ROCHESTER — They arrive in all seasons and from every corner of the earth: the chronically ill, the suddenly stricken, the worried well. They come seeking answers, guidance, and healing at this medical oasis in the Minnesota cornfields.
Monica Robles, a copy center supervisor from Arvada, Colo., was referred to Mayo Clinic to be treated by a top specialist in her rare heart condition. Vicky Wright, who organizes marriage workshops in Austin, Texas, flew in for a complicated biopsy. Kuwaiti aviation official Abdullah Al Obaid is spending four or five months in this small city south of Minneapolis so Mayo neurologists can adjust and monitor his multiple sclerosis treatments.
"Everything is right here," said Al Obaid, 57, who is comfortably ensconced with his wife, Khaledah, at the nearby Kahler Grand Hotel, where they are regulars at the Starbucks counter. "I like the people here. It's easy to move between the hotel and the clinic."
Rochester, with its population of just over 100,000 and its iconic water tower painted like an outsized ear of corn, may not be a place many would choose to vacation.
But the presence of Mayo — a world-class medical center that draws presidents, kings, and entertainers — has turned it into a thriving destination for reluctant tourists from every US state and about 140 countries. Roughly 40 percent of the 400,000 patients seen at Mayo's main campus here each year come from outside a 500-mile radius, including more than 8,500 international patients. They are traveling not to tropical beaches or ski slopes but to doctors, nurses, and expertise. It is a role the city, and the state, are embracing.
"We're a global destination for complex care," said John H. Noseworthy, the Melrose-born Mayo Clinic chief executive. "That's what we excel at, providing hope where there is none."
Mayo has enjoyed a reputation for its long reach and welcoming culture since pioneer doctor William Worrell Mayo, an English immigrant who settled in Rochester during the Civil War, joined with Franciscan nuns to treat residents injured in an 1883 tornado. The founder's sons, Drs. William James Mayo and Charles Horace Mayo, traversed the globe to learn and share best practices. They also hosted foreign doctors who visited their Rochester clinic.
In a historical anecdote often recounted here, the younger William Mayo, known as Dr. Will, attended a Mexican bullfight as the guest of the country's president in the 1920s and rushed to a makeshift care area behind the ring to stanch the bleeding of gored matator Alvaro Obregón. That began a long relationship between Mexico and Mayo Clinic that continues today and now encompasses scores of other countries. They include Canada, China, India, and a number of Gulf Arab states that refer patients here through their US embassies.
"Sometimes you walk in the lobby and you feel like you're in Dubai," said Dr. Mikel Prieto, the Spanish-born international medical director at Mayo. "It's very cosmopolitan."
Hoping to build on that tradition and further extend Mayo's reach at a time when rival institutions ranging from Massachusetts General Hospital to Cleveland Clinic are marketing their health care globally, the Minnesota Legislature in 2013 passed a "destination medical center" law. It committed $585 million in state funds to supplement $5 billion to $6 billion in expansion projects envisioned for Mayo and Rochester over the next two decades.
"Mayo Clinic decided we're going to grow, and grow in Rochester," said Lisa M. Clarke, a Mayo executive who doubles as executive director for the city's new Destination Medical Center economic development agency. "But we wanted to make sure that Rochester lifted up its brand to support what Mayo is doing. When they step off the curb at Mayo, patients expect something different than they did 10 years ago — a different kind of lodging, retail, arts, and culture."
The state funds will be used mainly for infrastructure upgrades. They will accomodate $3 billion in investments from Mayo and $2.3 billion from private developers in new downtown housing, hotels, restaurants, shops, arts venues, and parks, much of it along the Zumbro River, which winds through the city. "It's time for us to activate the river," Clarke said. She said Rochester hopes to attract more visitors from around Minnesota and neighboring Iowa for baseball and hockey tournaments on the weekends, when fewer Mayo patients fill hotel beds.
