Of the many challenges for America’s rural communities, near the top of the list is access to health care. Rural clinics and hospitals are closing across the nation. When they close, it’s hard for younger families, and older residents, to stay in town—and harder to attract new businesses, or attract replacements for the doctors, nurses, and other health-care workers who may be retiring from their practices or just leaving town.
Previously we’ve reported on the realities of smaller-town and rural health care in Brownsville, Texas, and Ajo, Arizona. This is a report from the smallest city we have visited in our travels, in spectacularly beautiful though remote far Down East Maine.
Today’s health care in Eastport, Maine, traces its roots back to Lyndon Johnson’s War on Poverty and the establishment of the Office of Economic Opportunity (OEO). In this, it is like a large number of other small communities across the country. Just as today’s libraries bear the century-old imprint of Andrew Carnegie, and many of today’s post offices and other public buildings are legacies of construction and mural-painting efforts launched during the Great Depression by Franklin D. Roosevelt, today’s remaining rural clinics are, in many cases, the effects of an initiative launched 50 years ago. Along with other OEO initiatives, such as Job Corps, VISTA, and Head Start, that remain to this day, this rural-health initiative has shaped the primary health care in poor or underserved areas long since it was started.
Back in the 1960s, enter a young medical doctor and civil-rights activist with a vision. This was H. Jack Geiger, who had spent time in South Africa during medical school and had seen the positive impact that the community health-care model had in the very poor area of Pholela. Later, back in the United States, he spent time in the Mississippi Delta for the Freedom Summer project of 1964 as field coordinator for the Medical Committee for Human Rights.
When he returned to Boston, Geiger connected his observations in South Africa and the Mississippi Delta. Along with a colleague, Count Gibson, Geiger proposed to the OEO to try out what he had learned by starting two experimental, community-based health-care programs, one in Boston’s Columbia Point housing project and the other in the Mississippi Delta. Eventually, these became models for the roughly 1,400 Federally Qualified Health Centers (FQHC) that serve more than 28 million people around the U.S. today.
Their FQHC designation is a godsend for rural health-care centers. It ensures that the centers will receive, among other things, enhanced reimbursements for patients covered by Medicaid and Medicare, and will offer a sliding scale for those without any coverage. It promises federal malpractice-insurance coverage for providers, extra partnerships for the centers, and more specialist care. Each center is unique in its profile, depending on the community’s needs. For example, the Rowland B. French Medical Center has providers for behavioral health counseling, podiatry, radiology, nephrology, and social support. Desert Senita has a regularly visiting cardiologist and ophthalmologist, a certified Spanish translator, and a special phone line with third-party translators for multiple languages.
During my visit last month to the Eastport center, I noticed a language, spirit, and way of operating that reminded me, surprisingly, of what I had heard so frequently in public libraries around the country. As for libraries, when Andrew Carnegie donated funds to help build nearly 1,700 public libraries, he required that the towns he supported demonstrate a need for a library; that the towns invest some of their own funds in the present or future operations of the library; and that the library serve all the people. Today’s public libraries, Carnegie-built or not, reflect the mission of serving the public in this democratic way.
The community health centers, like Eastport’s, strike similar chords: The centers are built in underserved communities; they require majority local representation in their governing and decisions; and they are committed to serving everyone, regardless of ability to pay. Not precisely the same as Carnegie’s libraries, but eerily similar in terms of being locally driven and serving the needs of all residents in a democratic way. As Holly Gartmayer-DeYoung, the CEO of Eastport Health Care Inc., which includes the Rowland B. French Medical Center, put it to me, we are here to “understand and heartfully serve the community.”
Eastport Health Care (EHC) serves Washington County, Maine, in its three center locations in Eastport and the neighboring towns of Machias and Calais. What does the health profile of the region look like, and how does EHC answer to the region’s needs?
By most statistical measures, it looks bad. The health profile of Washington County, which includes Eastport, Machias, and Calais, is low even by Maine’s standards. Washington County ranks 15th of 16 counties in Maine in a composite measure of “Health Factors,” which is made up of health-related behaviors (such as tobacco, alcohol, and physical activity), access to care, socioeconomic factors (some 20 percent of Washington County residents live in poverty), and the physical environment (a subcategory in which beautiful, quiet, remote Washington County ranks No. 2).
Washington County ranks 16th of 16 in Maine for “Health Outcomes,” which includes measures of length of life and quality of life. (I would point out that quality-of-life measures don’t include personal safety: On our first night in Eastport, Jim and I locked ourselves out of our apartment. We hung out with the neighbors next door until someone could be found to hunt for a key. We learned our lesson: Never lock your door.)
With such a profile, where is EHC and its citizen board to start? Perhaps with the bad news. Here is a list in descending order that EHC decided were its major health needs to tackle: the opioid epidemic, diabetes, hypertension, obesity, food or heat insecurity (it’s cold in Maine), and mental health.
Now on to the good news. Here are some of EHC’s creative ideas for plans and solutions to their most pressing problems:
What can we do to mitigate travel issues?
