With him on this special day was his wife of five years, Frances, an elementary teacher from Clarion, IA. In the backseat were their three kids: Fay, three; Paul, two; and myself, nine months. Roy “Paparoyo” Fell graduated from Des Moines Still College of Osteopathy and Surgery, Class of 1954, and had just completed an internship at Des Moines General and Broadlawns hospitals.

As a DMU alumnus myself, I was part of his remarkable journey as was he a huge part of mine. He died on Feb. 20, 2011, at 87, a mere seven months after his wife of 60 years passed at age 82. The highs and lows of his 30-plus years as a rural medical professional offer insights into the chronic difficulties of finding and training future rural medical providers.

Dad didn’t see it coming, but throughout his career he would also need to become a recruiter. Upon his arrival in Mount Ayr, there was no big shortage of medical staff. The Ringgold County Hospital was relatively new. As he settled his family into this beautiful town, however, a few hurdles began to arise. The local bank was reluctant to risk money to help start a new medical practice. The medical staff required an initial test period prior to hospital staff privileges being granted. Dad was granted privileges at a hospital 30 miles away; soon his inpatient practice became busy enough that the Mount Ayr hospital changed its requirements and granted him local access before his test period was over. To make financial ends meet, he shared a small office with another general practitioner.

Residents learned of Dad’s passion for helping others, his interest in obstetrics and his great OMM skills. He shared his leadership skills, positive outlook and moral compass as a volunteer on the school board, in church, at a local group home and on other community projects. Soon he needed a larger office to keep up with his popularity. Eventually, he built a larger clinic. He regularly saw 50 patients a day, and often as many as 100 checked in for the day. He continued a busy OB practice, made house calls and even found time to add three more kids to his family.

I didn’t realize it at the time, but we kids became his biggest challenge. Mom was his office manager and, as our sports activities became more frequent, Mount Ayr became our “village.” At Mom’s funeral, Dad – after sharing his sadness of his sweetheart’s passing – thanked the community for keeping an eye on his kids all those years.

According to the Office of Rural Health Policy, 25 percent of Americans live in rural areas, but only 10 percent of American physicians do. How can we encourage and prepare future health care providers to embrace the challenges and rewards of rural medicine?

As physicians retired or left and Dad’s “call” went from every four nights to every other night, we saw him even less. One way we got to spend time with him was going on house calls with him. With this new shortage of providers, his work took even more time as he stepped up his recruiting efforts. Many came and many left, but a few began to stay. He often said that you really couldn’t learn to do rural primary care unless you were from a rural area. Then you needed to possess a strong passion for taking care of others, a commitment to keeping them healthy and happy and the ability to encourage people to remain productive as long as possible.

I told Dad about DMU’s rural medicine educational pathway program and the Iowa Area Health Education Center Program, established to recruit and retain Iowa’s health care workforce. Of course he already knew about these and encouraged me to keep looking for young people who would consider committing to rural practice. He also knew that I’ve been involved in interviewing potential D.O.s at DMU and that I look for his qualities in all of them. I don’t think any less of these bright, unique applicants when I don’t see those qualities, but when I do, I get very excited.

Dr. Fell died as an inpatient at Ringgold County Hospital, a new hospital that opened in the past year. Once again there’s no real shortage of primary care providers in Mount Ayr. Dad was very proud of this increase but disappointed a woman still must drive 30 miles to have a baby. We and the malpractice attorneys must work on this.

D.O.s from the “greatest generation” removed many hurdles for us to practice alongside our allopathic colleagues. A remaining hurdle will be recruiting and training the most capable and likely people to enjoy the challenging lifestyle of rural medicine.

John Fell, D.O.’88, is a retired physician and founder of One Fell Swoop Problem Solving in West Des Moines.

Kelly Thomason, PA-C'05

In the early part of this century, Kelly Thomason, PA-C’05, was juggling a lot. She graduated in 2003 from Iowa State University with majors in business and marketing and minors in biology and Spanish. She married husband Patrick, enrolled in DMU’s physician assistant program and launched an event design firm, Bella Flora, in Urbandale, IA. When daughter Grace was born in 2007, Thomason found herself juggling motherhood with the business and her dermatology practice.

