By Peter Morningstar

I’m a pediatrician. I work primarily in Presque Isle, Maine, for a big practice that probably doesn’t really need me, but where I make a modestly meaningful impact, while not overworking myself, spending plenty of time with the family, and having the opportunity to do things I enjoy, like four wheeling and mountain biking, playing hockey, and writing.

I used to work full time in Machias, Maine. Machias is an Indian name that means Bad Little Falls. There is a Bad Little Falls in Machias, where the Machias River goes over a series of ledges next to the Main Street corridor. It’s not a super big drop, and it’s easy to miss if you are in a car on Route 1, but there is a lot of water going through a narrow curve, and it looks pretty, and pretty rough. You see all this if you wander out behind the Mobil station and look over the embankment.

I asked my buddy Dave Whitney who is a big kayaker and canoer, and owns several businesses in town, if he had ever run the falls and he looked taken aback. He arched upright, his glasses slipped down his nose, and his eyes opened wide and wild. “Nooo.  No.  Nooo…” Too rough? I guessed.  “Oh it’s rough, and it’s a good drop for a raft, let alone a kayak or a canoe, but the biggest problem is there’s eddies in there that would suck even a raft down, and the falls are full of metal posts from back in the days they ran logs down the river. A person would get shredded in those falls.” Anyone ever done it? “If someone did he hasn’t been back bragging.”

I worked for the hospital there in Machias, and it was a Bad Little Hospital. I don’t mean bad like low quality, or poorly equipped; I mean bad like terrible, like rough and mean, like the Machias River Falls: small, kind of cool looking, tempting, and filled with old sharp steel. I remember when I was a nerdy kid, being attracted to the tough girls my mother didn’t even bother to warn me against, the girls who smoked and glared at passing cars by the high school my mother wouldn’t send me to anyway. The hospital in Machias was like those girls.  The doctors there had been warring amongst themselves for years, and warring against the hospital administration for even longer. The nurses if anything were even more out for blood than the doctors. It seemed like every indiscretion, no matter how mild, was reported to a state licensing board. When I interviewed, there were three pediatricians, when I arrived there was just one… Pediatricians had come and gone and come and gone. I lasted the longest, four years, the first year and some, and for various stretches later on, all by myself. I can’t imagine what moved me to want to move there, but I was excited to go. I like to be needed.

Of course I finally gave up and left three years ago. The family didn’t like the town so much.  There’s not much to do in Machias, no movies or mall, no ice rink or ski hill to make the winter go by, and too many biting insects to enjoy the summer much. Like the Falls, it’s pretty to look at, but not a place to immerse your family, unless they are really good at making their own fun, and not bothered much by black flies and mosquitoes. On a bright Autumn day, or in the Spring when the snow is melting and the flies are still sleeping, it may be the prettiest place in the world. It is kind of a Bad Little Town that way, a place my mother would never have thought to forbid. We were all relieved to move somewhere less Bad and less Little. Presque Isle is isolated, but you can ride your snowmobile right up to the mall, and the bugs are scarce.

Since I left town, the hospital in Machias has improved some.  I don’t take the betterness following my departure at all personally. An inpatient had wandered out into a storm after arguing with staff and froze to death in the snow, sparking a state and federal investigation that toppled the last administration. Since then the hospital has gone to some lengths, and with some success to get less Bad, if not less Little.

Actually, even after we cleared out I couldn’t tear myself away completely. I still go down there every four weeks for two days to look after the kids from that Bad Little Town. In part because in three years no one has stepped in to replace me. My friend Alf is an excellent physician assistant who handles almost all the pediatrics there and does a fine job.  But the role of assistant by its nature demands an assistee, and that person is still me. I drive three and a half hours each way from our home in Caribou down the loneliest stretch of highway in the east to Machias every fourth week, work like a madman for two days, then load up on caffeine and head home.  One trip in the snow two years ago I saw only seven vehicles out for the whole 175 mile run: four plough trucks, two pick ups, and a border patroller.  That was when the mill in Baileyville was shut down and the log trucks were all parked. I almost always stay with friends there those Thursday nights. The truth is that the friends I met in that Bad Little Town, and the patients I treat at that Bad Little Hospital, are about the best friends, and most loyal patients a person could have. It’s funny that such good people can be found so far out along the edge of nowhere, and that is why I keep going back to that Bad Little Town, even three years after we escaped. I can’t help myself. I love the place.