Doctor's Day 2020

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A Doctor’s Day tribute to physicians of the North Platte region.

Doctor’s Day

Special Needs R A I S I N G A C H I L D W I T H

When Dr. Jovanka (Vanja) Vuksanovic, hospitalist at Great Plains Health, and her husband, Dr. Eduardo Freitas, physician at Great Plains Health Infectious Disease, moved to North Platte 11 years ago, they noticed that their 18-month-old son, Marko, still wasn’t speaking. Since there were three languages spoken in the home (Portuguese, Serbian, and English), they thought that might explain the delay in speech. They focused on speaking only English in the home, but there was no improvement. When they took him to the pediatrician for a well-child visit at age two, the pediatrician noticed other things. While most children at that age are shy or stick close to their parent, Marko ran into the room and immediately started playing with toys. The pediatrician asked Dr. Vuksanovic to fill out questionnaires related to speech, social and interactive behavior. Thus began a lengthy two-year process and finally a diagnosis: autism.

At the time, Dr. Vuksanovic knew nothing about autism. She had never met someone with autism, and the only point of reference she could think of was the movie “Rain Man.” She immediately began the process of advocating for Marko and getting him help. They started with applied behavioral analysis (ABA), which was not available in North Platte. They hired someone to come from Kearney to give the therapy and had the therapist not only train Drs. Vuksanovic and Freitas but also their nanny. Dr. Vuksanovic remarked, “We were lucky that we could afford the therapy, which was all out of pocket.”

Dr. Freitas and Dr. Vuksanovic also have help from family. “We always have someone living at our house,” said Dr. Vuksanovic. “Our families make extended visits and stay anywhere from two to six months.”

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2020 Doctor’s Day National Doctor’s Day on March 30 provides the Great Plains Health team and our region’s communities another opportunity to show our appreciation for the many fine physicians who serve our region. We are truly grateful for the commitment to exceptional medical care that our physicians provide and for the many miles they travel to ensure that the people of our region receive quality care as close to home as possible. This special publication is a tribute to our physicians, who spend countless hours making a significant impact on the health of our community. In an age of increasing regulation, reimbursement reductions, and change, the healthcare industry has become a highly complex environment to deliver care. Our physicians work tirelessly to stay in step with these complex changes while keeping patients at the center of care, always. Our physicians not only care for local residents, but they are community leaders, neighbors, soccer coaches and friends. We salute these fine men and women who have dedicated their careers to improving the lives of others. As we carry out our mission to inspire health and healing by putting our patients first – ALWAYS – and move forward to our vision to be the region’s most trusted healthcare community, we are honored to partner with the physicians of the North Platte region.

Dr. Vuksanovic said that Marko does have some savant characteristics. When he was very young, he had some blocks with letters on them. He arranged them in a specific way, which at first looked like nonsense. Upon closer inspection, it was apparent that he had arranged the letters in the formation of a keyboard. He also has an excellent memory. When it was time for Marko to start daycare, they sent their therapist with him. When Marko started school at McDaid, there were no other children at the school with special needs. They sent their nanny to school with him. Soon, the school found him a para, but Marko didn’t like to be separated from the other children. Before Marko started kindergarten, the school held a special assembly for children and parents to educate them about autism, which meant a lot to Dr. Vuksanovic. Marko has a lot of great friends at school. One day, Marko lost his beloved fidget spinner. The entire class went out and searched the playground but couldn’t find it. The next day, a classmate brought Marko a new one. When speaking of what it is like to parent a child with autism, Dr. Vuksanovic says that isolation is common. It is hard for other families to understand. On one occasion, Dr. Vuksanovic remembers taking Marko trick or treating. All the other families were out having a good time, and “I was chasing Marko all around, so he didn’t run in the street and get hit by a car. I had to leave my younger daughter to chase after him – something that is supposed to be enjoyable. And when you look at him, he doesn’t have an obvious disability, so there are always the looks when he is having a meltdown in public. Something as simple as going to Walmart is extremely difficult.” When asked what advice she would give to families in a similar situation, Dr. Vuksanovic said, “Educate the people in your inner circle.” Good friends who understand can make all the difference. Dr. Vuksanovic also always exposed Marko to social situations. “I didn’t shield him from things; he needs to learn how to get along in the world.” Dr. Vuksanovic also remarked that the community has changed a lot since she has moved here. There is a wonderful autism group that provides community experiences – for example, they have sensory-friendly movies and early entry to the carnival.

