Martha’s Vineyard dentist reached out to a patient in need

Dr. Garrett Orazem's dental treatment area is set up to accommodate wheelchair patients. — Photo by Ralph Stewart

For most Islanders, going to the dentist is just a short walk or ride by car, bus, or bike. For someone in a wheelchair, that trip may be postponed or curtailed by limited transportation options. Dr. Garrett Orazem found that out last week as he sought to get a patient who needed treatment to his office. But with his efforts to find a way, his receptionist’s quick thinking, and the kindness of a fellow Islander, Alan Muckerheide of Oak Bluffs did not have to suffer through the Christmas holiday.

Mr. Muckerheide has been paralyzed from the chest down since 1983 from injuries he suffered in a motorcycle accident, and he uses a motorized wheelchair. Although he has a mobility van with a wheelchair lift, it was down for maintenance on December 13, when he called Dr. Orazem complaining of a toothache.

“I suggested I’d come over and see what needed to be done, so he wouldn’t have to make arrangements to get to my office and waste a visit,” Dr. Orazem said. His office is at 31 Beach Road in Vineyard Haven on the second floor.

Dr. Orazem went to Mr. Muckerheide’s home with some gloves, a flashlight and a dental mirror and examined him there. He found that an x-ray would be necessary, so he set up a follow-up appointment for Mr. Muckerheide on December 20 and prescribed some medication to help him in the interim.

The day before Mr. Muckerheide’s appointment, however, he called to say that his van still wasn’t fixed and he had no transportation. He said he had tried to arrange for a ride on The Lift, the para-transit service operated by the Vineyard Transit Authority (VTA), but he was told that since he was not registered for the service it would take two weeks to complete the process.

Although regular VTA buses are equipped with wheelchair lifts, that was not an option for Mr. Muckerheide, who would be unable to maneuver his wheelchair from where the bus would drop him off on the street through the parking lot.

“At the time I was upset, because I had done a lot to get Alan in and we had moved our schedule around here,” Dr. Orazem said. “It was really important that I see him in a timely fashion in order to avoid having to get into other medications.”

Before seeing his next patient, Dr. Orazem said he tried to think of someone to call who might be able to intercede on Mr. Muckerheide’s behalf. In the meantime, Rosemary Jackson, his dental assistant since 1986, came up with a solution. She called Mike Ciancio, whose wife Elaine is a patient who also uses a wheelchair, and asked if he would transport Mr. Muckerheide in their mobility van. Mr. Ciancio, the plumbing and gas inspector for the town of Tisbury, told The Times he has known Mr. Muckerheide and his family for years, and he was happy to help.

His only concern was that his wife’s wheelchair isn’t motorized and is much lighter than Mr. Muckerheide’s.

“I told them, as long as my lift can pick him up, I’ll get him over there, and they understood,” Mr. Ciancio said. “The lift didn’t have any problem, and everything worked perfect. Alan was happy, and his caregiver was happy I could get him over there, and went with us.”

Dr. Orazem said their arrival was a welcome sight. “It all worked like a charm,” he said. “I looked out the window, and there Mr. Muckerheide was, coming up the ramp. Rosemary and Mr. Ciancio are the heroes in this story.”

Mr. Muckerheide agreed. “They’re the only reason I got there,” he told The Times in a phone conversation last week.

“When it comes right down to it, though, I think the biggest issue is I haven’t been in the loop with all these things,” Mr. Muckerheide said. “I should be signed up with The Lift service, and I’ve got the paperwork now.”

Dr. Orazem said The Lift does help a lot of his patients, although he was surprised and frustrated by Mr. Muckerheide’s experience last week.

“As far as I understand it, someone just has to say pick the guy up, bring him to the dental appointment, and take him home,” he said. “This was not about to happen, because of paper.”

Why no Lift?

The VTA provides year-round para-transit service, called The Lift, to the Island’s six towns. It also provides weekly van service to Boston area medical facilities.

“Unfortunately, we can’t do that last-minute, somebody-needs-help kind of thing,” VTA administrator Angela Grant explained in a phone conversation with The Times last week.

“The Lift service runs within three-quarters of a mile of fixed route bus service,” she added. “So basically, wherever there is a bus running down the road, within three-quarters of a mile of that, people that are not able to access the bus due to a disability are able to access the van, so they get equal access to public transportation. That’s the intent of the law.”

The VTA follows the certification requirements and process set by the Federal Transit Administration within the confines of the Americans with Disabilities Act [ADA]. There are different types of certifications, including unconditional eligibility and conditional eligibility, which take both cognitive and physical abilities into account.

“There is definitely some responsibility on everybody to solve the transportation component to a person’s needs, it’s not just the VTA, the service provider that’s responsible, but it might be a social service agency involved, it might be a family, it might be the individual, depending on what level of cognitive ability somebody has,” Ms. Grant said.

“It would be nice if somebody did get an accessible taxicab on the Island, because then people would have options,” she added. “Some people don’t want to register with us. There are some who feel they don’t want to subject themselves to having to go through a process. And that’s their right, and we need to respect that.”