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Road to a medical degree required a lifetime's work

CHARLESTON, W.Va. - Dr. Elizabeth Spangler has been cleaning out her office for weeks but says she still has a way to go.

Papers, files and textbooks have a way of piling up over a 50-year career. Spangler is  cleaning off her bookshelves, but the nine diplomas and certificates hanging on her back wall are untouched.

The simple gold frames are neatly arranged in a large grid pattern. Her West Virginia medical license hangs at the top of the arrangement. Spangler's medical school diploma hangs just below it.

There also is a license from the National Board of Medical Examiners, a membership certificate from the Alpha Kappa Mu medical honor society and a certificate from the American Board of Internal Medicine.

Though Spangler, Charleston Area Medical Center's vice president for medical affairs, will retire Jan. 11, she doesn't appear to be in a hurry to take those frames off the wall.

"The stuff on the wall is a story," she said. "It's a story of a lifetime of trying to achieve what I wanted to achieve."

It's a long story, and an impressive one that started in Glendale, Calif. By her senior year of high school, Spangler says knew she wanted to become a doctor. Her family was not very supportive.

"In those days, no one in my family went to college," she said.

There wasn't a lot of money to go around, and Spangler said her family didn't see her education as a good investment.

She said many people felt that way in the 1950s. Spending money on a girl's college tuition was often considered a waste since she soon would get married and quit work.

Spangler also could not get a loan to pay her tuition because banks at the time required signees to be at least 21 years old. She had to abandon her dreams of becoming a doctor but did not give up on education. She received a scholarship from Mercy Hospital School of Nursing in Springfield, Mass., where she graduated at the top of her class in 1959.

She married her husband, Mike, in 1961, while he was in the Air Force. The couple decided to move to West Virginia, Mike's home state, when he left the military in 1962.

Spangler began working at Charleston Memorial Hospital as an operating room nurse but quickly was promoted to nursing instructor and then became head nurse for the operating room.

Hospital administrators then picked Spangler to be the supervisor of the hospital's new obstetrics department. The hospital wanted to begin offering on-site Caesarean sections, and needed a nurse with an operating room background to lead the unit.

After several years in that position, Spangler was promoted to director of Memorial Hospital's emergency department, where her dreams of becoming a doctor were revived.

She said at the time the hospital's emergency department employed a small group of doctors and they could not always be contacted when needed. Sometimes it was up to Spangler to make life-or-death decisions.

"I said, 'I've wanted to do this my whole life. Why don't I give it a try?' "

Becoming a doctor is never easy, but it would be especially difficult for Spangler. She had a young family and a demanding full-time job. Because she had only a diploma degree in nursing school, she would have to finish her bachelor's degree before applying to a medical school.

Spangler began taking undergraduate classes in 1968, picking up a few credits at a time while still working full-time at the hospital. It was a slow process. By 1982, Spangler still had not received enough credits to complete her bachelor's degree.

She thought time was running out on her dream. She said medical schools in those days wouldn't accept students in their late 30s or 40s. She was 40, but decided to apply anyway, even without her bachelor's degree. 

The application process did not go well at first. During one of her interviews, an administrator cast doubt on her abilities to manage medical school and a family.

"He said, 'Don't you know you can't teach old dogs new tricks?' "

Spangler told him that after working full-time, raising a family and taking undergraduate classes in her free time and maintaining a 4.0 grade point average, medical school would be a welcome relief.

"I said, 'Lord, that'd be a vacation.' "

Although Spangler was kept in the medical school's applicant pool, she was not immediately accepted.

Marshall University's medical school was interested in Spangler, however. She said the school recognized her large skill set from years as a hospital nurse and was impressed by her work ethic. In a meeting with the school's dean, Spangler said he didn't make any jokes about old dogs and new tricks.

"He said, 'How have you done all this and kept a 4.0 average?' "

Two weeks later, Spangler received an acceptance letter to Marshall's medical school.

It signaled the beginning of four years of hard work and sacrifice for the wife and mother of two. She tried commuting to school during her first semester.

"One day when I was driving back, I fell asleep at the wheel."

She woke up before veering off the road, but the experience frightened her. Spangler realized she could not live in Charleston and commute to school every day. She took an apartment in Huntington, and drove back to Charleston on the weekends.

The move required some sacrifices from her family.

Spangler's son, Sterling, was a senior at Charleston Catholic High School at the time. Instead of moving off to college, he decided to attend West Virginia State College for his undergraduate degree, so he could stay home with his father.

She said Mike also had to become more self-sufficient.

"My husband needed to learn to do more than boil water. When I went to medical school, we bought a microwave," she said.

Medical school was difficult, but Spangler said her experience as a nurse helped a lot. And she doesn't downplay the importance of a strong work ethic.

"You have to have fire in your belly," she said. "If you don't have a fire in your heart to be a doctor, don't start."

During her time at Marshall, Spangler was named a member of Alpha Kappa Mu, a national honor society for medical students. She graduated in 1986 and headed straight into an internal medicine residency program at CAMC.

She said it was different writing orders instead of receiving them but said her nursing background came in handy again because she understood better than others how a hospital works. Her background also gave her a rapport with nurses.

After completing her residency in 1989, Spangler joined CAMC's staff as director of medical affairs. She also began volunteering at the West Virginia Health Right Clinic, which allowed her to put her newfound doctoring skills to use as a primary care physician.

Spangler became the hospital system's vice president for medical affairs in 1995, before becoming the medical director of CAMC's home healthcare operation, CAMCARE. The hospital sold that section of its business a few years later and moved Spangler in 1998 to its health insurance company, Carelink, where she became the executive vice president and chief medical officer.

She said the job wasn't a good fit.

"I'm not a businessperson. I'm not an economics major. I really love the clinical environment," she said.

Fortunately, CAMC sold off Carelink a year after she moved into the job. In 1999, Spangler rejoined the hospital system's executive offices, becoming the chief medical officer and vice president for medical affairs, the job she holds to this day.

It's a demanding, wide-ranging position, requiring Spangler to work 50 to 60 hours a week. She oversees hospital physicians' accreditations and credentials and manages CAMC's doctor review program. She also runs the hospital's program for troubled doctors having issues with stress or substance abuse.

Even at 74, she's not ready to retire. But she has to.

"My health is not going to give me the strength to continue. I know you can't stay too long at the dance," Spangler said.

She and Mike plan to move to Texas, where their daughter, Kathleen, works as an instructor for United Airlines. They already own a home in the Woodlands, a community about an hour northeast of Houston.

Spangler doesn't plan to hang up her stethoscope yet. She's already applying for her Texas medical license. She said she might volunteer at a clinic but doesn't have any definite plans.

"I like people. I like learning."

The fire in her belly is still burning.

Contact writer Zack Harold at 304-348-7939 or  Follow him at



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