Car space kerfuffle complicates medical trip

Open heart surgery patient forced to use Patriot over Steamship Authority.

Rachel Self and her partner Billy Gazaille faced challenges with the Steamship Authority in getting back to the Vineyard after a procedure Gazaille had in Boston. — Sean Francis

Updated June 27

A Chappaquiddick man endured stress and discomfort when the Steamship Authority refused to allow his partner medical passage to collect him from Massachusetts General Hospital following open-heart surgery. The post-op man was forced to cross Vineyard Sound on the Patriot’s Quickwater, trading the comfort of a pickup truck on a ferry for the windy stern of the relatively small boat. 

After his physicians deemed he could no longer delay the procedure, Billy Gazaille underwent surgery on May 7, despite the ongoing pandemic and the curtailments it placed on medical care. He was released from MGH on May 12. His partner, Rachel Self, had driven him up to Boston without issue. Self and Gazaille rode the Quickwater to Falmouth, and then, using what she called her “Patriot car,” drove to MGH. Trouble began when she tried to book passage to retrieve him after the surgery was done. 

Self said she wasn’t permitted to enter the hospital to visit Gazaille due to pandemic restrictions. Also due to pandemic restrictions, there was nowhere to lodge in Boston, so she waited at home on Cape Poge for his release authorization. When it came, he wasn’t getting an ambulance ride.

“He didn’t need to be transported in an ambulance,” Self said. Medical staff, she recalled, said he was to be driven home.

She also said she couldn’t have made a Steamship Authority reservation because of the uncertainty surrounding when he would be cleared for release. 

Instead of using the car she had in the Patriot parking lot, Self opted to use their pickup truck, because she said her partner is a big guy, and the truck would afford him as much comfort as possible, given its roominess. 

In a letter sent to the Steamship Authority and several state officials, Self described her attempt to secure passage on May 11 for May 12.

“As soon as I got off the phone with the doctor,” she wrote, “I called the Steamship Authority to find out how to get our vehicle on a boat so that I could transport Bill home in the safest way for him and everyone around us. I spoke with a woman … whom, I was later shocked to learn, was a manager with the authority. I had been given a letter from Bill’s surgeon, and I asked if I could provide this letter, proving Bill’s need for transport; I was told that I could not, because ‘people fake letters.’ I was told I needed a ‘special form’ filled out by the doctor. She did not elaborate on how exactly this ‘special form’ would differ in any meaningful way from the letter I already had, which provides both the details of his treatment and the information necessary to contact Bill’s doctors for corroboration. She then informed me that it needed to be sent by 4 pm, because ‘we close at 4 pm,’ and needed to come directly from the doctor, ‘because people lie.’”

Self alleged the woman staffer said even if MGH sent the proper form before 4 pm, there was no guarantee of passage. When Self asked to speak to a manager, Self alleges, the woman staffer said she was a manager, and knows “more about this process than anyone else in the office,” her letter states. 

“[The female manager] informed me that even if all the appropriate documentation was provided in time,” she wrote, “there was no way I would be able to take our vehicle off the Island before 3:45 pm the next day — because if Bill was not with me, the form didn’t count. I would not be accommodated in taking our vehicle off the Island to pick him up at the hospital, because he would not be physically with me and the ‘special form’ only applies to him.”

With few other choices, Self made a 5 am reservation on the Chappy Ferry for May 12, which she said she had no trouble doing, and drove to the SSA Vineyard Haven terminal with a completed medical form. She said she had an 8:30 am appointment to pick up Gazaille that had little latitude, due to pandemic restrictions. She got to the terminal at 5:30 am, expecting to seek passage on a 6 am ferry. She learned there was no 6 am ferry at that time, and admitted this seemed to be common knowledge that had escaped her. Distraught, she said she spoke with an SSA staffer who was disrespectful to her, she alleged, by yelling and exhibiting an “adversarial mentality.”

At some point, she said, former terminal manager Richard Clark spoke with her, and was polite and respectful and told her the earliest possible ferry was 7 am, if there was space. 

