What started as a vacation turned into an idea and, eventually, a whole new job.
That was the path taken by Dr. Eric Grigsby, a certified pain management doctor in Napa, California, who opened The Spine and Pain Center of Kauai.
Ten years ago, he and his wife first vacationed on Kauai. “Like so many people do,” Grigsby said.
But it didn’t take long for the conversation with his wife, a dentist, to turn to health care — even on a getaway. They run a family foundation called Health Roots that helps underserved areas.
Kauai, beautiful but isolated, had room to expand its health care services — especially specialized practices.
“Kauai is by no means a developing country but there are certainly some areas in medicine that are not represented here,” he said.
Around three years ago, he began turning the idea into reality with support from several people in the health care field already here.
“An unusual string of really good events,” Grigsby called it.
Last year, the center opened at 3176 Poipu Road in Koloa. It’s served 1,000 patient referrals in 14 months.
The center manages chronic pain for cancer and non-cancer patients, including spine ailments and neurological conditions like migraines, as well as end-of-life care. They use four main strategies: act like a primary care doctor and refer patients out; manage opiates; issue injections; or implement pain management devices into their patients.
Grigsby, who trained at the Mayo Clinic, splits his time between Kauai and Northern California. But he recently hired Dr. Dawn Sparks, a board-certified anesthesiologist and pain management doctor trained at the renowned Cleveland Clinic, to work at the center full time.
“I’d certainly like to help the community and help everyone who’s dealing with pain and feeling kind of out of sorts,” Sparks said about her goal helping run the office. “I want them to feel like they have somewhere to go and someone will listen and hopefully, let them get better.”
Last week, Grigsby sat down with The Garden Island to introduce Sparks and talk about the world of specialized medicine.
How did you figure out that there was such a need for specialized pain management care?
Honestly, just talking to people. I was lucky that Kathy Clark, who is the former CEO of the hospital here, she and I had nice conversations around the community needs, so she helped me get the basics. Several of the doctors here on the island were very generous with their time, trying to help me understand, could we be some benefit and how. It’s just been kind of an information collecting thing. It took about two years for me to really understand we could be successful here and contribute to the community.
But how did it begin? It started with a vacation?
Yeah, like a lot of people do.
But I imagine at first, while on vacation, you didn’t want to talk medicine, you wanted to relax. How did that trickle happen?
Well, we always talk medicine, my wife and I do. We have a family foundation called Health Roots. And so we’ve traveled all over this world and a lot of what we do is try to understand if there are opportunities for our foundation or for us personally to contribute in some way. We’ve done a lot of work on the African continent, we still have some projects in a little country called Malawi over there. We have a busy project with the UC Berkeley School of Public Health, hoping to stimulate development of technologies for use in the developing world. So we’re always thinking about it like that. And to be honest, Kauai was this great combination of a place we really loved and enjoyed being on a personal level but also had a need for the service.
So that’s what drove us to to begin thinking about it. And then it got to be one night my wife and I are sitting at the table and we said, “All right, we’re gonna do it.” And then of course once you say it, you have to do it.
Is that the rule?
That’s the rule. So then we were off and we started planning it.
How long of a process was that?
About three years ago we started the thought pattern.
Two years ago, in July of ‘13, we really started to investigate the community, and that’s when I started trying to meet with as many people as I could and really understand the nature of the community, socially, medially, economically, where the holes were and see if there was a pain practice that we could develop here. And then a year and two months ago, we opened the doors. July 20, ‘14. And it’s been an incredible journey. We’ve benefited from the help of so many people on the island and the reception we’ve gotten. I have to say, I mean, I tell my wife, it’s been a little bit of a charmed project from the get-go.
How much time do you spend on island?
I’ve been here two weeks a month for about a year. It became clear really quickly, like the first month (there was a need).
Do you feel like you live here?
I do feel like I live here, but in a good way. We love the community. … It’s been a really incredibly productive year, it seems to me. And it’s abundantly clear that we’re doing a good service.
You can imagine the nature of Kauai as an outer island and the farthest away, is that if you have a really bad pain or cancer, about the last thing you want to do is get on an airplane and spend all day and night going from here to Honolulu to visit with a doctor for a few minutes and then get some treatment that’s going to require you go back there anyway.
I can’t imagine anything worse.
It’s impossible, right? It’s hard financially, it’s hard medically. Kauai is a small town, basically, and nobody wants to go to Honolulu and sit on the H1.
We felt it was not fair. It was just not right.
What are the patients like? Pain is a very serious topic. How bad do you have to be?
We treat a real range. We saw a number of patients this week who just had a backache and sciatica; it’s bad, but it’s mainly fairly new. So they had questions like,”Do I need surgery?”
On the other end of the spectrum, we also see people who have had a life-changing problem. For example, a paraplegic or spinal cord injury that has pain and they have had two or three back surgeries and have a lot of misery and are taking some medicines and can’t get out of the house.
And then of course the end-of-life challenges are their own situation. But I want to spend a little time on pain medicine.
Kauai’s had a surge of difficulty with pain pills. And I think all the clinicians on the island who have been here for a little while realize. Eight or nine years ago, I believe that there was a physician who came from Florida and he was the biggest Oxycontin prescriber in Florida … and unfortunately opened up an office on Kauai and began basically selling prescriptions … he’s since gone to the prison.
The doctors that preceded me on island did an excellent job trying to get a rope around this and say, “Wait, this is not what pain management is.”
So we came into this situation where people had a little skepticism. … But we tried to carve out a whole different type of situation.
Is it difficult always working with patients who are suffering?
It is, on balance, an incredibly satisfying career, just to be really honest. There’s a common thread that most of our patients have. They’ve had, I don’t want to say bad luck, but they haven’t had the best outcome sometimes with their interactions with the health system despite the best efforts of everybody involved. They had a surgeon, for example, who did a good operation but it didn’t result in pain relief. Then they feel let-down. Then the surgeon says, “I don’t think there’s another surgery to help you.” And the patient hears, “There’s nothing else that can be done for you.” So our patients commonly feel disenfranchised.
One of the most satisfying things, and the most important thing we do, is give them a place where we’re going to look into it. We believe they have pain.
Where do you see yourself in the next year or so?
The most important thing that’s happened to us lately is that Dr. Sparks started at our practice about 10 days ago and she lives on the island full-time.
Dr. Sparks: “I really want to be able to help the community and help with all kinds of pain, whatever it is.”
With a population around 67,000, isn’t it normal not to have specialized health care?
It is normal. And Napa, for example is a town of 70,000 people. The difference is it’s a 45-minute drive from a 1,000-bed hospital with every kind of medical specialty. The challenge of being on Kauai is that it’s expensive, and difficult and culturally unfamiliar for a lot of our local Kauai community to go to Honolulu and it’s even more expensive and difficult to go to the Mainland for basic health care.
The more you can do locally, the better, the more acceptance and the more you will penetrate the need.