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AV Health Center: Founders & Early Days

Many readers know the Anderson Valley Health Center has recently launched a Capital Campaign to fund construction of the much needed addition to its offices on Airport Drive.  The new space is essential to the HC’s continual growth in programs and staff providing Anderson Valley healthcare needs.  As a long-standing local resident I have witnessed much of its history from its earlier days two generations ago, and as I age am increasingly dependent on its array of services.

However, with the exception of occasional unplanned walk-ins to its offices , I had only peripheral personal contact with and anecdotal knowledge of its earliest days back in the nineteen seventies.  So like any good journalist I reached out to surviving first generation staffers and interviewed them about their recollections of those times and the sources of their founders’ medical vision and creation of first services.  And to avoid intruding into their compelling recollections, I have identified them collectively at the article conclusion.

The Health Center’s origins, I claim, is a story of compassion and medical innovation in a poor rural community with limited access to primary healthcare for most of its hundred year history.  It’s a story I find touching, one I like to tell with pride when I am with friends, medical professionals and not, outside of Anderson Valley’s borders.  It begins with Phranklin Apfel, the son of a Jewish doctor’s family raised in New York City’s Bronx- yes.  His cousin Mark Apfel, MD, participant in the clinics early growth and recent retiree after 45 years’ service, describes Phranklin as “brilliant and inspirational.”  After graduating with an MD degree from Columbia University Medical School, Phranklin migrated post-residency to Berkeley then, as often happened to City People in those days, “back to the land,” living part-time at the Sky Ranch commune out Signal Ridge Road.

Living here in The Valley gave Phranklin a taste of rural life, including the absence of local healthcare services in a geographically complex community of 3,500 people or so.  Knowing he had found his professional mission, Phranklin was joined by local RN, Peggy Miniclier, then McFadden.  Peggy was interested in becoming a Family Nurse Practitioner and was enrolled for the degree in the UC Davis program.  She and Phranklin started their practice making housecalls around the Valley to those urgently needing their assistance.  For their services they charged no fees.  There was at the time a resident MD living in The Valley, Dr. Bradford, a doctor of considerable reputation and skill, I believe, but more or less retired except upon call.  After a year of being circuit practitioners, Phranklin and Peggy decided it was time to find a permanent office site to house their business and all the formal files required to support its growing patient information management needs.

The location they found was what they could afford, the empty office space in the decrepit and now more decayed Spenard Building in downtown Boonville.  If you drive slowly by this famous dereliction just south of Haehl Street and the current  Pearl’s Antique Shop, notice three sets of French doors in the middle of the building.  The middle one was the first office of attorney, later Judge Richard Kossow, the one on the left was the first clinic site.  On August 13th, 1976, page 2, the Ukiah  Daily Journal reports that on the following Sunday, the 15th, a new medical center called The Clinic would celebrate its grand opening with a ribbon-cutting at its front door.

Prior to opening, however, the office space was in no condition to support a walk-in medical facility.  There were leaks in roof and windows, fragile plumbing and heating, failing foundation and flooring, and more.  Community members including contractor Walter (“Shine”) Tuttle, cabinet-maker Tom McFadden, Bill Seekins, Steve Tylicki, and others stepped up to make the needed repairs.  Another cadre of volunteers agreed to take on the administrative tasks necessary to support an office and formal operating hours.  Kathy Bailey temporarily signed on as receptionist. Terry Anderson, later Health Center Head Administrative Officer, undertook the critically important, thankless office and medical records manager responsibility, and in her spare time found carpeting scraps at a Ukiah store and helped install them to hide the aging flooring, and so on.

The Daily Journal article went on to say that Phranklin Apfel was clinic founder, and that its services program would include Mondays as “Women’s Day,” with Peggy Miniclier, FNP, as primary caregiver; Thursdays Gregory Sims, Licensed Clinical Psychologist, would “deal with individuals, families and groups” and “hopes to work with local schools.”  The renovation/restoration budgeted for $2,000 had consumed closer to $6,000 as the actual work revealed more repair needs than estimated.  So it was decided to offer “memberships” to individuals for $5.00 and whole families for $10.00, including an initial free first visit for the whole family.  If a patient couldn’t afford to pay cash, staff would work out a trade in labor for medical fees.  The UDJ didn’t report it, but indeed, once The Clinic’s doors were open, it began paying regular staff wages and charging medical service fees.

