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In this recent aerial photo, an ever-shifting sandbar that has formed off Wasque Point near the breech is visible in the foreground. Fishermen take their chances when when wading out on the bar. Photo by Skip Bettencourt

The 69th Martha’s Vineyard Striped Bass and Bluefish Derby begins at 12:01 am Sunday. It seems like it was just last week I was jigging for squid on State Beach in anticipation of this moment. How did it get here so fast?

Summer was fine, but I was quite happy to say goodbye to the traffic, crowds, and daily Obama golf bulletins. In September, we revert to Derby time. No need to set the clocks back or forward. Time is measured by wind and tides and rumors of fish.

The 2014 Derby features a separate contest for kayakers and some rule changes for fly fishermen. All the information is available online at mvderby.com or in the rules brochures. Kids Day is Sunday, Sept. 21. The awards ceremony is Sunday, Oct. 19.

If you are one of those misguided fishermen who does not buy a Derby button because you think you will not catch a Derby-winning fish, I have some advice: Buy a button. Lightning does strike in the Derby. There are numerous stories of people who went fishing without a button and regretted that decision. They tell themselves it doesn’t matter, but deep down, you can tell just by the way they say it, it does.

Fill in the blank

I have started to compose a news story.

“Fill-in-the-blank” drowned today after he stepped off a sandbar while fishing for striped bass off Wasque on the southeast corner of Martha’s Vineyard and was swept away in the treacherous current. The Coast Guard recovered Mr. Fill-in-the-blank following a brief search.

Mr. Fill-in-the-blank, an experienced fisherman, was not wearing a PFD or any other safety equipment when he waded out on an ever-shifting bar that has formed near the cut in Norton Point Beach in search of a Derby-winning fish.

Prior to the start of the well-known fishing tournament, Chris Kennedy, Martha’s Vineyard superintendent for The Trustees of Reservations, asked fishermen to exercise extreme caution when fishing near the cut. Mr. Kennedy said conditions change on a daily basis.

“Several of our rangers were called out a couple of nights ago at Wasque when our night ranger on Norton Point lost sight of several fishermen who had ventured onto the offshore bar more than a hundred feet off of Wasque while fishing the breach,” Mr. Kennedy told The Times last week. “Their lights suddenly went out, and our ranger didn’t know if they turned the lights off voluntarily or had been pulled off the bar. Luckily the fishermen safely made it back to shore without incident, but several of them had no PFDs or inflatable suspenders in case they went into the water. They were happy, they caught several stripers, but I shudder to think at what potential cost.”

Mr. Kennedy urged fishermen to use caution and common sense when venturing onto bars and jetties, especially at night. “Basic safety equipment, when wading at night, should be the first thing you grab out of the truck before heading down the beach,” he said. “Otherwise, help could be a long time in coming.”

Get the picture? I do not want to fill in the blank. Chris said the bar changes daily. What was safe one day may become dangerous the next.

Pre-Derby planning

"King Mackerel & The Blues Are Running: Songs & Stories of the Carolina Coast" echoes themes Islanders will find familiar.
“King Mackerel & The Blues Are Running: Songs & Stories of the Carolina Coast” echoes themes Islanders will find familiar.

Derby veterans know that the five-week fishing contest shares some qualities with a marathon. In a road race, the key is to pace yourself so you will have enough energy in the final miles to finish the contest.

In the Derby, the question of pacing has more to do with the endurance of your spouse — will the contest end before he or she has had it with your fishing schedule to the point that your fishing rods are in danger of being used for kindling?

Besides spooling reels with new line and sharpening hooks, a good pre-Derby fishing strategy should include any activity that will make your spouse think you are a pretty good guy, because believe me, in about three weeks she or he might have some doubts.

I have a suggestion that will whet your appetite for fishing, yet should meet any spouse’s criteria for a fun night out: Go out to dinner and then see the Coastal Cohorts at the Martha’s Vineyard Playhouse Friday and Saturday night perform “King Mackerel and the Blues are Running: Songs and Stories of the Carolina Coast.

My friend Ed Strong invited the trio to perform because he knows them well, he thinks they are very talented, and he thought their stories and songs, which focus on coastal living and the unique characters it attracts, would find a receptive audience on the Vineyard.

This is not opera. This is fun, entertaining music (sung in English) about events Islanders understand. A YouTube clip of a performance at the University of North Carolina contains the following lyrics: “Summertime is just about gone, all that’s left to think about is the fishin’ comin’ on …” Performances begin at 7:30 pm on Friday and Saturday night. Tickets are $50 for adults; $40 for seniors; $30 for students. Tickets are available online or by visiting the theater at 24 Church St. in Vineyard Haven. For more information, visit mvplayhouse.org.

