Where Does It Hurt? by Jonathan Bush

Author:Jonathan Bush
Language: eng
Format: epub
Publisher: Penguin Group US
Published: 2014-05-14T16:00:00+00:00

CHAPTER EIGHT

The Medical Home in the Woods

On a summer day in the mid-1970s, a young doctor from Yale paddled a canoe through the pristine waters of the Adirondack Mountains. His name was John Rugge. He and a friend, James West Davidson, had a contract to write a book about wilderness canoeing. The area suited Rugge. The canoeing was excellent, and he had family nearby.

Rugge soon learned that a doctor and receptionist in the remote village of Chestertown had fallen in love and abruptly left the community. One thing led to another, and before long, Rugge’s summer canoeing gig had morphed into a full-time job as medical director at the Chestertown practice. From a paddler’s perspective, Chestertown looked promising. It was some eighty miles north of Albany and right between Loon Lake and the Scroon River.

There was also a growing need for health care. Three decades earlier, the northern Adirondacks had welcomed a slew of doctors fleeing Hitler’s Europe. These doctors settled in the small villages scattered throughout the region and provided a vital service. But by the mid-seventies, they were retiring. The immense area was turning into what Rugge calls a “medical vacuum.” Rugge, who went to divinity school before studying medicine, already had a clear sense of mission. In the Adirondacks he found a job to hitch it to. Since then, he has spent four decades using every tool at hand—vision, ingenuity, salesmanship, and political connections, to name four—to fill that vacuum in the headwaters of the Hudson.

If you listen to John Rugge tell his story, he appears to be an unlikely hero for this book. At first glance, he’s nothing like the Florida obstetricians, Dr. Konsker and Dr. Briggs, who are building a profitable birthing empire in the South. He couldn’t be more different from Steward’s Ralph de la Torre, who feeds on the pendulous profit belly of Massachusetts General. It’s true that Rugge shares a sense of mission with Rushika Fernandopulle, and for that matter with the other entrepreneurs. They all want to improve the industry. But for Rugge, the money flowing into Hudson Headwaters simply funds the mission. And he uses it to extend a version of Rushika’s vision to a large and scattered population.

Rugge runs a nonprofit. I’m not talking about nonprofits like the research hospitals, many of which actually make good money. Rugge’s nonprofit, Hudson Headwaters, is the real thing. He has to scrape together money to provide medical services for more than seventy thousand far-flung people in the rural north. And to do this, he doesn’t hesitate to hit up the government—yes, the same government I’ve been railing against for the last several chapters. In the 1970s, he and his colleagues landed government grants to fund medical cooperatives, each one at least half owned by the communities. When the group runs into financial trouble or needs a break, Rugge doesn’t hesitate to put in a call to the senior senator from New York, Charles Schumer, who is one of his biggest fans.

As you

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