But there's a recognition that cultural amenities alone won't bring people to Rochester. The hospitality of local residents also plays a vital role, especially religious groups that serve as patrons to some visiting patients who lack the means to afford medical care.
Anna and Oleg Pecherskii originally came from Moscow in 2010 so their 14-month-old son, Roman, could get a kidney transplant. They returned to Russia, where Oleg worked as a software engineer and Anna as a financial manager. But when they found it difficult to get the right medication and care for Roman, they left their native land and moved to Rochester in 2012 with Roman, now a healthy and lively 5-year-old, and his 13-year-old brother, Sergei.
Shortly after Roman was born, the doctors in Russia "told us he will die because he didn't have a [functioning] kidney," Anna said. "I didn't believe he would die. They said, 'Don't have hope.' No hospital in Moscow would take him. Oleg found Mayo Clinic on the Internet."
Oleg recently received a work permit and Anna volunteers locally. But until they get on their feet, they've been helped by charitable sponsors from Rochester. They also benefited from a "kidney exchange," in which Oleg donated his kidney to an American woman in exchange for the kidney that was removed from a young man to be transplanted in Roman.
Over the past few decades, Mayo Clinic has expanded its footprint by setting up clinics and acquiring hospitals in 72 communities across the Midwest. It also has satellite operations in Scottsdale, Ariz., and Jacksonville, Fla., and a network of telemedicine alliances in the United States and Mexico, including one with Dartmouth-Hitchcock Medical Center in Lebanon, N.H., in which Mayo specialists collaborate with partner hospitals on patient care.
While it is now a nonprofit insitution generating $10 billion in annual revenue, Mayo has resisted invitations to build new hospitals overseas, as some of its peers are doing. "We're asked multiple times a month to build a hospital in China or India," said Noseworthy. "We could do it, but it would be hard to manage it. We feel that we can't scale our culture."
That means that the flow of patients to southeast Minnesota will continue. Among the notables treated by Mayo doctors have been former President Ronald Reagan, hotelier Conrad Hilton, country music singer Glen Campbell, and Jordan's King Hussein, who used to fly himself to Rochester and park his private L-1011 jet on a runway at the local airport.
When George H. W. Bush parachuted out of an airplane over coastal Maine to celebrate his 90th birthday, "those were Mayo knees and a Mayo hip he was landing on," said Matthew D. Dacy, director of the clinic's Heritage Hall museum.
When patients get here, Mayo tries to schedule their tests, surgeries, and consultations as closely together as possible. "We create a very tight and efficient itinerary for people coming in for a procedure or a diagnosis," said Mayo chief administrative officer Jeffrey W. Bolton.
The journey to Rochester for Wright, 58, began after doctors in Austin and Chicago told her the biopsy she needed would be difficult. She was tested in four labs. "All the tests were being sent to Mayo," she said, "so [her husband] Phil said, 'Why don't we just go to Mayo?' ''
Robles, 49, the Colorado woman who was born with a congenital heart defect called Ebstein's anomaly, hadn't expected to be taking her summer break in Rochester. But when she found herself gasping for breath while hiking this spring, her doctors referred her to a Mayo doctor who specializes in treating the condition. She, too, feels grateful to be here.
"I'm walking around enjoying this little town," said Robles, who recalled eating twice at a Dutch diner during the first days of her visit. "I kind of joke and say it's a vacation, and I'm going to take in some sights. But I probably wouldn't come other than for this very unique, very complex surgery. It's pretty amazing, just the way the hospital is run. They know what they're doing for sure. That's why my doctor referred me here. They're the best of the best."
For Al Obaid, who has been traveling from Kuwait for years for his multiple sclerosis treatments, returning is like attending a reunion.
"Many people from the Gulf are here," his wife, Khaledah, said, "from Saudi Arabia, Qatar, Emirates, Bahrain. Many of them we see every year. We go out to dinner."
Robert Weisman can be reached at firstname.lastname@example.org. Follow him on Twitter @GlobeRobW.