Between the demands of the job and a culture of stoicism, Maine lobstermen often don't connect with better health care, but one student is trying to help
This is the second in an occasional series about a Tufts medical student from a lobstering family and her effort to bring better medical care to her home community.
When you meet Jon Rogers, the 57-year-old Maine lobsterman looks to be in great shape. He’s sturdily built, with a weathered, ruddy complexion, and he carries a welcoming brightness in his light blue eyes. But he’s living in a world of hurt. Where exactly does Rogers feel the pain? “Knees, hips, back, shoulders,” he answers with a smile. “Basically all the working parts.”
Rogers has been lobstering for 47 years, since he first set out from a dock on Bailey Island with his grandfather at the age of 10. The strenuous work of pulling lobsters out of the ocean day after day has taken its toll.
Rogers is typical of a special breed of men—and they are almost all men—that his own daughter, Miranda Rogers, M17, a student in the School of Medicine’s Maine Track program, is trying to connect with medicine and help heal (see “Dockside Medicine,” an earlier story about her work). He’s the average age of a Maine lobsterman. These men carry a host of hidden scars. Apart from the inevitable accrued damage to muscle, joints and bone, they tend to have high blood pressure and high cholesterol, widespread hearing loss and recurrent melanomas. In countless ways they bear this all alone.
It makes sense, in a way. Those who take up this challenging job are stoic, independent-minded sorts in thrall to the flukes of the weather. Naturally, they don’t much like sitting in a doctor’s office, waiting for the expert to show.
Last year, as an initial step in conducting a first-ever health assessment of Maine lobstermen, Miranda distributed 444 surveys to them in paper and electronic form. The response of 64 completed surveys, while small in number, was suggestive. More than one third (35 percent) of respondents had no health insurance. Some 28 percent had experienced a serious job-related injury. About half (49 percent) reported having had to reschedule doctor appointments in the past year. More than two-thirds (68 percent) claimed an annual income below $61,000.
All these undercurrents met in early March at Maine’s annual four-day commercial fishing conference, held at a big hotel on a scenic spit of land in mid-coast Rockland, where several thousand lobstermen mingled, surveyed nautical exhibits and attended talks. (There are about 7,300 commercial fishermen in the state, and roughly 80 percent of them are lobstermen.) Miranda occupied a small table in a row of tables, promoting her health outreach amid all the competing claims for attention. Rope? Propeller? Health care?
Jan Burson, a retired nursing professor from the University of Southern Maine, has run a health clinic here at the conference for the past 13 years. In a room just off a main corridor, a handful of white-coated RNs and nursing students from the university offer free blood pressure, blood glucose and cholesterol screenings for anyone who stops in. “High blood pressure, high cholesterol,” she says of the results. “It’s just about what you’d expect from a high-risk population that’s out in the open air.”
Skin cancer runs at elevated levels among these men, but Burson reports that whenever a member of her team asks clinic visitors about their approach to skin care, the query draws laughter. “It’s not part of their lifestyle,” she says. Once, when she told a group that they needed to apply “a glob of medicine” to the back of their hands if and when they get infections there (a common side effect of handling rotten bait), the men immediately protested, saying, “We can’t handle our traps with that stuff on our hands.”
Context changes everything. Imagine being in a small boat 10 or 20 miles at sea. Medicine does not fit comfortably in this boat, and the grueling work will not wait. Lobstermen acquire hearing loss from standing near loud engines all day. They bang into things, suffer contusions. They endure long hours in glaring sun, or wet and brutal cold. And the muscular strain never relents.
“You are reaching down over the side of the boat to lift a 120-pound trap up and over, and that trap has 450 feet of rope on it,” the elder Rogers says. “You’re overextended all the time. There’s no way to get your feet under you.” This is exercise, but not the good kind. Rogers maintains some 400 traps.
Grassroots Medicine
Politics colors Miranda Rogers’ quest. Going back to Lexington and Concord, the right to be left alone is a perennial thread in American culture. Rural folks, in particular, are wary of intrusion, and people eking out a life along the coast of Maine may be the ultimate libertarians in spirit. “When did the government ever come up with a program that worked right?” lobsterman Rogers pressed me, halfway through our conversation. “The answer is never.” He is suspicious of large-scale plans, while remaining a steadfast supporter of his daughter’s initiative.
If there’s an irony there, it’s not the only one. Lobstering is a huge, multinational enterprise that depends on legions of small, two- and three-man boats bobbing offshore. J.J. Bartlett, president of Fishing Partnership Support Services, a Massachusetts-based nonprofit that promotes the well-being of fishing families and is partnering with Miranda on her outreach effort, notes that fishing amounts to as much as a $1.5 billion industry across New England. Maine lobster catches accounted for roughly a third of that total in 2014.
“If this activity were all in one place,” he points out, “lobstermen would have a $15 million HR department taking care of them.” Instead, the business is scattered among coves and inlets, and the men must fend for themselves.
By the end of the conference, 10 fishermen had filled out Miranda’s health questionnaire on the spot, and another 100 had picked up the forms to complete later. This is retail politics, where you set up a card table outside the town supermarket and solicit your neighbors’ signatures in order to run for public office. The idea must build slowly and steadily if it is ever going to take hold. Will Miranda someday have a medical van that travels the Maine coastline, delivering care to lobstermen on terms that suit them? That’s certainly a goal.
Jon Rogers admires his daughter’s grit and holds out hope that she will prevail. His own world has changed, after all. When he started out, he didn’t have any health insurance, and now he does. He shrugged off the threat of skin cancer at age 20 and 30; now he applies sunscreen every time he heads out to sea. Making his colleagues healthier may be a matter of spreading more awareness around, he suggests, before likening Miranda’s effort to a traffic cop parked along the highway, reminding people of the posted speed and improving public safety, or health, in the process.
Still, there are no guarantees in a world ruled by fog and wind. Let’s say you’re a lobsterman who has scheduled a doctor appointment. “If you wake up today and it’s the first clear day you’ve had in three weeks,” says Rogers, with a quick appraising glance through a nearby window out toward the bright horizon line, “you’re probably going to call and cancel.”
This article first appeared in the Spring 2015 issue of Tufts Medicine magazine.
Bruce Morgan can be reached at bruce.morgan@tufts.edu.