Lessons from tragedy

From 1998 to 2001, Capt. W. Russell Webster was the commander of Coast Guard Group Woods Hole, now known as Sector Southeastern New England.

During his tour, Captain Webster, now retired, was instrumental in extending the Coast Guard’s emergency radio coverage to a so-called “black hole” behind Nomans Land in anticipation of later upgrades. The temporary fix was to place an antenna on Peaked Hill in Chilmark in 2000.

Captain Webster, a Coast Guard historian, was determined to rectify the lack of radio coverage in part because of what he had learned about the loss of Fairhaven fishermen Hokey Hokanson and his teenage son, Billy, on March 25, 1990.

Billy transmitted a brief, heavily garbled radio distress call. A hoax call immediately followed Billy’s cry for help, and believing that the two were connected, the Coast Guard did not launch rescue units for several days. The Hokansons’ deaths prompted a new anti-hoax law and helped lead to changes in Coast Guard search and rescue procedures.

In a newly published book, “The Sol e Mar Tragedy Off Martha’s Vineyard” (historypress.net), Captain Webster and his co-author and wife, journalist Elizabeth B. Webster, describe the events that unfolded following the loss of the Sol e Mar. This is a short, eye-opening read. To his credit, Captain Webster does not shy away from describing where the Coast Guard went wrong, in this case or several others: Overworked and inexperienced watchstanders, insensitive next-of-kin notification procedures, and a reliance on outdated technology all contributed to mistakes.

The recognition that mistakes were made and a determination to correct them is why the Coast Guard is better prepared than ever to fulfill its mission.

The Websters will be signing copies of their book from 11 am to 4 pm Saturday at the Secret Garden on Circuit Avenue in Oak Bluffs.

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New unit will increase access to care and decrease costs for patients and for caregivers, hospital officials said.

The new walk-in clinic will provide an alternative to the busy hospital emergency room. (Photos by Michael Cummo)

The Martha’s Vineyard Hospital has begun renovating the no-longer-used emergency room in the old hospital building for use as a walk-in clinic. Hospital leaders said the new clinic is necessary to address a longstanding shortage of access to non-critical health care for Islanders.

Tim Walsh, Martha's Vineyard Hospital CEO (left), and Dr. Jeffrey Zack, chief of emergency medicine, said changes in health care are driving changes at the hospital.
Tim Walsh, Martha’s Vineyard Hospital CEO (left), and Dr. Jeffrey Zack, chief of emergency medicine, said changes in health care are driving changes at the hospital.

In a conversation with The Times on Wednesday, Tim Walsh, hospital CEO, and Dr. Jeffrey Zack, director of emergency medical services, discussed this newest addition to an expanding scope of services that the hospital now offers.

The hospital officials said the addition of a walk-in clinic would provide an alternative to the emergency room and become part of a continuum of care that includes emergency care, primary care and inpatient care overseen by hospitalists, all linked by a system of electronic medical record keeping under the umbrella of the hospital’s parent organisation, Massachusetts General Hospital (MGH), which now provides the Vineyard hospital with radiology, anesthesiology and oncology services.

In March 2007, Martha’s Vineyard Hospital became an affiliate of Massachusetts General Hospital and a member of Partners HealthCare.

“This is part of a system-wide overhaul that we’ve been doing over the last few years to better accommodate the needs of our patients on the medical end and also the financial end,” Dr. Zack said. “The goal here is to design a system that can cover from the very sickest to the non-critical patients, and the walk-in facility has been a big hole in our delivery system.”

Dr. Zack said all too often, patients utilize the emergency room (ER) because they may not have a primary care doctor. “Emergency medicine is here for the sickest of the sick, yet over the last 10, 20 years we’ve started to take care of everybody. We do a lot of primary care, especially here on the Island. It isn’t the most cost-effective way to deliver quality care. This [walk-in clinic] fills that need of ‘not too sick but can’t wait for an office visit in a week.’”

Dr. Zack said that the walk-in clinic will also help manage the surge in patients when there’s an outbreak of the flu or a virus like the one currently spreading in the midwest. “Historically this overflow would go into the ER, which diverts resources and is a costly way to practice medicine. But up until now, there’s been very little options for folks on the Island.”