Upon hearing that, Self said she hastened to Oak Bluffs, where Patriot Party Boats staff allowed her to park in a space designated for their company, and she boarded the Quickwater for Falmouth, and then took her car up to Boston. At MGH, she said, they were tardy in bringing Gazaille down due to elevator problems. Security staff had given her two minutes to park and collect Gazaille. Four minutes later, she said, three security personnel were outside her car demanding she drive away. A nurse then appeared, she said, and said Gazaille would emerge imminently. 

Sapped from a double bypass, Gazaille got in the car, and they drove to Falmouth.

Gazaille told The Times he would have much preferred being in their pickup truck in a ferry. When they arrived at the Quickwater, “I didn’t want to sit inside because I’d just come from the hospital,” he said, in reference to his concerns about possible novel coronavirus exposure. 

He sat on the stern of the vessel in the wind, which he described as “uncomfortable.”

Once in Oak Bluffs, he said, it was difficult to exit the boat, but the crew helped. “The deck hands each had an arm,” he said. 

“It was a whole lot of stress for Rachel, and it kind of ticked me off,” he said.

Gazaille, a 1973 graduate of Martha’s Vineyard High School, said he’d never had such an experience.

Gazaille later said he got a call from the SSA employee Self had spoken to originally. She “didn’t sound happy about it, but it was an apology,” he said.

Self said that the manager apologized to her too, and said she’d had a very bad day on May 11, and was “very, very, apologetic”.

In her letter, Self’s criticism of the SSA was unsparing. She leveled equal opprobrium speaking with The Times. “They definitely failed miserably,” she said. “They failed me. They failed Billy.”

Conversely, she said, the Chappy Ferry and Patriot Party Boats treated herself and her partner very well. “Patriot Party Boats saved us that day, and could not have been kinder,” she said. “They are my heroes.” 

She said she hopes the SSA will not just try to reform “a major hole in their policy” but will actually get the job of policy reform done. 

The female manager Gazaille and Self dealt with could not be reached for comment. Asked about the ordeal Gazaille and Self endured, SSA spokesman Sean Driscoll issued a statement, and declined to answer further questions on the matter. 

“We have received Ms. Self’s letter, and thank her for taking the time to communicate her concerns regarding our medical travel policy,” Driscoll stated. “Steamship Authority staff regularly assist individuals and families who have urgent medical needs, and make travel accommodations for them in accordance with our travel policies. We have assisted with a number of these instances during the current COVID-19 crisis as well, which is an especially stressful time for everyone. We are reviewing our medical travel policy and procedures, and anticipate bringing recommendations for revisions to the Port Council and board in July. Again, we thank Ms. Self for bringing this matter to our attention so we can continue to improve our service for our traveling public.”

The Port Council is slated to convene on July 1. 

Self also said she had a productive call with SSA general manager Robert Davis. She said Davis was very apologetic, and said she shouldn’t have had the experience she did. 

In a follow-up email Self shared, Davis echoed Driscoll’s statement about impending policy changes. “I have had discussions with staff to review the medical travel policy and to provide me with their thoughts,” he said. “Those ideas, along with the suggestions you provided, will form the recommendations we present to our board and Port Council at an upcoming meeting(s) for approval. I anticipate having a draft of those recommendations later this month, and would be happy to share those with you for your thoughts before requesting action by the Port Council and Board in July.” 

SSA board chair Jim Malkin emailed Self after receiving her letter. “I am very sorry to read your description of a troubling and difficult experience,” he wrote, and added an investigation and “appropriate action” would be forthcoming. 

Self replied that her conversations with Davis and the manager had been productive. She indicated the manager “agreed change is needed, and that the Steamship’s adversarial posture on this issue is not the right place to be coming from, and that the concerns for people ‘faking it’ shouldn’t ever trump the risk that someone actually might be denied desperately needed medical transportation.” 

She went on to write, “It’s always darkest before the dawn. Billy is now home, and he has been healing well, so now that the worst is behind us, we are hopeful that our experience can help others, and that we can move forward to effect the change so desperately needed on this issue (sooner rather than later). Thank you again so much for caring.”

On June 23, Gazaille said, “I just today got permission to drive again.” He went on to joke, “I don’t make a good passenger.”


