From: The New Yorker - September 26, 2011
Letter From Nucla, Colorado
The life of a small-town druggist.
by Peter Hessler
In the southwestern corner of Colorado, where the Uncompahgre Plateau descends through spruce forest and scrubland toward the Utah border, there is a region of more than four thousand square miles which has no hospitals, no department stores, and only one pharmacy. The pharmacist is Don Colcord, who lives in the town of Nucla. More than a century ago, Nucla was founded by idealists who hoped their community would become the “center of Socialistic government for the world.” But these days it feels like the edge of the earth. Highway 97 dead-ends at the top of Main Street; the population is around seven hundred and falling. The nearest traffic light is an hour and a half away. When old ranching couples drive their pickups into Nucla, the wives leave the passenger’s side empty and sit in the middle of the front seat, close enough to touch their husbands. It’s as if something about the landscape—those endless hills, that vacant sky—makes a person appreciate the intimacy of a Ford F-150 cab.
Don Colcord has owned Nucla’s Apothecary Shoppe for more than thirty years. In the past, such stores played a key role in American rural health care, and this region had three more pharmacies, but all of them have closed. Some people drive eighty miles just to visit the Apothecary Shoppe. It consists of a few rows of grocery shelves, a gift-card rack, a Pepsi fountain, and a diabetes section, which is decorated with the mounted heads of two mule deer and an antelope. Next to the game heads is the pharmacist’s counter. Customers don’t line up at a discreet distance, the way city folk do; in Nucla they crowd the counter and talk loudly about health problems.
“What have you heard about sticking your head in a beehive?” This on a Tuesday afternoon, from a heavyset man suffering from arthritis and an acute desire to find low-cost treatment.
“It’s been used, progressive bee-sting therapy,” Don says. “When you get stung, your body produces cortisol. It reduces swelling, but it goes away. And you don’t know when you’re going to have that one reaction and go into anaphylactic shock and maybe drop dead. It’s highly risky. You don’t know where that bee has been. You don’t know what proteins it’s been getting.”
“You’re a helpful guy. Thank you.”
“I would recommend hyaluronic acid. It’s kind of expensive, about twenty-five dollars a month. But it works for some people. They make it out of rooster combs.”
Somebody else asks about decongestants; a young woman inquires about the risk of birth defects while using a collagen stimulator. A preacher from the Abundant Life Church asks about drugs for a paralyzed vocal cord. (“When I do a sermon, it needs to last for thirty minutes.”) Others stop by just to chat. Don, in addition to being the only pharmacist, is probably the most talkative and friendly person within four thousand square miles. The first time I visited his counter, he asked about my family, and I mentioned my newborn twin daughters. He filled a jar with thick brown ointment that he had recently compounded. “It’s tincture of benzoin,” he said. “Rodeo cowboys use it while riding a bull or a bronc. They put it on their hands; it makes the hands tacky. It’s a respiratory stimulant, mostly used in wound care. You won’t find anything better for diaper rash.”
Don Colcord was born in Nucla, and he has spent all of his sixty years in Colorado, where community-minded individuals often develop some qualities that may seem contradictory. Don sells cigarettes at his pharmacy, because he believes that people have the right to do unhealthy things. He votes Democratic, a rarity in this region. He listens to Bocelli and drives a Lexus. At Easter, the Colcord family tradition is to dye eggs, line them up in a pasture, and fire away with a 25-06 Remington. A loyal N.R.A. member, Don describes shooting as essentially peaceful. “Your arm moves up and down every time you breathe, so you control your breathing,” he says. “It’s very similar to meditation.” He was once the star marksman of the University of Colorado’s rifle team, and for many years he held a range record for standing shooting at the Air Force Academy.
