By Liora Engel-Smith
Amaza “Rita” Hall has been to the hospital many times with severe asthma attacks, but there’s one ER run the lifelong asthmatic from Gates County remembers by date: May 19, 1999. Hall, now 73, had been admitted to the hospital yet again.
With an oxygen cannula in her nose and an IV in her arm, she learned that her house was on fire.
No one was hurt, but the house and all its contents were gone, she soon learned.
As was customary at the rural hospital in Ahoskie at the time, Hall’s family physician, Charles Sawyer, had seen her during evening rounds before going home. But someone must have told him about the fire, because he came back, said Hall.
“He sat there with me and he talked to me and encouraged me and comforted me and gave me words of encouragement and words of comfort,” she recalled. “That meant a lot to me and it still means a lot to me now.”
For the last 55 years, Sawyer, now 88, has been a rural country doctor for what would eventually become the Roanoke Chowan Community Health Center, a clinic in the middle of tobacco country. He’s been Hall’s doctor for roughly 50 of those years.
Sawyer has been there for the good times too. He delivered Hall’s second daughter, Courtney, now 42. He’s helped Hall get her asthma under control and encouraged her to change her lifestyle and keep her cholesterol in check.
“I hate to even think about Roanoke Chowan Community Health Center without a Doctor Sawyer,” she said.
Hall need not worry. Sawyer has no plans of stopping anytime soon.
He didn’t stop practicing medicine two and a half years ago when he had a heart attack that required four stents. The coronavirus pandemic has relegated him to conducting mostly virtual visits, but he’s found workarounds there too.
Sawyer, a Windsor native who now lives in town, has only ever worked in Ahoskie after completing his medical education in Chapel Hill at the University of North Carolina. In that time, he’s cared for whole families — babies, seniors and everything in between. He found himself at Ahoskie by chance: a job in a primary care clinic became available, he said. He stayed there on purpose.
As a rural doctor in a county near the bottom of state rankings in terms of health outcomes, Sawyer has seen his share of disparities. Patients here are older, sicker and less affluent than the average North Carolinian. Almost 30 percent of those patients receive Medicaid. The mortality rate from diabetes is more than double the state average. Colorectal cancer rates here are among the highest in the nation.
Sawyer knows he could have made more money elsewhere, and he’s had job offers over the years, but the needs of the population have kept him in Ahoskie.
A force for rural health
Sawyer didn’t just stay in Ahoskie. He’s influenced at least one other provider to work at the clinic, which now serves many low-income and uninsured people. In a high-needs county where the number of primary care providers has been in the low double-digits for years, recruiting one more physician could make a big difference for access to care.
Longtime colleague Dr. Julian Taylor hasn’t forgotten a conversation he had with Sawyer as a young provider in the early 70s. Taylor, then a young primary care doctor, knew he wanted to work in a small town. But he was leaning toward taking another job at a clinic in Clinton, roughly two and a half hours south of Ahoskie.
Sawyer’s words tipped the scale in favor of Ahoskie for Taylor.
“I never forgot it,” Taylor said. “He said ‘If they need you worse than we do, you damn well better get there.’”
Taylor worked in Hertford County until the early 90s when he left for a clinic in Rocky Mount. He came back to Ahoskie in 2001 and has been there ever since.
‘Anything for anybody’
The decision to come to Ahoskie turned out to be a good one. One of the first lessons Taylor learned from Sawyer, he said, was about delivering bad news to parents. Sawyer, who by all accounts has delivered babies for so long that some of them are even his colleagues now, had a way of comforting the parents of a sick child.
One of Taylor’s patients, a newborn with a heart abnormality, needed to be transferred to a larger facility for surgery. Taylor wasn’t sure how to tell the parents, so he asked for Sawyer’s help.
“Dr. Sawyer knew the people personally,” he said. “And he came in, and just smoothed it out. … [He told] them gently that there was something wrong that needed to be looked into.”
There was no panic, no frantic note in Sawyer’s voice, Taylor recalled, and the parents responded well. The baby was transferred to a larger hospital — either in Virginia or Greenville — and survived the surgery.
“He would do anything for anybody — friend or patient,” Taylor said.
A kind word and a lobster
Other staff at the bustling clinic in Ahoskie say that Sawyer has a way of letting people know they matter.
Medical technician Regina Jacobs has worked with Sawyer for roughly 15 years. During that time, he’s found small and big ways to let her and the other lab workers know he cares.
“It’s nothing for him to stop at the lab on his way home and say ‘appreciate you girls, thanks so much,’” she said.
Every fall, Sawyer also expresses his gratitude with lobsters. The Episcopal church Sawyer attends sells lobsters for its annual fundraiser. Sawyer buys lobsters for all his staff members and for the women in the lab.
“He makes sure we’re not left out,” Jacobs said. “ … that’s his way of showing his appreciation.”
Sawyer has had to slow down considerably since his heart attack. He now goes home around lunchtime for a 30-minute nap. He also sees fewer patients.
“I’m not going to work forever and ever,” he said. “I mean, we’re way beyond my expectations. … The main thing is, I don’t want to work if I’m not completely skilled or if I lose my competency.”
But when he’s in the clinic, he’s there for his patients in any way he can be. Recently, a couple he cares for lost their 50-year-old son quite suddenly. Sawyer, who prays at the Episcopal church every morning before work, was moved to write them a prayer, which he delivered on their next face-to-face visit.
He knows that empathy — be it through lobsters or heartfelt words– is often the most important skill in a doctor’s toolkit.