For Jo Smith, there's no such thing as impossible. As director of Special Services at the University of Arkansas for Medical Sciences, she's a miracle worker, the ultimate insider, a woman who has spent nearly 50 years watching UAMS grow up around her and still, there's no door that won't open, no one who won't take her call.
During a recent weekday conversation, Smith laughs her way down memory lane as her phone hums a steady staccato of messages. She glances at them without breaking the stride of her stories, 10 times in about 60 minutes, the vast majority of them wanting something. It's not vanity that keeps that phone on and buzzing 24 hours a day, but it is a need she has. The need to be needed, to be the one people lean on, talk to, cry with.
"I love to fix things and make things better," she says. "I can remember one day in the Camden hospital I was working on Christmas Eve and a little boy came in with appendicitis. He was like, 6, and he was by himself. His parents had gone home and the next day was Christmas.
"I remember that he was in a four-bedroom ward and he was in there all by himself. I asked him what-all he wanted for Christmas and I remember calling my dad and my dad and mother ran to somewhere and got a little Christmas tree, my brothers got toys that they wanted to give away and we had probably the biggest Christmas that child ever had."
The story is more remarkable having occurred while Smith was in high school, volunteering at her hometown hospital. And it is all the more telling because of how it foreshadows her life's work to come at UAMS over almost five decades, with a brief detour to CHI St. Vincent to close out the 1970s.
"I never really meet a stranger," she says of her wiring. "I have boxes of cards people have sent me and I'll get them and think, 'How did they know my name?' It all amounts to I'm fed by doing for others."
Growing up in Camden, Nancy Jo Atkins was showered with two messages -- do what makes you happy in life and measure your success in what you can do for someone else -- delivered daily in word and deed by her parents, Buddy and Martha Atkins.
"I come from a large family, number two of five children," she says. "We're very close and we were extremely close to our parents, too. Growing up, I thought everyone had the perfect family like I had. You know, everybody loves everybody, everybody's happy.
"We went to church on Sundays to the First Methodist Church in Camden and my parents taught us to base our lives on helping others. I can remember at Christmas, people ringing our doorbell and my daddy giving money to people to help them make ends meet. My parents always did stuff like that. My mother was a big volunteer in the community and my dad was always helping people."
In fact, Martha's community activism was the catalyst for Jo's interest in nursing in the first place. As president of the local Junior Auxiliary, Martha was trying to jump-start participation in a candy striper program at the local hospital.
"She said, 'Jo, you're going to have to be a candy striper, because I can't get everybody else to do it if you're not going to do it,'" Smith says. "I started working at Ouachita County Hospital as an eighth grader and I think I got over 500 hours. I was there every day in the summer.
"They asked me if I wanted to go to work there when I turned 16, so I started working as a nursing assistant there on Saturdays, Sundays and holidays. I just fell in love with it so then I went to nursing school."
SHE'S AN OLD SOUL
Smith studied to be a nurse practitioner for two years at Henderson State University in Arkadelphia then headed to Little Rock for an additional three years as part of the first nurse practitioner program at the UAMS College of Nursing. Early assignments included working in the UAMS emergency department, the burn unit and finally in orthopedics under the late Dr. Carl Nelson, where she'd serve as head nurse for years.
"When I went to work for Dr. Nelson, who was head of orthopedics here at that time, we did the first hip and knee replacements," she says. "I always liked that, because I've always liked to see broken stuff get fixed. Orthopedics were hurt patients and other patients are sick patients. I liked to see people get better."
Relating to orthopedics patients, who tended to be older, was in Smith's bedside wheelhouse.
"Probably what I liked the best was getting to know the person, where they were from, did they have kids," she says. "I always liked to get people ready to go home, telling them, 'Now, when you go home you can't bend your knee or do this; you need to do this to get in and out of the shower,' stuff like that. I got to know those folks really well.
"I like older people. Always have. My mother's mother lived with us when I was growing up, and my other grandparents lived in town, my dad's folks. I would spend the night at their house every Sunday night and my granddad would take me to school. I loved it; I guess I'm old at heart."
Twenty years ago, in September -- on 9/11, in fact -- Smith took a position in special services that would come to define her career from that day forward.
"We did mostly, at that time, the international patients who were coming here for myeloma," she says. "We helped patients get through the system if they were having problems. We were getting patients from all over the world in here and I would help them find places to live. I would get their kids in school. I would find churches for them. I would find grocery stores for them. I met some very, very interesting people. It was interesting work."
It was also a role she was born to play. Even as international traffic waned, Smith became the ultimate navigator for patients with special circumstances or those who just needed the help of a jack-of-all-trades problem-solver for whom no challenge was too steep, no problem too complex.
"I always tried to put myself in the patient's place," she says. "If I was from somewhere else and all of a sudden got this terrible disease and I found out the best place in the country to go was Little Rock, Arkansas, I would want someone to help me. That's what I've always tried to do."
NAVIGATING THE LOST
Along the way, Smith's clientele has included many of the state's rich and powerful, something she doesn't like to dwell on lest people think she's only here to serve the privileged. She is not; as any given day's work will attest.
"A lot of people have extenuating circumstances when they come in and I try to help," she says. "I do a lot with patients who get messed up in the system. They've called and they can't get in to see a doctor for months and I try to get them in sooner.
