Clearlake and Mt. Konocti.

As a patient and also as a complementary provider of wellness services, I’m finding medical care in Lake County, CA to be just as problematic (or maybe even more so) than the Pahoa District of Hawai’i Island. At least on Hawai’i Island they have vans to bring medical care to the tiny, far-flung communities and neighborhoods of the island’s “lower east side.”

The Pahoa district of Hawai’i island is rural, economically disadvantaged, and contains a fair amount of retirees, unoccupied vacation homes, and people with substance abuse problems (notably meth). Houselessness among the displaced Kanaka Maoli (native Hawaiians) is a problem throughout Hawai’i, but Pahoa and neighboring towns also have “mainland” transplants who are not native and who are also living rough. No one can keep up with the social problems and desperate need for all kinds of medical care. Again, much like here.

But there was truly a culture of caring in Hawai’i – that famous “aloha spirit” that is under such strain due to the occupation and appropriation of lands, people, and culture – still persists in day to day interactions among human beings. Often, I would be close to weeping at how pleasant, warm, and lovely even a front-desk clerk in a health care setting would be. There, I was “Auntie” to the younger folks who talked story with me. Elders are mostly valued in the host culture of Hawai’i and people generally cared for the welfare of people in my age group. Here – there is no culture of caring, and certainly no extra TLC for the old and getting older. Nor for anyone else, for that matter.

I’ve lived in California for almost my entire life, except for that brief time in Hawai’i. I knew what I going to find when I came back, an America that is presently at great pains to exhibit the worst of its grasping, greed, and unconcern, a reckless and gleeful dismantling of quality of life advances for its citizens, and even a vigorous will to obliterate people of color, immigrants, elders, whole families, entire communities – not only abroad, but here too. California is trying to make a stand against this juggernaut of destruction and I only hope we can prevail.

All this is the context of rural health in Lake County, a place where people struggle to find urgent care outside of the emergency room; to have continuity of care as doctors and nurses work off their student loans and “train” in a rural setting before moving on to more lucrative positions in urban areas; to even get a call back from someone to get prescriptions filled or refilled! There’s no Kaiser Permanente (my mainstay for over forty years), only Sutter Health and Adventist Health Care, along with the tribal clinic and a couple of smaller clinics. People here frequently travel to Ukiah, Santa Rosa, Napa, and as far as San Francisco (about three hours away) for some of their care, especially when they need to see a specialist. As for medical cannabis, you can still only find it in the City of Clearlake.

It’s insane. And as far as I can see, will get worse before it gets better.

I’d like to help with that “getting better” part, however, so I started a patient/consumer advocacy Facebook group called Better Medical Care for Lake County CA Now! and am currently running a quickie survey (non-scientific) to gauge the challenges and feelings of people here, regarding the medical care challenges in Lake County. I will share those results soon in a future blog.

Now this is an area that has also seen a fair amount of disastrous fire and also has the potential for other sorts of natural disasters – earthquakes in particular. Even our beloved Mt. Konocti is really a “threat level” volcano and not inactive as we all seem to think. Tell me, please, that emergency medical care in the case of disaster is going to be at all what is needed. How can it be, when everyday care is so wretched for so many people?

There are too few medical personnel, too few mental health care facilities, not very many “alternative and complementary providers” (like me) and also very little infrastructure that supports small wellness practices, or individual medical/mental health practices. In other words, no chance of renting a therapy office by the hour in order to make a start at seeing clients in this new location. I know. I’ve been looking!

Lake County is one of the lowest ranking places in California in terms of health outcomes, 56 out of 57. (Lake County Wellness Roadmap, June 2017). It is impoverished. In 2015, it was ranked the 4th poorest county in the state, where “1 in 4 out of 63,860 residents lives in poverty”  (Glenda Anderson, Press Democrat, Feb. 4, 2015). You’re more likely to commit suicide here too. Lake County has a suicide rate almost triple the state average (2008-2013, based number of deaths per 100,000 people: 28.6 in Lake County, 12.5 national average, 10.4 California, Wellness Roadmap, p. 17).

It’s also mostly white (87.5% white), and I suspect that at times, racism and anti-immigrant views are expressed in micro- and macro- aggressions toward talented doctors and nurses, perhaps hastening them away from the area after they finish working off their student loans. The other day a former member of my Facebook group expressed her anger at a health worker by saying she wanted to “kick her ass back to” a [specific] foreign country that she’d presumed the worker was from. (That post is now deleted and the author is no longer in my group.)

Even so, Lake County has much to offer. It has the cleanest air in the state (one reason I’m here), incredible natural beauty, lower cost housing (but perhaps not enough of it, due to several years of wildfires), and some very sweet people, really. (I’ve already met more neighbors here than I ever did in Pahoa!) Lake County wants a more robust economy. It wants something to shore up its moribund tourism (based on bass fishing) and to help replace its  reputation as a meth lab haven with a more tony reputation for cultivation of fine wines. But I believe that Lake County has the potential to be a place for “healing tourism” as well. A better collection overall of medical and mental health services would improve matters for residents (including an increasing population of retirees – 21.9% age 65 and up, 2016) but also serve as incentive for businesses that might consider locating here. In addition, a greater complement of massage therapists, hypnotists, accupuncturists, etc., could offer the kinds of “wellness” and even “spa” types of services that would appeal to tourists as well as locals. And it could provide inspiration for younger people to train in these careers.

I really see improved medical and wellness services as a key to a better life quality for residents, with potential value to tourists (in addition to the rebuilding of Harbin Hot Springs), and also as key to the ability of this area to attract a valuable mix of businesses.

In the meantime, I still can’t find a way to get an urgent care appointment should I come down with another acute case of diverticulitis, as I did last week. (I was only saved by the telehealth feature of my new health insurance, which enabled me to get a prescription for the drugs which help with this). This situation concerns me, greatly. And it’s not just me in this pickle – it’s everyone here, apparently.

The very neighborhood where I live is quite high in premature death rates for people in my age bracket. I get it: Momento mori. But in the meantime, can I just get my prescriptions filled, please?