Managing chronic diseases is the public health challenge of the 21st century, according to the Centers for Disease Control and Prevention. The organization reports that 7 of 10 Americans die every year from chronic diseases, like heart disease and stroke, cancer, diabetes, arthritis, obesity, respiratory diseases, and oral conditions. But that burden is worse for aging and low-income populations, like those found in Mingo County.
A man living in Fairfax County, Virginia, will likely live 15 years longer than one 300 miles away in Mingo County, West Virginia, according to mortality data from the National Center for Health Statistics.
It’s easy to forget about Mingo County. One doesn’t visit a town like Gilbert accidentally. It takes a concerted effort. It’s a world where coal is still the dominant industry, but the population is aging, and according to data from the US Census and the CDC, the region is home to some of the poorest and least healthy communities in the country. But doctors from all three of the medical schools in West Virginia make monthly trips there to offer specialty care to residents in the region. It all started 10 years ago with the Doctors Brick.
Traveling South
Once a month for the past decade brothers, rheumatologist Dr. James Brick and neurologist Dr. John Brick, make the trip to Gilbert. They used to wake up at 3 am and drive four or five hours from Morgantown. But today they can usually cut the first leg of the trip substantially…
“We’re on the West Virginia University foundation plane,” Dr. James Brick said over the roar of the plane engine. “We just left Morgantown. And we’re going to Charleston.”
After twenty minutes of reminiscing about past trips, the brothers and the president of WVU Gordon Gee along with a couple of medical students touched down at the Yeager Airport in Charleston.
Dr. John and Dr. James are identical twins from Dunbar. Dr. James Brick is a professor and chair of the Department of Medicine at WVU and Dr. John Brick is a professor and chair of the Neurology Department at WVU.
In the hour and half winding and scenic van ride from Charleston to Gilbert the brother doctors told attending med students about the community. Dr. John talked about the economy.
“It’s a small town, maybe 300 people,” Dr. John Brick said. “The major source of jobs was the mining business and Mr. Harless had sawmills there. The sawmills are closed, but there are still mines in the area.”
Buck Harless
The doctors Brick love to reminisce about their old friend and former patient who was instrumental in bringing them to southern West Virginia, the late Buck Harless. Mr. Harless, they say, had an epic life. He started in the world orphaned and died a legend, with timber and sawmill interests in five states, manufacturing operations in four states and also holdings in real estate and coal. But Gilbert, they say, was always Buck Harless’ home.
And he invested in it. Harless built this huge facility, 55,000 square feet, that looks kind of out of place in this tiny town for his community, and named it after his deceased son. The Larry Joe Harless Community Center houses a track, a pool, cinema, basketball courts, and the health clinic.
Specialty Care
“I’ve been coming to see the rheumatologist here ever since this clinic opened because I live just up the street,” said Marica White.
Marica says Dr. Brick saves her from having to make the two-hour trip to Huntington, where her regular rheumatologist is.
“While I can drive if I feel like or have family that will take me, a lot of local people have trouble with transportation,” White said. “So it’s very important to have a neurologist and a cardiologist that these people can see.”
Dr. James Brick explains how it can be difficult for a specialty doctor to sustain a practice in a sparsely populated, rural region. But he said there is a need because the aging population has a lot of chronic illness.
“This was a town that has a lot retired folks living in it, retired miners, people retired from working in the sawmills,” Dr. James Brick said. “I see lots of osteoarthritis—that’s the most common form of arthritis, and Rheumatoid Arthritis, gout, fibromyalgia… Those are the most common diagnoses, but also the most common diagnoses we see in Morgantown.”
But Mingo County is a little different. It’s in an area that has one of the worst life expectancy rates in the nation. In fact, according to mortality data from the National Center for Health Statistics, while life expectancy has slowly been increasing throughout the nation, it’s been dropping in regions of southern West Virginia.
Data visualizations by Dave Mistich.
Special People
The Doctors Brick see some patients fairly regularly, and it’s clear that both he and his brother have an affinity for the town and the region.
They sponsor local basketball teams, fire off trivia with visiting med students about the area, and were recently honored by leaders in community for dedicating time every month for over a decade.
However, Dr. John, the neurologist, also observes that medically, the patients he sees are not different from those he treats in the rest of the state.
“They have the same problems as virtually every other population in WV, but I do think the people are unique. They’re wonderful people,” he said. “I get a lot of satisfaction from taking care of them. This is my job but if I could finds a way, I’d do it anyway. They share a little piece of their life with me and that’s what makes it worth it.”
Teamwork Makes the Dream Work
Interim president of Marshall University, Gary White says the clinic in Gilbert is a successful example of the power of collaboration because all three of the main medical schools in the state, WVU, Marshall, and the West Virginia School of Osteopathic Medicine work together to provide equipment and services.
“Here in the little town of Gilbert we can provide the services that folks desperately need and fulfill the vision that Mr. Harless had,” White said. “I think it can be replicated all across the state.”
A native of neighboring Logan County, White says towns like Gilbert will languish and die without creative and motivated community members. White says the area faces stark challenges today, especially economically, as the coal industry the community relies on has been declining, but he has hope for the future. He believes his community will adjust, and that the last generation has paved the way (literally) to make that possible.