Something had to give.

“It was bittersweet. I really love medicine, and I miss it,” she says. “But we’ve been able to grow the business every year, even in this recession.”

Bella Flora indeed has bloomed. From corporate parties to fundraising galas to weddings, holiday celebrations and other events, Thomason and her crew manage all the mind-boggling details – flowers, lighting, centerpieces, “tablescaping” and more – all to fit specific budgets, quirky tastes, unforgiving deadlines and inevitable last-minute changes. They offer one of the largest collections of linens in central Iowa. Typically managing multiple events at any given time, the staff have to turn away more than half of their callers. They’re outgrowing their space.

“It can be a crazy job, but I love the balance of business, creativity and motherhood,” Thomason says, calmly cradling month-old son Grant amid the firm’s colorful tableau of tables, covered chairs, centerpieces, partyware, pedestals, fabrics and flowers. Among other events, Bella Flora created the eye-popping floral arrangements for the inauguration of DMU President Angela Walker Franklin.

“It’s a great sense of accomplishment when we’ve carried a large event a long way,” Thomason notes. “When you see a big weekend come to a successful close and things went well, it’s very satisfying.”

The Messenger family: Caden, Andy, Mya, Avery and Dana.

Dana Jacob Messenger, D.O.’04, knew she wanted to be a doctor since elementary school, when her mother, Joan Jacob, found her dissecting a grasshopper with a box cutter. She and her husband, Andy, also knew they wanted to have children. Perseverance made both goals possible.

Messenger says a rotation in obstetrics and gynecology showed her the field offered the “perfect mix of the excitement of delivering babies to the next day seeing an older patient with whom you’ve developed a relationship.” She set her sights on the four-year ob/gyn. residency program at the University of Iowa. The challenge: No D.O. had been accepted into the program before.

“I knew several physicians who’d gone through the program and was impressed by them,” she says. “But it wasn’t the easiest road.”

While striving to overcome any misconceptions about D.O.s among her M.D. colleagues, Messenger – who’d struggled to become pregnant – gave birth to her first daughter, Mya, 10 weeks before her due date. She credits her ability to survive “that drama” to her and Andy’s supportive families nearby, the preparation she gained at DMU and her own will power.

“Let it be an inspiration to all that you can have it all if you stay at it,” she says.

Messenger hopes to share that inspiration as a new DMU alumni mentor for current students. She’s happy that since she completed her residency, two more D.O.s entered the program. Now the mother of three – with Mya, now five, Caden, three, and Avery, two months – she was thrilled in March to be named a partner at OB-GYN Associates, P.C., in Cedar Rapids, IA, where she’d practiced for two years.

“I’m so thankful for my training and opportunity that DMU gave me,” she says. “I love my career. The group has welcomed me with open arms, and it’s so much fun taking care of these awesome women.”

DMU alumni Ashlee Mickle Brozak and Shannon Brozak, with Ashlee’s parents Gwen and Jack, made sure her brother, Aaron, had a role in their wedding.

On Dec. 4, 1994, 12-year-old Ashlee Mickle and her brother, Aaron, 16, had taken off their seatbelts for a more comfortable snooze in the backseat of their parents’ car after a family skiing vacation. Their parents, Gwen and Jack, were teachers who loved traveling and camping during school breaks. That all changed that Sunday afternoon, when another driver crossed lanes to pass the vehicle in front of her. She hit the Mickle family head-on at 60 miles per hour.

Ashlee was the least injured member of the family, with a dislocated left hip and cracked pelvis. Gwen’s neck was broken at the fourth and fifth vertebrae; Jack sustained a bruised heart and lungs with many crushed bones. As bad as all that was, Aaron suffered worse: His traumatic brain injury put him in a coma for seven months.

Suddenly, the Mickles’ social network became a lifeline as they recovered from their injuries.

“My family was in the hospital until mid-February,” says Ashlee Mickle Brozak, D.P.T.’09. “I had to grow up fast.”

