My husband and I moved from New Jersey to rural West Virginia. Access to health care is so poor that we returned to New Jersey.

• Jess Rinker moved to rural West Virginia in 2019.

• In January 2023, her husband was diagnosed with cancer.

• His appointments were 90 minutes from her house.

This 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 wrote Children’s book that focus heavily on nature. My husband Joe and I love it Hike and be surrounded by mountains. In 2019 we moved from our home New Jersey in a rural area West Virginia.

Our cabin it became a sanctuary for us. We lived on an eight-acre property on a dirt road. We grew our own vegetables and made paths into the forest. In winter we heated with a wood stove.

It was a stroke of luck until Joe was diagnosed with stage IV esophageal cancer. The news came completely out of the blue – he had no risk factors that could explain it. But amid the horror of this diagnosis, I immediately realized that we would have to abandon our rural home.

Joe’s appointments were 90 minutes from our home

There was a small 25-bed hospital in our town that was about the size of a grocery store. But to get cancer treatment, Joe had to visit doctors 90 minutes away. I was terrified of driving through the mountain roads of West Virginia in bad weather. Even worse, I feared that if there was a medical emergency at home, no ambulance would be able to get up our dirt road.

The medical system can be challenging anywhere. But in rural areas it is even more so. However, only 20% of the population lives in rural America 11% of doctors. Specialists like the doctors who would treat Joe’s cancer are even less likely to practice in rural areas.

After Joe’s diagnosis, his doctors said he would need daily radiation for eight weeks. I had to drive him to and from these appointments and spend three hours on mountain roads every day. It seemed impossible.

I was grateful for the resources, but still overwhelmed

Luckily our friends and family were able to help. They raised enough money for Joe and I to stay in a hotel near the hospital. I was so grateful. I couldn’t imagine Joe having to endure a car ride through the mountains after a long day of radiation. I knew many rural Americans did this higher poverty rates than their urban counterparts – would not have a network of people with the resources to help them financially.

Access to cancer treatment is a blessing. However, people do not realize how stressful it is to get treatment. There is of course the physical toll. There are also financial burdens (payments for gas, hotels and food) and the caregiver’s time. Even though I helped Joe with treatment, there was no way I would have been able to hold down 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, has helped me focus on what matters most, from securing hotel discounts to finding good doctors. This guidance was helpful and grounding when things felt overwhelming.

We moved back to New Jersey

Despite all our support, it was not possible to remain in West Virginia. I knew we couldn’t spend another winter in the cabin. We would be too far away from Joe’s care team and I wouldn’t be able to physically take care of the homestead – chopping wood and clearing downed trees – without Joe’s help.

So we moved back to New Jersey to my dad’s basement. Leaving our home was another loss, but this is what we must do to give Joe the best care possible. Luckily, we are very adaptable people. We embrace this new normal together, even if we don’t know what the future will bring.

Joe has more good days than bad at this point. Me too. We listed our little house in the mountains, but it didn’t sell, so we’re renting it out now. I still have a pipe dream of being able to keep our sanctuary, but I know that’s unlikely. I am grateful that we had the privilege and means to leave when rural life got in the way of Joe’s care.

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