Laughter echoes down the wide, polished hallway. Four smiling adults in matching T-shirts emblazoned with a hashtag and a child’s name joyfully stride through, a beaming nurse their escort, a bright-eyed infant in a festooned stroller their guest of honor.
The tot is going home today, and from the looks of it, for the first time since he entered this world. His folks fairly skip as they head for the exits.
Twenty paces down that hallway — where blue tiles set into the gleaming floor create a meandering azure river and a bank of tiny lights in the ceiling mimic summer stars — two massive doors swing open. Four adults in matching scrubs and flinty expressions roll a hospital bed and a calliope of monitors across the grain of the corridor.
A half-dozen plastic bags, each the size of a hymnal, dangle and sway with the weight of fluid. They’re tethered, like grim antiseptic balloons, by yards of plastic tubing to a tiny glimpse of a child. The girl is halfway through another day in the life of a critically ill infant. Her caregivers evaporate into a room and all is quiet.
From any spot at Arkansas Children’s Hospital in Little Rock, one can observe human diorama through the lens of alpha or omega emotions, a thousand times a day, every day. You don’t have to go looking for them, they call out to you like laughter from a playground, sear your mind like the wail of a grieving mother. One minute your heart swells with joy for the rambunctious girl in pajamas playing video games, the next it’s in your throat for a sallow, hollow-eyed boy in a wheelchair, looking for the sun.
In the lobby, a man-made stream flows, gurgling, washing over a basin peppered with dozens of sparkling coins, all representing the same wish.
"When I was a summer intern here in 1988, [the hospital] was state-of-the-art of the day then, but it has changed dramatically," says Marcy Doderer, ACH president and CEO. "There was less color then. It was a little more juvenile then, a little more institutional feel than where we’ve evolved today.
"When you walk the halls of Arkansas Children’s Hospital in Little Rock today and Arkansas Children’s Northwest in Springdale, the spaces are designed to ensure that you can capture the personality of the patients we take care of. We specifically look at the spaces and the way the lighting and the art put the patient at ease. You do that with color and art and sound. We have a name for it at Arkansas Children’s: Delight and Discovery."
Doderer, who took over the reins here in 2013, knows there’s much more to operating a world-class children’s hospital than fanciful artwork, piped-in calls of songbirds or televisions chattering with kids programming in waiting rooms. But she doesn’t discount such touches either, given their ability to penetrate the veil of illness. Like everything here, there’s a therapeutic method at work.
"We want kids to delight in the spaces and be able to discover interesting things," Doderer says. "You create a sense of normalcy for them, take away some of their fear, hopefully calm them in a way that meets the 2-year-old’s needs, the 12-year-old’s needs or the 20-year-old’s needs. That is relatively new in children’s health care."
That Doderer went from ACH intern to CEO during the course of her career is noteworthy and explains why, despite having only been in office for five years, she passes for a lifer, so completely is she imbued with the ethos of the place.
And it’s been an effective run, too. In the past 18 months alone, the Little Rock hospital achieved Magnet status, a ranking from the American Nurses Credentialing Center held by less than six percent of hospitals worldwide. Last year, 93 of the hospital’s physicians were designated by Best Doctors, the largest ongoing peer survey in the medical industry.
And in February 2018, Arkansas Children’s Northwest opened, an $80 million, 233,000-square-foot swipe of glass and steel rising out of the Springdale landscape, serving some 200,000 kids across some of the state’s fastest-growing counties.
All of which is impressive, but merely the opening stanza of a strategic plan that looks to transcend simply treating patients to impacting the overall health of the state’s children and families on a systemic level.
"If you look at any national ranking across this country that orders our states from number one to 50, with one being good in terms of child health and well-being, Arkansas ranks in the bottom 10 states," she says. "Some rankings we’re in the bottom five, depending on the year and the metrics used. We find that to be an embarrassing statistic. There are so many great things about Arkansas, why do we want to rank number 45 in child health and well-being?
"When the board of directors hired me, they didn’t want the status quo. They knew about the external pressures in health care and that things are changing. They wanted someone to come in who could create a new vision, build a strategy that we could execute. Something that, at the end of the day, will move the needle on child health."
Dec. 8 | 6 p.m.
