We all know the old adage that the road to Hell is paved with good intentions; I prefer to believe noble ideas have their places in Heaven and on earth, provided they’ve got a little work backing them up.

Tuesday night, I realized good intentions, combined with education and effort, belong inside hospital board rooms, too. As the Princeton Community Hospital Board of Directors faced a decision that will hopefully be its toughest in a long while, at the same time that almost 200 friends and neighbors pulled members toward continued non-profit operation, I hoped that the people casting the votes were there for the right reasons.

Heated debates approached boiling in recents weeks as very different predictions emerged about the future of the hospital built largely with community dollars and standing solidly on city property.

The prognosis and proposed cures depended primarily upon who was doing the diagnosing.

One camp argued that the current profit margins are nowhere near enough to survive the economic hardship of a lengthy national recession and the variable of health care reform, while still allowing reinvestment in the facility.

One claimed the hospital is fiscally healthy and needs only proper management and lots of tender, loving care from the community that still very clearly believes PCH belongs to the citizens.

A third acknowledged that a capital partner may someday need to be part of the equation, but even those people were skeptical of LifePoint Hospitals, which seems to have made few friends in the neighborhoods into which the corporation has moved recently.

Since last spring, when a motion to begin exploring collaboration with LifePoint left the region reeling, people who hoped to keep the community a part of PCH watched anxiously for signs that sales talks could be resuming.

Six weeks ago, a special strategic planning session piqued media interest, sounded volunteers’ alarms and set the most determined among the local activists into action.

Amid dueling campaigns of full-page ads, confidential interview requests, petition drives, public surveys, City Council appearances, Chamber of Commerce debates and very little “official” information, there appeared to be literally hundreds of people who believed they knew the right thing to do.

Standing staunchly behind their “strategic planning” process, some PCH leaders appeared equally determined that they knew best, calling for citizen input only weeks after the negotiations began and a memorandum of understanding was drafted that would begin collaboration between PCH, Bluefield Regional Medical Center and West Virginia United Hospitals.

Tuesday was decision day.

It was the day PCH sales opponents said Princeton would either hold onto its hospital or surrender local control to a profit-driven conglomerate in Tennessee. It was the day PCH officials said the board could begin a process to solidify the hospital’s future with help from outside. It was the day many PCH employees feared would be their last in a place that had become their second home.

Tuesday was a single day that carried one big decision and more ramifications than any of us could imagine or understand, even after the fact.

I believe it was also a day when 15 people with good intentions were charged with making a life-and-death decision for the entire region before an equally well-meaning, anxious, outspoken audience.

At the end of the day, the motion to merge failed, because there wasn’t a motion. The audience members who had worked so hard and spoken their minds, even under fear of losing their friends or jobs, were jubilant. But they were respectful, too, quick to express their thanks and leave the proceedings.

Some of the board and PCH administrators were likely disappointed, but like most of the planning, they kept that to themselves, too. They simply thanked the community for its interest and investment in the hospital and pushed through the rest of the business meeting.

Was Tuesday’s decision the right one? We all have opinions, but none of us really know for sure.

The best we can hope is that it was made with the best of intentions for the right purposes and that there will be lots of wise plans, stirred souls and strong backs equally willing to work for PCH’s tomorrow as they were to keep it in the community today.

Tammie Toler is Princeton Times editor. Contact her at ttoler@ptonline.net.