Country Doctor Leads Drive for Modern Tangier Island Clinic

By Stephanie Heinatz, Daily Press, Newport News, Va.

Dec. 29–Claudine Eskridge walked into Tangier Island’s Gladstone Memorial Medical Center, hoping to walk out free of pain and knowing why her right knee was swollen and her feet throbbed.

The 37-year-old mother of four young boys needs to get around the isolated island in the Chesapeake Bay with ease. Her waterman husband is gone during the week, leaving her to tend to the boys largely on her own.

Until this appointment with Dr. David Nichols, she dealt with the problem by taking up to 17 Advils a day. Nichols hoped to find the root of Eskridge’s pain, which has plagued her for months, with an X-ray.

But while another patient lay on a table bound together with duct tape, the X-ray machine stopped working.

At the 50-year-old clinic, that’s par for the course, said Nichols, a resident of Virginia’s Northern Neck and owner of the modern White Stone Family Practice.

At the Tangier clinic, clear packing tape holds the main power cord onto the X-ray machine. Ceiling tiles are water-stained. Years of deterioration have left a sour smell throughout the building. There’s no hot water.

And the restroom, some patients joke, is “Use at your own risk.”

But neither Eskridge nor any of the nearly 600 other residents of the island complain. Most are grateful that Nichols is there for them.

Getting to Virginia’s Eastern Shore or to Maryland can cost up to $100 for a ferry ride and cab fare. It’s a long and tiresome trip that many of the elderly islanders don’t make.

Since 1979, Nichols has been the only doctor to steadily visit Tangier Island, which is as historic as it is isolated.

A 25-mile trip over water from Nichols’ practice in White Stone takes him to the island that Capt. John Smith discovered in 1608.

The island has become known in recent years as a getaway for mainlanders. Tourists are drawn to the quaint bed and breakfasts, home-cooked meals at small restaurants and interesting dialect–a cross between Deep South and Celtic tongues.

For his years of piloting his private plane or helicopter to the island’s weed-ravaged airstrip to work in the dilapidated clinic, Nichols was named the 2006 Country Doctor of the Year, a national award that recognizes physicians who dedicate their time to small, rural communities.

But now Nichols wants more.

He hopes to bring modern medicine to Tangier, which the U.S. Department of Health and Human Services has designated a medically underserved area.

Last year, more than 50 people had to be airlifted off the island by the state for emergency health care.

It’s a high percentage, Nichols said, given the population of the island.

Because the town can’t afford a new clinic–a large number of the islanders earn less than $26,000 a year and fall below the poverty line–Nichols is trying to raise $1.25 million for a new medical center stocked with properly functioning equipment.

It’s something he’s been working on for two years, or since he flew a friend to Tangier for lunch. That friend, Jimmie Carter, also of the Northern Neck, was moved by the condition of the current clinic and helped establish the Tangier Island Health Foundation to raise money for a new site. The foundation has had a new clinic designed and purchased a plot for the site, one that will be four times larger than the current clinic.

Whereas mix-matched furniture fills the current clinic’s waiting room, the new health center will have a covered porch, waiting room and reception office. A laboratory with a separate restroom for collecting urine samples will replace the single, poorly functioning restroom. A record room–as opposed to wooden shelves in a hallway–four exam rooms, an X-ray room with a separate reading room, a procedure room, dental office, storage area, laundry site and emergency area will fill the rest of the square footage.

Doctors, nurses and physician assistants will even have office space. Right now, members of the medical staff transcribe their notes into patient files in the privacy of a storage closet.

“We’ve provided good health care in these conditions,” said Michelle Hass, a physician assistant with Nichols’ White Stone practice who has been coming to Tangier’s clinic for eight years. “Now we need a good facility to keep up with it.”

This year, the state voted to lend its support with a $300,000 matching grant. In addition to a couple of five-digit donations, the Tangier clinic’s receptionist has started selling cookbooks to raise money, and private citizens, including teenagers on the Northern Neck, have held small fundraisers to help with the cause.

“I always wanted to help people,” Nichols said. “Tangier’s a place we can help in our own backyard.”

Nichols is as close to a full-time doctor as the island has seen in years. Before Nichols, a Canadian native, other doctors came and went.

At first, Nichols flew out to Tangier once a week on his day off. As his White Stone practice grew to include more doctors, Nichols alternated weeks with fellow physicians. Even on his off weeks, though, Nichols flies the other doctors out there.

“The townspeople love what Dr. Nichols has done but are excited about a new medical center,” said James Eskridge, Tangier’s mayor.

Tangier can’t afford to build the medical center from town money, but it’s a project that’s high on the mayor’s list of priorities.

“You could say it’s as important to the town as finding a way to protect the island from constant erosion,” Eskridge said. “Just being isolated 12 miles from the mainland means we need a good-quality medical facility here.”

In the nearly three decades that Nichols has been visiting the island, he’s gotten to know a lot about the people and what they need.

“It’s what keeps me coming back–the people,” Nichols said.

Claudine Eskridge, for instance, was born in the clinic and has been Nichols’ patient since she was a child. Nichols knows each of her four sons, who range from 1 to 11.

Looking at 71-year-old Burke Landon’s hands during a recent visit, Nichols can recite Landon’s life story of working on the water and how each callous and scrape has come from that labor. Nichols knows how Landon figuratively wrings those hands worrying about his wife, who–despite severe arthritis in her knees that forces her to walk hunched over while watching their autistic son _ can’t afford surgery.

Few people on the island have medical insurance, another problem that Nichols wishes he could solve. They’re self-employed and often can’t afford private coverage.

It’s a scary thing at Tangier, Nichols said, because the islanders have three times as many problems with heart disease as his mainland patients.

Nichols assumes that even the 20-year-olds who come to see him complaining of chest pain are suffering from a heart problem until proven otherwise.

“That’s why people should think about supporting our new clinic,” said Anna Parks, a Tangier nurse. “They’d help us advance our medical care into the 21st century and save lives.”

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On the Web:

www.tangierclinic.org.

The Daily Press is published in Newport News.

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