Dr. Judd Lindley

I told my grandmother at the time that I got admitted to medical school, thinking she would say, congratulations. Good job. I'm proud of you. And the first thing out of her mouth was, Don't you dare get a big head you put your pants on the same way as everybody else. That was her response to my admission to medical school. It's like, okay, I hear you, grandmother, so I'll be good.

Kristen Carpenter

I'm Kristen Carpenter, and this is Appalachian Care Chronicles, a podcast bringing you stories from every corner of West Virginia's health sector. Join me as we journey alongside a variety of problem solvers, change makers and daily helpers who are all working behind the scenes and on the front lines to care for our communities Together, we'll explore what they do day to day, the steps that got them there and the whys that continue to draw them back. How, in the face of some of the most challenging situations possible, do they manage to keep themselves and the rest of us from falling apart? Far from predictable, the paths they've walked are full of twists and surprises, discovery and purpose. This podcast is for anyone who's ever thought about going into the healthcare field or has a passion for caring for others in times of need.

Kristen Carpenter

Our guest today is Dr. Judd Lindley, an obstetrician gynecologist, also known in the healthcare field as OB-GYN. Dr. Lindley works in some of the highest needs areas in West Virginia regions that have been designated as medically underserved, and in Welch, where Dr. Lindley sees patients two days a week, resources are scarce. There's just one acute care hospital in all of McDowell County's 533 square miles, and health outcomes here are among the worst in the country. That's where we tagged along with Dr. Lindley to observe his work.

Dr. Judd Lindley

So how's life with no uterus. Somewhat better, somewhat better. I don't know.

Patient

I've been absolutely miserable with hot flashes. Okay, my hair is falling out in golf.

Dr. Judd Lindley

Okay. Has anything to do with that? I mean, it can.

Kristen Carpenter

Here he's trying to find out what might be causing an increase in menopause symptoms for one of his patients, a nursing student in her 40s who'd recently had a hysterectomy.

Dr. Judd Lindley

…is it getting worse, or is kind of about the same as it was before?

Patient

So, the hot flashes, my hair wasn't falling out before, but the hot flashes are just a little stroll through Hades.

Dr. Judd Lindley

So you were having hot flashes of even before we did the surgery. And now things are worse.

Patient

Yeah, now they're extreme, like, 50% worse, 100% worse, I'd say a good 50% worse. Like, I'm pouring I'm sitting here now, and I'm pouring this way, and it feels like somebody has a brand in my back.

Dr. Judd Lindley

Okay, all right, so let's do this. Let's stop that over the counter menopausal supplement. Stop that for like a week or two, and then I like to check an FSH. That's the hormone that tells us whether you're fully menopausal or not. The definition of menopause is no period for a year. At this point, that ship has sailed. So anyway, so with that, let's see whether your menopausal, and see whether there's a role for just plain old, just normal estrogen, menopausal. Then we'll kind of go from there. So Okay, any other issues?

Patient

I spotted a little bit like a week ago, but I haven't really got to do I may have lifted more than I should have.

Dr. Judd Lindley

Okay, well, well, we're only a month out, so okay. I mean, you're still healing, so going to the bathroom. Okay, some surgery.

Patient

Um, I struggled for about a week.

Dr. Judd Lindley

Back to normal? Okay, okay, intercourse, yet? Not everybody listens, but that's the right answer, okay, okay, good, okay, all right. This is the final pathology report. Okay. So basically, your cervix looks fine. Endometrium lining room look fine. You had what's called adenomiosis. That's where the inner lining of your womb grows into the muscle layer, and you would perceive that as bad cramping. Okay, did you know?

Patient

I feel validated.

Dr. Judd Lindley

Okay, all right. So yeah, so you had definitely reasons for this. So so you can keep that. You can either frame it or line your bird cage with it, or whatever you want to do. So okay, there we go. Okay, all right, I'm gonna step out and we'll let you change. Just waste down. We'll do an exam see how things are healing up. Okay, okay, okay.

