Lifelines: People along Lake Huron's north shore concerned about services, long drives for health care

This is the third story in CBC Sudbury's Lifelines series exploring access to health care in the communities of Lake Huron's North Shore. You can read the other stories in the series here and here. 

Cathy Marshall knows every bend and dip of Highway 17 between Sault Ste. Marie and Blind River in northern Ontario because of a life-threatening health scare last year and her daughterly duties of watching over aging parents in care in different communities.

Born and raised in Iron Bridge, Marshall is rooted there.

She's also among people who credit small-town health care with helping them survive life-altering crises and worry its vitality is precarious after emergency room closures in 2023.

The North Shore Health Network consists of an 18-bed hospital in Blind River and emergency rooms in Thessalon and Richard's Landing. Marshall commends doctors there for diagnosing her with an invasive strep infection and septic shock in January 2023.

They stabilized her before sending her to Sudbury's Health Sciences North, 220 kilometres away on the Trans-Canada Highway.

"I can honestly say I'm here today because of this hospital [in Thessalon]," she said, tearing up.

She was discharged from Sudbury to the Blind River Hospital, where she waited for a rehabilitation bed at the Sault Area Hospital, 142 kilometres down the Trans-Canada in the other direction.

Having returned to work a year after her diagnosis, she is retracing her steps, this time when her mother broke a hip and was admitted to Sault Area Hospital while her father, who has Alzheimer's disease, was admitted to the Blind River Hospital where he is awaiting long-term care.

Marshall's mother was discharged in time to celebrate her 60th wedding anniversary at her dad's hospital room; she is now in assisted living in Thessalon. 

Marshall, living midway between the two towns, said the constant travelling was, and is, exhausting. She wishes there was more support closer to home.

Four in-patient beds at the Thessalon site were closed in 2020.

Stories of survival

On one particular day in July, it was quiet at the Thessalon emergency room.

A young local boy came in complaining of a sore ear and a mother drove her adult son all the way from Sault Ste Marie to avoid a long wait at the Sault Area Hospital's emergency department.

Shaw Houslander had put his truck in the ditch in Chapleau and just wanted to get checked out but didn't relish being put on a long list in a crowded emergency room.

He was pleasantly surprised after the 45-minute drive.

"We came here especially because we're from the Sault and we knew the Sault would be a 20-hour wait," he said. "It was nice coming here because it was very quick."

Another family camping in the area en route to Toronto brought in an elderly family member with dementia who had fallen. A doctor was able to determine through X-rays that no bones were broken, but did not have access to a CT scan at that location.

Visitors rely on health-care access

At the Valu-Mart in Blind River, Sue Hutton was another visitor to the area, having made the long drive north to her family's camp.

Her great-grandfather was mayor of Thessalon in 1902. Her husband is a rural family physician in southern Ontario.

While loading up on groceries, she said she's well aware of how critical rural health care is for everyone in the area.

"It would be an absolute crisis if any of these small hospitals closed," Hutton said. "Just from the person that has an incident on the highway that's  driving across the country, to the local person who lives in the town."

The North Shore Network's CEO, Tim Vine, has said they have been able to avoid closures so far this year. He's also committed to keeping the Blind River, Thessalon and Richard's Landing sites operating, despite inflation and staffing shortages.

But that doesn't stop Thessalon resident Mary Jane Thompson from worrying about whether people are getting the health care they deserve.

She has been collecting anecdotes about the importance of rural health-care services for the grassroots Ontario Health Coalition.

She got involved when the North Shore Health Network closed four in-patient beds at the Thessalon site in 2020, in what it said was a temporary move due to concerns it couldn't meet COVID-19 infection protocols.

The beds have never been reinstated and the current administration said that given limited resources, they won't be in the foreseeable future.

Thompson shakes with frustration when she recalls how the mayor reassured her four years ago the closure was temporary.

Thompson is worried it's a sign of erosion of services and that people will stop choosing rural life.

"They just will move away or they won't ever come here in the first place," she said. "Or like my husband says, we gotta move out of town if we can't get a doctor and if we can't get to appointments. We got to move. He's 76 and I don't want to move, but you know, that's the way he thinks because we can't fix this problem."

Still living in the home she was born in and steps from the chapel she goes to, Thompson is digging her heels in.

The prospect of losing emergency services was one that faced the community of Richard's Landing on St. Joseph Island in 2009.

At the time, the Matthews Memorial Hospital was under the auspices of the Sault Area Hospital.

Current Mayor Jody Wildman remembers that a report recommending it be closed was leaked to the community, which didn't wait to hear it officially and began a campaign to save it.

They succeeded. 

The 24-hour emergency clinic is now integrated into the North Shore Health Network.

While Wildman said there are tough decisions ahead for him and council on how to recruit doctors and ensure appropriate health service continues, he doesn't think the community is dying for lack of care, pointing out its population has increased.

"But rural Ontario can be killed, it can be starved," he said. "Those things once they get centralized, then some people are going to make decisions about what community they want to live in. If you take those services away, it's going to impact the viability of your community."

His advice to those worried about declining health-care service is to be a thorn in the decision-makers' sides.

The rural communities aren't the only ones advocating for their health care. The CEO of the Sault Area Hospital said it's vital that smaller outposts remain healthy to be able to provide care to everyone where they live.

Ila Watson said if people can't get primary or urgent care in rural areas, they may end up in the emergency room at her hospital, where the wait for low-acuity cases can be up to 13 hours.

"The availability of care close to home for people who might live in a community like Wawa, Blind River and rural areas in between is really, really important.," she said.

"We have difficult winters here, so often people have to drive if they can't get care locally — they drive in some pretty awful conditions. When you're talking about an older population, that is an increased challenge of just simply being able to access care in an equitable manner that they might if they lived in a larger centre."

A matter of health equity

Watson notes the Sault Area Hospital has its own challenges in doctor recruiting, concentrating on specialists in obstetrics and gynecology, internal medicine, pathology, plastic surgery and neurology. 

She said that if patients can't get services in the Sault, they continue down the road to bigger centres in Sudbury, or even Toronto and London.

She said it's a matter of health equity to ensure people in rural and remote Ontario can get services where they live to avoid a buildup of demand in larger centres that are already at capacity.