Outsiders may not understand the almost proprietary support Pinelake Center enjoys among the people of Carthage. Their feelings are passionate.

For years, Carthage had no facility to care for residents in need of acute care. Town leaders recognized the need for a facility close at hand for their own people when they could no longer live independently and needed professional attention. They were not looking for a plush retirement center, and they certainly did not want a sloppily operated place eternally under the frowning scrutiny of state inspectors.

The concept had its detractors, who argued that Carthage was too small for such a facility. And besides, why not make use of multiple facilities already available in Southern Pines and Pinehurst?

But Southern Pines and Pinehurst meant a 20-minute or longer drive, and the friends and families of many acute care patients were unable, or uncomfortable, driving that distance, battling New York City-style traffic and searching for a parking place. Nursing home visitors tend to be older, and some may not be able to drive. It's easier to catch a ride when your destination is no more than a mile or two away.

Carthage, where the population now exceeds 2,000, not only landed a first-class health and rehabilitation facility but now has two. The other, Tara Plantation, is also superb, and both places stay full.

In a 2008 report, Pinelake earned a five-star rating in the Five-Star Quality Rating System released by the Centers for Medicare and Medicaid Services. That's the highest rating awarded. Pinelake, in its modest setting beside the Moore County Office Park, outranked more prestigious facilities.

The late Woodrow Wilhoit, my longtime co-worker for the Pilot in Carthage, was among the enthusiastic supporters of Pinelake. Perhaps, deep down, Woodrow was aware that he might need Pinelake, and he did. He spent his final couple of years there.

But that was not the reason Woodrow pushed for the facility. He held an intense belief that Carthage needed and deserved a health-care facility. He kept up with every move taken by local officials to advance the cause and wrote article after article about that campaign.

Younger Carthaginians may not remember the vigor of the communitywide campaign to attract a first-class facility. Billie Mackie, who spearheaded the effort, has vivid memories of the struggle to secure that vital Certificate of Need from the state. Billie was a member of the Town Board at the time and later served as mayor.

Carthage faced keen competition for the CON, without which the facility could not become reality. Several communities were vying for that certificate. The Carthage people kept pushing until they reached the finals. One competitor was from the powerful southern end of the county.

Billie remembers recruiting residents for the public hearing. A bus was filled with Carthage supporters. Others from Carthage and outlying areas filled their own vehicles and traveled to the hearing. Billie thinks that the outpouring of support from the Carthage area had a major impact on state officials, because the town won that certificate.

Visitors flock to Pinelake on weekends. Gilbert Bailey delivers freshly picked gladioli from his extensive garden. Several years ago, Pinelake held a pet event, with friends bringing dogs and cats and other pets to share with patients.

News of the senseless slayings at the nursing home electrified the community, as it would anywhere. But in the case of Carthage, the attack was not merely an attack on one facility and its residents but an attack on an entire community.

Irony heightens the tragedy because patients received the finest care at Pinelake, a place loved and frequented by the people of Carthage. They worked hard to land this beloved facility, and now an intruder has gunned down innocent people whose care had been guarded with affection and commitment as well as professional skill.

Devotion does not go away. Despite tragedy and loss, the spirit remains.

Florence Gilkeson can be reached at 947-4962 or by e-mail at florence@thepilot.com.