Sincerely,

Mel McNea, MHA Chief Executive Officer Great Plains Health Mike Simonson, MD Chief of Staff Great Plains Health

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FINDING

In July 2018, the Wray family was living a happy, busy life. Dr. Joshua Wray was working as a podiatrist with Great Plains Foot & Ankle Specialists, and Dina was caring for their six small children – four-year-old triplets, two- year-old twins, and a six-month-old baby. One day, their four-year- old daughter, Hope, wasn’t feeling well. It started with symptoms of the stomach flu – vomiting and diarrhea. It quickly became severe. They took Hope to the pediatrician, who sent them home with some medication and instructions to bring her back if things weren’t better by that evening. Her health continued

After Hope’s passing, the Wrays felt bolstered up and loved by the community. “You could see that, in just how many people came to her funeral,” said Dina. “We had friends drive two hours just to come to her viewing for 15 minutes,” added Dr. Wray. For the Wrays, it is impossible to talk about the loss of Hope without also talking about the love of God. Their Christian beliefs brought them solace and comfort throughout the grieving process. They have also had opportunities to create friendships with families that have suffered similar losses, and to help others through the grieving process. In their small church congregation, there are four other families who have also lost young children. The group has formed a tight bond.

to deteriorate, and she was admitted to the hospital. The diagnosis? An E. coli infection. A few days later she was transferred to Children’s Hospital in Omaha, where she suffered a mini stroke. Then the unthinkable happened – their beautiful daughter passed away. The Wrays moved to North Platte in 2015. Dr. Wray, originally from Idaho, had been dreaming of buying farmland in the Sandhills for years. Dina, originally from Oklahoma, wasn’t as sure about living on a farm, but when they came to interview, she said it immediately felt like home. They raise “Cows, cats, and kids,” joked Dr. Wray.

Although Hope’s death was tragic, the Wrays focus on her life. She was an exceptional little girl, and they love to share stories about her.

In 2013, while living in Vineland, New Jersey, the Wrays learned they were expecting triplets (two identical twin boys and one girl). According to Dina’s memory, they both agreed to name the little girl Callie, but “I knew she was Hope,” said Dr. Wray.

Hope was born first, and took on the role of big sister with ease. From as early as six months of age, Hope was the clear leader of the three. While Hope was feisty and spunky, the boys were mild-mannered and quiet.

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When they were 18 months old, Hope kept getting out of her crib at night. No matter how many times she was told to stay in bed, she didn’t. Finally, Dr. Wray built a wall with storage bins next to her crib to keep her from getting out. He also took her favorite blanket and set it on the dresser. No sooner had he gone to bed than there was a giant crash from the triplets’ room. This time, it wasn’t Hope but one of the boys. He had climbed out of his crib, taken Hope’s blanket from the dresser and launched it over the makeshift wall. It was stuck on the top of the wall, and the crash was him falling as he quickly tried to get back into his crib. He was never the type to disobey but would do anything for his sister, even at that young age. When the triplets were toddlers, they were playing in the next room and Dina heard Hope say, “No, we aren’t going to play like that anymore. We are going to play this way.” In unison, the brothers said, “Okay, Hope.” They never questioned her leadership – she was wise beyond her years.

Once a babysitter was worried about telling the boys apart, or putting them in the wrong beds. The Wrays just pointed to their tiny daughter and said, “If you have any questions, just ask Hope. She knows what to do.”

As the younger siblings came along, Hope led the little troop with natural ease. On one occasion her parents overheard her telling her unruly younger twin siblings they were going to play church. Unsure of how they would react to being told what to play, their parents were surprised to hear them singing hymns moments later. She had a way of not just leading but charming everyone around her as well. To say she had her daddy wrapped around her little finger would be an understatement. “She was definitely a daddy’s girl,” said Dina. She idolized her father and wanted to be just like him. Dr. Wray does not like cheese, and, at the age of three, Hope declared she also would no longer be eating cheese. What advice does the couple have for those who don’t know what to say when a tragedy like this strikes? “I’ve learned that it is better to say something than to say nothing at all,” said Dr. Wray. “If someone asks how I’m doing with everything, it gives me a chance to share, a chance to talk about Hope.” Although they both admit that it can bring some pain, they love to talk about their daughter. “It is especially meaningful when people remember her – when they tell me stories about her or what they remember about her,” said Dina.

