Goshen Portraits

A Medical Degree for Community Work

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[Photo by Maple City Health Care]

By Annie Martens

James Nelson Gingerich didn’t go to medical school to become a doctor. He went because he wanted to open an affordable health care center in Goshen that would build bridges across cultures.

Gingerich grew up in Luxembourg with missionary parents and after that in Tennessee where his father studied theology, including the work of John Howard Yoder. Gingerich describes their household as one “that was constantly talking about John Yoder and Christian community…and seeing ourselves as a little minority in a bigger society.” In this environment, he became “more challenged by what forms radical Christianity could take.”

Out of this theology and the challenge of radical Christianity, Gingerich began thinking about community development. When he started attending Goshen College for his undergraduate education in 1981, Gingerich quickly became involved with Assembly Mennonite Church, a congregation that that was only a year old at the time. Gingerich describes it as a “high-energy, high-intensity” kind of place. It was also the place where Gingerich met his wife, Barbara.

While at Assembly, Gingerich and four other young adults from the congregation created a household together, where they lived in intentional community, sharing a common pot and a vision for their North Goshen neighborhood and the broader city. These young men worked in Goshen with Boys and Girls Clubs, Big Brothers Big Sisters programs and homes for the indigent, and they started the first bilingual education programs for public schools in Indiana.

In this context, Gingerich says they were developing a vision for the Assembly congregation “which was that as people think about moving, they think about moving into low-income neighborhoods, and that we deliberately think about what it means as a congregation to build bridges that are cross-cultural.”

In a history on their website, Assembly Mennonite Church describes the church’s first 15 years, with a section describing the tension between Gingerich and his housemates’ vision for the church and the direction the church was going. Gingerich was a strong voice in encouraging the church not to purchase and move the congregation into a new building on south 11th Street in Goshen. The church had been meeting in various places in Goshen and at Goshen College, with no set meeting place to call their own. Many in the church wanted this type of home for the congregation, but Gingerich spoke out about his conviction that moving the congregation into the new building would allow it to become “comfortable,” rather than continuing to intentionally work at being a presence in lower-income communities.

Though the church didn’t take to this idea as enthusiastically as Gingerich’s household had, Gingerich cites this as a formative goal in arriving where he is today. While living in Goshen and majoring in history, biology and German at the college, Gingerich discovered an outlet for the radical Christianity he had been exploring since he was a boy in Luxembourg and Tennessee—he began to notice that there were people in his household’s North Goshen neighborhood who had inadequate access to healthcare.

Gingerich started to think about how healthcare could be done differently—not only to bring access to healthcare to people, but also to foster community development. He asked himself, “How do you foster healthy community, how do you foster inclusive community, how do you foster cross-cultural community and have a connecting point in healthcare?”

With these questions in mind, Gingerich headed to University of Chicago, where Barbara, whom he married in 1980, was studying theology.  His intention was to create an affordable health care center in Goshen when he graduated. The university’s medical school focused on “sub-specialty care and research,” Gingerich remembers, and it produced more deans and faculty members of medical schools than any other school in the country. Gingerich was one of only four students in his graduating class of 103 who intended to use their medical degrees to work in family practices.

Gingerich laughs as he recalls the four of them being called into the dean’s office and “chastised for wasting a University of Chicago education on primary care.”

“It was not a place that fostered primary care, let alone cross-cultural poverty care,” Gingerich says, though he is quick to give the school credit: “I got a great education. It was a fine place in many ways.”

When he finished his residency in 1988, Gingerich returned to Goshen with Barbara and their first son, Jonathan, who was born while Gingerich was completing his residency at St. Francis Hospital in Indianapolis. He began actively seeking ways in which he could fulfill his goal of opening a health care center in North Goshen.

Fortuitously, a fire station in that neighborhood had recently become redundant, as the fire station in downtown Goshen could access the neighborhood more quickly than the neighborhood station, so the mayor at the time, Michael Puro, decided to shut it down.

One day, Gingerich says, “the mayor called me and said, ‘I have a building looking for a project. I hear you have a project looking for a building.’” They negotiated a 20-year lease for $1 a year, and the city donated some funds to the project.

Thus, through financial donations and the  time of many volunteers, Gingerich saw the project he’d planned since he was an undergraduate come to fruition. When the Maple City Health Care Center opened in 1989 with no money and no resources, Gingerich says he had “$75,000 of medical school debt and a dream.”

Located just off of Main Street in North Goshen, at 213 Middlebury St., the center has grown and changed with the community and Goshen’s demographics, though in 23 years of operation it hasn’t strayed far from Gingerich’s original vision. The center is not only medical center, but a medical home, a place that provides healthcare and community care.

The Maple City Health Care Center provides medical services to community members on a sliding scale, determined by the patient’s income. Patients pay between 10 percent and 100 percent of their medical bills. Seventy percent of the center’s income comes from patient and insurance payments, and the other 30 percent comes from grants and donations.

The socioeconomic gap  was one of the cultural divides Gingerich was hoping to bridge with the center’s opening. The sliding scale of payment and its location allowed it to do just that. But, as the demographics of Goshen have changed, so has the center.

Gingerich says that when the center first opened, Latinos made up only 3 percent of the city’s population. At the time, the socioeconomic gaps were the biggest. Now, as Latinos compose nearly 30 percent of Goshen’s population, the center has adjusted its focus, hiring a large number of bilingual staff  to better serve the growing number of Latinos that are patients at the center.

The center has also started  programs for patients and community members to bring the sometimes disparate ethnic groups in the community together. One of these programs is  Our Futures Together, which brings together strangers whose only connection is that they live in the same neighborhood.  They meet once a week for six weeks to talk about the futures they want for their children.  These groups use a translator, so that each group member’s words can be understood by all.

Though those who meet in the Our Futures Together group have no connection, Gingerich speaks proudly of the successfully the groups have come together and made meaningful connections despite the various barriers that divide them.

As Gingerich describes a Latina woman and an Anglo man overcoming their differences by discovering a common thread in the bakery the Latina opened to support her children, he leans forward, fingers splayed together in a contemplative pose.

Gingerich, now 53, attends 8th Street Mennonite Church, which is just down the street from the house where he lives with Barbara and their second son, Daniel, now a college student.

Gingerich’s life work is on display at the Maple City Health Care Center, work that he has not only helped build and grow, but with which he too has grown. No matter how many changes the center or Gingerich undergo, community is the current that has shaped his life, and thus the life of the center.

 

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