Calmness is one reason that he has such influence in the community. He’s short and slight, with owlish glasses, and he seems as comfortable talking to women as to men. “It’s like Don looks you in the eye and the rest of the world disappears,” one local tells me. Faith in Don’s judgment is all but absolute. People sometimes telephone him at two o’clock in the morning, describe their symptoms, and ask if they should call an ambulance for the two-hour trip to the nearest hospital. Occasionally, they show up at his house. A few years ago, a Mexican immigrant family had an eight-year-old son who was sick; twice they visited a clinic in another community, where they were told that the boy was dehydrated. But the child didn’t improve, and finally all eight family members showed up one evening in Don’s driveway. He did a quick evaluation—the boy’s belly was distended and felt hot to the touch. He told the parents to take him to the emergency room. They went to the nearest hospital, in Montrose, where the staff diagnosed severe brucellosis and immediately evacuated the boy on a plane to Denver. He spent two weeks in the I.C.U. before making a complete recovery. One of the Denver doctors told Don that the boy would have died if they had waited any longer to get him to a hospital.
At the Apothecary Shoppe, Don never wears a white coat. He takes people’s blood pressure, and he often gives injections; if it has to be done in the backside, he escorts the customer into the bathroom for privacy. Elderly folks refer to him as “Dr. Don,” although he has no medical degree and discourages people from using this title. He doesn’t wear a nametag. “I wear old Levi’s,” he says. “People want to talk to somebody who looks like them, talks like them, is part of the community. I know a lot of pharmacists wear a coat because it makes you look more professional. But it’s different here.” He would rather be known as a druggist. “A druggist is the guy who repairs your watch and your glasses,” he explains. “A pharmacist is the guy who works at Walmart.”
He keeps watch-repair tools behind the counter, and he uses them almost as frequently as he complains about Walmart, insurance companies, and Medicare Part D. Since 2006, the program has provided prescription-drug coverage for the elderly and disabled, insuring that millions of people get their medication. But it’s also had the unintended effect of driving rural pharmacies out of business. Instead of establishing a national formulary with standard drug prices, the way many countries do, the U.S. government allows private insurance plans to negotiate with drug providers. Big chains and mail-order pharmacies receive much better rates than independent stores, because of volume. Within the first two years of the program, more than five hundred rural pharmacies went out of business. Don gives the example of a local customer who needs Humira for rheumatoid arthritis. The insurance company reimburses $1,721.83 for a month’s supply, but Don pays $1,765.23 for the drug. “I lose $43.40 every time I fill it, once a month,” he says. Don’s customer doesn’t like using mail-order pharmacies; he worries about missing a delivery, and he wants to be able to ask a pharmacist questions face to face. “I like the guy,” Don says. “So I keep doing it.” Don’s margins have grown so small that on three occasions he has had to put his savings into the Apothecary Shoppe in order to keep the doors open.
He is, by the strictest definition, a bad businessman. If a customer can’t pay, Don often rings up the order anyway and tapes the receipt to the inside wall above his counter. “This one said he was covered by insurance, but it wasn’t,” he explains, pointing at a slip of paper on a wall full of them. “This one said he’ll be in on Tuesday. This one is a patient who is going on an extended vacation.” Most of his customers simply don’t have the money. Each year, Don writes off between ten and twenty thousand dollars, and he estimates that he is owed around three hundred thousand dollars in total. His annual salary is sixty-five thousand dollars. Over the course of many days at the Apothecary Shoppe, I never saw a customer walk in whom Don doesn’t know by name.
“It’s just a cost of doing business in a small town,” he says. “I don’t know how you can look your neighbor in the eye and say, ‘I know you’re having a tough time, but I can’t help you and your kid can’t get well.’ ”
Settlers originally came to this remote place because they desired an alternative to capitalism. During the eighteen-nineties, a group called the Colorado Co-operative Colony hoped to build a utopian community in the region. Its Declaration of Principles explained that market-oriented competition makes it “almost impossible for an honest man or woman to make a comfortable living, and that a co-operative system, if properly carried out, will give the best opportunity to develop all that is good and noble in humanity.” (The history of the colony and its values is described in a 2001 dissertation by Pamela J. Clark at the University of Wyoming.)
At the end of the nineteenth century, socialist communities weren’t uncommon in the West. The arid landscape required extensive irrigation systems, and principles of shared labor made sense to people who were inspired by the theories of Karl Marx and Robert Owen. Anaheim, California, was settled through a coöperative water venture, as was nearby Riverside. Others failed but left idealistic names on the map: Equality, Freeland, Altruria. The Colorado Co-operative Colony published a newspaper called the Altrurian, which tracked the progress of the colony’s founding project, an eighteen-mile irrigation ditch that was intended to carry water from the San Miguel River. Settlers also planned to do away with debt, interest, and rent. The Altrurian dreamed of a glorious future: “If a small colony of outlaws and refugees could build Rome and maintain the state for twelve hundred years, who could guess what a well organized colony of intelligent Americans may accomplish.”