And through it all, life carries on. Dr. Wray continues doing amazing work at Great Plains Foot & Ankle Specialist and Dina runs her home with love and structure. “She really is supermom,” said Dr. Wray. “I may work eight to 10 hours a day, but she easily works double that.” Although they

are no longer living with Hope physically, the Wrays are holding onto hope – the hope that they will see their daughter again in the next life, and the joy and memories she brought to them during her short journey on earth.

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The medical staff of Great Plains Health

ANESTHESIOLOGY

CARDIOLOGY

Rick Heirigs, MD

Naomi Matthews, MD

Edith Newsome, MD

Forrest Ragland, MD

Olena Dotsenko, MD

Georgy Kaspar, MD

Ravishankar Kalaga, MD

Azariah Kirubakaran, MD

DERMATOLOGY

EMERGENCY MEDICINE

CARDIOLOGY

Daniel Mosel, MD

Renee Engler, MD

Jim Smith, MD

Richard Markiewicz, MD

Clyde Sullivan, MD

Marc Hyde, MD

Todd Jensen, MD

Julie Query, MD

EMERGENCY MEDICINE

FAMILY MEDICINE

ENDOCRINOLOGY

Paul Travis, MD

John Mihailidis, MD

Kent Allison, MD

Jeffrey Brittan, MD

Jason Citta, MD

Jesse Dunn, MD

Wendy Gosnell, MD

Emily Jones, MD

FAMILY MEDICINE

GENERAL SURGERY

HAND SURGERY

Michael Simonson, MD

JacobWiesen, MD

Douglas States, MD

Kali Rubenthaler, DO

Michael Joyner, MD

Leland Lamberty, MD

David Lindley, MD

Shawn Murdock, MD

GENERAL SURGERY

HOSPITALIST

Raj Goje, MD

NorbertAlexSeidenschwarz,MD

Sidrah Sheikh, MD

Jovanka Vuksanovic, MD

Kasia Wolanin, MD

Amulya Abburi, MD

Renu Kadian, MD

Olivia Necola, MD

INTERNAL MEDICINE

INFECTIOUS DISEASE

HOSPITALIST

NEPHROLOGY

MEDICAL ONCOLOGY/HEMATOLOGY

Loretta Baca, MD

Demytra Mitsis, MD

Raymond Carlson, DO

Pushkar Kanade, MD

Kartik Anand, MD

Avinash Pasam, MD

Eduardo Freitas, MD

JiashanWang, MD

The medical staff of Great Plains Health

ORTHOPAEDIC SURGERY

OBSTETRICS & GYNECOLOGY

OPHTHALMOLOGY

ORAL SURGERY

NEUROSCIENCES

Anil Kumar, MD

Michael Bianco, MD

Chris Johng, MD

Benjamin Klug, DO

Amy Short, MD

Kristen Burwick, MD

Steven Hinze, DDS, OMS

Evan Correll, MD

OTOLARYNGOLOGY

PAIN MEDICINE

ORTHOPAEDIC SURGERY

John D. Hannah, MD

Nathan Jacobson, MD

Mark McKenzie, MD

Pinak Shukla, MD

Elaine Fitzpatrick, MD

Philip Fitzpatrick, MD

Roger Simpson, MD

Stephanie Marcy, DO

PATHOLOGY

PAIN MEDICINE

PEDIATRICS

Lyle Barksdale, MD

Bryon Barksdale, MD

Delane Wycoff, MD

Kathy Lopez, MD

Melissa Mosel, MD

Soogandaren Naidoo, MD

Grishma Parikh, MD

Aleeta Somers-Dehaney, MD

PULMONOLOGY/ CRITICAL CARE

PODIATRY

PSYCHIATRY

PHYSIATRY

RADIATION ONCOLOGY

Geetanjali Sahu, MD

Caroline Sorenson, MD

Todd Hlavaty, MD

Dusty Christensen, DPM

Richard Raska, DPM

Narayana Koduri, MD

JoshWray, DPM

Guido Molina, MD

RADIOLOGY

UROLOGY

RHEUMATOLOGY

SLEEP MEDICINE

Bradley Mattson, MD

David Hatch, MD

Rick Kukulka, MD

Dwayne Collier, MD

Kristin Lake, MD

Jefrey Start, DO

ImanualSomers-Dehaney,MD

Ladd Lake, MD

UROLOGY

WOUND CARE

Jose DeGuzman, MD

Clinton Schafer, DPM

Millie Erickson, MD

She continued, “With two, it is twice the work, but it is also twice the fun.” The older twin, Keyan, is the more obedient of the two. “You ask him to do something, and he does it right away,” said Dr. Anand. “With Keyash (the younger twin), he will do what you tell him not to do.” Keyan walks around the house calling “Kiachh” all day, something that makes the couple laugh. The boys are the best of friends, or they are rolling on the floor wrestling and fighting, as most toddlers do. and double the trouble if you’re blessed with twins The couple moved to North Platte because of the employment opportunity at Great Plains Health, and they have come to appreciate the small-town feel. “I wanted a place where my kids could play outside, ride their bikes down the road,” said Dr. Sahu. The couple has also made friendships in the community. “When we lived in Houston, we really didn’t do anything socially,” said Dr. Sahu. “So it is nice to have a close group of friends.” It’s double the giggles and double the grins,

