the coronavirus pandemic made it commonplace. That’s been a godsend since the babies arrived.

Their doctor noted that some women simply cannot get pregnant or have a healthy pregnancy, and the Sawageds showed unusual persistence in the face of unexplained infertility.

“She went through a lot to get pregnant,” Robertson said. “She went through a lot more cycles than a lot of people would have.”

Maria also spent a month in the hospital before the babies were delivered. “There are some women that would find that very difficult or impossible to do,” Robertson said. “She wasn’t doing anything other than sitting around and helping these kids grow.”

Each one of those moments contributed to the joy the Sawageds now feel, and the many moments ahead for them and their family.

Visit bestcare.org for more information on Methodist Health System.

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