The DO Book Club, March 2024: ‘Go by Boat’ and ‘Island Medicine’

Fortunately for us, author Chuck Radis, DO, loves to share the moving stories of how he came to practice internal medicine and raise his family on a Maine island. Unlike many medical memoirs that play out in the urban hospitals of Boston, New York City or Philadelphia, Dr. Radis brings us to the wild and isolated islands off the Portland, Maine, coast to meet lobstermen, cantankerous islanders and some feisty nuns.

His memoir reads a little bit like James Herriott’s classic “All Creatures Great and Small,” which chronicles the British veterinarian’s heartwarming and humorous stories about veterinary practice, animals and their owners in the rural UK. Dr. Radis even takes a short foray into veterinary care on the islands of Casco Bay.

The first challenge Dr. Radis faces every day, like so many of us, is commuting to work. Most of us hop in a beautiful sedan or SUV parked in our warm garage, check our traffic app and make the drive into work. Not so for this island doctor—he must mold his schedule to the local ferries, ice storms, friendly fishermen and police boats.

To admit patients at the local hospital and teach residents, he must time his visits around the ferry schedules from the island of Peaks to the city of Portland. Once he arrives on the mainland, he either drives his own car, borrows a truck or, if weather permits, pedals his bike. Every maneuver is predicated, of course, on being able to locate his perpetually misplaced keys and wallet.

Practicing on the island

Published in 2021, “Go by Boat: Stories of a Maine Island Doctor” is the first book chronologically, with tales of the beginning of establishing his practice in Casco Bay in 1989. Dr. Radis writes from the perspective of a young man not knowing where his path will lead him.

While both books introduce the reader to the complex internal medicine and primary care patients who live on the various islands and rarely want to leave, “Go by Boat” details how going for a consultation or an admission involves a police boat or ferry ride. Many of the people resist transfer and beseech Dr. Radis to do all that he can right on Peaks or their home islands.

Osteopathic physicians reading his books, particularly “Go by Boat,” may identify with his tale of gaining acceptance in the community as a DO and getting his patients to accept admission to the local osteopathic hospital. As a small hospital, many of the more complicated cases are transferred to the tertiary care center or elsewhere.

Getting his patients to trust him as a new osteopathic physician and request him as their attending physician becomes both a challenge and a burden as his house calls and responsibilities on different islands and in his own clinic become impossible to manage.

Readers will feel the frustration of Dr. Radis as he speaks to a psychiatry attending on behalf of one of his teenage patients who suffers from major depression and presents to the emergency department after harming himself. The psychiatrist on duty notifies Dr. Radis of the disposition on the troubled boy. Over the objections of Dr. Radis, the boy is released. The teenager is sent from the mainland hospital back to his family home, his doctor and his island community, where he once again tries to harm himself.

In the “pre-computerized record” world of his Maine community, Dr. Radis notes, “In my jaded experience on the island, only the people that didn’t need psychiatric care got it; the rest fell by the wayside or ended up in the emergency room. What was equally frustrating was that I almost never received a copy of the consult or counseling sessions from either psychiatrists or social workers … for most patients, I’d become their de facto mental health specialist.” (p. 98)

Fortunately for the people of Peaks and the outlying islands, Dr. Radis takes a great deal of responsibility and care in meeting their mostly reasonable needs. With mutual respect and a growing affection, the young doctor serves his community in an extraordinary way. The local folks work to get Dr. Radis the office space and local ambulance transport service that he needs to serve them better.

Being a DO in an atypical setting

His second book, “Island Medicine: Life, Healing, and Community on a Maine Island,” published in 2022, gives more of the back story of how Dr. Radis became a DO and how he ended up practicing on the islands of Maine, where his wife has gotten a local job and his two young daughters accompany him on a few house calls.

The beauty and impracticality of Maine island living permeates both books. For example, Dr. Radis and his wife must herd their very young daughters onto the nearby ferry to go to school. With Dr. Radis also commuting by boat for his work, the narrative feels like he is constantly running to make a boat and working around the comings and goings of the ships travelling between the islands and from the mainland to his island and back.

Then, the doctor and his wife decide that purchasing their own boat will make it a little easier on his complicated commute and allow him to spend more time with the family. What could possibly go wrong? Introduced are new problems of losing keys, running over lobster buoys, foggy weather, thunderstorms and a near-drowning experience. For the island doctor, there is never a dull moment.

What Dr. Radis does so adeptly is introduce his readers to a whole host of island residents whom he tends to over the years. He shares his strong sense of duty as he treats gout, diabetes, smokers and congestive heart failure patients. Like stubborn farmers and city dwellers, the island citizens do not want to go to the hospital or follow the good doctor’s plan. At one point, the frustrated physician exclaims, “Does anyone on this island take my advice?” (“Island Medicine,” p. 71)

Dr. Radis is brutally honest about the strains that his schedule placed on his marriage and his own health. As a young man trying to establish a practice and make some money, he is at first terrible at setting boundaries and claiming his own private time. He stretches himself far too thin and seems unable to ever say no. At one vulnerable point, he has his own frightening “doctor-as-patient” moment that helps him realize the importance of self-care.

Dr. Radis gravitates toward the interesting rheumatologic cases he picks up over the years. Near the end of “Island Medicine,” he must decide whether to redirect the course of his career and his family’s future.

I will not spoil the ending, but the gray-haired picture of Dr. Radis on the books’ covers gives a clue as to where he settled after his fellowship training. I enjoyed both volumes, but if I had to recommend just one, I would say “Island Medicine” is a complete and more polished book. As the author says in his subtitle, it covers, “Life, Healing and Community on a Maine Island.”

Connect with The DO Book Club on Goodreads to see past selections and reviews, and to check out what we’re reading next.

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