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Dr. David Nichols: A legacy of love & compassion

On a tour of the new facility, Gov. Bob McDonnell pledged continued support for the clinic. From left are Virginia Department of Health commissioner Karen Remley, Rep. Rob Wittman, Dr. David Nichols, Tangier Health Foundation president Jimmie Carter and Gov. McDonnell.
by Audrey Thomasson

Dr. David Nichols is a quiet man in voice and mannerisms. Yet, his call for help to improve medical care for some 500 citizens on Virginia’s tiny island of Tangier roared across the Chesapeake Bay and echoed around the nation.

That is a story of triumph.

Within months, however, the community faces a story of tragedy — the loss of its well-known physician.

Dr. David Nichols talks about the realization of his lifelong goal to provide Tangier Island residents with a modern health clinic. (Videos by Michael Kucera)
According to Dr. Nichols, his commitment to the island would not have been possible without the success of his White Stone Family Practice, which subsidized much of the expense.
With the support and advice of his son Davey (his “life coach"), Dr. Nichols is focusing his energy and attention on living for today.
Dr. Nichols is dying of cancer. Six years ago he survived melanoma of the eye; last month he learned the cancer had spread to his liver.

“I kept it very private,” Dr. Nichols said in an interview at his home on Friday. “I’m a very private person.”

But he acknowledged it was impractical to think the news wouldn’t spread once he told close friends and his “Tangier family,” as he calls them.

“I feel great. I’m ready. I’ve faced reality and feel extremely lucky to have lived the life I’ve lived. Overall, what I did at Tangier was the best part of my practice. I’ve gained from my family on Tangier.

“When I die, I want my ashes buried in the cemetery next to the clinic,” he said.

He readily admits physicians will not make money serving Tangier. “In fact, it will cost them money,” he said. Yet, he called his time on the island a blessing.

When he first started going there, he shared visits with other physicians and dentists from Maryland. But the long journey, especially in difficult weather, was costly and resulted in all the others giving up. 

Understandably, the island residents were doubtful about his commitment as well, he said. But he persevered and eventually won their trust. And the relationship between the doctor and the Tangier community soon developed into kindness given and received. 

The community is made up mostly of watermen. Living in isolation for hundreds of years, most islanders through diet and genetics have extremely low to nonexistent levels of good cholesterol and their bad cholesterol is off the charts. Heart disease was widespread and life expectancy for islanders was in the 40s and 50s range. Dr. Nichols managed to change their thinking about preventive medical care by communicating in ways in which they could relate.

“You change the oil on the boat even if the engine doesn’t act up,” he told them. Over time they came to understand and accept his cautionary words about lifestyle changes, he said. Now their health has greatly improved, there are fewer heart attacks among young adults and hopefully, they’ll live longer lives, he said.

Winning trust and respect also came from the way he approaches patients, spending time, not herding them through, and always wrapping up an examination by asking, “Is there anything else I can do for you?”

“When a patient leaves my office, I want them to feel like the doctor listened to them,” he said. It is a belief he feels is no longer practiced by a new wave of young doctors who give priority to their personal lives. “There’s nothing wrong with that. It’s like a paradigm shift. You just have to change your thinking,” he said. “I’m intense and I worry about people a lot. It’s taken its toll on me and my family. I wish I could go back and not be so tense, but it’s not me. I like to do everything well. It’s very important to treat patients like you want your family to be treated.”

And he does.

On one trip to the island, Dr. Nichols packed his helicopter with all the gear involved in performing a colonoscopy on a patient. After the team arrived at the clinic and set up for the patient, a lightbulb went out on the unit. “I had to fly back to White Stone to pick up a new bulb. When I got back, the patient was still there waiting,” he said.

“Having cancer changes start looking at life differently. The hardest part is not what is happening to me but how my wife is taking it and my family and patients. I feel like my family sacrificed a lot.”

His face lights up as he talks about his wife, Dianne, and kids, attributing their great family life to her efforts. Dianne gave up a nursing career to raise their two children, Davey, and Sarah who works at a medical facility in another state.

“My son Davey has become my life coach” helping to focus on today and now. “He said, ‘Dad, you’ve got to live for the moment—not the past or the future.’”

Davey, who lives in the area, quit his job to help his father and take over the responsibility of flying him to Tangier.

The physician has a clear perspective on his limited time left on earth. “Twenty million people in Pakistan are dying,” he says, referring to recent news of unprecedented flooding in that region of the world. “What do I have to complain about? So much suffering. I’m 62 years old. To have lived this life and be blessed...”

Dianne, who is as quiet-mannered as her husband, said reality has not hit her yet.

“I’ve been up, down. There’s been so much going many phone hasn’t really dawned on me. Hearing of a lifespan of four to six months, you compress all the things you want to do. The sentence brings everything into focus.”

On the living room coffee table is a shoebox overflowing with notes and cards from friends and patients. “Each is filled with wonderful memories that are so meaningful,” she said.

“It’s like getting sympathy cards before I die,” Dr. Nichols said, while admitting it is also a good thing.

Dianne learned not to worry about her husband flying his helicopter to Tangier during weather conditions that grounded most aircraft and many times diverted his return to Newport News and other airports away from home. “I used to worry, but I decided I’d only worry when someone knocked on the door.”

While her husband expressed concern that his family was shortchanged by his absences, Dianne said an investment in a timeshare years ago forced him into short family vacations four times a year. She said their flights to the Outer Banks kept him balanced, although she admitted to being a co-pilot on tranquilizers.

Dianne has hope that a new immune therapy, still in the test stages, will help her husband. “It’s a drug that is supposed to shrink the tumor. He’s going to start treatment at a cancer center in Newport News or Williamsburg.”

Dr. Nichols accepts dedication

The crowd that flocked to the island Sunday for the dedication was a testament to the abundant affection for the man who improved the health of an island. The David B. Nichols Medical Center will be his legacy on the island.

But making it happen came from the roar heard around the nation—the selection of Dr. Nichols as the 2006 Country Doctor of the Year. His friend, Jimmie Carter, took full advantage of the resulting national attention focused on Tangier to raise funds for the clinic, Dr. Nichols said with affection.

“The Washington Post did an article based on a Rappahannock Record article and it spiraled to TV stations,” eventually leading to the Country Doctor award. “I’ll be forgotten for my practice in White Stone where I earned a living. But I’ll be remembered for Tangier,” he joked.

Based on all he has seen in his life and in his practice, he firmly believes there is a bigger life after this earthly one.

Dr. Nichols loves to tell folks, “On Tangier you’re a little closer to heaven.” But through his kindness, friendship and love, perhaps the doctor brought heaven a little closer to Tangier.

Related articles and videos:
Tangier clinic dedicated in honor of Dr. Nichols (videos)
Film depicts Dr. Nichols’ dedication to Tangier Island (video)
All aboard for Tangier Island (slide show)

posted 09.01.2010

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