Friday November 6, 2009, 2:08 pm
’He’s just here for everybody, morning, noon and night. . . . He’s so dedicated to the island, to us, and to all his family. We’re so fortunate to have him.’



ARICHAT — It’s a Wednesday afternoon and there are about a dozen people waiting in Dr. Lawrence MacNeil’s office. There’s a little kid with red eyes rubbing at his nose, a middle-aged man coughing into his elbow, and two women sitting side by side, one caressing the other’s back.

"It’s going to be like this tomorrow," Dr. MacNeil says when asked if he would prefer to speak with a reporter another time. "Every day’s a busy day."

He’s not kidding.

The Arichat doctor sees 300 to 400 patients a week, works as the chief of staff at the local emergency room and has a pager attached to his hip every other night so that he can respond to medical crises.

He is the only permanent doctor working on Isle Madame, an Acadian community of about 4,300 people on Cape Breton’s southeastern shore.

"It’s quite a responsibility," said Dr. MacNeil. ""You often don’t think that anybody else knows about you. I’m not going to the doctor’s lounge in a hospital every day and chatting with the other guys. I’m alone and the most contact that I have with those other physicians is a lot of letters and phone calls."

But the Nova Scotia College of Family Physicians did notice the work Dr. MacNeil had been doing for the last 26 years. He won the organization’s award for 2009 physician of the year, primarily for his dedication to the patients in his rural community.

It’s an honour he might not have received had he followed his initial plan of becoming a trauma plastic surgeon. In 1983, the year after Dr. MacNeil graduated from Dalhousie medical school, he and his wife Barbara moved to Arichat, where he planned to work for a few years, make some money and get some experience.

Then, he would move on to something that seemed a little more cutting-edge. A little more exciting.

But after a year or two on Isle Madame, Dr. MacNeil says he knew that he would stay.

"I wanted to do plastics trauma (because) you took somebody who had a major problem and you fixed it, you made it better. I found that I could do that every day here in general practice. And it’s more intellectually challenging because you don’t do the same thing all the time. As strange as it sounds, I think I would have gotten bored after five or 10 years in the (operating room).

"You never get bored here."

It’s been a challenge to get another full-time doctor in Arichat since several left to pursue specialties about a dozen years ago. Another retired.

Since then, Dr. MacNeil has had some help from two doctors: one who helps out for two weeks a month and another who covers for one week each month.

The emergency room at St. Anne Community and Nursing Care Centre may have shut down if Dr. MacNeil had not offered to stay on-call every other night. The closure of the island’s trauma centre would have meant that an ambulance travelling from the tip of Isle Madame would not make it to Strait Richmond Hospital for about 45 minutes.

Dr. MacNeil lives just down the road from the emergency centre and nursing home. He says he can make it there in about three minutes.

It’s there that he’s seen a wide range of patients. He’s delivered the occasional baby — most go to a hospital — and given trauma care to car crash victims.

One of his first trauma cases won’t fade from his memory, Dr. MacNeil says. A 22-year-old crashed his motorcycle into a telephone pole and fractured nearly every bone in his body.

The man shouldn’t have survived, Dr. MacNeil says.

"He came into the emergency room not breathing and clinically dead. Everything was broken. And then, three months later, I got a thank you card from him."

But not every patient’s story has a happy ending.

Dr. MacNeil treated Marilyn MacKay for years as she suffered with interstitial lung disease, a progressive scarring of those organs. The Louisdale woman moved to Toronto for more than two years as she waited for a double lung transplant.

Shortly after Ms. MacKay went public with how much it cost her to live away from home, Nova Scotia created a fund to cover up to $1,500 of the living expenses each month for out-of-province patients.

Ms. MacKay died last month after undergoing a double lung transplant.

"She was a lady that I really fought for to get services," Dr. MacNeil says. "She was a fighter, too. Her death was tragic."

Pauline Bona has been a patient of Dr. MacNeil’s for nine years. And her mother, Loretta, has gone to him for as long as he’s been practising.

"He’s just here for everybody, morning, noon and night," says the owner of L’Auberge Acadienne. "He’s so dedicated to the island, to us, and to all his family. We’re so fortunate to have him."

When her mother became ill, Ms. Bona brought her to see the doctor at his clinic and was back home within a half-hour.

"You just don’t see that in the big cities," she says.

Photos of three kids hang on the wall in Dr. MacNeil’s office, all grown now. You can tell that he’s proud of his children when he talks about them, beaming a little as he recounts each of their accomplishments.

Christina, 27, is an engineer and runs a company in Waterloo, Ont. Scott, 24, is in medical school and wants to come back to Isle Madame to practise.

"And we have a 21-year-old autistic fellow, Stephen, who lives at home with us. He certainly gives me insight into the challenges that my patients can face in having to look after a disabled person."

Then, the interview ends and Dr. MacNeil jumps up, needing to get back to the crowded waiting room. He doesn’t shake hands — it’s flu season, he explains.

And if he gets sick, there’s unlikely to be another doctor to take care of him."