NATCHEZ &045;&045; A return to Natchez to begin a career in medicine seemed unlikely for Dr. Keith Schwager. But the new emergency room specialist practicing at Natchez Regional Medical Center since July is sure he made the right decision.

Schwager lived in Natchez from age 7, in 1981, attending several schools before transferring to the Mississippi School for Mathematics and Science to finish high school.

Completing his undergraduate work at Mississippi State University in biochemistry and molecular biology, he envisioned a career in research, perhaps studying complicated virus strains. He chose medical school instead.

At University of Mississippi Medical School in Jackson, he matured and learned how to study, Schwager said. He graduated ninth in his class. &uot;I really thought I wouldn’t like it so much, but I ended up liking it a lot.&uot;

Emergency medicine was a perfect fit for him, he decided, as he completed the four years of medical school and went on to complete an internship and residency. &uot;I like emergency medicine because of the variety and the excitement of it,&uot; he said. &uot;And I like the hours. We work 12-hour shifts, sometimes day and sometimes night. There are usually no surprises about our schedules.&uot;

A town such as Natchez was probably at the bottom of the list of choices for Schwager and his wife, the former Natalie Crow of Ferriday, La., to whom he has been married since 1998, as they began to look for a position for Keith.

The Schwagers have two daughters, Anna, who will be 5 in January, and Rose, 2. The couple decided Natchez was a good place to rear their children as they began to measure their options: big city, urban lifestyle &045;&045; or a small town that has just about every quality they could wish for their young family.

And for Natalie, being near her mother and father was a plus. &uot;My parents live in Ferriday, and I’m very close to my family,&uot; she said. &uot;So I was very excited about coming here.&uot;

And the job offer at Natchez Regional was excellent, Keith said.

&uot;Natchez was the nicest offer, the best job; and then the more we came back here to visit, the more we liked it,&uot; he said. &uot;We bought an old house on Homochitto Street that had already been fixed up. It’s just what Natalie and I both wanted.&uot;

Emergency room work in a small town setting has held some surprises for the young doctor, who is board certified in emergency medicine. &uot;What really surprised me is that the patient population is no different from those I worked with at UMC. It’s just fewer people,&uot; he said. &uot;I though there might be less trauma, but that’s not the case.&uot;

Another surprise has been the number of tourists he sees in the emergency room. &uot;I’ve taken care of riverboat passengers and employees and many people who are from far away, visiting and get sick,&uot; he said.

He has been pleased to ease the fears of some who are accustomed to larger medical centers and arrive in the emergency room at Natchez Regional wondering whether they will get adequate care, he said. &uot;They are always pleasantly surprised.&uot;

Emergency room medicine takes particular skills, Schwager said. &uot;It takes patience; and you have to have a sense of urgency and know how to keep things moving,&uot; he said. &uot;You have to have good people skills, sometimes to calm down anxious family members or patients. No one comes to the emergency room with an appointment.&uot;

The pace can be hectic and the trauma cases life threatening. That’s where the training kicks into play, Schwager said.

Four emergency-room doctors practice in Natchez at the two hospitals, two at Natchez Regional and two at Natchez Community, Schwager said. &uot;That’s not enough.&uot;

Further, more doctors in other specialties are needed, he said. &uot;There’s been a lot of progress in bringing in new doctors, but we need more.&uot;

Nurses are in short supply, too. But he has highest praise for the nurses working with him in the emergency room. &uot;They are great. They are very experienced,&uot; he said.

Schwager imagines remaining in Natchez for a long time. His wife is getting involved with club work. And both he and she have enjoyed making new friends and renewing old friendships.

&uot;You don’t appreciate a place like this until you live somewhere else and come back,&uot; he said.