Within a year, they held their first purge. Ten members were expelled for being too communistic, and after that the newspaper often published aphorisms that clarified theories. (“Communism may be co-operation, but co-operation is not necessarily communism.”) By the winter of 1898, settlers were running out of food. (“Competition is a product of Hell; Co-operation will make a paradise of earth.”) In 1901, a member of the board revealed that the colony was bankrupt. A former president committed suicide. (“So long as you think of yourself alone, you cannot be a good cooperator.”)
Eventually, the settlers abandoned the principle of shared labor and contracted out to private work crews. In 1904, water flowed through the completed ditch; six years later, they decided on the name Nucla, after “nucleus.” The socialist dreams were never realized, but the irrigation canal continues to function today. And there’s still a Colorado Cooperative Company, which employs a full-time “ditch-rider” to monitor the system. His name is Dean Naslund, and both his father and his grandfather worked on the ditch. Like most Nucla residents, Naslund doesn’t talk about his ancestors in terms of sociopolitical theories. (“They called him Daddy Joe. He kinda cowboyed. He liked to hop around. Maybe play cards all week sometimes and then work a little.”)
Nucla has a reputation as a tough town. It boomed in the nineteen-fifties and sixties, when the region’s uranium mining and processing thrived. But the nuclear industry collapsed after the Three Mile Island accident, in 1979, and the population continues to drop in Nucla and its sister town of Naturita, which is four miles away. In both these towns, the per-capita income is less than fourteen thousand dollars a year, a little higher than half the state figure, and only eight per cent of the adult population holds a college degree. This year, the school board decided to switch to a four-day school week, because of lack of funds. There’s only one restaurant in Nucla, one hamburger joint in Naturita, and one bar for both towns. It’s called the 141 Saloon, named for the state highway that passes through Naturita. On a Thursday night I’m the only customer, and the bartender, a woman named Casey, tells me that she just bought a three-bedroom house in Nucla for fifty-three thousand dollars. That’s a mortgage of two-fifty a month.
“Only problem is the siding is asbestos,” she says.
“Is that a big problem?”
“It’s not a problem as long as you don’t touch it. Asbestos lasts forever.” She leans on the wooden bar. “What’ll it be?”
“What do you have on tap?”
She smiles and says, “Only thing we got on tap is Jägermeister.”
By the time Don Colcord was eight years old, he knew that he wanted to be a druggist. He grew up in Uravan, a mining town near Nucla, and his mother was a clerk in the pharmacy, where Don liked to hang around and watch the druggist. As a teen-ager, he began breaking into the place. Along with some friends, he stole beer, Playboy, and condoms. (“The condoms went to waste.”) When the boys finally got caught, they were forced to pay for the goods by working at the store for twenty-five cents an hour. “Everybody knew why you were there,” Don says. “It was probably the best thing that happened to me.”
During his teen-age years, Don shared a room with his brother Jim, and one day he found a magazine hidden under the bed. It featured photographs of naked men. When Jim came home, Don asked, “Is this yours?”
“Yes,” said Jim, who didn’t seem embarrassed. He took the magazine back, and neither of them mentioned it again.
Jim was three years older than Don. He was six feet three and well built, but he didn’t enjoy sports or hunting, like most local kids. He spent a lot of time by himself, and in high school he became an excellent student. He was a source of disappointment to his father, who nagged at Jim to behave like a normal boy. In 1972, a couple of years after Jim left for college, he sent his family a letter explaining that he was gay and that he knew his father would never accept it. He asked them not to look for him; he was leaving Colorado for good. And for the next twelve years nobody heard from Jim.
At the age of eighteen, Don married his high-school girlfriend, Kretha; eventually, they settled in Nucla and opened the Apothecary Shoppe. In 1983, Don’s father died, and one of the first things his widow did was hire a private investigator. The detective found Jim in Chicago, where he was a clerk in the county court. He said he’d had a feeling that something had happened back home.
