Story and Photos by LYNN DARROCH THREE COUNTRY DOCTORS Beginning with Health Fairs in rural Tennessee and Virginia that provided basic medical screening to what were at that time some of the 1100 counties not served by private physicians, the Student Health Coalition fostered a dream of medical care for all. It attracted doctors, nurses and organizers who believed in improving health, not making money off sickness. Around this issue, they hoped to galvanize entire communities. Groups of students, community organizers and a few physicians took to the hills in those first summers, generating local enthusiasm for the establishment of permanent health clinics. In the coal mining town of St. Charles, Virginia, for instance, people raised money with bake and rummage sales to purchase land, bought materials with a grant from a Catholic charity, and built their clinic with volunteer labor within a year of the first Health Fair. In 1976, Dr. Art Van Zee, who had supervised some of those early community health forays, became the clinic’s first full time physician on a salary paid by the federal government. “The dream,” Art’s colleague Tommy Townsend remembers, thinking back over ten years to those heady days when he began to practice medicine in a crowded storeroom divided by a sheet in Independence, Virginia, “was that there was an obligation to distribute health care to all people.” He pauses. “Hell, it ward, his long Abe Lincoln face and beard nodding as he listened to 20 or 30 patients every day, endlessly listening. The people responded, not only by coming to the clinic but by serving on its Board and contributing time and money to buy equipment and, over the next six years, to double the size of their building and bring in another physician to take on some of the load. For it is their clinic, not the doctors’. That was an essential part of the dream. The St. Charles Health Council made up of local residents owns the building and all its equipment and hires the administrator, physicians, and all other employees. This was at first a startling concept for people used to living under the dominion of coal companies. “For a long time,” Art explains in his thoughtful manner, “it was perceived as just the doctor’s clinic because people weren’t used to the idea of a community running a clinic and me just working for them. “I wanted to work in community clinics,” he emphasizes, “because I think it’s good for the community. They are more responsive to what the people would like and need than an individual’s private practice. And a lot of other community developpment has come about because of it.... Seeing that on their own initiative and through hard work they could change an important thing like their health care had a lot of spin off, like the • ■ a ■ i 31 y ,,a home. The old man held my hand. “Tommv’s mv doctor,” he said, “but we’re good friends." lis eyes sought mine. “And that’s a wonderful thing.” wasn’t just a dream—it was an easily palpable vision.” Flush with the idealism of the 1960s and fresh from their training with a desire to serve, young doctors like Tommy Townsend, Art Van Zee, and Joanna Roberts, Art’s former mentor who introduced him to poor people’s medicine, were on the cutting edge of a health care adventure they hoped would transform the American medical system. Lee County, Virginia: A Moral Hero “In the beginning,” Art remembers, “the community support was really tremendous. Everybody perceived their health care needs as being a major issue." And that support was very gratifying, because in a region historically suspicious of strangers, these doctors were clearly outsiders. Van Zee, for example, was raised in Nevada, went to college in Portland, Oregon, and attended medical school in Ohio. But in Lee County, he found a home. “Doc" Van Zee became a familiar figure in the St. Charles area, his tall, skinny frame always slightly stooped forIPrologue: Children of the ‘60s n 1968, the Josiah Macy Foundation was worried about the growing threat of students taking over medical schools, and offered to fund projects that would help channel cam pus radicalism back into the system. The Student Health Coalition that formed at Vanderbilt University Medical School to take advantage of those grant funds, however, turned out to be a catalyst for a movement that—for a time—appeared more threatening to the medical establishment than student demonstrations. Poor People’s Medicine:
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