RICHMOND — Sean Elwood Goodale was born at 1:05 a.m. Wednesday, weighing 9 pounds, 8 ounces and measuring 21 inches long.
But he wasn’t born in a hospital, or at the Monadnock Birth Center in Swanzey, as his parents Jessica Maki and Patrick Goodale had planned, and where his sister, Ailey Goodale, was born almost exactly two years earlier. Instead, he was born in the parking lot of the Richmond fire station, welcomed to the world by a team of five first responders.
“We really just had the best of what could have been a scary experience,” Maki, 26, of Petersham, Mass., said Thursday.
Maki called her midwife at 12:24 a.m. Wednesday, about halfway through the roughly 50-minute drive to the birth center. She had gone into labor about two hours earlier, and was checking to make sure she and her husband would arrive around the same time as the midwife.
“And within nine minutes of that call, my water had broke, I felt the baby instantly drop down into the birth canal, and I told my husband we needed to pull the car over and call 911,” Maki said.
They stopped on the side of Route 32, and within a few minutes, Richmond Fire Capt. Spencer Heise, who lives just down the road, arrived.
“At that point, we decided she probably wasn’t going to make it to the hospital, and so we set up for delivery in the parking lot” of the fire station, which was less than a mile away, Heise said.
Heise’s brother, Trevor, a Richmond firefighter, was right behind him, and they met Lt. Rob Skrocki at the station on Winchester Road. Fitzwilliam EMS Lt. Tracey Jess and Firefighter/EMR Jeremiah Lapinsky got there within 10 minutes, and together, they safely delivered Sean, who is named after Maki’s father and Goodale’s uncle.
“It was a first for all of us,” said Jess, who actually delivered the baby. And although none of them had ever assisted with a birth, Skrocki said the team worked well together.
“Overall, we were all just in the moment,” he said. “We knew our roles and what we needed to do, so it was a good team effort from everyone. We all kept our cool and did what we needed to do.”
After Sean was born, he and his mom were taken to Cheshire Medical Center in Keene to ensure they were healthy. They were discharged Thursday afternoon and back home in Petersham by about 4 p.m., leaving Sean’s parents a bit bewildered at how fast he arrived, Maki said.
“But overall, we’re feeling really grateful that it worked out the way it did, where the firefighter was able to get to us so quickly, and we were right near the fire station,” she said. “All of the firefighters and EMTs from Richmond and Fitzwilliam were just absolutely amazing, and so calm.”
And for the first responders, Skrocki said Sean’s birth is a perfect example of what makes their jobs worthwhile.
“I don’t think any of us when we went to bed that night expected to wake up in the middle of the night to deliver a baby in the parking lot of the Richmond fire station,” he said. “But calls like this are certainly rewarding, and we were happy to be in the right place at the right time.”
With the state’s tight rental market, and affordable apartments hard to come by, Keene’s housing authority is offering new incentives for landlords in the area to rent out to tenants with housing vouchers.
Since late August, Keene Housing has offered one-time, $1,000 payments to landlords who are renting for the first time to people with vouchers, and a one-time $500 payment to a landlord who’s leasing to a voucher holder again.
Housing choice vouchers help lower-income people pay their rent in the private market.
“We’re hopeful that this owner incentive might make it a bit easier for voucher holders to compete with people who are able to come up with a first and last, and, ‘Hey, here’s another’s month’s rent,’ just to get in the door,” said Josh Meehan, executive director of Keene Housing.
So far, four landlords have signed up for the new incentive program, and earlier this week, Meehan got another promising call.
“And what’s particularly wonderful about those two calls is that it was a studio and a one-bedroom,” he said.
There are about 20 people in Keene who have a voucher, waiting for a one bedroom or studio apartment to open up. Meehan says that the utilization rate of these vouchers is at an all-time low.
“It’s not due to anything other than folks not being able to find a place to live with their voucher,” he said.
According to a recent report from New Hampshire Housing, the median rent for a one bedroom in Cheshire County is a little more than $1,000, and that just about a quarter of two-bedroom apartments in Cheshire County are below affordable rent.
“The dearth of units is really remarkable right now,” said Meehan.
New Hampshire is the only state in New England that doesn’t ban discrimination on the basis of someone’s source of income, according to the Poverty and Race Research Action Council. That means in some cases, landlords explicitly state that they don’t accept housing vouchers.
Previous reporting by NHPR found that in the last decade, the number of subsidized housing units across all of New Hampshire — including traditional public housing, Housing Choice Vouchers and other programs — has grown by fewer than 600 units, according to data from the U.S. Department of Housing and Urban Development.
Cheshire Medical Center plans to launch its residency program for new family-medicine doctors in 2024, hospital officials said Thursday.
And that training program — intended to boost the number of local primary-care providers — is just one part of the Keene hospital’s vision for expanding its services and strengthening health care in the region.
Dr. Don Caruso, Cheshire Medical’s president and CEO, and other officials described that vision in an interview with The Sentinel’s editorial board.
It includes expanding to a recently purchased property on Maple Avenue, which will house the residency program along with other services relocated from the hospital’s main Court Street campus. That, in turn, will free up space to expand clinical services on Court Street, including building up the hospital’s surgical capacity.
Caruso said he expects it to be a five-year, $100 million project.
Caruso said he sees Cheshire Medical Center as having two key roles: serving the health needs of Cheshire County and providing more specialized and higher-level care than is possible at smaller nearby hospitals like Monadnock Community Hospital in Peterborough or Valley Regional Hospital in Claremont.
