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Visiting Southwest Virginia #1

Teresa and Paula are determined, capable, resourceful, energetic, and creative. Nothing stops them as they plead for their patients. Here I am with Teresa Tyson and Paula Hill:

July 18, 2018

MARION: I was eager to visit Marion because I wanted to talk with Eric Blevins. Eric wrote an op-ed last April in the Richmond Times Dispatch about the drug addiction crisis in his hometown. Eric is in his early thirties and at about thirteen started using various drugs and alcohol. He has been clean for over six years. Currently, he is a peer counselor and is studying to become a licensed counselor. He has seen or experienced it all. I reached out to him to see if he would share his story and advice with me.

We met for lunch at Hungry Mother State Park. Eric was so open and informative. He has a bright future. He opened our eyes about how pervasive the drug culture is in the region. Some of the addiction started with injuries. Doctors prescribed painkillers in quantities we now know were excessive and caused addiction. As the medical profession and law enforcement have clamped down on opioids, the street cost has escalated. Heroin is now a cheaper alternative. It is also incredibly dangerous - it is much stronger than years back and is often laced with fentanyl. Meth use seems to have declined somewhat but is still readily available. All in all, it is a lethal brew.

One scenario Eric outlined was how whole families depend on the sale of individual pills for their daily expenses. People on disability or social security are injured and get a prescription. They then sell the opioids one pill at a time through a network on the streets. It helps them pay their daily living costs. And, it goes on indefinitely.

Of course, the poverty and despair felt by many here adds to the pressure to start drugs. There is also a whole subculture of users.

I am very aware most people in the region are not users and do not encourage drug use. All community leaders - governmental, religious, and business - are working to meet the needs of those struggling to get clean. I am convinced that Medicaid expansion will help thousands throughout Virginia. Here Eric and I are at the park where we shared lunch:

Bed and Breakfast - The Collins House. Bluegrass music lovers come from far and wide to enjoy the Saturday evening performances at the Lincoln Theatre. Sadly, we were there on Friday and missed it!

We did spend a couple hours wandering up and down Main Street. There is a fascinating museum run by the Marion Historical Society. And across the street is a great restaurant called the Wooden Pickle.  

ABINGDON: If you know SW Virginia at all, you probably know Abingdon. Famous for the Barter Theatre, The Mary Washington Inn, Victorian homes, good food, and the Virginia Creeper Trail, Abingdon is a dazzling tourist hotspot. Having visited the town several times over the years, I was less interested in the town itself than the surrounding areas.

Mary Trigiani spent hours with us driving around the local towns and hollows. Mary was raised in Big Stone Gap (her sister wrote the book!) but moved to Silicon Valley after college. A couple years ago she returned home to work at the local community bank. Mary is a feisty, energetic advocate for her people. She clearly loves the area and wants to encourage economic development and collaboration between local business and education leaders.

Mary drove us through St. Paul, which is on the Clinch River. St. Paul is undergoing restoration and is becoming something of a tourist hub itself. The Clinch River is one of the most bio-diverse ecosystems in the US. Kayakers, birders, canoeists, and ATV fans are attracted to the town.

Mary also drove us through Dante (pronounced Daint, rhyming with paint). Dante was founded in the 1700s by frontiersmen. However, with the discovery of coal nearby, the community exploded with growth. Now Dante has fewer than 500 residents. The homes are tiny and close together. Many appear not to have indoor plumbing. It strikes me as a typical Appalachia coal town. Some homes are well maintained; others are cluttered with rusting cars and fading plastic toys. I found the "Private Property: Do not Enter" signs on most fences very disturbing. We speculated it had to do with drugs.

We stopped for lunch at a favorite author's restaurant. Barbara Kingsolver has opened a farm to table restaurant near Abingdon - and everything was delicious and much more healthy than I usually eat!

We spent the afternoon in Abingdon with Jan and John Reeves. Jan was my legislative aide for several years. She was a wiz at constituent services - she also was chair of the Fairfax County Democratic Committee. I hope some of you remember her! Jan grew up in Southwest Virginia and always wanted to return home. She became a licensed counselor and put out her shingle. It was great seeing them again.

