Physician's sideline extends 6 feet under
■ A South Carolina family physician runs an eco-friendly cemetery.
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From time to time, patients visiting the office of Westminster, S.C., family physician Billy Campbell, MD, ask him about his side business.
"Sometimes I'll be seeing patients and they say, 'Look, doctor, I know I'm here about my blood pressure, but do you have any information about your cemetery?' "
Since 1998, Dr. Campbell has operated Memorial Ecosystems Inc., which does "green burials" -- an ecologically friendly way to bring life after death.
Coffins interred at Ramsey Creek Nature Preserve, a 37-acre woodland owned by Memorial Ecosystems, are made of nontoxic, biodegradable wood or reinforced cardboard. Bodies, stored and prepared by a local funeral home, aren't embalmed, so they decompose quickly, helping to nourish and restore burial areas. Grave sites are marked by flat inscribed stones, plants, flowers or trees.
"The graves become natural areas by themselves," Dr. Campbell said. Memorial Ecosystems restricts burials to spaces that have been plowed, farmed or overtaken by invasive species that need to be eradicated. "The burials help return that particular space where someone is actually buried to a very vital, growing living condition."
Dr. Campbell said the side business merges his passion about environmental issues with an interest in how and why the dead are buried. Still, it took Dr. Campbell 19 years to act on his idea of an environmentally friendly cemetery. He said he struggled with whether it was appropriate for a physician, whose job is to save lives, to run a cemetery.
Even now, he does not mix his work as a physician with his cemetery business. His office has no brochures or notices for Memorial Ecosystems, in keeping with AMA recommendations for a physician with any kind of side business.
And when patients ask about his cemetery, Dr. Campbell said, "I tell them I don't handle that part of the business. My wife Kimberley does that. I don't sell plots; I don't push that in my practice. I'll be glad to talk to them about it, but I don't do that as part of my office visit."
Dr. Campbell got the idea of operating an environmentally friendly cemetery in 1979, when he was a second-year student at the Medical University of South Carolina.
Two books inspired him. One was The American Way of Death, a 1963 expose of the American funeral industry by Jessica Mitford. The other was 1979's Kuru Sorcery: Disease and Danger in the New Guinea Highlands by Shirley Lindenbaum, a medical anthropology study of how mortuary cannibalism in a New Guinean tribe resulted in transmission of a fatal prion disease. But Dr. Campbell was struck by the South Fore tribe's belief that the spirit of the dead wandered into the forest, and no one dared cut down trees because it was believed that those spirits "would cause bad things to happen" to anyone who did.
"Some light bulb went off and I said, 'Wouldn't it be great if when we bury our dead, it could be a place to preserve natural open green space rather than consuming land?' "
But Dr. Campbell sat on the idea through his medical education and his first dozen years in Westminster.
"I'm the only doctor in town, and I'm going in the cemetery business? That was the biggest barrier for me. I just couldn't get past it," he said.
Fear of what the 66,000 people living in Oconee County, including 2,700 in the city of Westminster, would think about the idea of a green cemetery also stopped him. "I was afraid people wouldn't get it and that I would be kind of a laughingstock."
Still, the idea gnawed at him. He kept talking it up until his wife and a lawyer familiar with the funeral industry prodded him to act. "The reason I did it is my wife said, "If you don't do something about it, you're gonna have to quit talking about it! You're driving me crazy!' "
So in 1998, he founded Memorial Ecosystems, believed to be the first -- and before last year, the only -- green cemetery in the country.
Throughout the world, Dr. Campbell said, there are many religious faiths that do not embalm their dead, and there are places -- Great Britain, most notably -- that have scores of what are sometimes called woodland cemeteries. But as Dr. Campbell suspected, some patients and others around Westminster didn't warm to the idea of a green cemetery, especially one with a doctor in charge.
"There were a few bumps in the road when we first started with people who didn't understand it," Dr. Campbell said. "I probably lost a couple of patients because of it.
"They say they think it's the craziest thing they ever heard of a physician doing. I guess it's their privilege. I just have to get past that and say, 'Well I don't care that people laugh at me. This is the right thing.' "
But slowly, more of Dr. Campbell's patients and others are getting comfortable with his concept.
Patient Bonnie Ramey said she and her husband Charles bought two plots after reading a story in the local newspaper and questioning Dr. Campbell about green burials.
The idea of preserving land for future generations appealed to the Rameys because many out-of-towners have built expensive vacation homes in and near Westminster during the past 25 years, she said. "You hardly have any access to the lakes and the land like we used to. The animals have nowhere or soon won't have anywhere to go."
Charles Ramey was buried at Ramsey Creek in 2002.
"My husband's sister and her husband both went over there the morning before [Charles] was buried. They said it was the prettiest thing they had ever seen, and they love the idea of it now. But at first they didn't," Bonnie Ramey said.
To date, Dr. Campbell said, Memorial Ecosystems has buried 30 people and sold another 75 plots for about $2,000 each. His business is breaking even, he said.
It also appears ready to take off. Dr. Campbell is partnering with Forever Enterprises, which owns 10 cemeteries around the country, to develop more green cemeteries. The company bought a 17-acre property in the San Francisco area that it will convert into a green cemetery. Recent major newspaper articles also have cited growing interest in green burials.
Some patients still crack jokes about Dr. Campbell covering up his mistakes, and getting people either coming or going, he said. He has a lighthearted response to those jokes: "What I tell people is that I make a lot more money on people when they are alive and I'm taking very good care of them than I do when they die."