  1. Driscoll says “Steamship Authority staff regularly assist individuals and families who have urgent medical needs and make travel accommodations for them in accordance with our travel policies. We have assisted with a number of these instances during the current COVID-19 crisis as well,”

    I would like for the SSA to answer 1) how many they have assisted and 2) how many of them had “fake letters? ” he then states, “We have assisted with a number of these instances during the current COVID-19 crisis as well, which is an especially stressful time for everyone.” Did Mr. Driscoll not consider the stress that medical patients and their families are dealing with when trying to get off island? Then you stress them out even more and require them to get a ssa form to a doctor, who is stressed themselves dealing with Covid 19, and fill out a form?

    This “manager” should be named and fired! You can hide behind covid 19 only so long ssa, your finances are not really covid related , just highlighted due to Covid and your policy reactions are not covid related, they’re just highlighted due to covid.

    • I had a similar experience 2 years ago, and probably dealt with the same, nasty manager. Maybe her only 2 “bad days” were when I needed help and when Rachel Self needed help. But I doubt it. I gave up on the SSA bureaucracy after the hurdles they wanted me to go through. The Patriot was my savior, too. The SSA calls itself a lifeline. I have other (unprintable) thoughts on what to call the SSA. I’m certain Rachel’s complaint is not the first. It’s not the policy, it’s the SSA manager and how she wants to twist it.

    • I do not understand why these people think that they should receive any kind of ‘special’ service from the SSA.
      There was no medical emergency, not even a medical urgency.
      He was leaving a city with the best medical services in the world for a small island with a pack and ship hospital.
      If he wanted to get home in the least time, and the least stress, he would have flown.
      I am going to guess that with a “Patriot Car” and place on Chappy that the airfare would not be a significant financial burden.

      • You’re a real piece of work…and other words come to mind! The guy has double bypass surgery, he needs to get home. He’s an Islander. Hospitals get you out the door very quick. The SSA needs to err on the side of helping people out. Full stop. For any small group that might be lying to catch a boat…karma will catch up with them. And SSA employees who live off Island they just don’t get it. Put the power trip aside and just help folks get back and forth and let compassion guide the process.

        • If you want to get home to Chappy very quick, from a Boston hospital you fly.
          Like Chappy it is only a matter of money.

      • I just had heart surgery. You could not be more wrong. Flying would have been a much more involved and exhausting ordeal for him. Being wheeled to the hospital door and put his own comfortable car with pillows and a blanket, and driven straight to the ferry and directly to Chappy without ever having to get out of the car was the perfect, most comfortable and least stressful way to go and Ms Self was absolutely correct to do it that way.
        The Steamship Authority was entirely out of line, as are your comments.

        • I use to commute, by air to Boston 2-3 days a week.
          Twice after heart surgery (stent, not open).
          I found it far less stressful than dealing with all that traffic.

          What makes you think his car is comfortable?

          As it turned out he got a car ride to Falmouth, a boat ride to the Island, and a car ride to Chappy.
          He did not die.
          Someone with a paid reservation was not bumped off the boat.

          The down side of flying between Boston and the Island is that it is so expensive.
          A place on Chappy and a ‘Patriot Car’ kind of expensive.

        • How do you know that flying to the Island after heart surgery is more stressful than by car/boat?
          Have you ever done it?
          Have you flown to the Island?
          Was it more stressful?
          Than driving and boating?

          So many people use the SSA because it provides the least cost method to get to the Island.

          If the SSA doubled their rates they could afford to provide departures every 30 minutes around the clock.
          No reservations needed.
          Just like the Staten Island Ferry.

      • “These people” are island residents who are supposed to be the entire purpose for the SSA’s existence. Having had surgery in Boston last summer, I can tell you that having to enter and exit a vehicle multiple times with fresh stitches and the risk of infection is very stressful. I can’t imagine the stress of having to worry about Covid on top of that. You need to examine your life and ask youself why you feel the need to make these moronic comments that add absolutely nothing of value to this story.