"I get calls all the time. Someone who works here in the hospital saw these two elderly people last week and they were so lost. They couldn't find their way anywhere. So, she walked them to their appointment, got their name, and found out they have to come back to get more testing. They're from some little town. So now, I have their name and I'll walk over there and meet them and get them to their appointments. UAMS is a big place to someone from wherever."
Judy Adams, UAMS Advisory Board member and owner of Catering to You, has known Smith for 20 years and seen her unique skills in action.
"She cares about people and it doesn't matter who you are," Adams says. "Whether you're a governor or if you're a homeless person, if you need to see a doctor, she helps you get in and navigate the system quickly. I have called her numerous times with people who know that I'm on the board and who say, 'I have tried and tried and tried to get in to see Dr. Such-and-such,' or somebody at the aging center or somebody in neurology or they don't even know who they need to see. Jo will say, 'I know who they need to see. Yeah, we'll get him in.' And she does it."
To hear of the kind of influence that Smith wields in such situations might lead one to believe that she's the most feared individual in the system, the one person you don't say no to. Nothing could be further from the truth; as people around the hospital will tell you, her dedication to patients in matters both routine and profound make her someone you can't say no to.
"I guess part of it is because I know that it's somebody that really needs the help and something that just needs to be done, number one," says Dr. Lee Archer, professor and chairman of neurology, who has seen Smith's magic up close for 30 years. "Number two, she's going to help me if I have somebody and I'm not sure how to get something done. I can call her and she will say, 'Yeah, I'll show you how to do that.' So, it's both ways. I know it needs to get done when she calls me and she's going to help me when I have a problem."
"I've nicknamed her St. Jo, because she's always doing for others," says Leslie Taylor, vice chancellor of communications and marketing who's known Smith for more than two decades. "The fact that she's a nurse is helpful to her work, but I really feel like she could do anything. She is a people person; that's her main motivation for everything that she does. She likes people and she wants to help and she goes out of her way to do what she can to make people feel comfortable. Even though the people she's working with, the patients and the families, aren't in the most comfortable situations, St. Jo just works her magic."
Taylor's moniker is just one of the nicknames Smith has picked up over the years, crowding for space with "Angel" and "The Organizer" like so many honorariums behind her name.
"I was never a book person, I'm hands-on," Smith says. "I probably wasn't the smartest person in the class, but I have a lot of common sense. I'm a good problem-solver. I can sit there and talk to someone about what's wrong and I can kind of figure out what to do about it. Sometimes you just need someone to listen. I'm a great listener and I'm fortunate enough to know so many people."
Looking out any window at UAMS these days one sees physical expansion and with it, new doctors and nurses. As such, Smith is constantly curating her contact list, already large enough to stagger a smartphone, by connecting and welcoming new faces. Here's my number. Call me if you need me.
And, of course, the stream of patients never ebbs, people facing for the first time what she has seen by the score. It is in these moments that Smith does her most impressive work by simply appearing, being present, shrinking the sprawling UAMS universe down to a single room and precious, pivotal moments.
"I've been around a lot of people who have died. I get called a lot when someone's real bad up on the floor," she says. "I've gone on beaucoup home visits where they've been on hospice and they're really bad and they'll say, 'Will you come?' and I'll go. I've been with a lot of patients when they've gotten their diagnosis of cancer or heart disease or something like that and they'll call and visit with me and just talk.
"For some reason, I'm really very strong during that. I can do that very well. I'll help them get things done. I have one family, he was a lovely guy, a farmer, and they had two kids. He was just 60 and died not long ago. I went to the funeral and they wanted me to sit with the family."
It's impossible to fully crystallize a career as long as Smith's down to one moment, but the thing that comes closest involved a cancer patient and his daughter.
"The dad was here with multiple myeloma, very sick," Smith says. "One of the daughters told the receptionist that she's supposed to be getting married in a few months, so we did a wedding for her. We had it in the chapel. Someone bought flowers, someone bought a little wedding cake. We had music playing. We went to the hospital gift shop, robbed it of candles and artificial arrangements, silk table cloths.
"Technically, we couldn't call it a wedding, because they weren't here long enough to get certificates and all that, so we called it a commitment ceremony. And one of the chaplains did it. We had the video people broadcast it and it was the most touching thing. There wasn't a dry eye in there. The bride, her dad's lying on a stretcher, she held his hand and she said, 'I've always wanted to find a man that was like my dad.' She turns to him and she starts crying, and he's crying and we're crying. Oh, it was a fabulous moment."
It's late fall as Smith shares her story, a season that's an apt metaphor for her storied career. At 69, she plans to work only a few more years. Even as the pandemic has demonstrated she's probably needed more than ever, the time eventually comes for everyone. If nothing else, life in health care has taught her that.
"I get asked about once a month, 'When are you leaving?' because eventually I will. But I don't think about it that much," she says. "There's been a lot of changes here, but I roll with the punches. UAMS has people like myself that have been here a long, long time because they love it. There's a large group of us that have been here for a very long time because we want to be here.
"I could have always gone home to Camden, but I love Little Rock. I still to this day have people from Camden calling me. I've even had some of the physicians from Camden calling me saying, 'Hey, I need to get this lady in and they said I can't get them in for two months.' Well, that's kind of a challenge and I like a challenge."