The following year, Jim made a four-day visit to Nucla. He went for long drives with his mother, who told him that she had always known he was gay and that she was sorry she hadn’t been able to change his father’s attitude. In the evenings, Jim and Don sat up late talking. One night, Jim told Don that he had been infected with H.I.V., and that his doctor said he was likely to develop full-blown AIDS. Jim told Don where he wanted his ashes scattered. And he asked him to visit Chicago, where Jim lived with his longtime boyfriend.
That year, they talked frequently on the phone. But whenever the topic of a Chicago visit came up there was always a reason Don couldn’t go: he was too busy at the store; his son and his daughter had school activities. Kretha tried to persuade him to make the trip, but he never did.
When Jim died, one of his colleagues telephoned with the news. She sent the ashes in a box, with a copy of Jim’s will, some awards from work, and a few photographs. One of the pictures was taken at Wrigley Field, where Jim stands with his boyfriend in front of a “Go Cubs” sign. When Don looked at the photograph, he realized that he knew virtually nothing about his brother. He had seen Jim for all of four days in the past decade; he didn’t even know his boyfriend’s name. And he understood the real reason that he hadn’t made a trip to Chicago. “I was angry with myself for not being comfortable in a house where two men were sleeping together,” he says. “I didn’t want to see two men kissing each other. It wouldn’t bother me now, but it did then. I really regret it.”
Along with his mother and his younger sister, Don scattered Jim’s ashes at the juncture of the San Miguel and the Dolores Rivers. The Dolores flows from the south, where it crosses the great salt dome of Paradox Valley, and the water is saline and has no fish. If you swim there, you float as if you were in the ocean, a thousand miles away.
The last doctor in Naturita died fifteen years ago. There’s a small health clinic, and recently it contracted with a doctor in another part of Colorado to visit two days a week. But the mainstay is Ken Jenks, a physician’s assistant who is on call twenty-four hours a day. Jenks has lived in rural Colorado for a decade, and during that time he has learned that electrical tape is harder to remove from a wound than duct tape. Twice he has had patients suffer cervical fractures and drive themselves into the clinic rather than wait for an ambulance. It’s not unusual for somebody to sign out of the clinic A.M.A.—against medical advice. A couple of times, Jenks has told heart-attack victims that they needed to be evacuated by helicopter, only to have the patients decline because they believed they could get there cheaper. Jenks signed the forms, unhooked the I.V.s, and the patients got into their pickups to drive the two hours to a hospital. “And they made it,” Jenks says. “So they were right!”
Jenks grew up in Salt Lake City, but he has spent most of his working life in small towns. “Maybe I can describe it this way,” he says. “I like to play chess. I moved to a small town, and nobody played chess there, but one guy challenged me to checkers. I always thought it was kind of a simple game, but I accepted. And he beat me nine or ten games in a row. That’s sort of like living in a small town. It’s a simpler game, but it’s played to a higher level.” Jenks says that he is forced to have “a working relationship” with local methamphetamine users, treating their ailments in confidence. He explains that small towns might have a reputation for being closed-minded, but actually residents often learn to be nonjudgmental, because contact is so intense. “Someday I might be on the side of the road, and the person who pulls me out is going to be a meth user,” Jenks says. “The circle is much tighter.” He believes there is less gossip than one would assume, simply because so much is already known.
One morning, a young woman arrives at the Apothecary Shoppe after spending the weekend in jail. She had an argument with her husband, who called the police; Colorado law requires officers to make an arrest whenever they respond to a domestic dispute. The law is intended to protect women from being coerced into dropping charges, but in this case the husband claimed that he had been attacked. In the drugstore, the woman is approached by half a dozen neighbors who have read about the arrest in the local newspaper.
“It’s not what it sounds like,” she tells one elderly woman. “He’s lying about the whole thing, and he’s going to get in trouble for that.”
They stand at the pharmacy counter. “It’s terrible when I have the criminal element in the store,” Don jokes.
The young woman reads the police blotter in the newspaper. “He said I attacked him with a frying pan. He said I hit him in the arm. If I’d attacked him with a frying pan, I’d a hit him in the head.”