Washington County, with a population just shy of 32,000 residents, is twice the size of Rhode Island in square miles. That can translate into an hour’s drive to a clinic, or two or three hours to visit a specialist or for routine care for kids’ health, such as eye exams, glasses, the dentist, and orthodontia. Women in Eastport drive about 44 miles to Machias for prenatal services. For situations that require frequent, regular access to ongoing treatments, such as chemotherapy, the distances to travel can become simply untenable. When I expressed my chagrin at the idea of such distances, Gartmayer-DeYoung said with a this-is-Maine tone, “People get used to the drive.”
Without a miracle cure of close proximity to all care, one way the EHC eases the complex logistics of health care is with a “patient-navigator,” someone to manage the pieces: finding specialist help, arranging appointments, organizing transportation, managing overnight stays and last-mile transit, tracking and coordinating multiple issues, and helping identify and coordinate access to food, housing, utilities, etc. EHC has a full-time patient-navigator and has trained all staff to either help directly or be aware of all their patients’ needs.
How can we help an aging population?
Eastport’s population has declined from 5,000 in its early-20th-century sardine-canning heyday to 1,331 in 2010, to 1,259 in 2018. There are a lot of retirees, and they are not necessarily wealthy. The median resident age is 54, compared with 45 in Maine overall (chronically among the oldest in the United States). At Shead High School in Eastport, the total student population when I visited in 2013 was 110; this year it is 94.
Some solutions are simple and inexpensive, and carry a punch. Focused on safety, Eastport has begun programs to install grab bars and smoke detectors in homes with elderly residents. It also brings caregivers into the equation with an ID bracelet to register them with police and EMS as go-to contacts to facilitate quick, effective, connected responses for the vulnerable individuals they serve.
In a double win to help the elderly get around and improve their overall well-being, Eastport has created plans to improve sidewalks, install street lighting and crosswalks, put safety rails along steep inclines, and place benches for people to stop and rest.
How do we attract staff to the rural health centers?
Retention at Eastport Health Care is not a big issue. Of the currently fully staffed 52 employees at EHC, some 58 percent have been there for at least five years, 25 percent for 10 years.
But there are gaps. One of the two dentists moved west. The center would like a specialist in diabetes. Gartmayer-DeYoung worries about how to replace primary-care providers when they retire. Furthermore, she is concerned about finding her own replacement when she will soon retire for health reasons.
In remote areas, and with harsh climates, attracting new staff to replace or add to the roster can be challenging. Gartmayer-DeYoung believes that a successful solution must start with awareness of the strong local culture. Mainers are, well, famously Mainers. Straightforward, proud of their heritage, understated, no-nonsense, leaning on one another. Gartmayer-DeYoung says it would help to embed that cultural knowledge into the medical training for all those who are part of the region’s health ecology: students, doctors, pharmacists, dentists, et al.
EHC has placed a cultural-immersion component into local training programs, and two professionals have chosen to settle in Washington County so far because of it. A dozen more of the 50 participating graduate students stay connected with Eastport as they continue their training. The outlook for maintaining the culture of the clinic as well is long-term: “We have built a lot of trust. We see it as a stewardship,” says Gartmayer-DeYoung.
How can we keep the young people around and offer them hope for careers?
Many people in Eastport and other towns around the country are worried about this issue. In a long-term bet, the EHC board has initiated scholarship programs. “This translates into hope,” says Gartmayer-DeYoung. Along with initiatives for boosting training in health-related fields, this could lead to strong future staffing in the health center, related fields, and a broader base for regional employment in general. Since 2008, EHC has supported 58 high-school students with more than $100,000 in scholarships and supported community-college students on health-care professional tracks, as well as staff seeking to advance their skill sets.
We have visited Eastport several times over the past six years. As part of our habit to try to keep fit while traveling, I have gone in search of exercise options in Eastport each time. Success has been elusive: The closest swimming (my go-to exercise at YMCAs and public pools) is at least 30 minutes away in Calais. Water, water everywhere, but the water was 58 degrees in the Bay of Fundy this August. No gym. No track. No rental bikes to be found. This was a short-term challenge for me, but a long-term challenge for the residents of Eastport.
As for solutions, EHC has knocked on the door of the school to access its gym for walking, and hopes this option could become a catalyst for the community. Besides extending sidewalks for all walkers, EHC hopes to extend the trails from the old railroad lines for more ambitious walkers and bikers.
It has developed collaborations—for example, with the Cancer Support Center of Maine.
It has created Community Circles, groups to build citizens’-support networks, tackling topics such as hospice care, senior needs, integrated behavior health, LGBTQ needs, recovery support for addiction, teens helping teens, understanding Alzheimer’s disease, health and wellness, food insecurity, strategic planning, governance and leadership training, and more.
Summing up the state of play in Eastport’s health-care world today, Holly Gartmayer-DeYoung says, “We are hardy people. But sometimes overwhelmed.”
This is another road report on the state of local journalism, which is more and more important, and more and more imperiled.
It is important because so much of the future of American economic, cultural, and civic life is now being devised and determined at the local or state level. Educational innovation, promotion of new industries and creation of fairer opportunities, absorption of new arrivals (in growing communities) and retaining existing talent (in shrinking ones), reform of policing and prison practices, equitable housing and transportation policies, offsets to addiction and homelessness and other widespread problems, environmental sustainability—these and just about every other issue you can think of are the subjects of countless simultaneous experiments going on across the country. Voters, residents, and taxpayers need to know what is happening (or not), and what is working (or not), in their school systems, and their city councils, and their state capitals.
