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NEWLAND — Joe Zemanek might be 86 years old, but he’s certainly not helpless. When he moved to Avery County, in 1991, he and his late wife spent the first five years fixing up their old house.

And now, even after losing his wife four years ago, Zemanek still is able to take care of himself without much trouble. He says cooking food is pretty easy – he’ll just put chili into a crock-pot in the morning and let it cook on low all day. And he’s still able to drive most of the time, even though he was recently told that he had to wear glasses when he gets behind the wheel.

But sometimes, even someone as self-reliant as Zemanek needs to ask for help. Occasionally, he has to call on the Avery County Transportation Authority – the county’s public transportation department — to bring him to his eye appointments.

“I would drive to my own eye doctor’s appointments, but I would have no way getting home,” Zemanek says as he travels an hour and 30 minutes in one of Avery County’s vans to the Graystone Ophthalmology Center in Hickory.

That’s because in about an hour and a half from now, Zemanek will receive an injection in his eye.

***

Zemanek is definitely not the only person who needs the services that the Avery County Transportation Authority provides.

On an average day, the county’s 13 vans – which are available to transport all residents — make over 350 stops, said Debbie Smith, the department’s director. A lot of the van transportation is similar to what one experiences with the urban bus system, with vans providing trips to grocery stores before the end of the day. Some county residents even use the van services to get to work and back. But the transportation department views its out-of-county non-emergency medical transportation as one of its biggest priorities.

“For a lot of people in the county, it is their only means of everyday support for their lives” Smith said. “We have people who could not go to the grocery store or could not go to doctor’s appointments unless we were here to lend them a hand.”

Most of the rural counties in Western North Carolina have out-of-county public van transportation, but the main — and sometimes the only — city they often transport residents to is Asheville. Two exceptions are in Avery and Cherokee counties. Cherokee County’s van system is the only van system that drives riders as far as Avery County’s van system, with the system making scheduled trips to Atlanta, Chattanooga and Knoxville. Avery County residents use the county’s public van system to travel places like Boone, Hickory, Asheville, Winston-Salem and Charlotte for their medical appointments.

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Avery County is considered a health professional shortage area – there is less than one physician per 3,500 residents in the county, according to data from the county health rankings website. Most of those physicians are primary care doctors. There are even fewer specialists in Avery County, which many of the county’s older residents need. As a result, Avery County residents – like most residents in rural areas — have to travel outside of the county for appointments dealing with particular health issues, often serious. According to research from the National Center for Health Statistics, almost three-quarters of rural residents who traveled to urban areas received surgical or nonsurgical procedures during their hospitalization, compared with only 38 percent of rural residents who were hospitalized in rural hospitals.

The Avery County Transportation Authority feels a lot of pressure to help residents make it to their medical appointments. There haven’t been any staffing or financial cuts within the transportation department in recent years, but with only 11 drivers to provide these services, scheduling for residents can be challenging. [Find scheduling information here.]

“We are stretched pretty thin,” Smith said. “So we will do our best to make sure that everyone gets the ride that they need, but we do have to turn people down occasionally because we get overbooked, and we don’t always have enough vehicle or van power to cover everything that we need to do.”

***

Fortunately for Zemanek, the transportation department has a van that can get him to his eye appointment today. The trip to Hickory and back only costs $7. To put this in perspective, if you were to take a car that got 30 miles-per-gallon, it would take 4 gallons of gas to travel from Newland to Hickory and back. That would cost you at least $14 in gas. Avery relies on a state grant called the rural operating assistance grant to cover most of the costs for medical trips, which is why the medical transportation is more affordable.

On a Friday in mid-July, even though the van he is riding in is capable of seating six passengers, Zemanek is the only passenger.

His driver for the day is a 72-year-old Tommy Huskins Jr. Huskins is the kind of person that most people imagine when they fondly think their grandpa. He has a calm smile that shows both joy and contentment, but his handshake is firm and his hands are slightly calloused. He also has really wide eyes, which makes it look like he’s interested in everything that is being said in a conversation. To sum it up, he’s a pretty ideal road trip companion.