Dr. Anand Twins Dr. Kartik Anand, oncologist at the Callahan Cancer Center, and Dr. Geetanjali Sahu, child and adolescent psychiatrist at Great Plains Health Psychiatric Services, are parents of 18-month-old twin boys. When they found out they were having twins, Dr. Sahu was shocked. Twins do not run in either of their families. Dr. Anand was elated. “I don’t

think he understood how much work it was going to be until a few weeks before they came,” said Dr. Sahu. “Then reality seemed to hit him.”

Dr. Anand and Dr. Sahu moved to North Platte in the summer of 2019. The boys were still very young. Initially, family came to help with the boys. Now that family has left, Dr. Sahu admits, “It is challenging. There was a weekend where we were

both on call. Trying to juggle that with the children…it was tough.”

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Dr. Rubenthaler Twins When Dr. Kali Rubenthaler, family medicine physician at Great Plains Family Medicine, found out she was expecting twins seven years ago, she said, “I was shocked.” Dr. Rubenthaler and her husband, Austin Brunkhardt, already had a nine-month-old daughter. “My husband is an absolute saint. We had three kids in 18 months,” she said. “I was in the middle of my residency.” Austin set aside his business to take care of the children while Dr. Rubenthaler finished residency. After the birth of their twin sons, there was another bump in the road. One of the twins was born with a heart defect, and at just eight months old had open heart surgery. “That was the only day the boys have ever spent apart,” said Dr. Rubenthaler.

Dr. Pasam Twins

Dr. Avinash Pasam, oncologist at the Callahan Cancer Center, is the father of 23-month-old twin girls. When Dr. Pasam and his wife, Indu, found out they were expecting twins, they were shocked. “Twins do not run in my family,” said Dr. Pasam. One of the greatest challenges was getting the babies to sleep through the night. “We put them together, that didn’t work. So then we separated them, and that didn’t work so well, either,” laughed Dr. Pasam. “When they were old enough to speak, they would call out for one another, so we put them back together.”

Although the boys fight at times, as siblings do, they are very good friends. “We put them in the same class at school,” said Dr. Rubenthaler. “That doesn’t mean that they don’t have their own friends or don’t do things independently, they just like to see that their brother is nearby.” Since the boys don’t look alike, many people initially don’t realize they are twins. “It’s kind of nice, since there is a size difference between the two boys, we can pass hand-me-downs from one to the other,” laughs Dr. Rubenthaler.

The Pasams received help caring for the girls when they were young from both Dr. Pasam’s family and Indu’s family. According to Dr. Pasam, the girls are either great friends or fighting with each other. “They are just normal kids; when one takes a toy the other one wants, they fight over it. But they also love to play together.” Dr. Pasam moved to North Platte to join the oncology practice and enjoys raising his children in this community. “We are able to spend time together as a family, and that means a lot to me.”

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Dr. Raska Twins

Dr. Richard Raska and his wife, Donna, are the proud parents of three children: 25-year-old Ben and 21-year-old twins, Morgan and Madison. The Raskas were surprised when they found out they were expecting twins, but not shocked. Twins do run in Dr. Raska’s family.

