Community in action

In the last week I saw a community in action…well, it was a small group within the little town of Craig, AK. But these people accomplished a feat. They were able to get a man, virtually homeless and penniless, to the care of physicians at Duke University Medical Center in Durham, North Carolina.

This is the story.

Rob and I came to this clinic to work for three weeks on November 28. During our first few days, there were several conversations among clinic staff about a man who was in dire need of medical attention. He has no insurance, no money, and almost no support structure in Craig. I learned he had come here some time ago to take care of his mother, who died last year. He has some social issues, to put it politely. To put it bluntly, he is dirty, agoraphobic, and has a noticeable odor.

This man became a patient when he’d recently experienced a change in his voice. 50-ish, he has been a long-term smoker. A man in town who befriended him persuaded him to come to the clinic a few weeks ago to get checked out. A large tumor was found to be pressing on his vocal chords and impacting his airway.

The front office staff began to work on getting care lined up. You do not treat cancer in Craig. You leave and travel to a large medical center to get access to the various specialists your condition requires. From this region of Alaska, that resource is most often found in Seattle, WA. But in this situation, sending this man away with no funds and no support wasn’t an option.

It was discovered that there is a brother in North Carolina, living near Duke, one of the largest medical research facilities in the country. A medical referral was made; social workers contacted. The brother there agreed to receive the brother here. Medical costs will be underwritten by Medicaid.

But…Alaska is a looong way from North Carolina. It is expensive to make a trip like that. And this man couldn’t get there on his own. Turns out the brother is in financial difficulties too, so also unable to finance such a trip. Typically Medicaid will cover travel costs, but for some reason, not in this case.

So an application was made to a national organization that provides free air travel for medical emergencies…just like this situation. For a few days there was faxing and phoning back and forth. The office coordinator spent hours of her time working out details, making calls to solidify plans, meeting with the patient to reassure him of progress.

Then three days before the patient had to travel, the flight plans fell through. The organization was willing to cover travel to Seattle or Anchorage, but not to a location so far away, and outside the standard medical destinations for needy Alaskans. The manager was very polite…he wished they could help everyone, but this was clearly outside their policy parameters.

So, back to square one, with the clock ticking.

Someone suggested the local community cancer coalition might help. The office coordinator called, and within half an hour, two ladies representing the coalition were sitting in the clinic, listening to the story. Turns out they provide up to $1500 to cover travel expenses for medical care. You make an application, make the travel arrangements, and apply for reimbursement.

Someone produced a credit card. Airline ticket, ferry ticket to Ketchikan, airport ferry ticket were all purchased. The coalition would reimburse with a check.

The ferry travel to Ketchikan was full price, but when the accountant for the ferry company came in to the clinic for an appointment, the office coordinator mentioned to her that the staff was trying to assist this patient. The ferry accountant immediately offered to get the fare discounted, which she promptly did.

A nurse from Ketchikan with family in North Carolina was already scheduled to fly back and offered to escort the patient through the travel stages. The friend who brought the patient in escorted him to Ketchikan so he had no time on the journey that he was alone or without support.

So, a small town that supports a local cancer coalition, clinic employees, a caring friend, a nurse traveling home, a brother a long way off, social workers and medical providers on the other side of the country all worked together. And they pulled it off.

I don’t know how this story will end. I don’t know if this patient has a chance of surviving. I do he would have had no chance if he had stayed in Craig. Whatever happens, he has the gift of possibility this season. And the gift came from the community, given freely, knowing there would be no payback for the time, money or energy that it took to be successful.

Even more poignant, this man is not from Craig; he is not a pillar of the community; he is barely known here. But they helped anyway. No one will get credit, or special notice, for this effort. But this man will get a chance.

This isn’t a Christmas story of a gift given because of the time of year. Timing had nothing to do with it, except that the need was urgent. But it shows me the best of small town life. Small communities don’t have large medical centers. They don’t have unlimited resources. But when you need to get something done in a hurry, you know who to call. You’re not a faceless application form in someone’s email. And that’s the second part of this story.

Small towns can show off the best of community. And I just had a front row seat.