Wise VA – it’s not Las Vegas

but it is the reason I am not in Las Vegas.  I am here, in the Appalachian section of Virginia, in the Southwest, less than half an hour from the Kentucky border, for the 11th Annual Remote Area Medical / Mission of Mercy free medical and dental event.  I arrive shortly after noon, after a 6 hour drive from Arlington, and I will be here until late morning Sunday.  

I hope those of you at Netroots Nation, which is already underway, enjoy yourselves and find it worthwhile, as I have found my four previous bloggers’ conventions useful and worthwhile.

For me, and I speak only for me, it is more important that I am here.  

And although we have barely begun, perhaps I can offer some sense of why I feel that way.  I invite you to keep reading.

I have written about Wise before I ever came here, and wrote four diaries around my volunteering a year ago.  Last July I committed to coming back here as long as I was able, and since then have volunteered at three additional events, once having several of my students join me.  

The most important thing I do is teach, trying to do so with integrity.

After that, the most significant thing I do is volunteer at events like this.

I am not a medical or dental professional, but by now I am skilled at helping in dental triage.

Officially we begin giving services tomorrow.  Starting at about 2:20 this afternoon we began seeing patients.  I know we screened over 200, how many more I do not know.  Some were sent to x-rays, others were simply scheduled for various dental services beginning at 6 AM tomorrow.  A few were lucky –  we were able to get a couple of fillings done and one or two cases of dental hygiene where the traige dentists wanted to be able to more clearly evaluate after the mouth was thoroughly cleaned.

I am working with familiar faces – more than half of the dozen dentists who spent some time doing triage are people with whom I have worked before.  One came today because tomorrow afternoon she has to leave to see a very sick and probably dying member of her family.  But she has never missed one of these events, and felt compelled to come and offer what help she could.

There were people camping out in their cars, not as many as last year.  It was beastly hot.  Over 90 degrees in and around the mountains of Southwest Virginia is brutal –  many people do not have air-conditioning.  We got a brief shower, just enough to pump humidity into the air and make it really sticky.

But none of that matters.

Tom Cooke, former president of the Virginia Dental Society, is again in charge of triage.  Tom is always pleasant and positive to each person he sees, attempting to make them comfortable, ensuring that the persons in the chair knows he sees them as as human beings before he sees them as dental cases.

In checking the paperwork, I note from where the person has come to obtain these services.  There were a pair of young ladies who walked from less than half a mile away. There were people from Florida, Indiana and New Hampshire.

Yes, we may have passed some health care reform, but the immediate needs, especially of dental, have not gone away.  We are still serving as a giant emergency room.  

I am hot and sticky after being on-site for almost 6 hours.  The next two days will be far longer, arriving before 6 AM and leaving after 6 PM.  I suppose I could go out and socialize with the others, get to know some of the medical students from UVa and the dental students from VCU.  Yet I need to unwind, to process what I have experienced:  while I am volunteering there is little respite and almost no time for reflection.  

There will be a free clinic in DC in a few weeks, but most of Congress will have left for the August recess:  they still will not experience what I experienced for the first time a year ago, how severe the medical needs are in this nation.  Nor will they realize, except for a few, how foolish we are to separate dental health from other kinds of health.

Some in Congress get it.  A former key staffer for David Obey once told me that Obey reserves most of his earmarks for free dental clinics.  

This is now my 5th one of these events.  I am still shocked and dismayed to see people in their late 20s and early 30s most of whose teeth have rotted away.    We are still seeing full mouth extractions, with no hope of dentures for perhaps a year.  

Unhealthy children are not going to learn.

Children with rotting and aching teeth have trouble eating, and concentrating, and sleeping.

If we do not commit to addressing the basic health and nutrition needs of all our people, can we truly say we care about them, about their future?

This is not a thought-out posting.  I came in to my hotel room, opened my computer, and began writing.

Perhaps a few people will read it.  Perhaps not.  I do not control that.

I lack the words necessary to fully portray what I encounter at events like these.  This time I am in Southwest Virginia, in a poor part of the state.  In March I was within 20 miles of Capitol Hill, and saw the same needs –  one can be in urban and suburban areas and lack the resources to get basic medical and dental care.  

Basic medical and dental –  which cannot exist in isolation from nutrition, from potable water – some people around here rely on well water, but the wells are being poisoned by the runoff from mountaintop removal.  It is not only an ecological disaster, but increases the health problems as well.

My out of pocket costs to volunteer for the 3+ days are less than the cost of airfare to Las Vegas.  Knowing that, I wonder if I could justify Las Vegas even if it did not conflict with this event?  I enjoy being with other bloggers, I usually meet new people I come to value, and I certainly learn useful things I had not known.  Occasionally I bring some value with me, perhaps in some of the panels I organized in the past.

As I drove down today, after passing Roanoke and heading into the Southwest of the Commonwealth, I thought of 1865.  Jefferson Davis had wanted Lee to take his forces into these mountains and fight what we would call a guerrilla campaign against the Union forces.  Perhaps had Lee gotten the supplies he hoped for (some of which had been seized by Custer), perhaps he would have held out for some time longer.

Absent modern transportation these mountainous areas provide many places of strong defense.  Despite the devastation first by lumbering and then by coal, this area retains a rugged beauty, something easily appreciated when driving through it in daylight.  

The people of the area have a similarly strong spirit.  They have familial and cultural ties that keep them here despite the lack of economic opportunity.  

It is not all bleak.  There is a wonderful college here, the University of Virginia at Wise.  

But the area is still poor.  What we see in medical and dental health reflects that.

I am in Virginia.  I cn get to Knoxville TN, Charleston VA, and Lexington KY more quickly than I can to the capital of the Commonwealth in Richmond.  I can get from my home in Arlington to New York City in less time that it takes me to get here.  New York City has more in common with Arlington – in education, cultural diversity, educational opportunity, economic opportunity – that Wise does, even though it is in the same state as Arlington.

We too often forget how different some places in this nation still are.

I am in a Best Western, next to a McDonald’s, along a major travel route (Route 23).  If I drive 3 or 4 miles and get off the “main” road I am almost in a different time as well as a different place.

This is America.  The people here, and those who have traveled great distances to come here, are Americans.  How is it that for so long we have forgotten about their needs?  That is, we as a nation, as a government, as a society, are not shamed as we should be?

I ramble.  Perhaps I rant.  

And maybe, just maybe, this will help those of you who have read this far understand why I in Wise.  It certainly is not Las Vegas.  It is very much a part of America, a part we too often forget.  20% of our public school children attend rural schools.  There are still about 800 one-room schools in the US.  

Less than two months ago I had a major allergic reaction.  I could walk two blocks to my hospital emergency room.  Because of my health insurance I paid nothing for my treatment and my immediate prescriptions, and  reduced rate for the continuing prescriptions.

Were I a poor person in Appalachia, I might simply have to struggle through it on my own.  That is wrong.  That is immoral.

That is why I am writing this.

That is why I am not in Las Vegas.

That is why I am in Wise.

Peace.