The town of Pine Apple lies about 20 minutes off I-65 South tucked in the southeast corner of Wilcox County along Alabama's Black Belt. Driving through this farming community, you notice the picturesque countryside dotted with the occasional farm house and antebellum home. This is an old community with a population of around 150 residents.
However, Pine Apple is nestled into one of the poorest counties in the country with a population of about 12,000 residents and few physicians to make the rounds. Roseanne Cook, MD is one of a handful of physicians serving the county. The Pine Apple Clinic is a community health center with its business center in Selma. The clinic receives some federal funding, and Dr. Cook has taken care of patients there since 1986. The clinic isn't the average medical clinic, and Cook isn't the average rural physician.
Dr. Cook is a Roman Catholic nun, a sister of St. Joseph out of St. Louis, MO.
In 1979 working as a biology professor, Cook said she felt her life had another mission. So, at age 40, she entered medical school, and her life's work was about to fully take shape with the intent of delving even deeper into her ability to help our country's poor residents.
"I loved teaching, but I knew the Lord wanted me to do more. When I first went to my major superior about going to medical school, I wasn't sure what that answer would be." she said with a laugh. "The answer was if it's the Lord's inspiration, you'll get in, if not, you won't get in. And, I got in at age 40 - the age of most of my student colleagues' mothers."
After medical school, Cook had planned to follow her order to Peru, but the nurse practitioner from her order was already in Pine Apple and convinced her to come to Wilcox County instead to join the practice.
Now as a family physician serving several counties, she has her hands full with patients. But she and her staff always make the best of the situation.
"I've been in this area since 1986, and it's poverty stricken. Actually it's beyond poverty stricken," Cook said. "These residents work hard, and because they work, they don't qualify for Medicaid or subsidies, so we do everything we can to make their lives a little better."
The median income for a household in Wilcox county is around $16,646, and the median income for a family is about $22,200. According to the last census, about 36 percent of families of the population were below the poverty line, including 32 percent of those age 65 or over.
Dr. Cook's clinic is a small community unto itself and eagerly accepts donations to continue some of the services the surrounding residents have come to depend upon. The medical clinic building is flanked by an adult care building and learning center building. At the end of the square lies a thrift store-style facility. Unfortunately, due to lack of funding, the adult care and learning center has closed. Yet, the medical clinic building almost doubled in size due to a private donation in 1991.
"We do the best we can with what we have," Cook said. "Sometimes we have more. Sometimes less. But we always make it work."
Working in a rural setting presents unique challenges for any physician. But in 2001, Cook was faced with one of her most challenging moments when she stopped to help a vehicle of stranded motorists just outside of town.
She was on her way to the clinic when she spotted the car on the side of the road. It needed a jump, so she pulled up and got out of her vehicle with her jumper cables. Ready to deliver roadside aide, Cook wasn't prepared for what happened next.
She was knocked unconscious and tossed into the trunk of her vehicle. Driven down a desolate road deep into the county and only partially conscious, she wasn't sure what was happening until shots were fired into the trunk. Five shots rang out. Four missed. One grazed her cheek.
"God didn't want me to die that day," she said. Today, she can look back on the incident with an ease that she surely didn't have 15 years ago. It's part of her character, woven into every fiber of her soul that keeps her soldiering on every day to treat the patients she's grown to call members of her extended family.
And...she still makes the occasional house call.