It is imperiled for obvious reasons. What has happened to media revenues in general has happened worst, fastest, and hardest to local publications, newspapers most of all.
No one of these models or examples will necessarily apply in other places or circumstances. But any illustration of success is worth noticing, for tips.
This brings us to The Quoddy Tides, the twice-monthly, family-owned and -run newspaper that has a print circulation several times larger than the population of the city where it is based.
The home city is Eastport, Maine, whose library Deb wrote about recently, and which we described in our book, Our Towns. In its heyday as a sardine-canning capital, Eastport had a population of more than 5,000. Now the canneries are gone, and the year-round population is about 1,300, and nearly everyone in town holds a combination of jobs—lobster fishing, seasonal tourist businesses, work at the commercial port or in forestry, small crafts or art studios—to make ends meet. But in this setting, The Quoddy Tides has a paid print circulation of just less than 5,000, and now has more than 50 years of continuous operation. Its editorial and business office is in a white clapboard structure that at various times was a fishing-company office and then a Christian Science church, along the bay front in Eastport’s small but architecturally distinguished downtown. It is run on a shoestring, but it has some 20 contributors and correspondents in the region, and it is full of both articles and ads, and it matters in its community.
Part of The QT’s circulation secret is similar to that of Seven Days, in Vermont: It is aimed at an audience, and market, beyond its immediate hometown base. In addition to news of Eastport, The QT covers that of other down-east Maine towns such as Lubec, Machias, and Calais (pronounced like callous), and adjoining maritime islands and towns in the Canadian province of New Brunswick. It also has a substantial mail circulation, reaching subscribers in 49 states who are originally from the area, or have visited, or feel some interest or connection to it. (South Dakota is the outlier. People of Sioux Falls and Rapid City, c’mon!)
Also, like The Commercial Dispatch in Mississippi, the paper’s family ownership means that it can spend its modest resources as it chooses. It is not under external-ownership pressure to meet regular profitability targets, which has sent so many small papers into cycles of cutback and decline.
But when I spoke with the husband-and-wife couple who run the paper, Edward French and Lora Whelan, they emphasized that it was the kind of journalism they provide that has allowed them to survive.
The Quoddy Tides—named for the Passamaquoddy Bay on which Eastport sits, which feeds into the Bay of Fundy—was founded by Edward’s mother, Winifred, in 1968. She and her husband, Rowland, a doctor, had moved to Eastport from Arizona in the early 1950s, and stayed there to raise their family. (“My mother was looking for someplace not quite as hot,” Edward told me in The QT’s office earlier this month. “Coastal Maine qualified.”) Rowland became a leading local doctor, with a clinic now named in his honor. One of Edward’s brothers, Hugh, also lives now in Eastport, where with his wife, Kristin McKinlay, he runs a museum and arts organization called the Tides Institute.
In the late 1960s, as the family’s children were growing, Winifred decided that the community needed a newspaper. A previous one, from the town’s sardine-canning days, had gone out of business in the 1950s. “She had no newspaper experience,” Lora said of her mother-in-law. “But she thought these communities really needed a voice. So she talked to other small newspapers and had correspondence with people all around the country about how she should set this up.” After a year of research, she launched the paper in 1968.
Edward, then elementary-school age, grew up helping address papers for mail subscribers, and with the page layout. In those days, a fishing boat took article text across the water to a layout shop in Deer Island, Canada, and then another boat would carry the pasted-up pages back to the U.S. for printing.
Then and now, the striking characteristic of the paper is its density of local news. The most recent issue, when we visited, was 40 pages long, with many dozens of purely local, information-packed news stories.
For instance, the front page (at right) had five local stories: about the Passamaquoddy Tribal Council’s effort to defend water rights; about limits on sea-urchin fishing (a quickly growing market, mainly for export to Asia); about the impact of new tax preferences, for land conservation, on local tax revenues; a crime story; and one about an academic-freedom dispute at the local Maritime College of Forest Technology. Plus, a picture of a kayaker viewing a Minke whale—of which we saw large numbers in the bay.
In the rest of the paper you have: high-school sports. Commercial shipping schedules and tide tables. Gardening and cooking tips. Religious news. Birth and death notices. Puzzles. Local city-council roundups. A long editorial and letters-to-editors section. Everything.
“I think it’s important for newspapers not to keep cutting,” Edward told me at The QT’s office. “If you keep cutting, there’s less and less reason for people to buy the paper. If you want to keep a healthy circulation, you have to make the investment in reporters and providing the news that people can’t find anywhere else.” If there is a “secret” of the paper’s success, he said, it is “that you’re providing information that people can’t find any other place.”
Both Lora and Edward emphasized that the paper’s twice-a-month publishing schedule—the second and fourth Friday of each month, with a built-in cushion for them in the months that have five Fridays—gives them an advantage, in forcing them away from the daily or breaking-news stories that their readers would already have learned about elsewhere.
“I believe that daily newspapers struggle because they’re so often repeating what’s already been presented, either in social media or on the television news,” Edward said. “But when you have a local newspaper that is presenting news people aren’t going to find anywhere else, I think there will always be a need for that. I think that will allow local newspapers to survive very well.”
