HOW I FOUND MY RHYTHM WHEN THE MUSIC STOPPED

At a time in everyone’s life, we come to find ourselves in a situation where the music stops, and we must go on.  The unfortunate truth about life is that the unexpected will happen. Some of us learn from it, some of us change because of it and some of us find our life’s calling because of it. The latter was the case for me.  After our dad picked us up from middle school, we spent that afternoon like we had every afternoon that month. We went to the oncology unit at the hospital, where my brother was admitted.

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THE MAN IN A BLUE SARONG

I remember him. I remember the man in the dark blue sarong the same way I remember the lines on back of my own hand. He was hunched over next to a column on a dirty platform at a railway station in Calcutta, India in the middle of the harsh summer sun. His hands were withered, his fingers and toes looked like tiny nubs, and he was completely malnourished and alone. He had opaque blue eyes, as if fog had taken place of his irises and pupils.

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PATIENT “OWNERSHIP”

I studied insects in college; my favorite insects were the bees (I found them diligent and so helpful to humankind).  One of my favorite classes was about medical diseases caused by insects. My professors noticed my interest in the medical side of things and connected me with a professor who did clinical research. Our work focused on a clinical trial for children with intractable epilepsy and exposed me early on to patient care and patients.

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Generation two in the Stewart Legacy at the SH&S begins with the administration by John P. Stewart, M.D. in 1898. He became the president of the institution and kept that position until 1941. He is noted for increasing the size of the school as the United States went through the business headwinds of the Great Depression.


Generation three includes the only non- physician in the family of the SH&S legacy, John Dowling Stewart. This Dr. Stewart is the grandfather of John Dowling Stewart II, M.D. who is generation five, and the current Chairman and Medical Director of the SH&S. John took over the institution in 2014 at the death of his father at age 86. John Dowling Stewart was not a physician but was an administrator trained in business administration in college and was able to carry on the institutional needs from 1941 to 1963 until his untimely death.


After John D Stewart died, John P Stewart, MD, John D. Stewart II, MD’s father, became the Chairperson at the institution in 1963. He was a graduate of the University of Pennsylvania Medical School and completed his residency in Radiology at the University of Michigan. He is known in the Stewart family for developing special education programs at the SH&S and he was very personally involved in the institution and very progressive. He took the capacity of the institution from 175 persons in 1963 to greater than 400 persons by 2014. John P Stewart, MD, the fourth generation  of SH&S chairpersons, is also known for being president of the KMA in 1978. He is the second of the Stewart doctors to be president of the Kentucky Medical Association, as the first in this line, John Quincy Adams Stewart, M.D., was President of the Kentucky Medical Association in 1894.


John D. Stewart II, M.D. was very helpful to me in developing this wonderful history of the legacy of the Stewart family. I learned that the SH&S is a private, tuition-based, year-round facility acting as a special education boarding school for the intellectually disabled and developmentally disabled. John told me that the current residents are made up primarily of three diagnostic groups:  autism spectrum disorder, Down’s syndrome, and cerebral palsy. However, the school does have a significant number of fragile X syndrome patients, and those with diseases such as William’s syndrome. They are also noted to have other significantly rare syndromes of intellectual disability in their resident population.


One-third of the residents are senior in age. They continue to learn lifelong, and there are special programs for community integration for them. The present residents at the SH&S come from 35 states and 6 foreign countries.


John D. Stewart II, M.D. told me that new admissions have many more medical problems than 20 to 30 years ago. As the less disabled people are able to find community placements, individuals with significant medical problems are left in the remainder. At the SH&S today, there are 90 seizure patients, 108 patients on psychiatric medications, and 90% of the patients take prescribed medications. The current average census at the SH&S is about 345 persons.


The Stewart Home & School is one of the most prominent facilities of its kind in the United States, and it enjoys a national and international reputation for providing the highest of quality care and continuing care for the intellectually disabled person.     

I had the privilege of consulting to the Stewart Home & School (SH&S) 2 decades ago. John D Stewart II MD was practicing general and vascular surgery in Lexington at that time while working part time at the family business in Frankfort.


I came to know that John was the 5th generation of Stewarts to manage this institution. I asked him to help me with the history for this article and he graciously complied.


The SH&S was originally founded in 1893 at its current address in Frankfort. The main building was constructed in 1836 (see picture), and the architect was the famous Gideon Shryrock who was the architect for the Kentucky Capitol. The ground on which the SH&S sits today was first acquired by Colonel Robert Allen of Baltimore. He founded the Kentucky Military Institute in 1845. The Institute closed during the Civil War and was moved to Louisville. It eventually closed its doors in 1971. One of its famous alumni is Governor John Y. Brown.


John Quincy Adams Stewart MD, the first Stewart physician in a long legacy of medical practitioners in Kentucky, bought the buildings in 1892. Originally the buildings consisted of the old KMI Main Building (see picture) with dormitories forming a quadrangle. Dr. John Q.A. Stewart, as he is called today, began the school with his son who was an alumnus of the Kentucky Military Institute.  

BY ROBERT P. GRANACHER JR., MD, MBA

Dr. John Q.A. Stewart was born in 1829 in Hardin County, Kentucky. At age 18, he received a law degree from the University of Louisville. He, like many people in the United States, got gold fever, and he went west during the Gold Rush for several years. He was elected a magistrate in Sacramento, California and later got married. He obtained his medical degree from the University of Louisville after two years of medical education and received that degree in 1859. He practiced in Western Kentucky and he came to the attention of Governor McCreary in 1878 who enticed John Q.A. Stewart M.D. to come to Frankfort and head the Kentucky Institute for the Feebleminded . This politically incorrect title by our modern times later became the current facility owned by the state for the intellectually disabled in Somerset, Kentucky at Oakwood.


Dr. John Q.A. Stewart was a very intellectually precocious person. He became an advocate for the intellectually handicapped and developed vocational training for those individuals. He served under four governors. These are known to have been Governors: McCreary, Brown, Knott and another. In 1888, Dr. John Q.A. Stewart convened probably the first conference in the US for the intellectually handicapped. This took place in Frankfort, Kentucky and is thought to have lasted up to three-week durations. Dr. John Q.A. Stewart retired from state government in 1892.  

ROBERT P. GRANACHER, JR., MD, MBA

Robert P. Granacher, Jr., MD, MBA practices clinical and forensic neuropsychiaty in Lexington and Mt. Vernon, KY. He is a noted scientific author and past president of the Kentucky Psychiatric Medical Association. He is currently president-elect of the Lexington Medical Society and Clinical Professor of Psychiatry at the University of Kentucky College of Medicine.