        • The SSA only reason to exist is residents?
          What about homeowners who split their time between the Vineyard and St. Barts?
          People who have a taken the same Vineyard house for the month of August for generations.
          The week renters?
          The weekenders?
          The day trippers?
          Is the the SSA responsible to all?
          Should ‘Islanders’ receive special treatments.
          Even the recently ‘washedashores’?

  2. How can this be acceptable? My God, people lie? This manager requires discipline. This is horrible.

      • I’m sure some do lie, but that’s no excuse for discourtesy, regardless of the scenario – a returning cardiac patient, a sick dog, a lost reservation – abruptness, rudeness and discourtesy should not be tolerated in ANY service capacity.

  3. This story is a shame, but I have total confidence in that employee that there exist non-negligible quantities of people who would lie or fabricate doctor letters. This story was primarily a side-effect of that tendency, not the manager on the phone or the SSA.

  4. Never heard such of bunch of nonsense in my life-the SSA just keeps on getting worse and worse-i just can’t fathom that a Manager would give such an answer -as for Bob Davis -too little-to late-would is always the case ! Mr. Driscoll just says what he is told to say– not an original though there.

  5. Their policy is confusing, but I did find the SSA helpful this winter in a medical emergency. My husband was taken by helicopter from the MV Hospital for emergency surgery in Boston and I had to follow by car (I could have taken the chopper, but I couldn’t leave the dog at home alone and I needed to pack a week’s worth of clothes to boot). So, as I quickly packed my bags and rushed out the door, I called the SSA and got a ticket on the next boat. It helped that it was winter time, so it wasn’t full, but (a) I’m sure I sounded like a maniac and (b) everyone at the SSA was very kind to me regardless. Although it wasn’t needed, I was glad that the nurse at MV Hospital had offered to call the ferry and intercede if needed. I saw the helicopter take off just as we were leaded onto the ferry and I got a call from the pilot letting me know that my husband had been safely delivered just as we were pulling in to Woods Hole. I remember very little of the manic drive from WH to the hospital, but I was able to talk to my husband for a few minutes before he was taken into the OR. If I had missed that boat and been put on the next boat, I wouldn’t have been able to have that time with him. Fortunately, the surgery was successful and everything turned out well.

    Anyway, my point is that in a medical emergency you are not always going to have time to navigate a complex policy or get a form filled out. You are going to be stressed and rushed. And, as Ms. Self can attest, the ill party may not be in the car – they could be in an ambulance or an air ambulance. Good customer service means helping folks out when they need help – and no policy is going to cover every situation.

    And lastly, eternal shame should fall on any person who makes up a story to get on the boat. I have absolutely no doubt in my mind that the SSA deals with all sorts of self-entitled people who break the rules. By crying wolf you are being selfish and hurting those who are truly in a dire situation.

  6. Disgraceful! The man had HEART SURGERY!!!
    Mr Gazaille and Ms Self should be given free passage or the rest of their lives.
    Steamship — you FAIL. ONCE AGAIN.

    • That would be Communism.
      Free, free, free.
      Oh that’s right it is not free.
      We all have to pay for it.

  7. That manager’s name should be given and has no business being a manager. She should be demoted and placed on probation or fired.

  8. i had a similar situation when one of my employees lost his site in one of his eyes. we got ahold of a eye doctor on the other side who said we needed to get him there right away. i got a letter from them for the steamship but the lady on the phone said they could not do anything unless he had a profile. i explained to them that i was using my profile and he didnt even have a drivers licence. i was told there was no way to get a medical for him without a profile number with his name on it. i asked them what they do if people are not from here or if its a kid and got no answer for that. long story short i had to get my guy to the doctor and ended up putting the medical in my name so that it matched my profile. what do people do if they dont live here? the staff on the island has always helped me when needed but the person on the phone didnt know me and didnt want to listen to reason. it can be frustrating to deal with them on the phone and they should not assume you are trying to scam them to get on. the steamship is supposed to be there for us and there are times it feels like a battle but we need to get back to a time where its about islanders and not about profit

  9. Back in 2000 my first husband had stage 4 lung cancer. The SSA knew it, and Bridget Tobin knew it. Many of you will remember Bridget, At that time, she knew most of the Islanders. Whatever reservation we needed, we got it. Quite a few years ago there were parents that got letters saying that their children needed special education so the high school would have to pay for boarding school. People always seem to push the limits. This is no excuse for rude behavior by an employee of the SSA. My suggestion would be to have someone always available to handle the medical calls as long as the boats are running. This would take it out of the hands of regular employees. Regular employees can only go by the rules. Give it a thought SSA.

