MORGANTOWN — Lee Smith had it all worked out.
After a career in emergency medicine, the good doctor figured he’d throttle down, coast into retirement in a more leisurely role.
So, he signed on to run the Monongalia County Health Department.
Five years, he told them, and I’m outta here.
That was 10 years and one global pandemic ago.
“Boy, oh boy,” Smith says with a kind of reflective chuckle. “Little did I know.”
Now five years behind schedule, Smith, 71, is retiring.
Dr. Brian Huggins will join MCHD in May as its next medical director and county health officer. Smith’s tenure will conclude shortly thereafter.
Looking back from an outside perspective — and with all due respect — Smith’s plan was never realistic.
You see, he’s simply not the type to throttle down and coast into anything.
A Navy-trained son of Appalachia born to a blue-collar family, Smith went to work at 14. He eventually earned his way into the eye of the storm known as a short-order kitchen.
“The lessons learned in that helped me throughout my life because you’ve got things that cook quick and you’ve got things that cook slow and the orders just keep coming in. You’re always juggling and balancing the entire thing. An emergency department is not too dissimilar,” he said.
Nor is running a hard-charging health department.
For the first seven years, Smith served as MCHD’s executive director as well as the county’s top doc.
“I think that when I first arrived, a lot of the potential that existed here at the health department had never been realized for various and sundry reasons. Part of it is that, even though there are 55 counties, there are 48 health departments; and of those 48 health departments only four have full-time health officers,” he said.
“I think it would have been easy to think ‘poor pitiful me, I live between the two giants of Mon Health and WVU Medicine. What can I do?’ But I think that we have answered the call whenever possible, and I think the health institutions have come to realize that public health can do a lot of things that they cannot.”
That was never more evident than March 2020, when Monongalia County saw its first cases of COVID-19.
Smith recalls showing up at a local nursing home in Tyvek suits with hoods and respirators.
“It looked like we were ready to walk on the moon,” he said. “As you may recall, there was a lot of uncertainty and there was fear and unsettledness in many businesses. We needed to answer the call and face the situation. So we were having daily team meetings and it was all hands on deck.”
Smith and much of his staff worked long hours seven days a week for the first three months.
It was soon evident the world was facing a public health crisis.
It would be a defining moment for the Monongalia County Health Department.
“I was trying to set the tone and lead by example. We were going to be there. We were going to do it. We basically adopted the philosophy that we had built a public health machine and we fully intended on taking it into harm’s way,” Smith said.
“We never missed a day. We were doing swabs in the community — 1,000; 2,000; 3,000 a day. We never missed a day doing contact tracing, disease investigation, making our line lists and reporting our numbers.”
The MCHD had 64 employees pre-pandemic. At its height, just as vaccines were being rolled out, there were 124 people working for the health department.
It was around this time Smith began to realize he couldn’t work around the clock as the county’s health officer and handle the administrative functions of the organization.
In January 2022, Anthony DeFelice took over as MCHD’s executive director. Devan Smith filled DeFelice’s former role as chief financial officer.
“I didn’t fully realize the toll that COVID took on all of us. Once I started slowing down, I realized I couldn’t do the administrative part as good as I wanted to and still do the clinical part, which had become 24/7,” Smith said. “Bringing in a CEO was a godsend and so a lot of those administrative things got moved off my plate. It was at that time that I really began to realize just how fatigued I was.”
The health department has five main branches — environmental health, clinical services, threat preparedness, dental services and Women, Infants, Children, or WIC.
A full listing of all the programs and services and outreach efforts that fall under each of those branches is impressive in both its length and variety.
Today, the Monongalia County Health Department is the largest health department in the state in terms of employees, people served and services offered. It’s also the state’s only academic health department.
Smith said he believes MCHD has become an example for public health institutions in West Virginia and beyond largely because he stepped into a position surrounded by dedicated, hard-working people and he was prepared to both lead and work alongside them.
Now, however, it’s time to put the boat on the water and transition into full-time grandpa and part-time world traveler.
“When I look back over the last decade of work, I have an immense sense of pride in what has been accomplished and some of the challenges we have faced here at Monongalia County Health Department,” he said.
“It’s been a lot of sweat equity. It’s been a labor of love for us. I’m not feeling like I can’t do the job. It’s just that I feel like I’ve done what I was going to do here. That five years went by pretty quick. That other five they got as a bonus. Now I think it’s time a younger person helps steer this on.”