Dr. Thomas J. Whitfield, a visionary pediatrician, arrived in Great Barrington in 1974 with a plan to open a small office at his home, located outside the downtown area, to provide healthcare to local children.

South County was poor. Great Barrington was just a small town; Railroad Street was down on its heels. The buildings were mostly empty. There were two dingy bars. Gaines Furniture Co. was the only viable business on the street. The median income for the region was $14,959, with residents scattered over 310 square miles.

Poverty was the primary factor affecting many families in these communities. Fairview Hospital was a small facility with a limited number of doctors on staff. The Visiting Nurse Association provided public health services, with most of their patients being elderly. The Massachusetts Department of Public Health lacked relevant data on public health markers for families with young children. Each town operated independently, with many Boards of Health lacking even basic office space and often being unstaffed. The nearest pediatric practice was that of Dr. “Bill” Gallup, who had clinic hours in Canaan, CT, every week for a few hours that he could spare from his pediatric practice in Sharon, CT.

“The evolution of CHP and the CHP of the Berkshires is remarkable. I never imagined that they would be able to pick up, the dental component, in the way they did, nor the expansion of, physician practices up and down the county.”

-Linda Small, CHP’s First Executive Director  

Dr. Whitfield was deeply concerned by the children he saw in his early days of practice in South County. Children arrived seriously ill for treatment. Most had only spotty immunization histories. He had come from a robust pediatric practice in Concord, MA, where, in his own words, “parents came in with their children for a hang nail!” Dr. Whitfield’s proposal was met with enthusiasm by the Western Massachusetts Health Planning Council. Together, they sought funding to launch a pilot project that would offer free healthcare to families in the smaller towns of South County through well-child clinics.

Dr. Whitfield suggested starting with children from birth to five years, figuring that once they started school, other resources would be available to help them at that point. The superintendents of the two regional school districts were eager to join the program, as they were witnessing the dire consequences of inadequate healthcare in their kindergarten programs. Special education services for young children, aged three and older, were now the responsibility of each school district; identifying these children was critical to this new mission for the schools. They offered space in their schools for the well-child clinics.

As an antidote to the suspicion about these “new clinics” for children, CHP was awarded a contract for the new WIC (Women, Infants, Children) program, a preventive health and nutrition program. Parents could be easily enrolled at a well-child clinic or during a home visit.

Even more exciting, the initial food packages were delivered by the County’s only dairy, Crescent Creamery of Pittsfield. The drivers of these long routes in South Berkshire soon became a significant part of our outreach team. Families would ask them to tell the nurse to come and see an ill child, or they would inform the driver about another family down the road that needed CHP’s help. This program was an immense resource, helping CHP identify the families who were most in need.

Well-child clinics were initially held in the most rural towns, utilizing any available heated, clean, and vacant spaces in schools and/or town halls. Each Wednesday, cars were loaded with the necessary clinic equipment, records, information packets, and the essential coffee pot. My job was to set up a play area for the children to use while they waited for their appointments. Pat Parsons greeted the families as they arrived and ensured that all necessary documents were completed. Over the first summer, these 3-hour well-child clinics filled up.

In a new health initiative, Janet Stanton recruited her neighbor, Priscilla Rueger, a trained dental assistant, to join the team at the clinics to conduct a brief yet critical assessment of the child’s dental health. Severe dental disease was rampant among school-age children. Area dentists were enthusiastic supporters of this clinic program. They solidly backed Dr. Whitfield’s assessment of the need for pediatric care.

Mrs. Rueger was an inventive person who found a used high chair for her dental chair and purchased a portable dental engine for teeth cleanings. The children enjoyed spitting into her disposable baking pans. Each child left the dental assessment with their own toothbrush and their own toothpaste. She explained to parents with infants the importance of reducing the time spent with a bottle of milk in the crib. The children never seemed to be apprehensive or unwilling to climb into “Priscilla’s chair.”

Well-child home visits were added to the list of services. Janet Stanton, R.N., armed with the newly published Denver Developmental Screening Test, visited patients’ homes to assess developmental growth and address parents’ concerns. Parents’ concerns were evaluated and discussed in a quiet and detailed manner.

For young children showing signs of “failure to thrive”, they could be referred to contracted specialists – physical therapists, occupational therapists, or pediatric specialists. Comprehensive health care for this population had to be built slowly and carefully. Still, parents responded with relief that help was available.

We initiated an Early Intervention Program, funded by the State, to address the needs of children aged 0 to 3 with developmental delays. Once a child reached their third birthday, they would move on to school-based programming.

Schools began to plan programs for children with developmental delays starting when the children were three years old. As always, school personnel were CHP’s most vocal advocates, and the partnerships began early. Collaborations with Main Street Human Resources, a Massachusetts Department of Mental Health program serving South County, were established shortly after CHP started and provided us with an additional resource for the communities.