    • rosigirl– yes, I remember Bridget — I have had a few medical ’emergencies” similar to Rachel’s.
      Bridget made it work. And Richard Clark is a gem. Unfortunately he is retiring soon.
      Perhaps Bridget and Richard could be consultants for new people to help them understand what the words compassion and empathy mean.

      • You want a guy who just had a double bipass to get himself to the airport, get on a plane and fly home?

        • Absolutely not.
          I expect a loved one to accompany him.
          Just like I expect a loved one to accompany him on the drive down to Falmouth Harbor.
          And get him on the Patriot, and back off the Patriot.
          Which is just what happened.
          It just took two hours longer than by air. .
          But it cost less.
          With the price of real estate on Chappy this is very important…….

          • Ajay, who on Chappy did you wrong? You keep assuming that anyone who lives on Chappy is made of money. Anyone who has a car on the other side is made of money. I sense some jealousy?? What makes you assume that because Rachel is from
            Chappy she can afford to fly to Boston, can it to the hospital, can it back to the airport etc? You obviously have issues with the financial aspect of things. Not everyone enjoys flying. SSA is a charter that is there to get people from one side to the other and back again. Its a little crazy that your so adamant that she had flown. Get over it.

  10. I had a similar issue in 2003 when my 2 year old son required surgery at Children’s Hospital in Boston. Even though I had the letter from the surgeon sent directly to the SSA I was accused of falsifying the letter because “it was 4th of July weekend.” They wouldn’t book us passage back to the island. Astounded, my uncle made the suggestion to call… can anyone guess? Yes, Bridget Tobin. And that, was that. Ms. Tobin’s (well deserved) retirement marked the end of anyone in management truly caring. It was the only time we ever called her – but it was the only time we ever really needed someone like her. I have also been “bumped” off 3 ferries in 35 years & had to take the next one off island – once for an ambulance, and twice for cars with medical reasons – I even had to back off the ferry as the last car on to accommodate someone with a doctor’s appointment – so I know it IS done. Never did I think any of them lied. I, too tried to book a reservation back to the island May 9th-11th, ending up taking the next available one on May 12th, and know that those days were booked only because they had cut the schedule in half due to “lack of demand.” The SSA should have added a least one more round trip per day – profitable or not – and remembered that there original mission is to be the “Lifeline to the Island.”

      • I would be willing to be bumped for someone who needed to get on more than me. I bet if they asked the passengers someone or many someones would have volunteered.

      • Yes, we could not afford to fly. At the time we were barely scraping by and I’m beginning to resent your derision towards hardworking Islanders. (And before we get into the question of who is and who isn’t an Islander the answer is “1642” 19th generation). And really, a 2 year old on a plane for the first time to and from surgery? As I cried on the phone to the SSA that it was “easier to book a surgery with a world renowned pediatric surgeon that it was to get on and off this island” the answer is Yes, I did not care about who was inconvenienced during a 2 year olds medical situation in the EXACT SAME WAY I did not mind (as I stated previously) being inconvenienced myself on 3 prior occasions. We never looked into flying because we needed the car to spend the night before the 8 am surgery at the cheapest hotel possible. I’d ask you if you work for the airlines and are just trying to drum up business but you’re clearly just unempathetic and I don’t really think anything you’ll respond with will be anything other than blustering. Perhaps you don’t realize that… flights in and out of Logan for the 2 weeks prior to May 11th were experiencing severe delays so this was not an option for Billy to fly even if he chose to expose himself to Logan and the buses/subway/taxis necessary to travel to and from the hospital AFTER OPEN HEART SURGERY. Your comments Ajay, on my comment and the others in this article, are just ludicrous…

        • Hard working, successful Islanders can afford to fly.