BRISTOL: We spent Sunday morning driving around Bristol, VA and Bristol, TN. The city is divided between the two states. In many ways they look the same. But Bristol, TN is economically viable and Bristol, VA is struggling. Most of the commercial development - and hence tax revenue -- is on the Tennessee side.

Then we spent a leisurely afternoon driving through some of the most beautiful countryside in the world and ended up at the Inn at Wise.

WISE: We had a jam-packed day in Wise. There was so much to learn and see. We started at the University of Virginia at Wise. Chancellor Donna Henry, UVA President Theresa Sullivan, and several other university leaders briefed us on the college. Frankly, I didn't know much about it. Here I am with Augie Wallmeyer, Donna Henry and Theresa Sullivan:

The University of Virginia at Wise is a college affiliated with UVA. Graduates get a UVA-Wise diploma. About 2000 students attend, of whom about 600 live on campus. Impressive is the fact that graduates have less debt than any other college graduates in the country. The campus is lovely and situated on a reclaimed coal seam. In fact, the extracted coal helped pay for the campus.

Any student who is wait-listed at UVA Charlottesville can attend UVA-Wise. And, if they have good grades, they can transfer to UVA after two years. I am hopeful that some of my constituents will consider going to UVA-Wise. The educational quality is excellent and for students who want a smaller campus and student body and who love active outdoor recreation, it is a great option.

President Sullivan has been engaged in a study of the needs of rural Virginia, which is directly relevant to my trip. The report will be made public the end of this month - I am hopeful we will be able to implement recommendations next session. And, I hope the study will be ongoing.

While we were on campus, we visited the Convocation Center. It was preparing for the RAM weekend. Remote Area Medical will be providing medical care at the campgrounds and dental care at the Center. Hundreds of doctors, dentists, nurses, and other volunteers will be treating thousands of people. The patients come from all over the area, wait in line for hours, and pray they will be seen. Many are turned away.

Dental patients who come for help typically need their teeth extracted. Literally buckets are filled with teeth. This weekend the lucky ones will have their teeth all extracted. Then they will return next year for dentures.

While grateful for the medical volunteers, I think the need for such events in this state is disgraceful. We can and must do better.

After a lovely lunch at UVA-Wise, we went to the Health Wagon.

What an inspiration that was! You probably have seen reports about the Health Wagon on 60 Minutes. Two women - Doctor Teresa Tyson and Doctor Paula Hill - saw the medical needs in their area and set up the Health Wagon more than three decades ago. They run two clinics and a mobile Winnebago unit that travels to people in remote, hard to reach areas. They utilize every program imaginable to bring medical care and medicines to people in need. For example, they used drones to demonstrate how to deliver medicines to hard to reach patients.

Teresa and Paula are determined, capable, resourceful, energetic, and creative. Nothing stops them as they plead for their patients. Here I am with Teresa Tyson and Paula Hill:


The Health Wagon sees over 4000 people annually. Most have serious medical conditions that were ignored for years. Diabetes, high blood pressure, pulmonary disease, chronic pain, heart disease and cancer are commonplace. The Health Wagon treats them all. Their average patient is 38 years old. Ninety-eight percent of them have no insurance. Seventy percent are working and their average income is less than $20,000 a year. Those few with insurance typically have such high deductibles that they can't use it.

Isn't it appalling that we have a need for the Health Wagon? It feels like we are a third world country. Even with Medicaid expansion the people in this area will desperately need their services.

We finished up our day with a special treat. Dr. Bill Kanto, a nationally known rural health expert, and his wife Marguerite had us to dinner. Dr. Kanto grew up in Wise, practices in Georgia, and returns home to relax. He knows the health needs of the rural areas and has creative advice on how to address them. He takes a systems approach and focuses on public policy considerations. He shared several papers and presentations with me. I need the kinds of recommendations he makes. This trip has made me even more aware of the urgency of healthcare for so many Virginians. Dr. Kanto's advice is priceless.

My day was emotionally exhausting. And we haven't even reached the true coal communities yet.....