“Let me tell you what you should do,” the old woman says. She is in her seventies, with curly white hair and a sweet, grandmotherly smile. “Get you some wasp spray,” she says. “It’ll put their eyes out.”
“I can’t even have Mace, because it’s a weapon.”
With the wisdom of age, the elderly woman explains that wasp spray is not classified as a weapon and is thus available to people who are out on bail. “It’s better than pepper spray,” she says.
A while later, I see the young woman cutting out the arrest listing. “This way, if I’m ever stupid enough to think about taking him back, I’ll look at this,” she tells me. “I’ll keep it in my scrapbook.” (Eventually, all charges were dropped, and they divorced.)
At the store, Don never discusses anyone’s situation with a third party, but he frequently mentions his own problems. Twenty years ago, Kretha was diagnosed with a rare degenerative form of spina bifida, and now she rarely leaves home. Their oldest son flies F-16s for the Air Force, but their daughter has struggled with alcoholism. After she had difficulties caring for her son, Gavin, Don and Kretha took custody of the boy. Don often mentions such issues to a customer. “If I’m dealing with somebody who has an alcoholic in the family, it helps for them to know about my daughter,” he says. “You can’t pretend that your family is perfect. My daughter is not perfect, but she’s trying.” He continues, “Almost all druggists in a small town will tell you the same thing. You are part and parcel of the community. Nobody’s better, nobody’s worse.”
In Nucla, Wednesday is bowling league night. The local alley shut down to the public long ago, because there are so few people left, but the facility opens twice a week for community leagues. The alley was built in 1962 and all its equipment is original, with an exuberant use of steel that you don’t see anymore: long, shiny Brunswick ball racks, dining tables with heavy flared legs. Scorecards advertise businesses that have been dead for decades: Miracle Roofing and Insulation, Sir Speedy Instant Printing Center (“Instant Copies While You Wait!”). Don is the league’s president, and he certifies the lanes every year. He took a course in Montrose in order to be licensed to use a bowling-lane micrometer.
Don’s collection of certifications is impressively esoteric. He has taken CPR courses, and he’s qualified to use an electric defibrillator. He has a pyrotechnics-display license, so that Nucla can have fireworks on the Fourth of July. When he heard about a new type of hormone therapy, he flew to California to attend two days of classes, and now he compounds medicine for four transgendered patients who live in various parts of the West. Every three months, Don talks with them on the phone and prepares their drugs; he finds this interesting. On Friday nights, he announces Nucla High football games. They play eight-man ball, although if a bigger school comes to town they switch numbers with every possession, so that each side can practice its plays. When Nucla is on offense, it’s eight-on-eight, but it becomes eleven-on-eleven when the other team has the ball. Occasionally, somebody gets confused, and Don’s voice rings out over the loudspeakers: “There’s eleven white guys and eight blue guys, and that won’t work.” The football might not be first-rate, but the players’ names are a novelist’s dream. Nucla has Seth Knob, Chad Stoner, and Seldon Riddle. Dove Creek has a player named Tommy Fury. Blanding has Talon Jack and Sterling Black, Tecohda Tom and Herschel Todachinnie. Shilo Stanley, Terrance Tate, Dillon Daves: if alliteration ever needs an offensive line, recruiting should begin around the Colorado-Utah border.
When outsiders come to town—loners, drifters—they often find their way to Don. A number of years ago, a man in his seventies named Tim Brick moved to Naturita and rented a mobile home. He placed special orders at the Apothecary Shoppe: echinacea, goldenseal, chamomile teas. He distrusted doctors, and often had Don check his blood pressure. It was high, and eventually Don persuaded him to get on regular medication. Soon, he was visiting every four or five days, mostly to talk.
Don referred to him as Mr. Brick. He had no other local friends, and he was cagey about his past, although certain details emerged over time. His birth name had been Penrose Brick—he was a descendant of the Penrose family, which came from Philadelphia and had made a fortune from mining claims around Cripple Creek. But for some reason Mr. Brick had been estranged from all his relatives for decades. He had changed his first name, and he had spent most of his working life as an auto mechanic.