          1642, wow you go way back.
          How many of your parents, grandparents and great grandparents were born on the Island?
          Do both of your parents have to be born on the Island for you to be an “Islander”

          My older son was born on the Vineyard and grew up in Gosnold.
          Is he an Islander?
          Which Island?

          My younger son was born and grew up in Gosnold.
          He thinks islands suck.
          Is he an Islander?

          Speaking of hard working Islanders when did billy wash ashore?

        • Plenty of kids under two fly hundreds if not thousands of miles to and from surgery (think Angel Flights).

          “We never looked into flying because we needed the car to spend the night before the 8 am surgery at the cheapest hotel possible.”
          Plenty easy to rent a car at Logan.
          When you say a cheap hotel do you mean Vineyard cheap?

      • I know people who are so terrified of flying they would have a heart attack in a plane. It may be an unrealistic fear but it is a real fear, I have a family member who is so terrified of flying this person has asked the family to make sure to never use an airplane in any way if in medical distress. Not everyone who refuses to fly is a cheap person. I thought that comment was needlessly cruel.

      • I just found out that Cape Air was down to 2 flights per day during this time period – so flying would hardly be realistic alternative for Billy or Rachel in trying to accommodate a schedule relying on a hospital release time.

        • Cape Air does not fly empty airplanes except for maintenance and repositioning purposes.
          They adjusted their schedules to meet their demand.
          Just like the SSA.

          Billy needed just one flight.
          Did he find the times to be inconvenient?

          Generally speaking hospitals do not have rigid release times.
          +/- a few hours is not a problem.

  11. Rich Saltzberg, thank you for the story, but why protect the staffer/manager’s name? We learned the manager was female from your story, but doesn’t she have a name? Working as a manager as a quasi public agency gives her no right to have her name hidden from the public. It only encourages repeat performances. The MV Times is not going to mention my name any way, why change my behavior?

    • View- the only reason you need to know the person’s name is that you WANT to know, it doesn’t change what happened. I’m sure internal SSA office people know exactly who this person is. It’s not a public office, it’s a private job. The only reason you want to know the name is to make this person some sort of public humiliation.

    • You think that the SSA should be required to make unprofitable trips?
      You think that any SSA deficit should be paid by the Island real estate taxpayers.
      On that basis maybe that extra trip isn’t really necessary…..

    • I understand not identifying the employee at this particular time; but I do wonder why the phrase “female manager” was used repeatedly in this article.

      • Agreed, if you aren’t naming the person, the sex isn’t important in this scenario unless you are including it in the original quote of “I spoke with a woman on the phone.” After that it is extraneous.
        I’ve never seen a repeated reference to “a male manager” when there is no possible confusion in the story because everyone else is named.

  12. Imagine if we had the capability for heart surgery at our hospital. It would be a dream come true.

  13. Billy’s a nice guy who finished last. The SSA staff had a bad day. Quite the opposite of when Bridget was in charge. Her nature is to help anyone having the worse day of their life. Her personal comfort was lost that day at Billy’s expense. Shouldn’t happen. The moral of Billy’s ordeal is that kindness matters. Get well soon Billy, hope you’re feeling better. Next time take The Bridget Tobin Bridge/Tunnel.

  14. As I write this there have been 59 comments on this article. 21 of them by Ajay, more than 1/3 of the total comments. Is there a mute or block feature the Times might consider adopting?

  15. Ajay, your replies to KMMW’s personal experience are way out of line.

    Speaking of, no one who’s had heart surgery and is high risk should be expected to fly during a pandemic.

    Try being a little more understanding.

    • Pandemic is the reason to fly.
      Least exposure.
      Fly direct from the roof of the hospital to the house on Chappy.
      35-40 minutes.

  16. The Times might consider the content in place of the number of comments.
    No one is obligated to read my comments.
    Every computer has multiple mute and block button features.
    You must know a bored middle schooler, if you can not figure it out on your own. . .

  17. Since Bridget Tobin left there is no one competent left at the SSA.
    It should be disbanded and it’s equipment sold off.
    Return the proceeds to Island taxpayers.
    Entrepreneurs can provide cheaper and better service.
    Like they did before the monster SSA was created.
    Won’t that be fun.
    Make the Island Great Again.

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