After 23 years of practicing medicine in the only town where she’s ever done so, Dr. Alison Carleton is leaving Nevada at the end of this year to pursue the adventure of her lifetime in Canada.

Both she and her wife, Cyndie Blythe, who has also been her medical assistant for a number of years, are headed four hours northwest of Winnipeg to a little place called Winnipegosis, where Alison will be the “village doctor” and Cyndie will work in the clinic as a phlebotomist. Cyndie also hopes that she can use her skills to eventually re-open the community’s medical lab and offer basic lab services.

This incredible change and opportunity started out with Alison and Cyndie, now in their mid-50s, asking themselves “What do you want to do with the rest of your life?”

“I always wanted to go into a ‘mission field,’” Alison said. And she feels like this is a little bit like that, only the diseases won’t be things uncommon to her. She will deal with the same types of medical issues in Canada, but in a much more simplified health care system.

“Canada has one payer, the government,” Alison said. “People there have an expectation of good care and people expect that they will be cared for,” but medical services are offered in a much more modest way, Alison and Cyndie describe.

“Their medical system is set up for success, not competition,” Cyndie said. And after years of back and forth with insurance companies while helping Alison run her practice, Cyndie is excited that there will be none of that to deal with in Manitoba, Canada.

Alison said it will truly be like going back in time in some ways … it’s a very small town, serving a very big rural area in Manitoba; there is no cell phone service there; and the facilities are very modest. It sort of comes down to her with her stethoscope … a very basic way of practicing medicine, knowing that if people have needs for more than what she can provide, she will refer them to a bigger medical facility where those needs can be met.

Looking Back

Alison was 32 when she arrived in Nevada, at a time when Nevada was very much in need of medical providers who would put down roots. She came to Nevada with her now ex-husband and their children because her ex-husband’s roots were in this area.

“At that time, the hospital was in dire need (of providers),” she remembers. She joined Dr. Jones at a building at the corner of Seventh and G, which is now an apartment building. She, Jones and Dr. Bonthala were the only doctors in town at the time, and the only doctors to cover the little local hospital’s emergency room. Not long after her arrival, Dr. Jones left, and it was just her and Bonthala to cover.

“The hospital needed a doctor who would come and stay, and I was willing to do that,” she said. Eventually, with her becoming a mainstay, the hospital was able to attract others to come and stay here, too. “And the hospital added outlying clinics in other little towns. So, everything grew. Pharmacies stayed in business. Things turned around.” Carleton was in solo practice when she came to Nevada, eventually joined the staff of the local hospital for 10 years, and then on Dec. 1, 2009, she ventured out on her own again in solo practice, with Cyndie by her side. They set up shop in Nevada’s main business district on Sixth Street. “It will be eight years and two weeks when we stop practicing here (at their present location),” Cyndie added.

Camping leads to inquiry

One of the things that Alison and Cyndie enjoy most is camping and being outdoors. Over the past year, the two were looking for a place to go camping in June that would be cooler. They settled on going up into the mountains of Riding Mountain National Park in Manitoba, which they said is about a 16-hour trip from Nevada, and just a little over an hour from where their new home will be.

They loved the beauty of the area, which when you come out of the mountains, the temperatures and landscape is very similar to Iowa’s, they say. Cyndie said in looking at the average temperatures, they’re only a little colder than Iowa most of the year. Highs in the summer tend to stay under 90 degrees. Lows in the winter tend to not go lower than -10, but can go lower at times. Yet mostly, it will feel about 10 degrees cooler generally, than it would be here in central Iowa.

While they were in Canada, Alison said, “I got curious about what does it take to be a doctor in Canada?” And by the end of that June trip, they had talked to many people about that question.

Maybe Canada was the answer to the couple’s question of “What do you want to do with the rest of your life?”

They soon were in touch with a medical recruiter for Manitoba, and were making a visit to look at the various medical opportunities there. When they paid a visit to Winnipegosis, everything seemed to click.

“They (the people of Winnipegosis) had a doctor for 30 years, who did everything and worked constantly. He finally retired,” Alison said, and for the next five years, the town had been struggling to find a permanent doctor. “They’ve been pinching together care; they’ve lost some of their facilities, like their ER, in the process.”

A regional health care center, the little town of Winnipegosis still has a clinic, a transitional care facility (for those who are released from hospitalization, but still need full-time care) and a nursing home facility, serviced by the village doctor. Alison, as she heard about their needs, said, “I can do this.”

And when her partner Cyndie heard about the ease of the “single-payer” medical system, she said, “I can do this.”

And the people of the little village, which sits along the Mossey River — in fact, that river scenically winds right past the medical clinic — are ecstatic to have Alison and Cyndie coming to be their doctor and phlebotomist. “People there really care if we’re happy,” Alison said. They both could feel that. They could also feel that there was no judgment of them as a same-sex married couple. In fact, they met another same-sex female couple very early in their visit, who indicated they are very happy in the little village.

“They call it friendly Manitoba, and it is,” Cyndie said.

They will have Internet in Winnipegosis, but no cell service. And asked if that will bother either of them, Cyndie quickly replied, “We both spent 40 years of our lives without (cell phones); it never stopped us from camping, hiking and long bike rides before.” They laugh about how they see it as another way of “simplifying their lives” and enjoying each day more.

Leaving Nevada

The hardest thing about ending her career in Nevada, Alison said, is leaving her patients. “I really love my patients. There are people here I’ve taken care of for 23 years. I wish I could just take my patients with me,” she said.

Over the next few months, as they continue to see patients and prepare for their office to close on Dec. 15, Alison said she and Cyndie will, for one thing, be working with their patients to try to help them find their next provider who can suit their individual health care needs.

Their news, they said, is probably coming as a shock to many of those they have taken care of. But, in terms of the community, Alison said that, unlike the need that existed when she came to Nevada, there are plenty of providers serving Nevada-area residents now. She sees it a little like leaving a town where the need has now been met, and going to another place where once again she is very much needed.

All of the patients she has cared for, and people she and Cyndie have come to know during their time in Nevada, are invited to a special going-away open house for Carleton Family Medicine on Dec. 15, from 3-7 p.m. The open house will be held in the fellowship hall of Central Presbyterian Church in Nevada.

Cyndie holds up a map of Manitoba; many who have heard they’re leaving for Canada think the two are going to be way up north, but the map clearly shows that there’s a lot more that’s north of where they will be. “We aren’t going to the Great White North,” she said, “just the wonderful north.”