Island Health Care A Community Concern

By Eva Murray

“Where do you give birth?” I was asked this question at this year’s Fishermen’s Forum in Rockport, as I chatted with other attendees about medical care “out to sea.”

Since the early 1960’s, the residents of Matinicus Island have given birth in the same place they go to attend high school, buy shoes or buy lobster traps, eat Thai food, replace the snow tires, or learn to do a hockey stop. They do it on the mainland. Does that surprise you?

Nina Young was the last RN to live on Matinicus. Photo courtesy of Jeanette Young Beaudoin.

There is a very sticky myth that paints a picture of Maine islanders as rarely leaving our private little continents. Nobody could be more respected than the old stalwart who hasn’t seen the mainland since the Eisenhower administration.

Of course, that stereotype is pretty much baloney.

Keep in mind that a century ago, many island populations were substantially larger, with more services available locally. Matinicus used to have a well-stocked store and a resident island nurse. The late 1900’s absolutely were not “just like now, only with kerosene lamps.”

Of course, there are times — then and now — when the weather does not permit anybody to leave this island, no matter how sick or injured or ready to give birth they might be.

I live on Matinicus and am trained as an Emergency Medical Technician and a Wilderness First Responder. True emergencies here are thankfully infrequent, but when they do happen, no two situations are alike. There is no “standard operating procedure.” Far more common are calls for non-critical first aid, and sometimes people just want just somebody to talk with who will respect confidentiality.

The last births on Matinicus Island were in the early 1960’s. In the 1980’s, I remember Matinicus women describing trips to the health center on Vinalhaven to deliver. My own experience as an expectant mom on Matinicus was this: in 1990, when my first child was due to be born, the community was losing its collective mind at the size of me (I appeared ready to “pop” from about six months). “Why are you still here?” The only person who didn’t seem rattled by the idea of an island birth was my husband, but realistically, he hadn’t been through it before either. I went to the mainland two weeks ahead of my due date (much to the relief of the neighbors), moved in with my grandmother in South Thomaston, and waited. Once baby Eric had the usual inspection, our slightly larger family returned home.

In the early decades of the 20th century, Matinicus supported a Nursing Association which raised funds to hire a young RN to spend the winter on the island. This island nurse was expected to be EMT, midwife, hospice volunteer, geriatrician, pediatrician, and once Matinicus got telephone service, intermediary between the patient and a physician based elsewhere. These days, those jobs all require different training.

LifeFlight of Maine can transport Matinicus Island residents in emergency situations. LifeFlight photo.

Several of these young professionals married island fishermen and stayed to start families. Nina Young acted as official island nurse from around 1948 through the late 1970s while married and raising children. Her constant presence on the island as the wife of Clayton Young—the store owner, postmaster, and a native-born fisherman—meant the Nursing Association could fade out.

When Nina became ill and eventually died in 1980, there was no longer a mechanism in place to find, house, or subsidize her replacement. The beloved Nina was our last “island nurse.”

I moved to Matinicus as a teacher in 1987, when there was no nurse, EMT, or designated first aid volunteer (not counting that one fellow who had a cabinet full of pharmaceuticals that by all accounts belonged to Maersk Lines. He and his buddy Eddy were also willing to stitch each other up. Their rum-steadied kitchen table suturing became part of the island folklore, and led to years of people thinking I would, could, and should offer stitches on the island. The answer is still no.)

Matinicus Island had nobody in any health care role from the late 1970’s until 1994, when five of us began EMS training. Paramedic Luke Church, who had spent some time on Monhegan, was our visiting instructor. He’d stay in a fishing family’s spare room for a few days at a time during the winter of 1994, and each morning we’d gather around the kitchen table for a day of blood pressure practice, splinting each other, rules and regs and three-letter acronyms, and gory images of nasty injuries. We took our state exams on the mainland that summer and became a licensed and inspected “non-transporting” EMS service in the eyes of the State of Maine. The old folks thought we were nurses, and nothing we said would change their minds.

Matinicus Island Rescue has since gone out of business as a formal licensed entity due to attrition. These days, our pool of volunteer responders includes former EMTs and paramedics, a nurse or two, a ski patroller, and a few others who are willing to help, but we all have other jobs. With nobody paid full-time to stay on the island “just in case,” the availability of responders is inevitably erratic.

Matinicus, like other Maine islands, seems a bit less isolated than it did in 1987. We gratefully watched the formation of LifeFlight of Maine in 1998. Amazingly, our very first emergency med-evac by LifeFlight helicopter from Matinicus was just this spring! We also feel truly grateful that the Maine Seacoast Mission vessel Sunbeam began to bring an RN on its regular visits.

The Matinicus EMT shed is well-stocked for routine medical events. E. Murray photo.

When the technology became available, the Sunbeam began offering telemedicine appointments with various physicians and counselors by video link. Sharon Daley, RN, who was the Sunbeam’s first nurse, developed trust with medically-skeptical islanders by just being around and being friendly, year in and year out. She described what she called “truck calls,” where islanders who denied having any medical needs when asked in front of others would soften up and describe their pains or worries from behind the steering wheel when they’d come across Sharon walking the island’s roads.

On Swan’s Island, EMT and EMS Programs Manager Sonja Philbrook describes a bit more regularity in terms of health care on her island, yet with quite a few gaps. There are scheduled visits from several kinds of providers and a daily ferry that can take an ambulance, but the presence of a doctor has been on-and-off over the years.

“When transport decisions are dictated by the weather, the pressure on EMTs can be immense,” Philbrook said, “but being able to be there for our neighbors and families when they need us, that’s a blessing.”

The island has organized a “doc on the rock” sort of program this summer, similar to what Monhegan did for years. SIFA Station is an advanced first aid station staffed by volunteer medical professionals which will provide non-emergency care. It will be open to all, for free, for one hour in the morning and one hour in the late afternoon, five days a week, through July and August

That sounds like something that every island might benefit from, but it’s easier said than done. Physicians and their patients generally expect medical equipment and a controlled setting, not improvised treatment in the back of a moving pickup truck. And yes, that happens.