Unlike her husband, Lora is not originally from Eastport. She grew up in New York; some of her relatives ran a small newspaper in Santa Barbara, California; and she originally came to Maine, before she met Edward, to work on an economic-development project. They met, and married, and she became involved with the newspaper. Now she is the assistant editor and publisher, and does much of the local-news coverage.
“I don’t know what journalism schools are doing these days, but I really wish they would focus more on local news,” she told me. “It can be boring, I mean really boring, to go to city-council meetings every month, and county-commissioner meetings every month. But at the same time, it’s incredibly important. And at least once a year, something will come out that’s incredibly important, and that you would not know if you hadn’t been there.”
“Those are the kinds of stories that local people need to know, and want to know, and that are getting lost with some of the papers that don’t have the resources, or don’t understand how important it is to cover those boring meetings month after month.”
“It’s not exciting most of the time,” she said—and Deb and I knew what she was talking about, since we’d been to an Eastport City Council meeting that she was covering. “But it’s critical. It’s like how most of us live our lives. Not terribly exciting most of the time—but, you know, we have these moments!”
Edward had an aw-shucks, self-deprecating manner when talking about his newspaper’s influence and record. Maybe this is The Maine Way; maybe it’s just him. But he wasn’t afraid to seem earnest when talking about why he believed that local journalism mattered.
“I think we provide quite a bit of investigative reporting, and try to get into the meat of what’s happening so that people can make informed decisions. We really try to provide a voice for people in our communities that might otherwise not have a voice, so that people in power have to address their concerns and be held accountable.”
“I think that’s really the basis for a healthy democracy,” he said. “I think without community newspapers, democracy will really suffer.” It’s worth noting at this point that we’ve been following the Eastport and Quoddy Tides saga for more than six years now, and what Edward and Lora said about their paper matches what other people in the community have told us as well. It’s not unusual to overhear people saying, “Well, I saw in the Tides …”
Lora said that in a town as small as Eastport, she and her husband and their contributors knew that every day they would encounter people they were writing about, and people who read their paper. “It’s a delicate balance in a community this small,” she said. “We’d walk into the IGA”—the local grocery store—“and people would come up to us waving a story we’d written.” For a long time, she said, she and Edward didn’t have a phone-answering machine, because they didn’t want to deal with some messages.
But overall, she said, “actually it’s a blessing to feel that trust that people have in you. They come up to you and say, ‘This is what I’m worried about. Is there any way you can look into it?’ Sometimes we can. Sometimes we cannot. But it is a beautiful feeling to have someone trust you like that.”
The Quoddy Tides model may not work in other communities, and it may not work forever even in this one. But for now it’s a useful illustration of the way journalism, community, public discourse, and civic engagement can interact in a positive cycle, rather than in the destructive ways we’re all so familiar with.
Andrew Carnegie was the force of Gilded Age philanthropy behind the building of public libraries. Along with other recognizable names who made their fortune in the late 1800s and early 1900s—Rockefeller, Ford, Mellon, Morgan, Stanford, Harriman, Heinz—Carnegie’s influence endures today largely because of the way he gave away the vast fortune he amassed.
For about 35 years beginning in 1883, Carnegie donated money from his steelmaking empire (which became U.S. Steel) to build nearly 1,700 libraries around the country and another 800 around other parts of the world. He was careful about his “formula” for agreeing to construct the commanding, elegant buildings, a formula whose elements remain fundamental in the basic operations and democratic spirit of public libraries today. The libraries were required, among other things, to support staff and maintenance, to gather at least some of their funding from public sources, and to be open and free to the public to use.
It has been stunning to see the physical and spiritual legacy of Carnegie libraries—large and small—as we have visited more than 50 towns around the country for our Our Towns reporting project. It has been inspiring to bear witness to how libraries have evolved from the simple idea of serving the wants and needs of the public to becoming crucial, essential public institutions of communities in this modern era.
Around the turn of the 20th century in Columbus, Ohio, an audacious city librarian named John Pugh hopped the train for New York to knock on Carnegie’s door, and—appealing to their shared Celtic background— charmed Carnegie into donating $200,000 for the construction of the imposing granite and marble main library in downtown Columbus. Today the building has been newly renovated and expanded, retaining its original main building and entry, where the words OPEN TO ALL are carved in granite over the door. From the library’s main reading room, you can look out the two-story glass windows onto the seven acres of topiary park with more than 200 different types of trees.
In Dodge City, Kansas, a small but distinguished group of residents, inspired by the town’s women’s club, appealed to Carnegie in 1905 for support to build their public library, as he had previously done for five other towns in Kansas. He gave them $7,500, and they agreed to ante 10 percent of that sum annually to maintain it. The town’s population grew and eventually outgrew the small library. Today it is home to the Carnegie Center for the Arts.
Carnegie wasn’t the only one with visions for public libraries. I visited at least two libraries in other towns with lesser-known patrons from the same era who built libraries in the same spirit.
