In 2002, when Genesis Medical Center in Davenport, Iowa, built a three-story addition to what had been its entrance, it looked beautiful from the front. A cascading fountain with limestone boulders and artful plantings greeted visitors as they came up the walkway.

But inside, the view was another story. Patients on the third through fifth floors, who had once seen trees and the surrounding bucolic residential neighborhood from their windows, now looked out on sewer vents, heating and air conditioning hardware, and drain grates.

Joseph Lohmuller, M.D., a general surgeon who was then the hospital's trauma program medical director, couldn't get past the aesthetic lapse. "I had patients up there who were recovering from major operations, sometimes dying of cancer," recalls Lohmuller. "You can't have them lying here sick, looking out on this gravel roof."

Hoping the roof was unfinished, he went to the hospital administration. "I said, 'What are you going to put out there?' They said, 'We're not going to put anything out there.'"

"Certain things bother me, and I think that they ought to be fixed," says Lohmuller, the son of a doctor who founded a clinic for migrant workers in Bluffton, Ind. "When you see a problem, you can either live with it or try to fix it. If you live with it, it's a matter of how much does it bother you every day?"

Next, he bent the ear of Missy Gowey, the executive director of the hospital's foundation. "I've been here 20 years, I know everybody. So I said, 'Hey, Missy, come for a walk with me.'" They visited an empty patient room on the third floor that had a spectacular view — of the heating vents. "I said, 'I'm prepared to give you a very large donation, but I will only give it to you if you use it to fix this roof,'" he remembers.

She invited him to present his case to the foundation's board. "So, what I did was go on the roof before the board meeting and take some pictures," he says. "Of course, I picked a gray, dreary day to do it."

He enlarged the details of sewer vents and drains, assembled photos of green roofs he found on the Internet, and created a pretty convincing slide show. "If you just do a little search on healing environments, you'll find all sorts of data about recovery times and the psychology results from patients who are in warm, inviting, comfortable environments compared with stark, cold, staid environments," Lohmuller says.

The board agreed to contribute to the cause if Lohmuller could raise some funds himself. It wasn't a crazy idea. He already had done fundraising on a large scale for his church and the local natural history museum. And with the help of family and friends, he'd been putting together 20- to 30-person Genesis teams — and acquiring the donated medical equipment to go with them — for annual mission trips to Arequipa, Peru.

"I beg people shamelessly," he says.

Doug Cropper, CEO of Genesis Health System for the past four years, puts it another way. "I've worked with a lot of doctors over the course of 30 years," Cropper says. "Dr. Lohmuller is a unique physician in that he's clinically excellent, he's got a great leadership presence that he's developed over time, and he has a unique ability to make things happen that are good for patient care."

To raise money for the roofscape, Lohmuller enlisted the help of his wife and some hospital colleagues. Together, they put on a few receptions and sold plants for the roof "at $25 a pop." Genesis matched their efforts, paying for half of the $200,000 price tag, says Lohmuller.

In 2010, eight years after the gravel roof went up, it was transformed with 800 varieties of sedum plants. Because it was an interior roof, "we had to get cranes to haul all the stuff in" on pallets, Lohmuller says. "The crane was so high they couldn't run it if the wind was more than five miles an hour.

"It took a lot. But I made a prediction to the foundation and the hospital. I said, 'No one will comment on this roof right now. You wait until this thing is done and in full bloom, there will be no end of comments about how nice it is that we did this.' That's exactly what happened."