Kristen Carpenter

That simple comment, “I feel validated,” is key to how Dr. Lindley provides care. He doesn't just talk at patients. He talks with them. In a field like OB-GYN, where female patients are overwhelmed with conflicting information, providers are often expected to serve as both clinicians and interpreters. Dr. Lindley builds trust through small but deliberate choices, listening fully, explaining clearly, and treating every concern as worthy of attention. When patients feel safe enough to ask questions, they're also in a better position to receive meaningful education. That sense of safety doesn't come from the diagnosis alone. It starts the moment Dr. Lindley enters the room.

Dr. Judd Lindley

Every single patient, when I go in the room, I always shake their hand. It doesn't matter, you know, short, tall, fat, skinny, stinky, dirty, well groomed, clean, I will shake everybody's hand. Hi, I'm Dr. Lindley. How can I help you? What do you need? And then sit down on the stool. I never stand over top of a patient. I never lean over them. And even if I don't happen to have a stool in the exam room, I'll say, “Hang on a minute. Let me go find someplace to sit down.” You know, sit down. Take a minute. How can I help you? What do you need? What do you what are you here for? Hear the patient out, and then I also try and go, “And what else? What else? What else? What else? What else?” And I'll keep asking, “What else?” until they're like, “I think I've told you everything.” And even if I can't solve all their problems, or even if I have no idea what's going on, at a bare minimum, the patient feels like they've been heard.

Kristen Carpenter

Dr. Lindley grew up in the northern part of West Virginia, just along the Pennsylvania border.

Dr. Judd Lindley

So I grew up in Preston County in Kingwood. Was actually admitted to WVU as an engineering major out of high school. Then I got into what was called the Health Careers Opportunity Program, which was kind of a pre freshman program for people looking at health careers, w ent through that said, “Okay, some sort of health profession seems interesting.” And even through undergraduate, I thought about switching to medical technology. That was an option.

I ultimately got a degree in Biology, a BA in Biology from WVU. Applied to WVU medical school. Applied early decision. Got in that fall to medical school. I thought about all kinds of different things in medical school. I thought about family practice, trauma surgery, orthopedic surgery, pediatrics, med peds, and then kind of came around sort of full circle to OB-GYN. And I guess kind of the sentinel moment was, I was a third year medical student doing my OB-GYN rotation, was myself and a faculty member, there was a clinic in the physician's office center where, basically it was for young women to come in, basically get birth control. Went through, saw this lady, she'd never had a pelvic exam in her life, went through the whole thing, “Here's what's going to happen, here's what you're going to feel, here's how this is going to be,” went through, did the exam with the faculty member, and at the end of it, that lady said, “Well, that wasn't so bad after all.” And I was like, “Okay, I think, I think this is the one.”

It's happy medicine, because you get to deliver babies, and then you can fix things. If somebody has bad bleeding, you can do hysterectomy. I've seen patients as young as 10 or 11 with menstrual disorders, and I've seen ladies well into their 90s. So whatever comes through the door, I'll take care of it, anything from well woman to problem visits take all comers.

Kristen Carpenter

Dr. Lindley found rural medicine to be a unique mix of close relationships and complex realities. Providers in rural communities often end up caring for multiple generations of the same family and getting to know the details of their patients lives, not just their diagnoses, but that proximity also means seeing firsthand how poverty, isolation and lack of infrastructure, shape medical decisions. In southern West Virginia, something as basic as getting to an appointment can become the biggest barrier to care.