In Redlands, California, Albert and Alfred Smiley, twin transplants from back East like many other early Redlanders, helped develop this paradise of an orange-growing town. So strongly did Albert believe in the institution of the public library that he personally borrowed money to build the town’s public library. He then enticed his good friend Andrew Carnegie to travel to Redlands to see the library himself. During his visit in 1910, Carnegie offered these touching remarks about Smiley and the library:
Before giving libraries, I waited until I had this useless dross that men call money, because it is useless until it is put to some good use, and he could not wait. His love for the cause impelled him to give, and he actually borrowed money—borrowed the money, I say, to build this magnificent structure.
The Peavey Memorial Library in Eastport, Maine, has a story, too: not a Carnegie story, but one that is romantic and similar in its origin. In the late 1800s, Frank Peavey, a native Eastporter, built a library in honor of his father, Albert Peavey, who was born in Eastport and died there at just 35 years old, when Frank was only 9. Frank moved from Maine to the Midwest as a very young man, where he built a fortune in the grain industry. He invested in railroads and lake steamers, and also invented the first circular concrete grain elevator in the U.S. Peavey followed a kind of Carnegie model, with a twist. He built the library in Eastport on the condition that the residents of the town would stock it with 5,000 of their own books.
The library is a deep-red brick one-story building, designed in the Romanesque Revival style. Its main reading room, with a rounded bay on one end, looked to me like its best season would be winter, when people could sit, warm and cozy, reading newspapers or books. There is a collection of dictionaries along one wall of the room, including the massive 1,200-page Passamaquoddy-Maliseet-English Dictionary. It was published in 2008 and still stood proudly on a pedestal the first time I visited, in 2013. Today it remains on display in the reading room, looking a little more thumbed through.
Apart from the original entry and small room of the stacks of books, and an adjacent room with archives of Maine and maritime memorabilia, there is an addition for the children’s room, which doubles as the activities and programs room for the library.
When we visited Eastport this summer, I went to a program featuring one of the Tides Institute’s artists in residence, Ada Cruz, demonstrating gyotaku printmaking. Gyotaku? Imagine the equivalent of brass-rubbing of a fish. The room strained to hold the crowd, full of people eager to try a hand. Some of the overflow like me spilled outdoors to the book sale, where books were stacked in watertight rubber bins on tables in the backyard.
As for the rest of the programming, Dana Chevalier, the library’s director, says that it’s important for it to organize activities to get a lot of bang for its buck. It tries to be democratic (as libraries are!), integrating programs for young and old alike. The summer list of activities was chockablock and creative. In the high season of summer, when Eastport serves many tourists and summer residents as well as the year-round population, it had organized programs of paper cutting, gardening for health, rock painting, jewelry making, author talks, poetry, tote-bag stenciling, seaweed printmaking, chess, marbleized painting, paper beads, talk about vaping, astronomy, faux stained-glass windows, and home coffee roasting, to name a few.
Eastport is not a wealthy town. And it is small, only about 1,300 year-round residents. That makes for challenges for the library, which operates on a lean budget. Chevalier is the only full-time employee. There is another part-time employee and a corps of loyal volunteers.
As in most public libraries, the computers and internet are crucial to this community. Many people in Eastport can’t afford computers and can’t afford high-speed internet connection. The Pew Research Center reports that for residents of rural areas (like Eastport), access to home broadband is much lower than for non-rural Americans. Some 58 percent of rural Americans subscribe to home broadband, compared with about 70 percent of urban and suburban residents. This is not just a data point for Eastport, explains Chevalier. “It is a reality for them.”
The most serious problem for the library now is its infrastructure: a damaged roof, some crumbling bricks, and problems around the main front entry.
The library is responding on many fronts to raise the money for the fixes. On the weekend we were there, a free music festival in the library’s backyard attracted lots of residents and tourists, who donated their dollars, which will be matched equally by a generous donor. The plywood thermometer sign in front of the library was at $10,000 when we arrived, and at $20,000 a week later. That was still a long way to go to the fundraising goal, which currently stands at about $640,000. The library also recently hired a grant writer from Bangor to see what it might win from outside the town.
I frequently stumble upon a surprise or two at the libraries I visit. In Eastport, the surprise was a young man named Andrew Wach, who was at the front desk on one of the days I stopped in. Andrew, who grew up in Miami, is stationed in this way-down-east town on a four-year tour of duty with the Coast Guard. He told me that he and the others are encouraged to participate in the town, so they sometimes come over to help move heavy things around in the library. Andrew, a boatswain’s mate, is taking this several steps further. He’s thinking of going to library school when he finishes with the Coast Guard, he said, and he is volunteering at the library regularly now as a way to see and test out the realities of library work for himself.
My husband, Jim, keeps writing that the United States is in the middle of a second Gilded Age, parallel to the half century that followed the American Civil War. Now, as then, technology is creating huge new fortunes, while disrupting or destroying long-established businesses. Now, as then, migration within the country and around the world is rapidly changing communities. Now, as then, national-level politics is struggling (and usually failing) to keep up with events.
One of the outcomes of that era, he also keeps pointing out, is that it eventually triggered many broad waves of reform—in women’s suffrage, through the labor movement, in good-government efforts, in the struggle for civil rights for African Americans and other minorities. And even before that, it spawned the generation of philanthropists, led by Andrew Carnegie, who resolved to use some of their wealth to address the most acute problems of that age.
