My husband and I moved from New Jersey to rural West Virginia. Healthcare access is so bad we moved back to New Jersey.
Courtesy of Jess Rinker
- Jess Rinker moved to rural West Virginia in 2019.
- Her husband was diagnosed with cancer in January 2023.
- His appointments were 90 minutes away from their house.
This as-told-to essay is based on a conversation with Jess Rinker. It has been edited for length and clarity.
Nature has always been important in my life — so important that I've written children's books that are heavily focused on the natural world. My husband, Joe, and I love to hike and be surrounded by mountains. In 2019, we moved from our home in New Jersey to a rural area in West Virginia.
Our cabin there became a sanctuary for us. We lived on eight acres, up a dirt road. We grew our own vegetables and cut trails into the forest. During the winter, we heated using a wood stove.
It was bliss until Joe was diagnosed with stage IV esophageal cancer. The news came entirely out of the blue — he had no risk factors that might explain this. But amid the terror of that diagnosis, I immediately knew we needed to give up our rural home.
Joe's appointments were 90 minutes away from our home
Our town had a tiny, 25-bed hospital that was about the size of a grocery store. But to get cancer treatment, Joe needed to see doctors that were 90 minutes away. I was terrified of driving through West Virginia's mountain roads in bad weather. Even worse, I worried that if there were a medical emergency at home, no ambulance would be able to get up our dirt road.
The medical system can be challenging anywhere. But it's even more so in rural areas. Rural America holds 20% of the population but only 11% of doctors. Specialists like the doctors who would treat Joe's cancer are even less likely to practice in rural regions.
After Joe's diagnosis, his doctors said he needed eight weeks of daily radiation. I would need to drive him to and from those appointments, spending three hours each day on mountain roads. It seemed impossible.
I was grateful for resources but still overwhelmed
Luckily, our friends and family were able to help. They crowdfunded enough money for Joe and me to stay at a hotel near the hospital. I was so grateful. After a long day of radiation, I couldn't imagine Joe needing to endure a mountainous car ride. I knew that many rural Americans — who have higher poverty rates than their urban counterparts — wouldn't have a network of people with the resources to help them financially.
Having access to cancer treatment is a blessing. But people don't realize the effort that it takes to get to treatment. There's the physical toll, of course. There's also a financial toll (payments for gas, hotels, and food) and the time of the caregiver. While I helped Joe through treatment, there was no way I could have held a full-time job.
Some days, I didn't know where to find the motivation to keep going. But I knew it had to be done, so I did it. A mentor from Cancer Hope Network, a peer support community, helped me focus on what was most important, from securing hotel discounts to finding great doctors. That guidance was helpful and grounding when things felt overwhelming.
We moved back to New Jersey
Even with all our support, it wasn't feasible to stay in West Virginia. I knew that we couldn't spend another winter in the cabin. We would be too far from Joe's care team, and I couldn't physically take care of the homestead — chopping wood and cutting fallen trees — without Joe's help.
So, we moved back to New Jersey into my dad's basement. Leaving our home was another loss, but it's what we need to do to get Joe the best care possible. Luckily, we're very adaptable people. We're taking on this new normal together, even if we do not know what the future will bring.
Joe has more good days than bad at this stage. I do, too. We listed our little house in the mountains, but it didn't sell, so now we're renting it out. I still have a pipe dream of being able to keep our sanctuary, but I know that's unlikely. I'm grateful that when rural life was standing in the way of Joe's care, we had the privilege and means to leave.