Dr. Judd Lindley

I can, usually once I gain the patient's trust, I can, if I need to send them out of the area, I can usually get them to go. But yeah, there is some sort of arrogance on administrator’s part of “They can just drive. They can just go.” You'll hear people say, “Well, that patient is non compliant.” I don't believe that there's a person in the world who says, “I want to intentionally sabotage my health.” So the whole notion of “I'm non-compliant,” I think, is ridiculous. I think it comes down to, you know, “I didn't have gas money, I didn't have a transmission in my truck.” I mean, I saw pregnantly the other day. I hadn't seen her for. Probably three months, and you come into it with like, “Hey, what happened? Where have you been? Is everything okay? What's going on?” Well, her older child had a very serious health problem, and she was with her older child in the hospital, in a children's hospital, for those three months that she was gone, and she basically saying, “It's more important for me to be there for my other child, who's already here. I feel like my pregnancy is okay,” and she kind of came back into care, and sure enough, everything was okay. If you approach her from that position of “What's going on, how can I help you?” as opposed to, “You don't care. "You're not compliant.” And unfortunately, I've tried to send patients to the tertiary care centers and they say, “Well, they told me I was 15 minutes late, that I had to reschedule.” Well, they've waited for this appointment for six months. It was a four hour drive. The fact that they were late by 15 minutes because they didn't know where they were going in town… Just see the patient! Please. Like, don't turn them away.

You know when you come and meet patients on their terms, on their turf, as opposed to saying, “No, you have to travel to Charleston, you have to travel to Morgantown, you have to this huge city…” Patients are very uncomfortable in those settings. When you are just right down the street from them, they're comfortable, and they'll open up and they'll tell you their story a little bit better. You know, ladies over the years, I mean, I've had people bring me moonshine. I've had people bake me cakes at Christmas time. I've had people bring me cards and thank you notes. And there's one lady I've seen for years and years, and, you know, she needed some help with some issue, and then I needed some help from her son about some farming issues. Of, like, we it's just this symbiotic relationship of, “You know me, I know you. We're all good people. Let's just, you know, let's just work together.”

Kristen Carpenter

West Virginia needs great mental health professionals if you're practicing in an underserved area and need help repaying your student loans. Apply for the Mental Health Loan Repayment Program through the West Virginia Higher Education Policy Commission, visit cfwv.com to apply, that's C F W V.com.

Kristen Carpenter

You heard that, right. Dr. Lindley needed some farming help. He and his wife, Kristen, a critical care nurse, raise grass fed cattle, pigs and chickens, and sell the meat to local distributors. And they have committed to being good stewards of the land. We spent time with them on their farm, making the rounds, so to speak.

Dr. Judd Lindley

You know, we let everybody free range. We've got some nest boxes set up here, and then there's some over in the other barn. So every day is like an Easter egg hunt. We bought the farm in 2003. We built the house. We moved into the house in November of 2006 and have been here ever since. You know, she picked out the plans online for the house as a five bedroom house. And our contractor, which is a friend of mine who helps me with the cattle, he's like, “Five bedrooms. What are you doing?” Like at the time, we had just one kid, and yeah, then we get the house started, and Kristen goes, “David. Pregnant.” and he’s like, “I better hurry up!” And yeah, so there's three bedrooms. And then the boys came along, then again, after the fact of you know, so we got the place full now. It is. It's pretty fun.

Kristen Carpenter

The Lindleys are really committed to sustainability. During the early days of the covid pandemic, they persuaded their daughters to learn how to use animal byproducts they'd normally throw away. They make soap from pig lard in scents like fruit loops and Margarita they render beef fat into tallow and use it in body butter and lip balms.

Kristen Lindley

I was at Sam's Club, and there was some kind of 100% beef dog treats. And I was like, “What is in this?” And I turned it over, and it was pumpkin and beef long. And I was like, whoo, hold on, I have access to beef lungs. And again, I really like using the animals rather. I don't like them being thrown away. Like we take care of them. We care about them. So we started getting the lungs and livers from the butcher and slicing them and dehydrating them, and we sell that as dog treats.

Dr. Judd Lindley

Well, and that's and that's kind of the way it sort of works. If, when we have pigs the hospital. Cafeteria gives me leftover food that would ordinarily just be thrown away, and so we'll get five gallon buckets worth of food, and I'll just put it in here. The pigs will eat it in addition to their normal feed.