I wish the Eastport library, Andrew Wach, and the librarians of the future well. And I hope they and their counterparts around the country attract the attention of this era’s potential Carnegies.
We were flying away from Washington D.C. again, leaving the Sturm und Drang of our hometown in early August for a point nearly as far east on the U.S. map as one can get. It is “Down East,” in the vernacular of Maine, and the town of Eastport, where residents say the sun first rises over the United States, as does the moon, which gets far too little attention.
In Eastport, it is difficult to rise before the fishermen do; they are often out by dawn, returning with a catch before most of us see the sun, and then they head to the local Waco Diner, which is ready for them with bacon and coffee.
Close in to shore this morning, seagulls cry back and forth to each other. Winches lower lobster traps onto boats for setting in the bay. A few townspeople arrive at the new town pier in pickups stocked with their fishing gear. They cast their lines some six feet down from the pier to the water at high tide, and as much as 25 at low tide. The tidal difference is greatest when the moon is full, as it is now. I watched the fishermen catching mackerel, smelt, and herring for their dinner tables.
The port’s pilot boat glides silently offshore; I know a big ship is scheduled to arrive at the port this week, maybe like the Industrial Ruby, which came and went last week, loaded up with wood pulp for China. It’s a Dutch-built and -owned ship, registered in Liberia, with Russian and Ukrainian officers and a Filipino crew.
Many elements in Eastport help you touch the whole world, in a hugely romantic way rather than the fearing and dark way in which many elements in our hometown touch the world. Ships heading for China; evening flights departing the east coast for early arrivals in London or maybe Paris, their lights flickering and their huge jet engines barely whispering in our ears.
Canada is right across the water; from Eastport, you see the island of Campobello, where Franklin and Eleanor Roosevelt spent summers with their family. Within a few days in August of 1921, FDR contracted a sudden series of symptoms that were finally diagnosed as polio. Eventually, he was ferried across the water to Eastport, and taken by train to New York. His dark-red house with the dark-green roof, surprisingly comfortably rambling, still stands at the top of lawns that slope down to the water. His small sailboat sits dry on the lawn. The trains have long since gone away.
On land, workers are hammering at Eastport’s 1887 Masonic Block, owned by the Tides Institute, replacing the crumbling wood beams with monstrous steel ones to keep the building standing for two centuries more, at least. It’s worth the trouble to be sure that the west side of Water Street remains solid with its row of red brick buildings.
Just uphill is the Peavey Memorial Library, which desperately needs some attention like the Masonic Block is getting so that more of Peavey’s bricks don’t crumble. Like many other public libraries, they are looking every which way to find the funds for this. There was a music festival behind the library all weekend, free but for library donations. There’s a thermometer drawn on a poster out front marking donations rising like degrees, and according to the Quoddy Tides, Eastport’s biweekly paper, a grant writer from Bangor, Maine, has been hired to seek money from outside Eastport.
Getting to Eastport from just about anywhere requires some planning and purpose. For us, it was easier than for most others. In a Cirrus, it takes about three and a half hours from D.C., which seems miraculous compared with some 14 hours of driving. We are immensely grateful for this plane.
It was a very warm and beautiful Friday afternoon to fly. From a view of 2,500 feet above the ground, everyone along the East Coast seemed to be out enjoying life in America. Through Maryland and Pennsylvania, swimming pools were swarming with clusters of tiny dots of swimmers. On inland lakes, small boats buzzed about. The mighty Susquehanna and Hudson were fairly quiet; maybe weekend boaters were not yet on the water. Beaches along the Maine coast, where the water is very, very cold, were bright with colorful umbrellas.
The skies were busy; some fliers enjoying the day like we were, and others trying to get somewhere for the weekend as fast as possible. For four hours along the mid-Atlantic, the air traffic controllers (ATC), my heroes of the skies, warned pilots half a dozen times of parachuters out for adventure. “Let me know when you have jumpers away,” the ATC would request the pilot of the adventure trip, and then pass along the crucial information to us. The ATC would occasionally speak to us: “Vector 20 degrees to the right to avoid jumpers.” I find it a little unnerving when jumpers are in the air near us. We always scour the skies, but never once have seen jumpers.
Even Air Force One was on the move that day. There was a Temporary Flight Restriction (TFR) in place that afternoon around both Bedminster, New Jersey (for golf), and Long Island (for a private fundraiser). We skirted a bit to the west to avoid the TFR, grateful that we hadn’t been caught on the ground for the long delay, which has happened to us a few times before.
I was surprised by the affluence of the American look. Not only the recreational part of it, but also the infrastructure. We spotted so many schools; sprawling complexes with new buildings in star-shaped designs, with baseball diamonds, football and soccer fields, even some outdoor swimming pools, and spacious parking lots suggesting many kids drove their own cars rather than riding in school buses. There were many rather mysterious industrial buildings, revealing few clues of what actually went on inside. Big buildings, oddly shaped; few cars; probably public buildings of some sort, but never rusty and colorless like those we grew accustomed to seeing when we lived in China. These were often freshly painted, in shades of gentle blues and greens. Happy-looking, if impersonal, buildings were surrounded by mowed and tended lawns.
