Investing in Community | Butler Stories
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Investing in Community

Marc D. Allan MFA ’18

After 20-plus years as a cardiologist, when he could be spending retirement on a beach somewhere overlooking the bluest water, Dr. David Dageforde '70 instead is working to improve the physical, spiritual, psychological, and social well-being of residents in the west Louisville neighborhood of Shawnee.

He's inside the Shawnee Christian Healthcare Center—a clinic he helped start in 2011 and whose board he chairs—showing visitors the medical exam rooms, the expanded space for mental-health counseling, and the offices and desks for the staff of around 30 and volunteers that include his wife, Emily '73.

There's also the new dental clinic that's a couple of doors down, a garden across the street that local residents can use to grow their own vegetables, and three clinics the center runs at neighborhood schools.

"I read a book that said: 'Take care of all the health and do nothing for the villagers and you've gained nothing. Give the villagers all the community help they need but don't take care of their health and you've got nothing,'" Dageforde said. "So we do medical care and community engagement."

Approximately 18,000 residents live in the Shawnee neighborhood. More than 60 percent live at 200 percent or less of the federal poverty rate. In 2017, the clinic will have served about 4,000 patients—1,000 more than the previous year.

"A lot of us have been in this community for 50 years or more and have been involved in community service," said Loueva Moss, who's both a patient and a Shawnee Center board member. "Dr. David has taken us to another step."

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Dageforde grew up in Anderson, Indiana. In ninth grade, he wrote a paper about three potential careers for him—the three M's, he called them: Medicine, music, and minister.

As a junior in high school, he gave a sermon. "It stunk, and I thought I could never do that." When he got to Butler in 1966, he was in the band for one semester. "I thought I was good till I heard other students practicing. I thought I'd end up teaching flutophone in a cornfield somewhere. So pre-med became an easy choice."

And the Butler professor who showed him the way forward—"The man who changed my educational life"—was H. Marshall Dixon, who taught Theoretical Physics. Dageforde took that course during sophomore year, and he memorized everything he thought he needed to know for the first test.

He got a C.

He remembers Dixon saying, "David, you haven't learned how to think. I'm going to teach you how to think."

Dixon asked questions that weren't in their notes. He would say, "David, maybe I didn't discuss it in the notes. Maybe none of it applies to the equations that you memorized. But maybe if you think of the equations, maybe you can think this thing through and project an idea and then put it together."

"He opened up my whole mind," Dageforde said." Memorizing, which is a lot of what medicine is, isn't always the way to go forward. It's to think."

While Dageforde was learning that, Emily '73 was in Kingsport, Tennessee, where her father worked for American Electric Power Co. One summer, his company had a marketing meeting in Indianapolis. Butler was on the tour of the city.

"It was different," she said. "A lot of my peers in high school would go to the University of Tennessee in Knoxville or to girls' schools in Virginia. That didn't interest me at all."

She came to Butler to study Home Economics with an emphasis in Merchandising and Textile Design, planning to work as a buyer. The night her parents dropped her off, she attended a campus mixer where a senior walked up to her and said, "Let's show 'em how to dance."

Nine months later, they were married.

David went on to the Indiana University School of Medicine while Emily finished up at Butler.

"I know I got a great education at Butler," she said. "It was a great start to a life. I would do it again. My reason for wanting to go there was to step out of my comfort zone, step out of the little box you sometimes get put in, and go somewhere where you could try new things, meet new people, and have new experiences. Butler helped me along with that."

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After David finished his residency at Baylor College of Medicine and fellowship in cardiovascular disease at Georgetown University, the Dagefordes moved to Louisville in 1979. He loved interventional cardiology and being part of CardioVascular Associates, a huge practice of 250-plus staff that included 20-plus doctors. He thought he'd do that until he was 70. Emily, meanwhile, earned her MBA at the University of Louisville.

Then, in 1994, David took his first overseas medical mission trip to Ethiopia, where he met missionaries Ray and Effie Giles.

"They transformed my life," he said.

Dageforde was impressed and affected by the Gileses' work and how they could do so much—handling cases of typhoid, malaria, and rheumatic fever—with relatively little. At the end of that first trip, Ray Giles told Dageforde, "He who drinks from the African stream will always return."

David realized that giving money to his church and having Emily give her time teaching Bible study was not enough.

