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Health Care on the High Plains

Published July 2021 | In Summer 2021

A Physician Assistant, Registered Nurse and a Patient Access Specialist who doubles as an EMT are meeting the health care needs of South Dakota's most isolated county.

Health Care on the High Plains Media

Mention Brady Thompson to pretty much anyone in Buffalo, and they’ll respond with a smile. Everybody knows this pint-sized 7-year-old, and they agree he’s a character.

Brady lives on the family ranch southwest of town with his parents, two older sisters, a dog, a cat and three goats. He’s outgoing, talkative and has a fondness for spicy food – the hotter the better. He can talk ranching like an old timer, but when asked to pose for a photo inside the goat pen, Brady firmly replied, “Ah, no.”

“He has kind of an old soul,” said his mom, Terisa Thompson. “His teacher told me he thinks the other kindergartners are too noisy. He’d rather sit down over a cup of coffee and talk about life.”

“He’s so cute. He carries hot sauce everywhere,” said Crystal Page, the physician assistant at Monument Health Buffalo Clinic. She has cared for Brady for much of his young life.

It’s a childhood that almost didn’t get this far. Brady was born with hypoplastic left heart syndrome, a rare condition in which the left ventricle is underdeveloped. Before he was 3, Brady had undergone open heart surgery three times, the first when he was just two days old.

Not long after returning home from the third surgery, Brady started crying and grabbing at his chest one afternoon. The family called 911. His dad, Mac Thompson, scooped the child up and they headed for help. By the time they made the bumpy 7-mile drive to the nearest paved road, Brady was completely limp.

When they reached the highway, Crystal Page, PA-C, and Jennie Glines, RN, of the Buffalo Clinic were there to meet them. They stabilized Brady’s condition and made sure he was ready for the 80-mile ambulance ride to the hospital in Spearfish.
 

It means that the left side of his heart didn’t fully develop before birth. The right side pumps blood to the lungs, but the left side can’t properly pump that oxygen-rich blood to the rest of the body.

Brady pulled through, but still needs regular medical care. Along with a list of other medications, he takes blood thinners that require regular blood tests.

At one point early in his illness, Brady’s parents seriously wondered whether the Thompson family could stay on the Harding County ranch that has been in Mac’s family for more than 100 years. Fortunately, the three-person staff at Monument Health Buffalo Clinic provides a surprising breadth of medical services for Brady and his neighbors throughout the Buffalo area.

Wide Open Spaces

Harding County, in the far northwestern corner of South Dakota, is about as rural as you can get. With 0.47 people per square mile, it’s South Dakota’s least-densely populated county, and the 24th least-densely populated in the United States. But the rolling prairies, sweeping views and quiet serenity offer an attractive lifestyle for Harding County’s 1,200 residents.

Buffalo — population 350 — has a selfsupporting downtown business district. There’s a SuperValu grocery store on Main Street, a few doors down from Buffalo Hardware and Lumber. Buffalo also has convenience stores, a handful of bars and restaurants, a modern school that hosts grades K–12, a bank, a couple of churches and a post office. Tucked away on Ramsland Street a block north of Main Street is the Monument Health Buffalo Clinic.

Staff at the Monument Health Buffalo Clinic consists of Crystal, a physician assistant, Jennie, a registered nurse, and patient access specialist Ann Parfrey. Ann is also an emergency medical technician, which allows her to assist with checking patient vitals and other clinical duties.

Part of the Community

On a recent Thursday afternoon, the clinic waiting room had a handful of patients, including Steve Pemble, who was stopping in for his COVID-19 vaccination. Steve joked with Ann before heading back to get his shot. The COVID-19 vaccination is a good example of the importance of having health care close to home. Spearfish is a three-hour round trip; a long drive for a shot that takes fewer than 20 minutes.

It helps that Crystal, Jennie and Ann are woven into the fabric of the Buffalo community. Crystal grew up in Nebraska, and Jennie is from Spearfish — but they are married to Harding County natives. Crystal has four school-age children who attend Harding County School. Jennie’s two kids are not old enough for school yet. Ann’s three grown children completed school here.

Crystal, Jennie and Ann know the families, attend school events, go to football games – occasionally opening the clinic on a Friday night to X-ray a football injury. They are active in the community and well-known.

It's one of the lowest population densities of all counties in America. By comparison, the Island of Manhattan has almost 70,000 people per square mile.

Meeting the Needs

The Buffalo Clinic is fairly well-equipped. Monument Health recently installed a new X-ray machine, and the lab has an Abbot ID Now analyzer for diagnosing COVID-19. They can also process several lab tests inhouse, including analysis of blood samples for heart patients like Brady. Tests that can’t be processed in-house are sent to Rapid City Hospital, usually with a one-day turnaround.

“We have to be well-equipped,” said Crystal. “Otherwise, what’s the point of having a clinic?”

The team works closely with the ambulance service. In fact, there are times when they’ve had to close the clinic so Ann, Jennie and Crystal could respond to a serious automobile accident. “When things like that happen, patients with appointments are gracious about rescheduling,” Crystal said.

Favorite Patient

When Brady Thompson stops by the clinic, hot sauce in hand, he brightens everyone’s day, Crystal said. On a recent visit, Jennie told him that Cheetos has a new Cheesy Jalape o Mac ‘n Cheese. His eyes grew wide, and he turned to his mom and said, “We need to get that!”

Apparently a fondness for spicy foods is not unusual for youngsters with hypoplastic left heart syndrome, according to Terisa.

How else can you explain that a 7-yearold’s favorite snack is bread dipped in Tabasco sauce?

In addition to the rural clinics in Belle Fourche, Hill City, Hot Springs and Wall, Monument Health also runs critical care hospitals in Custer, Deadwood and Sturgis.