Not all was affluent, and not all was lovely. Herringbone patterns of mobile homes looked fragile and makeshift. Prisons were plentiful. And in Portland, Maine, where we stopped to refuel, we knew many frustrated passengers sat inside the commercial planes on the taxiways, in line for take-off right behind us. We listened to the ATC talk with the pilot of one flight, saying something like: “Wow, you’re still here? I thought you’d be gone by the time I got back from lunch.” Then followed by, “Don’t shoot the messenger, but La Guardia just put on another hold. They say they’ll have an update in about an hour.” Even though we were only looking at the plane, I could almost hear the collective groan from the cabin full of passengers as they would receive this news from the captain.
Critics are letting their disdain for the president blind them to geopolitical realities.
When a new coronavirus emerged in China and began spreading around the world, including in the United States, President Donald Trump’s many critics in the American foreign-policy establishment were quick to identify him as part of the problem. Trump had campaigned on an “America first” foreign policy, which after his victory was enshrined in the official National Security Strategy that his administration published in 2017. At the time, I served in the administration and orchestrated the writing of that document. In the years since, Trump has been criticized for supposedly overturning the post–World War II order and rejecting the role the United States has long played in the world. Amid a global pandemic, he’s being accused—on this site and elsewhere—of alienating allies, undercutting multinational cooperation, and causing America to fight the coronavirus alone.
The U.S. may end up with the worst COVID-19 outbreak in the industrialized world. This is how it’s going to play out.
Three months ago, no one knew that SARS-CoV-2 existed. Now the virus has spread to almost every country, infecting at least 446,000 people whom we know about, and many more whom we do not. It has crashed economies and broken health-care systems, filled hospitals and emptied public spaces. It has separated people from their workplaces and their friends. It has disrupted modern society on a scale that most living people have never witnessed. Soon, most everyone in the United States will know someone who has been infected. Like World War II or the 9/11 attacks, this pandemic has already imprinted itself upon the nation’s psyche.
A global pandemic of this scale was inevitable. In recent years, hundreds of health experts have written books, white papers, and op-eds warning of the possibility. Bill Gates has been telling anyone who would listen, including the 18 million viewers of his TED Talk. In 2018, I wrote a story for The Atlantic arguing that America was not ready for the pandemic that would eventually come. In October, the Johns Hopkins Center for Health Security war-gamed what might happen if a new coronavirus swept the globe. And then one did. Hypotheticals became reality. “What if?” became “Now what?”
The coronavirus pandemic and a chapter of history that should have expired long ago
In a large windowlessroom in the bowels of the CIA, there is a sign that reads Every day is September 12th. When I first saw those words, during a tour of the agency’s operations, I felt conflicted. As a New Yorker who witnessed the 9/11 attacks, I once felt that way myself, but by the time I saw the sign, during the second term of the Obama administration, it seemed to ignore all the things that our country had gotten wrong because of that mindset. Now, as COVID-19 has transformed the way that Americans live, and threatens to claim exponentially more lives than any terrorist has, it is time to finally end the chapter of our history that began on September 11, 2001.
I say that as someone whose life was shaped by 9/11. I was a 24-year-old graduate student working on a city-council campaign when I watched the second plane curve into the World Trade Center and then saw the first tower collapse. Everything that I’d done in my life up to that point suddenly seemed trivial. I walked several miles to my apartment, as my fellow New Yorkers came out into the streets to be near one another (as we can’t be today). In the days that followed, my Queens neighborhood was the setting for a number of funerals for firemen. I will never forget the image of one devastated widow sitting in a lawn chair in her front yard, receiving condolences from a line of the toughest—but most broken—men I had ever seen.
The country has reasserted its foundational stability, and in doing so made real change more likely once this is all over.
Perhaps a testament to how close Britain has come to losing its way is the fact that it took a pandemic, an emergency of foggy complexity, for the country to get back on its path. This was a weekend that felt defining, not just for the immediate story, the coronavirus, but for British politics—and for Britain itself.
It was not a good weekend. Prime Minister Boris Johnson was hospitalized, and Britain’s death toll jumped as another 621 people died over 24 hours. The gravity of the situation moved the Queen to deliver an emergency address to the nation, something she has done only a handful of times in her 68-year reign. This was not a weekend in which Britain reached, or even caught a glimpse of, the peak of the coronavirus outbreak—never mind found a route back down from it and off the mountain.
What is actually known about hydroxychloroquine, the medication that Trump is fixated on recommending for COVID-19
Two weeks ago, French doctors published a provocative observation in a microbiology journal. In the absence of a known treatment for COVID-19, the doctors had taken to experimentation with a potent drug known as hydroxychloroquine. For decades, the drug has been used to treat malaria—which is caused by a parasite, not a virus. In six patients with COVID-19, the doctors combined hydroxychloroquine with azithromycin (known to many as “Z-Pak,” an antibiotic that kills bacteria, not viruses) and reported that after six days of this regimen, all six people tested negative for the virus.
