In my last entry, I wrote about my hometown of Clarion, Iowa, and the relationship between the look of the surrounding landscape and the practicalities of living there.  Pictures I’ve taken with my new Canon 5D Mark II (see below) indicate I won’t be abandoning those themes of specificity and abstraction anytime soon – the Midwestern identity, aesthetic, and experience are rich in these sorts of tensions, a fundamentally ironic one being that the region’s reputation as a ‘place where nothing much happens’ often undercuts their mention.

So, with thoroughly Midwestern tensions in mind, I hesitated a bit with the title on this entry. The rural medical center certainly embraces many small-town ideals, placing a high value on friendliness and viewing its function as an integral part of  the community it serves. Residents know their doctors, professionally and socially; the clinic itself is the setting for dramatic times of joy and sorrow and hundreds of everyday events in between. While this no doubt happens in cities of all sizes, an important small town difference is how this experience in one particular clinic is shared by the majority. Heck, before Clarion got its first hospital building in 1951, surgeries were performed in what was a house, doctor-owned, a one-time home – an apt symbol of the integration of medicine, community, and expectations that care be both professional and patients still be treated “like family.” Long since demolished, I imagine this house as the Eagle Rock Hospital in Cold Turkey, Norman Lear’s pre-All in the Family satire of (among other things) small-town Americana, shot on location in the Iowa towns of Greenfield and Winterset (birthplace of John Wayne, seat of bridges-laden Madison County).

At the same time, the rural medical center tends to be sensitive about being perceived as a podunk ‘band-aid station’ by its urban peers. In that sense the hospital is an effective synedoche for a significant aspect of the Midwestern experience: a fear that comfort is a symptom of provincialism, as exacerbated by the Midwestern capacity for joking self-effacement and the default tendency of media to ignore, romanticize, and/or dismiss what happens outside the city.  It’s telling that Cold Turkey – an eminently watchable film prominently involving well-known talent (Lear, Dick Van Dyke, Randy Newman) and in my opinion one of the funniest films of the 1970s – has yet to see an official release on DVD (let alone Blu-Ray or Netflix) and is most readily available through a Youtube channel named “Rarevintagefilms.” Put another way, while small town America is still very much alive in the present, the friendliness-and-apple-pie part of its image has connotations of belonging to an idealized past, creating a dissonance (or at least a pause) when one thinks of the small town and its relationship with advanced technology and (in this case) the drama of medicine.

To be sure,  hospitals in small towns usually don’t have the pressures and excitement you’d find in a big city E.R. In recent years, however,they have begun to intentionally identify and boldly seize on the strengths of their locations. There exists in northern Iowa a friendly unity and rivalry among several expanding medical centers, each striving to serve their communities with high-quality family practice clinics while angling to become regional centers in differing specialty services.

In the case of Clarion’s Wright Medical Center (WMC), the services offered (particularly orthopaedics) are ever-expanding, while the service quality is patterned after what one might expect from a good hotel if it were run by one’s family. People say hello in the halls; staff don’t just point  you where you need to go, they walk with you to your destination. WMC’s$70 million facility is profitable without subsidies, employing several hundred people (in a town of 3,000 and a county of 13,000), including 26 full-time providers and 30 specialists on staff. As a community member it has been a thrill to watch WMC’s ambition and edifice grow, and yet still be able to find my old gym teacher exercising, walking throughout the connections between the hospital and the connected senior apartments.

By now, of course, you’ve no doubt noted another tension at work in this blog entry: one between reportage and commerce. I’m not just biased by hometown pride, but the fact that since 2008 I’ve produced several videos for WMC, beginning in 2008 when I shot one to honor CEO Steve Simonin at a national convention where he was named to healthcare consulting firm The Studer Group‘s Fire Starter Hall of Fame (Steve, incidentally, asked me to evoke Cold Turkey on this project, which was my introduction to the film). This followed with a move to high-definition in 2010, when I made another to introduce the hospital at the 2010 Iowa Recognition for Performance Excellence (IRPE) banquet. In these videos, I worked with WMC’s marketing department, Steve, and the non-profit Wright Medical Foundation to identify goals and then was turned loose to handle all aspects of production, including directing, shooting, and editing. The links below are to my own high definition streams on Youtube; WMC plans to upload lower-res versions to their own website soon.  Music in both videos is by Josh Woodward, a singer-songwriter who’s been kind enough not only to license all his songs under creative commons, but also to make them available on his website in both full and instrumental versions.

Introductory Video – Iowa Recognition for Performance Excellence – Silver Award, 2011

This video was made to introduce Silver Award winner WMC at the 2011 Iowa Governor’s Recognition of Performance Excellence Celebration, held May 5, and was an updated version of the video that played at 2010’s banquet. While no videos played at the 2011 event due to technical difficulties, the Iowa Quality Center has since found a home for them on its website. All interviews with staff, providers, and the CEO were unscripted; I shaped the narrative in editing.

Wright Medical Foundation – Fundraising Video, 2011

While Wright Medical Center makes more than enough revenue to cover its operating costs – including $14 million in improvements currently underway – many of its major expansions have been financed through the generosity of donors.  These include the first hospital building that was constructed in 1951 and expansions in the 90’s and 00’s that built senior apartments, assisted living facilities, and added new equipment that would otherwise not have been purchased. This video is designed to be played live as part of presentations in homes and at larger banquets and events. The interviews with CEO Steve Simonin and patients Kelly and Judy were captured unscripted, while I wrote the script for Foundation representatives Lisa and Duane. The video went through several major re-drafts, driven by the input of focus groups, before we reached the final version linked above.

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But enough words, you were promised photos! Since I shot these videos I’ve added some lenses and upgraded to the Canon 5D Mark II, renowned for its full frame sensor, vivid image quality, and terrible auto-focus system. While I haven’t yet experimented with its video function (which has been used by others to record such projects as the seventh season of House), here are some new pictures that revisit familiar themes. First: some shallow-depth-of-field-friendly portraiture of my friend Angela and her garden, which (the garden) you can read more about  in her blog  “Could the World Be About to Turn?”, which (the blog) covers gardening and the hope of peacefully promoting positive social change and justice, illuminating and embodying numerous regional tensions in her explorations of politics and agriculture:

Next: more life on an abstract plain, more Wright County from the air, in the cautionary words of my my friend Dave “a totalitarian use of land” (a quote I use on this detail-test piece to perhaps balance some of my more Romantic leanings):

Continuing the theme of Midwest-as-abstraction, my favorite of the set:  people relaxing in the middle of the lake, as viewed symmetrically from above, captured on the same flight –

And the city of my current home, Storm Lake, downtown, at night in low light, capturing the anxiety of the photographer over the surprising lack of effort needed to make some subjects look good:

That’s all for now – like I did this time last year, I’m leaving the internet to join one of the most quintessential Iowa experiences: RAGBRAI, the 20,000 person town-t0-town bicycle ride/week-long party that rolls  from the banks of the Missouri River (this year at Glenwood) to the mighty Mississippi (at Davenport).

Pie, beer and 454 miles await.