San Juan Islands residents brave ferry lines, medevacs to get to the doctor

||| FROM KUOW, NPR NETWORK |||

Bonnie Oak Boesky has lived in the San Juan Islands for more than 40 years, since she was in her early 20s. She raised her four children there.

“It’s like a chance to live in paradise for most of your life,” she said.

But the idyllic surroundings come at a cost, which became apparent when Boesky’s twins were small children and had both asthma and severe allergies.

Getting health care in the San Juan Islands can be tough for residents. There’s a body of water between them and any hospital or specialists they might need. Because of the challenges of getting to the mainland, residents say they sometimes delay care until it’s an emergency.

Boesky said whenever one of her twins had a cold, she would follow them around with a stethoscope to make sure their breathing was OK.

“I not-jokingly said that we were on code yellow all the time,” Boesky said.

Once, one of her children got a full-body rash, and the doctor on the island had her flown to a hospital in Bellingham.

“It was a very stormy night,” Boesky said, too stormy for a fixed-wing plane, and the helicopter didn’t have space for an extra person — that is, no room for a parent.

It was the middle of the night, Boesky said, “And here’s our daughter, who’s middle-school age, being flown off to the hospital by herself.”

While her daughter was on the plane, Boesky had to rush to the ferry to get to Bellingham as fast as she could.

“I was frantic,” she said. “I don’t think that there’s a solution for that. That’s the reality of living on an island.”

Residents shared all kinds of stories: rushing to the ferry for suspected appendicitis, for possible sepsis; a man who died of a heart attack because the weather was too wild even for a helicopter.

One resident said she has three different insurance plans to cover different medevac flight companies, because you never know what plane will be available in an emergency.

Ferry wait times can stretch from a couple hours to more than six, sometimes due to cancellations, or because every boat is full and people have to wait for the next one. There’s a reservation system, but that doesn’t work for a surprise illness.

That’s why the ferries have a formal priority boarding process for people with urgent health problems. On an average day, about 20 to 25 people use that process at the Orcas Island terminal alone.

Zale Noah, with Washington State Ferries, said the medical priority system was put in place about 20 years ago.

“In 1998, there actually was an issue with a woman who had a tumor, and unfortunately she was in line for four hours,” Noah said.

The woman lay in agony in her van’s backseat and died soon after.

Over the years, the system has become more formalized, so people won’t abuse it to skip the line. To be eligible, people must have a serious medical condition that could risk their health if they’re left waiting in a ferry line for too long.

Priority boarding is not for getting to regular doctor’s appointments.

In that situation, resident Annie McIntyre said, “You go the night before, get a hotel room.”

McIntyre has had a lot of medical appointments in recent months, as doctors monitor a growth on her kidney they’re worried could be cancer.

“Thankfully, I’m able to afford a hotel room if I need it, but there are people that can’t,” McIntyre said. “There’s people that have to spend the night in their cars.”

When people wait too long for care, they can end up needing a medical evacuation by airplane or helicopter.

Solutions have been proposed along the way, like allowing residents to use the ferry system to get to medical appointments, or hiring more medical staff for island clinics.

But residents say some of the problems — like having medical emergencies when there’s a body of water between you and a hospital — don’t have a solution. They’re just part of life on an island.

“The reality is we do live on an island,” Bonnie Oak Boesky said, “and I think everybody who lives here knows that.”

Visitors and dreamers wonder: How do you get health care in this wild and beautiful place? The answer is: Sometimes, you can’t.