Following an uptick in infant deaths in the late 70s and early 80s, CHP and Fairview Hospital joined together to begin a new era in family-centered pregnancy and delivery services. Linda Baxter, a certified nurse-midwife, led the development of Barrington Ob/Gyn services, which continues today, and added the additional component of modern obstetrical care to the area’s health services. It also marked a welcome collaboration between CHP and Fairview, which was critical to the eventual expansion of the Federally Qualified Health Center.

The tensions between learning to keep up with innovations in health care services while planning and implementing our own programs continued for all my time at CHP, but in reflection on CHP’s success – both then and I think now – I return to Tom Whitfield’s original premise – parents need support to be the primary caregivers of their children – whether infants or adolescents.

 Shortly after this revelation, a timid mother who had a couple of preschool children whispered to me as we sat on the floor with the toys and children, “We never get to see other mothers except here at the clinics.” I asked her how she believed we could help, and she outlined – again in a whisper – “if you could set up the play area like this one in a town each week and we could just come to visit.”

CHP began Parent-Child Playgroups shortly thereafter; we borrowed space, purchased toys, found blankets and quilts for the floor, and provided juice, crackers, and coffee. The parents came, and their children thrived. Playgroup leaders cheerfully hauled the equipment in the back of their cars and shared their insights and thoughts at leader meetings. Some parents even requested phone service in their homes so they could continue conversations with other parents. This was parent-to-parent support!

Soon after Playgroups started, the mothers began organizing the first CHP fundraiser, the Bike-a-thon. Kids rode their bikes – tricycles for the little ones – and parents, cousins, aunts, uncles chipped in so much a mile. Although we were initially skeptical that such an event would be successful, families loved it. The first Sunday in May became Bike-a-thon day for many years; carrying $ 3,000.00 to the bank in dimes, nickels, and quarters was all the testimony we needed.

With state funding for several years, we operated a Family Center in Great Barrington, offering playgroups, mothers’ groups, a Grandma’s Attic for exchanging outgrown children’s clothes, and services for teen mothers who had dropped out of school. We offered mothers driving lessons to ensure they had that skill, mainly since they lived in rural towns. Once they passed the driver’s license exam, they wanted to take the GED exam to obtain a high school diploma. Two excellent retired high school teachers volunteered to support them in preparing for the GED.

All the attention paid to mothers yielded great dividends. At the Department of Public Health’s suggestion, we needed to request a small amount of funding from each of the South County towns to support these growing services. The most rural towns were the most responsive, as they were familiar with the frequency of our cars at the school or at Town Hall itself. The parents were happy to vote at a town meeting for a program that they needed, wanted, and then operated. 

Dr. Tom Whitfield retired from CHP in 1983. Still, his joyous well-child exams and his gentle, kind support of each family created a powerful force in South County; families were engaged in numerous programs and were ready to voice their support when needed. Their combined strength pushed the whole enterprise forward.

Sometime in the 1980s, the Massachusetts Department of Public Health notified us that support from the Department for our innovative programming would no longer continue. We had to either close our doors or begin the process to become a Federally Qualified Health Center. I knew this was the ultimate challenge for what was still a small set of programs. However, knowing how deeply CHP’s roots were in South County, we began the process.

CHP now had four certified Pediatric Nurse Practitioners providing care under a rotating group of pediatricians, and playgroups were expanding. A Family Center opened in Great Barrington, and we started programs for Spanish-speaking families. Retired teachers were tutoring mothers who had dropped out of school to pass their GED exams. My first grant proposal was awarded to provide driving lessons to moms.

By this time, CHP had joined Berkshire United Way and became better known in the County. CHP’s Board of Directors was overseeing an Annual Fund Drive to ensure the budget was balanced each year. Parents in small towns, as well as larger communities, continued to support all these activities.

In our new collaboration with Fairview Hospital, we identified space on the fourth floor of the hospital that could be remodeled for a licensed clinic – a critical step in becoming an FQHC. That space was opened and dedicated in October 1998, attended by Dr. Tom Whitfield and Congressman John Olver, who was then shepherding three applications for rural FQHCs through the approval process.

Dr. Whitfield passed away later that year; he had been able to see that his notion of well-child programs for South County’s youngest citizens had grown into a robust entity in the County, as CHP was now able to offer medical care for children, adolescents, and adults.

His most significant legacy was the special interactions he had with rural mothers during the well-child clinics, as well as his influence on the subsequent pediatric nurse practitioners and their supervising physicians. That brand of healthcare became the model for each program, and those had become the lifeblood of CHP’s future successes, both programmatically and fiscally.

While access to healthcare is paramount throughout a person’s lifespan, there was another essential feature of this work. Women in South County had gained a voice to participate in the lives of the villages where they lived, as well as a voice in the region.

This growth in women’s lives was documented in a project organized by four professors of education and psychology, one of whom lived in South Berkshire. They were interested in interviewing hundreds of women, mostly in colleges and universities, to see if they could discern how women learned to “have a voice” in their educational worlds. As the interviews documented, CHP mothers could articulate their growth through their participation at CHP. The book that resulted from this massive project is titled “Women’s Ways of Knowing” and remains a tribute to CHP and to those amazing well-child exams we started in 1975.