Ashlee and Aaron grew up in Colorado Springs, CO, adoring each other, Gwen says, although their personalities are very different. Born prematurely, Aaron was slow to walk, talk and develop fine motor skills; he started kindergarten unable to hold a pencil. Ashlee, on the other hand, was independent.

“She learned all the skills I was working on with Aaron when she was only a toddler. She dressed herself, made her own lunch and became her brother’s model and protector,” recalls Gwen, a retired music teacher. “When they were in elementary school, I had one child in remedial class and one in gifted and talented.”

Ashlee’s fearless determination helped Aaron overcome his fears while skiing, motorcycle riding and playing in the ocean. That combined with overcoming his early developmental challenges, Gwen says, helped prepare him “for the very long journey of working through traumatic brain injury.” In turn, his post-coma fight to regain some mobility at Craig Hospital in Denver, a facility exclusively dedicated to spinal cord injury and traumatic brain injury rehabilitation and research, inspired and influenced his sister.

“Even in his coma, he had physical therapy,” says Ashlee, who worked with a physical therapist on her own recovery. “When he stood up in the parallel bars and walked for the first time, I got it in my brain that that’s what I wanted to do.”

Aaron’s long journey involved countless small steps – being able to open and close his eyes on command; moving his wheelchair by himself a single inch; laughing at a joke because he understood it; learning to communicate using an Alphasmart computer. He now lives in a group home in Colorado Springs.

Aaron and Ashlee before the collision that changed their lives.

Ashlee is a physical therapist with Mayo Clinic Health System Franciscan Healthcare in an outpatient clinic and transitional care unit in Sparta, WI. “With people who are struggling from stroke or injury that is life-changing, I feel I’m able to connect on another level given what Aaron and my parents went through,” she says. “I believe from our experience, we’ve grown closer as a family. It’s made me a better person.”

The family made sure Aaron was in Des Moines for Ashlee’s graduation from DMU, and she made sure he was part of her wedding last year to Shannon Brozak, PA-C’08, who practices at Gundersen Lutheran Medical Center in La Crosse, WI. While the family had planned to transport Aaron in his wheelchair, he “had been practicing really hard to walk with his walker,” Ashlee says. “He was able to walk partially down the aisle for me.”

“Over the years I have been proud of my children for their many accomplishments,” Gwen says. “But I have never been as proud as when Aaron walked, albeit with assistance, down the aisle at his sister’s wedding.”

Todd Capistrant dons serious cold-weather gear for dog-racing.

Todd Capistrant, D.O.’97, grew up enthralled by American author Jack London’s stories of men and animals against the environment and survival amid hardships. Growing up in St. Paul, MN, he embraced winter. Still, that doesn’t fully explain why he and his wife, Anne, in 1996 responded to a classified ad posted by a Wisconsin teacher with a sled dog team for sale.

“We picked up the team not knowing anything about dog teams, but we were living on a little farm so had the space,” he says.

Which also was unusual, in that both Todd and Anne were city kids. In addition, Anne grew up in Madison, WI, terrified of dogs. So perhaps it’s their love of science and the outdoors that explains it. The couple met at the Itasca Biological Station in northern Minnesota where Todd was finishing an undergraduate degree in biology and Anne was doing research for her Ph.D. in ecology. When he moved to Des Moines to attend DMU, their aging black Labrador, Kizzy, stayed with Anne, then teaching biology at Dana College in Nebraska.

“He began following her around and did wonders to erase Anne’s fear of dogs,” Todd says.

Apparently so. Not only did they later establish a “hobby farm” with pigs, poultry, rabbits and a huge garden in northern Minnesota, they founded and began expanding a kennel, Hoof ‘N’ Woof Sled Dogs. They traveled to Alaska several times to train their dogs. They eventually bought some Alaskan huskies from top mushers – the human component of a sled dog team – who’d competed in the Iditarod, the most famous of all sled dog races.

“We figured if we were going to get into this, we might as well buy good dogs. It’s kind of like trying to breed an NFL football team,” Todd says. “Running the Iditarod was a dream. Owning a dog team and running them was an achievable part of that dream.”