When the girls were little, they had their own language. They would push one another on the swing set and yell, “Da!” which meant, “Yes, do it again!” They also called Santa “Hinta.”

When the girls graduated high school, they chose to go to different colleges – Morgan to Concordia and Madison to UNK. They make frequent weekend trips to one another’s dorms to spend time together. They are also very close with their older brother.

Dr. Raska notes that an important part of parenting twins is not to compare the girls to one other. “They are the exact same age, have similar life experiences, came from the same womb, and yet they are so different, “ said Dr. Raska. Now that Dr. Raska and Donna are empty nesters, they look forward to visits with their children. “The kids have really fond memories of their childhood and love to reminisce,” Dr. Raska said. “It is a rewarding time of life.”

Dr. Lake Twins

When Dr. Kristin Lake, rheumatologist at Great Plains Health Family Medicine, found out she was having twins 10 years ago, she and her husband, Dr. Ladd Lake, radiologist at Innovative Imaging, were thrilled. They had a son but had wanted more children for years. Sydney was born one minute before her brother Sam, and she is very proud that she is the oldest. Although their personalities are very different, they have a special bond. Even before they could speak, they could communicate without words – through movement and body language. When asked if they ever get strange questions about the twins, Dr. Lake laughed and said, “Oh yes. I always get the question, are they identical? No, they’re not…they are different genders.” Along with 9-year-olds Sam and Sydney, the Lakes have a 17-year-old son and a 7-year-old daughter. Dr. Lake appreciates how the smaller community is conducive to a work/family balance. “When my daughter was younger, I could work in the morning and then go drive her to preschool,” she said. “In a bigger city, there would be no way I could do that.”

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Dr. Mosel Twins

Dr. Melissa Mosel, pediatrician at Great Plains Pediatrics, and her husband Dr. Dan Mosel, dermatologist at Greater Nebraska Dermatology Clinic, were shocked six years ago when they found out they were having twins. “We thought the OB was playing a joke on us for a minute,” said Dr. Melissa Mosel. The Mosels have four beautiful daughters: Cora, age eight; twins Avery and Kate, age five; and Julia, age two. “Dan came from a family of four boys,” said Dr. Mosel, “so having four daughters was very different for him.” Although the twins have different personalities – Avery is more social and loves to read, while Kate is a bit shyer and loves to be outdoors – they are the

very best of friends. “They play together constantly,” said Dr. Mosel. “They sometimes get annoyed when they have to take breaks from playing to do things like eat dinner with the family.” They are also very empathetic and caring for one another. “For example, if Avery were getting a splinter removed in one room, Kate would be in the next room crying.” Dr. Mosel doesn’t necessarily think they can feel one another’s pain, but they do share a special bond. The girls are not identical, but they look very similar. “Sometimes when I look at their baby pictures, I have a hard time telling who is who,” said Dr. Mosel. The Mosels chose to raise their family in North Platte to be closer to family and also to have access to outdoor activities.

Dr. Engler Twins

Dr. Renee Engler, emergency medicine physician at Great Plains Health, and her husband, Joe Engler, are proud parents of 15-year-old twin boys, Kaleb and Seth.

boys were immediately under the table,” said Dr. Engler. “We didn’t even eat,” adds Joe. “We just gathered the boys and left for the hotel.” But the trouble didn’t stop at the restaurant. The boys called the front desk at least 10 times before Joe and Dr. Engler unplugged the phone. Then they started jumping off the couch. Soon the hotel contacted them and let them know they were getting complaints from other guests. Finally, they decided to just pack up and go home. “Our first great vacation – it lasted all of 20 minutes!” laughed Joe. The twins may look alike, but that is where the similarities end. Dr. Engler said, “It’s strange because they don’t really feel like twins. They seem like two completely different people with the same birthday.” Kaleb loves anything to do with the outdoors, while Seth loves to play sports, and he plays trombone and sings in choir.

When they found out they were expecting twins, they were thrilled. Joe made the decision to give up the Marine Corps and his business to stay home with the boys. The twins were born premature and weighed only three pounds each. The OB told them not to take the babies outside the home for at least a year or two. During that time, the Englers only took the boys out for doctor’s visits or occasional visits to see grandparents. After two years, the Englers decided to take their first family vacation. They left their home in Lincoln and went to dinner in Omaha. “I remember we got to the restaurant, and the

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