By expanding, Caruso said, Cheshire Medical will be able to offer more services to patients in Keene, sparing them a trip to Dartmouth-Hitchcock Medical Center in Lebanon or an ambulatory surgery center in Concord.
“When we look into the future, we said we need to build on those two expectations,” Caruso said. “One is to take care of the community. The other is to really help support the region for the higher-end care that’s here, or that’s needed.”
Kathy Willbarger, Cheshire Medical’s chief operating officer, said that as executives searched for a facility to house the family-medicine residency, they realized they should think bigger.
In May, Cheshire Medical purchased the former Peerless Insurance building on Maple Avenue in Keene for $4.6 million. When they first saw it, she said, hospital officials thought it was way too big — more than 140,000 square feet, compared to the 25,000 they needed for the residency program.
“You step back, and you think, ‘But what if? What if we could make this work?’ “ she said. “And then our teams here were thinking about, ‘OK, where do we have this huge demand that we can’t meet because we don’t have the space? And what if space was not an issue?’ ”
They soon realized, she said, “We cannot not do this. Our community needs this now, and we know that if we need this now, with an aging community, that demand is going to increase even more.”
Cheshire Medical has engaged a consultant to evaluate its facilities, and plans are still preliminary. But Willbarger and Caruso said the biggest needs include expanding and modernizing the operating rooms, which were designed decades ago and are no longer big enough to handle all the demand and house the latest technology.
That, in turn, can be a barrier to recruiting — for example, urologists today are trained to use robots for surgery.
“We need a robot at Cheshire Medical Center,” Caruso said.
With more space, the hospital could also build up its in-demand orthopedics practice and develop the capability to do spinal surgeries on site, rather than sending patients to Dartmouth-Hitchcock Medical Center, Caruso said.
Officials are also considering putting an ambulatory surgery center — for procedures that don’t require an overnight hospital stay — at the main Cheshire Medical campus. That’s important partly because insurance companies prefer to pay for procedures at ambulatory surgery centers rather than hospitals, forcing some patients to travel to Concord or elsewhere, Caruso said.
But the Court Street campus has no extra space, officials said. To free up room for more clinical services, the idea is to move some functions that don’t have to be there to Maple Avenue. That could include physical therapy, pediatrics and some administrative offices, Willbarger said.
Caruso said the space for the residency program should be ready by October 2022, around the time the program’s director is slated to begin. (To get a residency program up and running and credentialed, he explained, the staff has to be in place 18 months before the first class of residents starts.) The hospital has also begun recruiting the other five physicians who will help train residents.
The timeline for the other components is still being worked out, Willbarger said.
Caruso said the new residency program will address a critical need: a shortage of local primary-care physicians. That has made it hard for patients to access care — even for hospital CEOs who happen to be family doctors.
“It’s really hard to get into primary care,” he said, “even for myself.”
Caruso said Cheshire Medical has the equivalent of 10 full-time, primary-care physicians plus additional nurse practitioners. Willbarger said those primary-care doctors each carry a slate of about 2,300 patients on average, when national standards are around 1,600 to 1,800. Caruso said he thinks a total of about 30 primary-care physicians are needed.
Each year, the three-year residency program will take six residents — newly graduated doctors who practice medicine while continuing their training under more experienced physicians — for a total of 18 at any one time. The residents will each see their own patients, as will the academic attending physicians who train them.
Ultimately, the aim is for many of those newly trained doctors to stick around the Monadnock Region long term, Caruso said, citing statistics showing that more than half of family-medicine graduates stay within 100 miles of their residency to practice.
“Which is really, really important for us in terms of getting that cadre, growing them, having them know what it’s like to practice in a rural community and then staying here,” Caruso said. “And that’s really the goal of what we’re doing.”
Much of COVID-19’s fallout has gotten a lot of attention: Mental health complaints are up, students have fallen behind, burned-out health care workers are leaving the field. This hasn’t: The state has seen a surge in its reports of Internet crimes against children, doubling from about 50 to 100 per month.
“We’re basically telling the entire United States of America to stay home all day and be on your electronic devices,” said Deputy Kevin Furlong of the Merrimack County Sheriff’s Office. “So, you have the victims that are on the computers more, but you also have the offenders that are on computers more.”
New Hampshire is not alone.
The National Center for Missing and Exploited Children saw reports of online “sexploitation” increase nearly 98 percent in 2020, according to the center’s website. Most of the time, offenders are known to victims and include parents, guardians, other relatives, babysitters or coaches, or family friends, according to the center.
Merrimack County Sheriff Dave Croft recruited Furlong, who has years of experience working these types of cases, away from his job as Mont Vernon’s police chief in response to New Hampshire’s surge.
Furlong is helping small local police departments that have limited resources investigate tips coming in from online platforms like Snapchat and Kik, and people who see suspicious activity online. They are most often reporting people sharing explicit photos and videos of children, but there are also reports of adults trying to entice children to share images of themselves or meet in person.
“The (police departments’) concerns were … they just don’t have the manpower, don’t have the knowledge or the skill level, and don’t have the equipment needed to really dig deep into the weeds with this thing,” Croft said.
Furlong’s hire adds Merrimack County to the list of affiliates working with the state’s Internet Crimes Against Children Task Force. Adults seeking guidance on protecting children from online predators can find a video on the task force website.