He returned to Louisville and immediately resigned as Practice Manager to work part time and devote himself to medical missions. Four years later, he quit outright, at age 52. He, Emily, and their children, Sean and Leigh Anne, subsequently went on multiple mission trips to Africa and Romania, and he's been to China, India, Guatemala, and Thailand.

Then in 2005, someone showed him the healthcare statistics of west Louisville. "It was as bad as what you see overseas," he said. Shawnee had no primary care doctor; cancer rates twice as high a rate as where the Dagefordes live, 11 miles away; and heart disease two and a half times higher.

He decided to develop a Christian healthcare clinic in the neighborhood. They got together like-minded people and neighborhood residents, many of whom were skeptical.

"I thought it was a real far-fetched idea," said Rudy Davidson, a Shawnee Christian Healthcare Clinic patient and board member. "What really convinced me was his commitment to the effort. He believes in what he's doing to the point that he worked his ass off. I'm going to say it just like that: He's worked his ass off to make this thing work. We'd get 10-page emails at 3:00 AM explaining this and that. But all of that is what it took. He mobilized a lot of people and got the resources."

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The clinic opened in 2011, thanks to financial support from Louisville-based Norton Healthcare and Southeast Christian Church, donated construction work by a fellow church parishioner, significantly reduced rent from Tony French, the owner of the neighborhood strip mall, and the efforts of dozens of volunteers.

But from 2011–2015, the operation struggled financially. "I maybe quit being chair 200 times, 400 times," Dageforde said. "We got down to our last $30,000 once," and there were times that he had to cut staff. The board would draw Dageforde back.

"I was concerned about his physical health because I could see the strain on him," board member Loueva Moss said. "What turned it around was getting resources—getting federal money, writing grants, plus the community buying into the concept and coming for care."

The federal money came when the Shawnee Center was designated as a Federally Qualified Health Center. Phyllis Platt—who started as a volunteer with the clinic and became its CEO in 2015—wrote the grant that brought in more than $600,000, about 40 percent of their budget. The remainder comes from patient fees ($25 and up, depending on a person's ability to pay), other grants, and donations.

Platt said she always felt confident that the clinic would grow and thrive because "when the Dagefordes are in, they're all in."

"Once he made the commitment, he was really invested in thinking about it all the time, talking to the right people all the time, being wherever he needed to be all the time," she said. "I think just to see their generosity in time and effort—Emily doesn't need to come here two days a week and call patients who don't show up for appointments—but it's another example of the willingness to give and to be invested on every level in a project that's obviously very dear to them."

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In the past year, Shawnee Christian Healthcare Center has expanded from 2,600 square feet to more than 6,000. It's added mental-health counseling and plans to add a second doctor and dentist. The budget for 2018 will be around $2 million, including a federal grant of $800,000.

"The exciting part is how much we've become part of the community," Platt said. "Every day, we have the ability to impact individual people but also the potential to change a neighborhood."

Board member Rudy Davidson said the neighborhood is, indeed, changing. The strip mall where the clinic is located is starting to attract others businesses, and there are a Pizza Hut and a Dollar Store opening nearby.

"The center gave community people a sense of confidence—something they could see instead of just talk about," he said.

On a typical day, the Center's entryway is bustling. Hallways are crowded with patients and staff moving back and forth. Patients often know each other because they're from the community, so if you're in the lobby—and especially if there's a baby—the Center turns into something of a community gathering place.

In many cases, the clinic is seeing patients for medical needs. But not always. Often times, the people who come there need referrals to resources that can provide help. David proudly recalled helping a patient whose car had fallen apart connect with a local mechanic who donated a used car.

Emily said her favorite moment at the Shawnee Center came when she bumped into a patient outside the Center who was walking her baby boy in a stroller. The woman recognized her and thanked her for the support the clinic had provided—first, when her mother died, and then when the baby was born.

"She said, 'I just love you all. You have done so much for me.'" Emily said. "For me, that just encapsulates what we do here – it's to touch people's lives and make a difference in their lives. People are important, and you need to not treat them as a global issue but as a personal issue. To be able to be influential in a positive way—that's what the work at this clinic is about."

Investing in Community

"I thought I was good till I heard other students practicing. I thought I'd end up teaching flutophone in a cornfield somewhere. So pre-med became an easy choice."