The couple attended seminars to learn all they could. Todd’s medical background and insights on how human marathoners eat and train helped. “The maintenance of the dogs’ health is so important to the team but also to the sport of sled dog racing,” he says. “You can’t just buy a bag of dog food off the shelf, feed it to a dog and expect it to run 100 miles.”

In February 2002, Todd and the Hoof ‘N’ Woof dogs made their debut in the Norman Vaughan Serum Run, a dog mushing expedition that commemorates the mushers who delivered life-saving diphtheria serum to Nome, AK, in 1925. Later that winter he raced in the Denali 300, placing sixth.

Grace, Anne, Rose and Todd Capistrant celebrate at the finish of the 300-mile Copper Basin race in 2003. Notorious for bad weather, the race that year averaged temperatures mostly 20 degrees below zero and, on some nights, 40 degrees below zero.

The couple returned to Alaska in 2003, when Todd raced in the Copper Basin 300, the Knik 200 and the stuff of legend, the Iditarod. To help raise money for his participation, the Capistrants produced t-shirts with the phrase “Embracing Dreams” on the front.

“We often visited middle schools with that message,” Todd says.

The historic Iditarod covers more than 1,150 miles of Alaska’s roughest, most beautiful terrain, from jagged mountain ranges and frozen rivers to dense forest and desolate tundra.

“You’re immediately in a special group of people if you qualify for the race. Fewer than 700 people have finished it. More people have reached the top of Mount Everest,” he says. “The time, energy and effort it takes to get there, plus the bond you have to have with your team, are major. You go through some pretty alarming terrain and extreme emotional highs and lows. You go through one stretch and everything’s perfect, then you wake up the next day and your best dog is hurt and you’re feeling at the bottom.”

He knows what he’s talking about. The year 2003 brought a “horrible season” for dog-sledding, Todd says, with more rain than snow. His dogs became sick, forcing the team to scratch. Still, by then the Capistrants felt connected to the dog-racing world. He ran the Iditarod in 2004 and Anne completed it in 2008; each finished, coincidentally, in 66th place.

“It’s a huge, amazing experience,” Todd says. “It took us years to build to that level, then once you’re in it, it’s surreal, running out of downtown Anchorage with all these people screaming and yelling at you.”

Dog-sledding daughters Rose, 11, in bottom and Grace, 9, above have embraced the sport and all its responsibilities.

It was during that trip that the Capistrants decided to go whole-dog: They moved Hoof ‘N’ Woof and their two daughters, Rose and Grace, to Healy, AK. These days, with their kennel of 30 dogs, they run two or three teams per day, starting with three miles and then building up to 100 miles in a season.

“It’s an all-encompassing life. You’ve got 30 dogs clamoring to go out for a run,” Todd says. “You can’t just take one dog on a walk.”

The couple does much more. Twice a day, Anne milks their 11 goats, turning the results into cheese. She cures bacon from their hogs and home-schools the girls, now ages 9 and 11. The couple makes wine and beer as well as honey from the bees they keep.

And then there are Todd’s other jobs, as director and board member of Tanana Valley Clinic, 90 miles away in Fairbanks, and regional dean for Pacific Northwestern University. In 2010, he became the second physician in the U.S. to become certified to

Rose Capistrant

teach seminars on the fascial distortion model (FDM), an anatomically based perspective for envisioning and treating orthopedic injuries and other medical conditions. He’s presented on it at DMU, around the United States and this summer at the FDM World Congress in Austria.

Above, Grace and Rose enjoy warmer weather in Maryland. They accompanied their father to a conference where he presented on the fascial distortion model of treatment.

“FDM has become a huge part of my medical career,” says Todd, a recent recipient of the Northwest Osteopathic Medical Foundation’s Rising Star Award. “It’s a really powerful tool we’re trying to get into the hands of more people.”

Doing so is a challenge with his practice and the family’s “all-encompassing life” of canine mania. Todd is proud their daughters have “really embraced it.” The girls likely are inspired by their parents’ example.

“Getting that first team of dogs was all about following our dreams. What other people thought really didn’t matter to us,” Todd says. “I didn’t want to reach a point in my life only to look back and wish I had done the Iditarod or purchased that first dog team…By setting goals and reaching for them, we have been able to be very successful and blessed here in our lives.”