Michael Gruhn is sedated for surgery at Bothwell Regional Health Center to address a case of carpel tunnel in Sedalia, Mo., on September 26, 2023. According to the Center for Healthcare Quality and Payment Reform, the small hospital that serves a population of 21,809 was determined to be “at risk” of closure. 

Dr. Douglas Kiburz changes into his personal clothes after a day of surgery. Dr. Kiburz often splits his time between surgery and sessions at a separate clinic, where he treats patients and mentors residents. “There is going to be a shortage of physicians, particularly in rural areas. The quality of life here is good and the quality of medicine is great.”

The sun rises during shift change at the emergency room of Bothwell Regional Health Center. If Bothwell were to shut down, the nearest hospital would be an extra 25-60 minutes by car. 

Dr. Kiburz, second from right, drawing in personal protective equipment before performing a double knee replacement on a patient.

Debbie Nolan, left, helps her husband Gary Nolan manage lunch after his double knee replacement surgery. “With Gary and me working for years like we did at the community college, we have had a lot of nurses and other healthcare professionals in our classes. And it always feels like home. I've had a few procedures at the hospital myself, but here comes somebody that I had in composition class, and he's in charge of my anesthesia," Debbie said. 

Medical student Marcus Mallen, center, eats lunch with his attending physician of the day, Dr. Stanley Wilson, left. Marcus is part of Bothwell’s Longitudinal Integrated Clerkship (LINC) program, which attracts and trains the next generation of rural medical professionals. 

The operation room is prepped for the double knee replacement surgery of patient Gary Nolan.

Dr. Kiburz, right, uses an electrocauterization tool during a double knee replacement surgery. 

Dr. John Wadley, second from left, trains medical student Marcus Mallen, left, to drain an abscess in the emergency room. 

Trisha Best, right, watches over her mother, Judy Best, as she settles into her inpatient room after a knee replacement surgery. Judy is not only a patient but was a Bothwell employee for over 20 years. “It supported my mom through work that she loved to do. And now you know it'll take care of her as she progresses in age."

Six-month-old Liliana Johnson is loaded onto a stretcher by the University of Missouri’s Children’s Critical Care Transport Unit after she experienced respiratory issues. Bothwell Regional Hospital is not equipped with the same level of pediatric equipment that larger medical institutions, like the university hospital. Pediatric patients are stabilized at Bothwell, then transported by helicopter or ambulance to Columbia, roughly an hour away by ground. 

A medical professional at Bothwell Regional Health Center rests between operations.