Arkansas Children's Hospital
Doderer, a Little Rock Central High grad whose previous career stops have included hospitals in Dallas and Paris, Texas, has tackled audacious plans before. Prior to arriving in Little Rock, she led the effort to transform CHRISTUS Santa Rosa Children’s Hospital into the free-standing Children’s Hospital of San Antonio. And even with the increasing economic pressures brought on by the health care reform maelstrom, she’s confident in ACH’s abilities to be a vanguard in children's health from battling food insecurity to improving Arkansas’ infant mortality rate.
"If we can take a tiny infant and provide it heart transplantation to give it a full and better life, why can’t we also help ensure that a child can reach their full potential when they don’t actually need us?" she says. "Not from an illness and injury standpoint, but from us helping them from an overall health perspective."
But there’s another element to Doderer that defines who she is as a leader and advocate for the children and families that stream endlessly through the doors seeking help, hope and healing. An element that makes the highly complex task of changing the health care continuum in a state of limited means seem elementary by comparison. An element that you only get by clutching a child — your child — against the dark grip of disease.
Katie Doderer, 20, the younger of Doderer’s two daughters, was born with a very rare genetic mutation called congenital central hypoventilation. The condition disrupts her autonomic nervous system, making things that should be automatic anything but. From the time she was born, Katie required a ventilator and other technology, without which her lungs would simply "forget" to breathe or her heart to beat in proper rhythm. Only about 1,200 people worldwide live with the disorder; in underdeveloped countries it's an automatic death sentence.
"Katie’s been in and out of children’s hospitals across the country. I think four or five different hospitals had the pleasure of caring for her in her 20 years," says Marcy, quietly. "My husband and I quit counting after mission number 30, so I honestly couldn’t tell you how many nights we spent on what I call the parent’s side of the bed. But it has completely and totally impacted our life as a family."
Among the ways Katie’s condition has impacted the family is that it inspired her older sister Emily to become a pediatrician; she’s currently in her second year of medical school at UAMS. Like her mom, Emily also interned at ACH and the two experiences have helped to define the kind of physician she wants to be.
"I think I have an extra level of understanding about what the patient and the family is going through compared to a lot of people," says Emily, 23. "Everybody has had somebody in their family that’s sick, but it's different when it’s very chronic and it’s very rare. I’ve seen a lot of really great physicians and how they’ve interacted with us and I’ve seen some really, really terrible ones. I’ve gained a broader view of how I want to treat patients and also how I don’t want to act.
"I think it’s very clear that every single person you talk to who works [at ACH] is there because they feel drawn to work for children and to make sure that children are healthy and happy and well-taken care of. You see that from the people who make the sandwiches in the cafeteria to the nurses to the physicians. Every single person is excited to be there and doing every single thing they do for the kids. And I think that that is incredibly valuable."
As for Katie herself, she’s also had a hand in hospital functions, serving on the hospital’s youth advisory council while in high school.
"There were 10 of us giving input from the teenage perspective about the hospital," she says. "We helped with some of their websites to make them more user friendly. We talked to a room of doctors about what it’s like as a teenage patient.
"A lot of children’s hospitals really focus on the tiny babies and the elementary school kids because they’re the most vulnerable. So we tried to give teenage input, which was a really cool experience giving a little insight around the hospital."
Like any proud mom, Marcy has photos of her girls on her office wall, not only as simple mementos of two of the people who mean the most to her, but as a firm reminder of her mission every single day. It’s part of what inspired her and her husband Mark to chair this year’s Miracle Ball, ACH Auxiliary’s sold-out annual fundraiser gala, setting the audacious goal of raising $1 million in the process.
More succinctly, it directs every single step she takes through the hospital’s whimsical hallways in service of all-too-real families.
"I have spent so many days in a clinic waiting room, in an ER," she says. "Katie spent her first 50 days alive in the NICU. I remember flying with her on medical transport from San Antonio, Texas, to Chicago one time when she was critically ill. It was one of the longest days of my life.
"I’ve watched all that and have literally changed policies because of what it felt like to be the parent and very purposely inserted myself in conversations that the regular CEO might not have. I’d recognize what I was witnessing as I went on rounds in a nursing unit or spent time with a physician that, wait, that’s not going to meet the needs of our families. I think that makes me a better executive. It has made me a better leader for 20 years. It puts life in a very different perspective."