Kristen Lindley

I've gone through several different cafeteria supervisors. Some are willing to do it, and some aren't, and we have to have clean buckets with lids. It has to be refrigerated. They put it out for us. We pick it up daily. So it's not like sitting around, but certain, certain supervisors will work with us, and some won't. And we don't, we understand

Dr. Judd Lindley

it really is. It's really kind of therapeutic, of like, I don't golf, I don't hunt, I don't fish, but yeah, just come over here and listen to the sounds of nature. And yeah, I mean, it's all four seasons.

Appalachian Care Chronicles Production Crew

When you all sleep?

Kristen Lindley

Never! As soon as I get home from work, I pass out…

Kristen Carpenter

Dr. Lindley has found a lot of purpose living in rural West Virginia, caring for his farm and caring for his patients in the southern coal fields. He actually had a connection to McDowell County long before he began working in the medical field. His grandmother lived in Coalwood where the Homer Hickam book, Rocket Boys, and the film adaptation, October Sky, is set. His family used to drive down after he got out of school on Fridays, back when it used to take eight hours to get there from Preston County. Though the drive is much shorter these days, the picture on the ground is very different. One hospital left and a community worried about the future.

Dr. Judd Lindley

You know, in the 1950s this county had a population well over 100,000. T his town had three separate hospitals. There was Welch Community Hospital, there was Grace Hospital, which is right downtown, and then there was Steven’s Clinic, which now has been turned into a prison, but you had your choice of three separate hospitals that you could go to. And as the population has dwindled and dwindled and dwindled and dwindled, it becomes sort of the forgotten county. Yeah, I mean, there's millions of dollars of coal severance tax have come out of this county over the years, the 100 plus years of mining coal, and the individuals that are left here are going, “What about us? We have supported this state for years and years,” and even still today, I mean, you pass coal trucks that are hauling coal today. There's still a ton of mining going on. There's still a ton of coal coming out of here, and so the individuals are left are like, “What about us?”

Kristen Carpenter

Some of the hardest lessons Dr. Lindley learned didn't come from the classroom. They came from real patients, real moments and real consequences early in his career, he made mistakes, but instead of burying those stories, Dr. Lindley shares them with his students, because he knows that being honest is one of the most powerful ways to help the next provider get it right. One story he shared with us was about an assumption he made about a 30 something woman he was preparing for surgery. He didn't realize it, but the woman wore dentures, which she had to remove before the procedure.

Dr. Judd Lindley

And I made some sort of arrogant, smart aleck-y comment about, you know, “What? Did you forget to brush your teeth?” or something to that effect, I forget what I said about her lack of teeth, but it was very clearly insensitive. She didn't really say anything to me. I went ahead and did her surgery. She stays overnight in the hospital. I'm rounding on her the next day, and she said to me, when I walked in the room the next morning, she said, “I was really angry at you before surgery, she says I was hit in the mouth with the baseball as a kid, and my parents tried to do everything we could to save my teeth, and it was not possible. And even my own husband hasn't seen me without my dentures in, and I didn't want to say anything to you right before surgery, because you're about ready to cut me open with a knife, and I didn't want you to be mad at me.”

And of course, at this point, I'm falling all over myself going, “Oh my gosh, I'm so sorry. I didn't know.” I'm trying to apologize profusely. “I'm sorry,” and I don't even think that lady even came back for her post op follow up because she was so angry at me, and I wouldn't I can't remember her name, I would love to go back in time and say to her, “You have taught me this incredibly valuable lesson over, “Don't make assumptions,” and I tell that story to my students again and again all the time.

Kristen Carpenter

Another time he had a patient with an itchy white spot, which he immediately diagnosed as a chronic inflammatory skin condition.