Staffing and hours

The medical personnel staffing the walk-in clinic will be a mixture of physicians and mid-level providers, such as physician’s assistants and nurse practitioners. Mr. Walsh said the hours of operation will be tailored to demand.

“We’re going to study and figure out the hours as we go along,” he said. “If there’s a need to stay open after hours, we’ll see what we can build around that. We’re hoping to play off the community. If there’s a real need to keep it open, say, until 7pm at night, then that’s what we’ll do. We’re open to figuring that one out.”

Long range benefits

In addition to the benefits in patient care and cost containment, Mr. Walsh said the clinic will help balance the books in the long term as well.

“Looking down the road at the Affordable Care Act, and where they’re trying to go, it’s really about population health management,” he said. “For a given population you’re responsible for everything that happens to them. We’re rethinking how you do it. They want to do global payments in the future, for every person that comes into your system they’ll pay you $25,000 a year — you take care of the health care. Right now, it’s about volume, the more you do, the more you make. That’s going to change to: the more you do, the more your expenses are. So you’re not making more money. That’s where a walk-in clinic can save money. A $300-dollar visit to the ER can be done instead for $100.”

Mr. Walsh said the goal is to make the walk-in clinic operational by next summer at the latest. “I’m hoping we can get it in by next February, but we got sidetracked with repairs to the air handling system in Wing 1 in the beginning of the summer. Replacing a new unit costs over $700,000. The next move will be to install air transfer in the old ER It’s interesting times around here.”

Increased demand
The walk-in clinic is the latest in a series of improvements and upgrades. These include the addition of a new MGH oncology unit, the recently completed $2 million transfer to electronic record keeping, and a $1 million investment in hiring hospitalists, doctors who solely treat hospital inpatients and thus provide consistent care and free up overwhelmed primary care doctors.

The expanding system was put to the test this summer, which according to hospital statistics, was the busiest in the hospital’s history. Patient days in acute care were up 28 percent, and patient days in skilled nursing facilities (SNF) were up 74.4 percent.

“We were busting at the seams,” Mr. Walsh said. “Because of our expanded services like the hospitalists, we were able to hold on to more patients here and not transfer off-Island. The ICU was much busier. It’s stunning how much volume we did. We were boarding in the ER, which is unusual for us. We had it happen in the past but not to this extent. Not even close.”

One goal is to avoid transfers to mainland hospitals when possible. “I don’t think the number of patients went up significantly; it’s the number of people we’re keeping in the system,” Dr. Zack said. “That’s the overall goal here. Our patients don’t want to go to Boston. They want to stay here with their families. So we’re adding more resources one bit at a time so we’re able to do that. Now looking at the big picture, we need to address the lower acuity stuff.”

Doc docs

The recent conversion to electronic records will enable the growing departments within the hospital, and partner hospitals off-Island, to instantly access critical medical information within the Partners Healthcare network.

“It’s an all-in-one system,” Dr. Zack said. “There’s no fishing around at 2 am trying to find information — it’s there. That time can be important, and maybe life-saving.”
“If you go from here to Mass General, they see the primary care records, the ER records, they see everything. And vise versa: when the patient comes back, we see everything they did in Boston,” Mr. Walsh said. If the hospital shows “meaningful use” of the electronic records system, according to an upcoming Medicare evaluation, it will receive a significant rebate to defray the cost of the system.

Choice is good

Mr. Walsh and Dr. Zack said the recent sale of Vineyard Medical Services, presently the only walk-in clinic on the Island, had no bearing on today’s announcement. “This has been on my radar for two years,” Dr. Zack said. “For us the hospitalist program was more important to get up and running; so that took precedence.”
“I talked to Dr. Jacobs several times over the years about buying his practice as a satellite facility,” Mr. Walsh said. “I like Dr. Jacobs, he’s a great guy. We’ve always had a really good relationship. The problem is the licensures. When you’re talking about a hospital satellite, you have to meet hospital code, and the standards are brutal, as they should be. The air-exchanges demands are extremely high. I don’t think any house could meet them.”

Mr. Walsh is supportive of the new walk-in venture. “It’s good for people to have choice. It’s on us to deliver a good product,” he said.

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The new men's section at Bananas. Photo by Michael Cummo.

The down-Island towns may be known for their abundance of shops and restaurants, but it’s definitely worthwhile for all you “urban” dwellers in Oak Bluffs, Vineyard Haven, and Edgartown to make the drive up Island to check out a few unique boutiques in the other towns. Now is the time. Not only are a couple of these stores closing for the season soon, they all have great sales going on.