Last week I interviewed Jane Cupples, then Clow.  She told me a compelling story of her encounter with The Clinic and its offices. In 1977, her four year old daughter came down with a ferocious case of poison oak, and Jane took her in for an appointment and the treatment was successful.  Jane was so pleased with the spirit of the whole medical encounter that later that year she volunteered to be a temporary receptionist while the regular staffperson went back east to visit her parents.  The regular never returned and Jane remained receptionist, records manager and trained professional for thirteen more years.  A year later, Jane reports, Phranklin encouraged her to qualify to become an x-ray technician.  The Clinic had acquired an old x-ray machine, one that created actual negative film for development.  Even though she had only a high school education, Jane enrolled in an extension course at the University of California, Berkeley, Med School and learned how to operate the machine and produce its x-ray film.

In 1977, The Clinic received a grant from the Mendocino County government.   The grant, along with the $6,000.00 raised through community donations, enabled it to begin paying wages to staff, at a rate of $4.00/hour, about what  mill and agriculture workers were making.  Other staff members now on payroll in 1977 included Annie Stenerson trained in Lab Technician’s blood and tissue sample analysis, Judy Nelson, RN, and Terry Anderson, book keeping and financial management.

I mention above local financial support for The Clinic in those early founding years.  More specifically, retired County Judge Eric Labowitz reports, there were periodic formal fund-raising activities engaging the whole Anderson Valley community.  The ones Eric remembers most fondly were dinners at the Fairgrounds.  He, Terry Anderson, Ellen Ellison and others would serendipitously cook what they enjoyed preparing, others brought potluck contributions to the events.  Perhaps a hundred people would come to dine and show their support for The Clinic by making an on-the-spot contribution to the organization in appreciation of the event and it cuisine.  After a couple of years, it was recognized that the financial return on the hours of effort invested in planning and executing the dinners wasn’t worth continuing that form of fund raising.

One of the themes I have queried the founding interviewees and other older community friends about asks for recollections of The Clinic’s first clients.  It pleased me to find that what I heard supported my own recollections of who they were.  Even before the office space opened I persuaded local best friend and counsellor, the old Navarro woodsman Bill Witherell, to meet with Phranklin about his high blood pressure and diminished physical energy.   Peggy Miniclier took up Bill’s care with regular home visits to monitor his blood/sugar and pressure level and his diet.   I also persuaded the Tex-Mex migratory sheep shearer and personal friend, Augustine Vargas, to visit the clinic about his obesity and declining stamina in the shearing shed.  When I first met Augie in 1972, he could shear 125 sheep a day; by 1977 he was doing only around 30.   Sure enough, Mark Apfel diagnosed diabetes and persuaded Vargas to minimize the number of Cokes consumed per day and move his diet away from Manteca and beans.  Philo oldtimer Linda Crispin, grand-daughter of the first town doctor, Dr. Brown, said that when her flu attack one winter became overwhelming her first visit to The Clinic was so successful she and family have been a loyal clients and supporters ever since.

The most compelling story about those first years of The Clinic concerned the neighbors across the street in Boonville, the Donald Pardini family.  Donna Pardini, Donald’s wife, Ernie and Tony’s mother, was diagnosed by an oncological surgeon outside The Valley, Mark in attendance, with inoperable terminal cancer, and Phranklin, Mark and Peggy made regular visits twice a day to the family to assist with her end-of-life care and comfort.  And as friends and neighbors so did the non-professional staff members, along with many Valley longtime friends, another example of the texture of healthcare collaboration this community generates on its best days.  In sum, what my interviewees remember is a spectrum of first medical clients representative of the whole Anderson Valley community in the 1970s.  As I noted previously many older locals had never had access to professional medical care.  There was also a growing population of urban retirees migrating to The Valley who were accustomed to formal care in the city and learned to trust the Boonville staff, never mind the quaintness of the facilities.  And the “back to the landers,” many of them new parents, were pleased to have access to local and inexpensive primary healthcare for the whole family, distributed by their friends and neighbors a service The Clinic was the pioneer of in rural Mendocino County.

So that’s the story of the AVHC’s founding personalities and adventures in the Spenard building rental, 1976-82, in my mind a remarkable achievement in the early era of spiraling primary healthcare costs and accompanying inequality in its distribution all over the United States.   The people I’ve told stories about here, professionals and not, paid and unpaid, and others undiscovered in my personal recollections and interviews, were the founding pioneers whose caring spirit have continued as part of the Anderson Valley Health Center community and its commitment to rural healthcare equity  until this very day, forty six years later.  Thank you, Health Center founders.

The interviewees for this article included: Mark Apfel, MD, Peggy Miniclier, FNP, Judy Nelson, RN, Jane Cupples, Med Tech, Eric Labowitz, Kathy Bailey, Bill Seekins, Linda Crispin, Steve Tylicki.  

(Next Chapter: The Clinic becomes the Health Center and opens its own doors.)

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