The report caught the eye of the celebrity doctor Mehmet Oz, who has since appeared on Fox News to talk about hydroxychloroquine 21 times. As Oz put it to Sean Hannity, “This French doctor, [Didier] Raoult, a very famous infectious-disease specialist, had done some interesting work at a pilot study showing that he could get rid of the virus in six days in 100 percent of the patients he treated.” Raoult has made news in recent years as a pan-disciplinary provocateur; he has questioned climate change and Darwinian evolution. On January 21, at the height of the coronavirus outbreak in China, Raoult said in a YouTube video, “The fact that people have died of coronavirus in China, you know, I don’t feel very concerned.” Last week, Oz, who has been advising the president on the coronavirus, described Raoult to Hannity as “very impressive.” Oz told Hannity that he had informed the White House as much.
Widespread social-distancing measures have produced some jarring effects across land, air, and sea.
From inside her living room in London, Paula Koelemeijer can feel the world around her growing quieter.
Koelemeijer, a seismologist, has a miniature seismometer sitting on a concrete slab at the base of her first-floor fireplace. The apparatus, though smaller than a box of tissues, can sense all kinds of movement, from the rattle of trains on the tracks near Koelemeijer’s home to the waves of earthquakes rolling in from afar. Since the United Kingdom announced stricter social-distancing rules last month, telling residents not to leave their home except for essential reasons, the seismometer has registered a sharp decrease in the vibrations produced by human activity.
With fewer trains, buses, and people pounding the pavement, the usual hum of public life has vanished, and so has its dependable rhythms: Before the spread of COVID-19 shut down the city, Koelemeijer could plot the seismometer’s data and see the train schedule reflected in the spikes, down to the minute. Now, with fewer trains running, the spikes seem to come at random.
New York’s Bill de Blasio seems irritated by the need to fight the coronavirus.
Bill de Blasio has long been spoiling for a fight, just not the one now before him and his city. When he became the 109th mayor of New York, on a colorless winter day in 2014, he promised to lead a struggle against “injustice and inequality.” Although he has had some genuine successes, he has failed to turn the city into a Copenhagen-on-the-Hudson. He hasn’t turned it into Caracas, either. New York is pretty much the same global metropolis it was when he took over.
Aware that his progressive ambitions have been frustrated, de Blasio has complained that legions of enemies—conservatives, capitalists, newspaper headline writers—are arrayed against his vision for the city.
However determined these forces have been to undo him, they are not responsible for whatNew York magazine called, on March 26, “his worst week as mayor.” Worse than the week in 2014 when two police officers were shot and killed, degrading his relationship with the department. Worse than the many weeks in 2016 of overlapping ethics investigations, which threatened to ensnare the mayor and his top aides.
How the coronavirus travels through the air has become one of the most divisive debates in this pandemic.
Updated at 7:22 p.m. ET on April 4, 2020.
As the coronavirus pandemic continues, many people are now overthinking things they never used to think about at all. Can you go outside? What if you’re walking downwind of another person? What if you’re stuck waiting at a crosswalk and someone is there? What if you’re going for a run, and another runner is heading toward you, and the sidewalk is narrow? Suddenly, daily mundanities seem to demand strategy.
Much of this confusion stems from the shifting conversation around the pandemic. Thus far, the official line has been that the new coronavirus, SARS-CoV-2, could be transmitted only through close contact with infected people or contaminated surfaces. But recently, news reports have suggested that the coronavirus can spread through the air. After 60 choir members in Washington State rehearsed together, 45 fell sick, even though no one seemed symptomatic at the time. Now people who were already feeling cooped up are worrying about going outside. Many state guidelines are ambiguous, and medical advice can muddy matters further. When the writer Deborah Copaken came down with COVID-19 symptoms, her doctor chided her for riding her bike through New York City a week earlier. Going outside in the city wasn’t safe, the physician implied, with “viral load everywhere.”
The president belatedly acknowledged how dire a threat COVID-19 is, but many of his enablers in right-wing media refuse to take his cue.
Mainstream news descriptions of the right-wing media’s approach to COVID-19 typically go something like this: At first, prominent conservatives on television and radio downplayed the threat; only when Donald Trump himself acknowledged that the coronavirus was likely to kill large numbers of Americans did his enablers on Fox News and talk radio reverse course.
On March 31, the New YorkTimes contributing opinion writer Kara Swisher asserted that Fox News had “dished out dangerous misinformation about the virus in the early days of the crisis” and had only recently gotten “much more serious in its reporting on the coronavirus, as has Mr. Trump.” On April 1, the Times reporter Jeremy Peters described an initial “denial among many of Mr. Trump’s followers” in the press about the seriousness of the COVID-19 threat, followed by a “sharp pivot” to acknowledging its severity but “blaming familiar enemies in the Democratic Party and the news media” for the destruction the virus has brought.
The pandemic seems to be hitting people of color the hardest.
I dread every time my partner leaves our home. I dread every time Sadiqa marches to the front lines of the war against COVID-19—the emergency department. I dread every time she comes home and removes her personal protective equipment.
Sadiqa is worried like a soldier in a total war, seeing so many medical providers going down, seeing so many patients going down. I am worried about her health—and my own, as someone surviving metastatic cancer. I am worried about all medical providers, all Americans who have compromised immune systems, all Americans who are infected, all Americans who are healthy and want to remain that way.
As a student of health disparities, I am especially worried about the well-being of people of color. And people of color appear to be especially worried about their own well-being. Black people, at 46 percent, and Latinos, at 39 percent, are about twice as likely as white people, at 21 percent, to view the coronavirus as a major threat to their health.