On the Cliffs

On the Cliffs is one of the Island’s best-kept secrets for those looking for great style as well as bargains. Adriana Ignacio, owner of Aquinnah’s On the Cliffs boutique (whose name is its location) has an eye for finding cool stuff at great prices. The tiny shop is packed with lots of fun and funky looks, as well as classic soft-as-cashmere ponchos, capes, and drapey sweaters from $30 to $68. If you prefer the real thing, there are Pia Rossini cashmeres for under $200.

The store also stocks a good selection of figure-shaping spandex leggings and more from a line called Lysee, which employee Sascha Wolodyka swears by. “I used to be a professional ice skater. I know my spandex,” she says.

While the fall looks are priced to sell, there’s also summer stock at an even better deal. The funky-chic Tsubo sandals are now 50% off. There’s a great selection of lighter-weight scarves on sale, and all of the jewelry is 30% off. The half-price rack out front holds lots of summer dresses, tops, and flowy lightweight pants. Check out the beautiful Dolma embroidered silk tunics ASAP. There’re only a few left, and at half off they’re going fast.

On the Cliffs also offers some of the best prices on Vineyard logo wear. Tees are now going for $9 to $12, heavyweight sweatshirts for $30. And, of course, given Ms. Ignacio’s great taste, the souvenir shirts all feature both high quality and stylish design.

Pandora’s Box

IMG_3370.jpgNo trip to Menemsha is complete without a stop at Pandora’s Box, at the top of Basin Road leading to the beach. One of the chicest boutiques on the Island, it has a vast selection of fall looks right now, including lots of cashmere and denim by Hudson Jeans, DL1961, and more. Some of the popular brands carried by Pandora’s include Free People, Johnny Was, Hard Tail, Odd Molly, Koch, and Margaret O’Leary, among others. There’re still a lot of summer looks left at 50% off, as well as shoes and boots (all 20% to 50% off) from Bed Stu, Lucky, Dr. Scholl’s, and Corkees.

The jewelry case includes a number of designs by local jewelers, including gold, brass, and leather looks from Ivry Russillo and Jenny Gaynor’s handblown glass pieces.

It’s worth stopping by Pandora’s just to check out some great skincare and fragrance lines. The boutique carries a variety of products by Tocca, and vegan organic oils made from healing herbs and flowers by Lotus Love Beauty. Pandora’s also stocks the hip Tokyo Milk brand whose current Dark line features fragrances named Bulletproof, Arsenic, and Tainted Love in blends like earth + moss, crushed herbs, wild grass and Jasmin or absinth, vanilla salt, cut greens and crushed fennel. The fragrances are unique, subtle, and downright delicious.

Bananas

When it comes to Vineyard fun and funky style, few people have the look nailed better than Judy Hartford, owner of Bananas on State Road in West Tisbury. The cozy former home is full of all the essentials for the look that can be described as boho chic with a flair for the feminine. Sort of Victorian meets street waif, meets prairie, meets gypsy. You get the idea. Well, maybe not. Best to see for yourself. Check out Bananas’ selection of dresses, skirts, tops, and pants, in high-quality fabrics, rich in texture and pattern. And bring the guys with you. Men now have a room of their own at Bananas, full of not only casually stylish sweaters, shirts, jackets, and more (from CP Shades, S. Moritz, etc.), but also lots of belts, wallets, and other accessories, and some of the coolest men’s shoes to be found on Island.

Which brings us to shoes. Bananas is known for its vast selection of shoes and boots for women, which all pair comfort with high style. Imagine a pair of heels or wedges in which you can actually chase down a runaway dog — or cow, or child — and you get the idea of what’s to be found at this West Tisbury gem of a store. Lines include Fly London, Trippen, Gentle Soles, Camper, Re-Mix, Gidigio, Softinos, and more. Summer shoes are all half off right now. Bananas’ current sale also includes summer and last year’s fall clothing from 30% to 50% off, and all jewelry is 20% off.

Go ahead, spend some of that hard-earned summer cash. You deserve something special for making it to the other side of the seasonal crunch.

On the Cliffs, 23 Aquinnah Circle, Aquinnah, is open through Columbus Day. Currently the store is open every day from 10 to 5, but check their Facebook page as the hours may change. 508-645-3660.

Pandora’s Box, 4 Basin Road, Chilmark, will be open through Columbus Day, every day from 11 to 5. 508-645-9696.

Bananas, 697 State Road, West Tisbury, is now open year round. Through Columbus Day they’ll be open every day from 10 to 6. Call ahead for days and hours after that. 508-696-5939.