The drive to Hickory is longer than an hour, so he and Zemanek have a lot of time to get to know each other. But both guys are pretty good at keeping the conversation going.

About a third of the way through the trip, Huskins opens up and starts talking about how he ended up becoming a van driver. He was 65 years old when he retired on a Friday from his job with the state’s highway department. The next Monday, he started his job as a van driver. His retirement lasted two whole days.

“They asked me if I wanted to take off a couple of weeks before I got started with the van job,” Huskins says. “I said, ‘No. I want to get started as soon as I can.’

“I wanted something to do, and I wanted to keep busy. If you just sit down and do nothing, you don’t last very long. If you’re able to work, you should work.”

***

Huskins and Zemanek arrive at Graystone in Hickory at about 1:30 p.m. After Huskins makes sure that Zemanek is checked in for his appointment, he parks his van and waits.

On the drive down the mountains, Huskins mentioned that there are two challenging aspects to his job. One is waiting on his riders as they finish up with their appointments. He sometimes has to wait up to four hours. But he says he usually finds a way to keep himself entertained – whether it’s picking up a local newspaper or grabbing a quick bite to eat.

However, having multiple riders to wait on can be particularly challenging. Earlier in the week, Huskins drove multiple patients to the VA hospital in Johnson City, Tenn. Most of the riders were finished with their appointments within a reasonable time. But one guy’s appointment took a longer, and they all had to wait an extra hour for him to finish up. He said those kinds of situations are tough because it forces everyone to be patient.

The other challenging aspect to Huskins’ job is that it is oftentimes emotionally draining. During his seven years of driving, 38 of his riders have passed away, he calculates. Most of them were cancer patients, and he took many of those patients to all of their chemotherapy appointments.

During the drive down to Hickory, he didn’t say much more about that aspect of his job. He just said that it’s the most painful part of his job because he got to know many of those riders very well, and he was with them during their toughest times. He said the worst thing is when a patient’s cancer temporarily goes into remission, but then comes back again. That’s what happened to one of his riders that died of cancer.

But its not just cancer patients that our tough to emotionally handle. He said that one of the biggest changes he has witnessed during his time as a driver is the age of the riders that he brings to the VA hospital in Johnson City. When he first started driving in 2007, most of the veterans he drove for were older folks. Now, most of them are young men that have returned from military service in Iraq or Afghanistan.

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Fortunately, Huskins doesn’t have to deal with any of those challenges today. His rider today, Zemanek, is only receiving his monthly eye injection for his glaucoma. Zemanek’s appointment takes less than 45 minutes, and when he walks up to the van after his appointment, he jokingly says he walked in with eyesight and came out blind.

He says he would normally drive to these appointments himself, but the eye doctor dilates his eyes, so he can’t see well enough to drive. None of his immediate family lives nearby, so they can’t help him get to his appointments. That’s why he has to call upon the Avery County Transportation for help.

***

The topics of conversation on the way back to Avery County are significantly more light hearted than the ones on the way down to Hickory. Zemanek and Huskins mostly talk about the ridiculous number of restaurants in Boone now and how the temperature is expected to drop down to the high 40s during the mornings next week.

But toward the end of the drive, Zemanek says that he’s thankful for Avery County’s public transportation. He’s thankful that they are willing to drive him all the way to Hickory and for only $7. But mostly, he’s thankful that Huskins drove him today.

“I’m so glad you know where you’re going,” Zemanek says. “If I had had to find the place myself, I would have been completely lost.”

Huskins calmly and softly replies, “Thank you.” Despite the challenges that challenges that come with his job, Huskins loves his job in moments like this.

“It gives you the feeling of doing something for somebody,” Huskins said earlier in the trip. “I enjoy it just about more than anything I’ve done.”


Learn More

For county-by-county resource lists on public transportation options throughout the 18 westernmost counties, visit Carolina Public Press’s WNC Transportation profiles. Each of the county-focused resource lists will be published throughout the coming weeks.

Chase Erickson

Chase Erickson was the summer 2014 intern at Carolina Public Press.

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