The cancer treatments and surgeries were hard enough — she’d leave the hospital with drainage tubes, or exhausted from chemotherapy.
But the breaking point for Sabrina Payne was the six-hour round trip from Fogo Island, N.L., to Gander that she’d take every two weeks to get them.
That included a sometimes unpredictable and mostly uncomfortable ferry crossing.
“I remember crying in the car. I did not want to get out of the car to go on the ferry,” she said.
Fogo Island’s ferry crossings are already filled with medical travellers, but with the provincewide doctor shortage about to hit that community, Payne’s story is going to become more common.
In June, the Fogo Island Health Clinic’s last permanent doctor is leaving his practice, which will send even more patients to the ferry — and maybe, off the island for good.
Payne said all that travel took an emotional and physical toll, aggravating the pain of a cancer diagnosis.
“I remember when I came back from having my double mastectomy in September, I just wanted to stay in the car. I had drainage tubes hanging everywhere, I wasn’t feeling good, I’d only had the surgery two days prior. And I begged them to let me stay in my car, and they weren’t allowed to do it.”
The trip became one more unnecessary headache: in the winter, you’d deal with poor weather, and in the summer, the ferry lineups became so long you may have to wait all day to secure a spot on a crossing.
In January, pushed to her limit, Payne sold her house and business on Fogo Island and moved to a rental apartment in Gander to be closer to her treatments.
“It took me a long time to make the decision, because I really loved the place,” she said. “But ultimately my mental health was declining because it was — everything was a chore.”
‘I guess we’re going to have to pull up and move’
Travelling for medical reasons is a fact of life for Fogo Islanders. While the health clinic on the island does offer laboratory and X-ray services, most specialist appointments are off the island.
Maureen Lynch has just started the voyage herself, travelling to Gander for physiotherapy appointments to work on her back. But because of the ferry’s unpredictability, scheduling them is no easy task.
“I try to schedule my appointments when the ferry is — not dangerous goods day and on a day that she’s doing a late trip because sometimes you can run into a late appointment,” she said.
On the current schedule, that’s only Wednesday and Friday.
“And it’s not easy always to get appointments when you want them,” Lynch said.
And even when you do it’s still a full day’s travel. She said she usually wakes at 4:30 a.m. on days when she has an appointment and doesn’t usually get home until 9:30 p.m.
She said people in her community of Island Harbour are devastated that the island’s last doctor, who has practised at the local clinic for more than a decade, is leaving.
“They don’t know where to turn,” she said. “Most people are saying, ‘Well, I guess we’re going to have to pull up and move, we’re going to have to leave Fogo Island.'”
Aaron Brown moved back to Fogo Island in September to help take care of his aging grandparents.
He said his grandfather, 79 and partially paralyzed, fought an infection for much of the winter and required six weeks of hospitalization at the Fogo Island Health Centre.
The loss of the island’s only doctor means that type of hospital admission might no longer be possible. It’s one less support for Brown and his family, and raises a lot of questions about his family’s future.
Brown says it’s just not realistic to bring his grandfather across the ferry to Gander for medical visits unless they become absolutely urgent — and that means delaying appointments for issues that should be looked at.
He says he believes his grandfather’s infection could have been resolved more easily if he had been able to access medical care sooner.
“At this point, I’m the last line, I guess, of medical care,” Brown said.
A grim milestone
Other communities in the province are also struggling to keep their health clinics operating, but residents of Fogo Island say they are uniquely vulnerable.
“We realize there’s not just us, but we are unique, because we are in the middle of the North Atlantic,” said Liz Keefe, who has lived on Fogo Island for almost 40 years. “If we had an emergency trip one night, and the ice is in, the ferry can’t move.
“I don’t know what the future is going to be, it’s going to be sad. We need doctors, that’s the bottom line.”
The doctor is set to leave his post on June 19. Central Health says it is working with locums to provide coverage over the summer and will update the community as their plans evolve.
Mayor Andrew Shea says this summer is set to be the first time since 1792 that the island has not had some sort of resident doctor.
It’s the latest blow to the community, which is also losing its only bank branch and some other businesses.
And it’s all happening against a backdrop of an exploding tourism industry. That’s left some people scratching their heads.
The world-famous Fogo Island Inn — a top pick for the rich and famous— charges at least $7,725 per stay ($2,575 per night for the cheapest room, with a three-night minimum). Those prices don’t include taxes.
“This is an up and coming spot,” said Brown.
“Unfortunately, the residents are leaving as the tourists are coming.”
Read more from CBC Newfoundland and Labrador