Host Sarah Jane Tribble checks in on Josh, the teenager who was coping with his aging grandparents and the emotional burden of his mother’s opioid death. Josh’s troubles began before Fort Scott’s hospital closed but worsened after. Sarah Jane gives Josh a call to find out his next steps.

Host Sarah Jane Tribble sets out on a mission to understand the Sisters of Mercy, the nuns who founded Fort Scott’s Mercy Hospital. They were once prominent leaders of the community, but by the beginning of her reporting the nuns are gone. Sarah Jane’s first glimpse into their lives takes her to an old convent.

In Fort Scott, Kansas, the Community Health Center’s big green and white sign replaced Mercy Hospital’s name on the front of the town’s massive medical building. In the final chapter of Season One: No Mercy, we have an appointment to see what’s inside. We also meet wife and mother Sherise Beckham. She helps explain how much more difficult it can be to have a baby when a town loses full-service maternity care. Then, later when she gets a job, at — where else? — the health center, Beckham gives us a front-row seat to the new vision for health care in town.

Trickle-down heartache reaches the next generation in a rural town with no hospital. Meet Josh. He’s a teenager in Fort Scott, Kansas, who dropped out of high school around the same time Mercy Hospital closed. He says those two things are related. The podcast also spotlights new health services now available in town. Mercy did not provide addiction or behavioral health services, but the new community health center in town does.

Sixty-five-year-old Karen Endicott-Coyan is living with a blood cancer and she needs frequent chemotherapy. Before Mercy Hospital closed, she got her cancer care right in town. These days getting to chemo means a long trek on rural roads and narrow highways. The stress and frustration of traveling illuminates one reason cancer death rates are higher in rural America.

For more than 100 years, Mercy Hospital — and the nuns who started it all — cared for local people in Fort Scott, Kansas. Town historian Fred Campbell says Mercy was part of the town’s DNA since its booming rail town days. But in recent years, Fort Scott’s economy and the hospital’s finances faltered. Locals say Mercy went “corporate.” We carry that claim to Sister Mary Roch Rocklage, the powerhouse who consolidated all the Mercy hospitals in the Midwest.

Emergency care gets complicated after a hospital closes. On a cold February evening, when Robert Findley falls and hits his head on a patch of ice and his wife, Linda, calls for 911, the delays that come next expose the frayed patchwork that sometimes stands in for rural health care.

Closing a hospital hurts. In Fort Scott, Kansas, no one was a bigger symbol for that loss — or bigger target for the town’s anger — than hospital president Reta Baker. Reta was at the helm when the doors closed at Mercy Hospital, putting her at bitter odds with City Manager Dave Martin, who some in town call “the Little Trump” of Fort Scott. He says his town wasn’t given the chance to keep the hospital open.

Midwesterners aren’t known for complaining. But after Mercy Hospital Fort Scott closed, hardship trickled down to people whose lives were already hard. Pat Wheeler has emphysema. Her husband, Ralph, has end-stage kidney failure, and the couple are barely making ends meet as they raise their teenage grandson. Pat is angry with hospital executives who she said yanked a lifeline from residents. “They took more than a hospital from us,” she said.

The story begins when Mercy Hospital Fort Scott shut its doors. Locals lost health care. Health workers lost jobs. Fort Scott’s sense of identity wavered. Season One is about what happened next — about the people who remain, surviving the best way they know how. No Mercy: The hole left behind is bigger than a hospital. Hosted by investigative journalist and Kansas native Sarah Jane Tribble, the podcast is a production of Kaiser Health News and St. Louis Public Radio.