One day, his mobile home was broken into, and thieves made off with some stock certificates. Mr. Brick had never used a broker—to him, they were just as untrustworthy as doctors—so he went to the Apothecary Shoppe for help. Before long, Don was making dozens of trips across Disappointment Valley, driving two hours each way, in order to get documents certified at the bank in Cortez, Colorado. Eventually, he sorted out Mr. Brick’s finances, but then the older man’s health began to decline. Don managed his care, helping him move out of various residences; on a couple of occasions, Mr. Brick lived at Don’s house for an extended stretch. At the age of ninety-one, Mr. Brick became seriously ill and went to see a doctor in Montrose. The doctor said that prostate cancer had spread to his stomach; with surgery, he might live another six months. Mr. Brick said he had never had surgery and he wasn’t going to start now.
Don spent the next night at the old man’s bedside. At one point in the evening, Mr. Brick was lucid enough to have a conversation. “I think you’re dying,” Don said.
“I’m not dying,” Mr. Brick said. “I’m just going to pray now.”
“Well, you better pray pretty hard,” Don said. “But I think you’re dying.” He asked if Mr. Brick needed to see a lawyer. The old man declined; he said his affairs were in order.
Don found a hospice nurse, and within two days Mr. Brick died. Don arranged a funeral Mass, and then he went through boxes of Mr. Brick’s effects. There was a collection of old highway maps, an antique cradle telephone, and a Catholic prayer stand. There were many photographs of naked men. Don found checkbooks under four different aliases. There were letters in Mr. Brick’s handwriting asking friends if they could introduce him to other men who were “of the same type as me.” But he must have lost courage, because those letters were never mailed. Don also found unopened letters that Mr. Brick’s mother had sent more than half a century ago. One contained a ten-dollar bill and a message begging her son to make contact. The bill, from the nineteen-forties, still looked brand-new, and seeing that crisp note made Don feel sad. Years ago, he had sensed that Mr. Brick was gay, and that this was the reason he was estranged from his family, but it wasn’t a conversation they ever had.
In his will, Mr. Brick left more than half a million dollars in cash and stock to the local druggist. After taxes and other expenses, it came to more than three hundred thousand dollars, which was almost exactly what the community owed Don Colcord. But Don didn’t seem to connect these events. He talked about all three subjects—neglecting his dying brother, offering credit to the townspeople, and helping Mr. Brick and receiving his gift—in different conversations that spanned more than a year. He probably never would have mentioned the money that was owed to him, but somebody in Nucla told me and I asked about it. From my perspective, it was tempting to apply a moral calculus, until everything added up to a neat story about redemption and reward in a former utopian community. But Don’s experiences seemed to have taught him that there is something solitary and unknowable about every human life. He saw connections of a different sort: these people and incidents were more like the spokes of a wheel. They didn’t touch directly, but each was linked to something bigger, and Don’s role was to try to keep the whole thing moving the best he could.
Don Colcord’s birthday is the Fourth of July. That’s also when Nucla celebrates its annual Water Days, which commemorates the completion of the town’s irrigation system. Today, the theme is “Where the Past Meets the Future,” and Don announces the floats for the parade down Main Street. After that, he helps out at the barbecue in the park, and then he prepares to set off the town’s fireworks. All these events are sponsored by the Lions Club. When Don joined the club, in 1978, he was the youngest member, and he still is. Soon, the Lions Club will be disbanded because of lack of members.
In the evening, we drive to the top of Nucla Hill. The view is spectacular in all directions: westward, the slate-blue La Sal Mountains, and the Uncompahgre Plateau to the east, where the feathered tops of cottonwoods mark the long line of the irrigation ditch. Three remaining members of the Lions Club are here, along with some volunteer firemen. Trucks and cars arrive from town and park at the bottom of the hill to watch the show. When darkness falls, the Lions prepare the fireworks in metal tubes, and Don ignites them one by one. After it’s over, we watch the pairs of headlights glide in a neat line back up Main Street, dispersing as drivers turn off toward home. Our attention drifts upward—now that the fireworks and the headlights are gone, the stars seem brilliant, clustered together like the lights of some faraway city. Don passes around a few bottles of beer. “I don’t care if it is a small town, we got good fireworks,” he says. He sips his beer and gazes up at the Milky Way. “When you see them from here, they look so close together,” he says. “It’s hard to believe they’re millions of miles apart.” ♦