Dr. Judd Lindley

So I prescribe the steroid cream because “I know everything” and comes back the next year I do her exam again. I'm like, “Oh, crap, that was not Lichen Sclerosus.” She had a actual vulvar cancer, and had I biopsied that a year before, it was small enough and would have been really simple to fix, and instead, it had become much more extensive. She now needed a much bigger surgery. Luckily, it was non invasive, hadn't spread anywhere, and she's done okay, and has to her credit, I don't even know to her credit, but she still continues to come see me every year. If I have a student with me, I tell them that story. “You think you know it all. You don't.” You have three choices. When you have a vulvar lesion, you can either biopsy it, or you can biopsy it, or you can biopsy it. Those are your three choices.

Kristen Carpenter

He's also known to bring some levity to his colleagues and patients. His jokes are disarming for patients, but they're also kind of corny.

Dr. Judd Lindley

Did ever tell you about the eyeglasses convention I went to?

Colleague

No wait a minute, I wear eyeglasses.

Dr. Judd Lindley

It was quite the spectacle.

Colleague

See, he makes me…

Dr. Judd Lindley

You know, where I keep all my dad jokes, right? In the Dada-base. And you know, and, you know, when a joke becomes a dad joke, right? When it becomes a parent.

Well, it, I mean, typically you do a rectal exam on on ladies over the age of 50 as a screening process for colon cancer. And there's not a woman in the world who's like, “Woohoo, I get a rectal exam!” Like, I mean, you just try and make it at least reasonably okay. Of like, “Yeah, this is a pain in the butt.” And they're like, of course, some of my long time ladies are like, “That's the same joke you tell me every year. Like, you need new material.” I said, “Well, better to laugh than cry while we're in here.”

Kristen Carpenter

So, Dr. Lindley isn't just providing health care, he's also helping shape the future of the profession. Medical training doesn't always teach new doctors how to build trust with patients, how to listen closely, or how to handle the quiet moments in the room. Those skills are learned by watching, asking, practicing side by side with someone who models them through rural rotations. Dr. Lindley gives students a front row seat to what real world medicine looks like in West Virginia. It's a big time commitment layered on top of a full patient load, and the compensation for it's typically pretty low, but for Dr. Lindley, it's about passing down a way of practicing that stays rooted in compassion, clarity and respect for the people being served.

Dr. Judd Lindley

I mean, I was blessed. I had people who took me under their wing. When I was a student, taught me. I did even some shadowing, even before I went to medical school. I like to teach. I like to impart to knowledge of “I feel passionate about women's health, and want to share this information” so I enjoy having students.

I've got some WVU students coming in the fall, when they go to do their rural OB-GYN rotation, they are given a list of here's locations. I'm a clinical assistant professor at WVU, I'm part of the faculty, it doesn't come with a salary, but it's a but if I take somebody for four weeks, WVU gives me $500 bucks. You know, I'm not going to retire on that, but it's a nice gesture of like these guys are paying a bunch in medical school tuition, I'm helping them educate their students, I think it's a reasonable relationship.

And so many patients will come in and says, “That doctor never even sat down, that doctor didn't listen to me, that doctor doesn't care,” And I'm not the smartest guy in the room. I don't know everything. I'm not the best surgeon, but you can simply be kind. And so hopefully by showing that when students rotate with me every single time, they can see how, you know, I try and show caring and compassion for the patient.

Kristen Carpenter

Appalachian Care Chronicles is a production of the West Virginia Higher Education Policy Commission Health Sciences Division, which is solely responsible for its content. Guest opinions are their own.

For more information about educational opportunities related to health care in West Virginia, visit appcarepod.com that's A P P carepod.com.

Special thanks to Welch Community Hospital.

I'm Kristen Carpenter, and you've been listening to Appalachian Care Chronicles. On the fourth and final episode of Season Four of Appalachian Care Chronicles, we're heading to the ER with trauma nurse, Petra Howell-Vasale. After a career in small business baking specialty cakes for customers, Petra found a new purpose caring for people in crisis.