It’s unusual to find a doctor like Dr. Lara Kenney practicing in such a small town.
She works in Leeton, a town of about 500 people in west-central Missouri, about an hour south of Kansas City. She’s a cancer doctor, specializing in hematology, oncology and hospice and palliative care, but she also treats people in nearby counties who just need to see a physician.
About a month ago, patients started calling her about COVID-19. Maybe they had symptoms, a positive test result or just questions after a close exposure. The calls multiplied by the day. A week later, the adjacent county reported a 30% positivity rate.
“It was like dominoes,” she said.
She wasn’t prepared for what happened next, even though the community is familiar to her.
Kenney grew up in rural Oregon and came to Missouri for medical school. After graduating, she enlisted in the U.S. Army, completed her residency at Fort Sam Houston and was deployed to Iraq multiple times as a medical officer. Kenney came back to Missouri for her specialized cancer training. It’s where she met and married her husband, who had grown up in rural Clinton.
In 2014, they left the suburbs of Kansas City and moved back to his hometown, where they wanted to raise their kids and lay down their roots.
Working in such a small town, Kenney knows all the patients in her practice well. Two of them have died of the coronavirus.
“Neither one was in a condition that I would expect them to pass,” she said, adding that they’d been living independently, not “limping along.” They had to be sent to hospitals in Kansas City, where they suffered for weeks, alone.
“I’m a cancer doctor,” she said. “We deal with death on a fairly regular basis; it’s part of our job. But we didn’t plan on it being like this.”
Normally, she would hug her patients when they entered hospice. She would hold their hands. Tell their adult children how much their mom or dad meant to her.
“All of that has been ripped away,” she said.
Instead, Kenney hears comments in her town about how the people who are dying were old, or sick, or going to die anyway. She hears people say, “I gotta live my life” as they continue to attend weddings and social events.
“I’m working my butt off here trying to help people, but I guess ...,” her voice trailed off. “I don’t even know what to say anymore.”
She has said plenty to patients who tell her the virus isn’t a big deal. She asks them: Why would doctors be worrying about it if it wasn’t worth worrying about? They don’t have answers when she challenges them.
Kenney says she’s not really surprised that she hasn’t been able to change many minds, even in a place where people know and trust her.
“We’re nine months into this thing,” she said. “For someone to look back and say they were wrong would mean (acknowledging) they have contributed to someone they love getting ill or even dying. To accept that their behaviors may have changed things for our community.
“We’re pretty far down the rabbit hole for people to change their minds without having a serious reckoning with themselves about the choices they made.”
It also means having to question the people they trusted who misled or lied to them. She said she’s been astounded by the failures in leadership during this crisis. Her military and medical training, combined with what she’s seeing happen on the ground, prompted her to make a personal plea to Missouri Gov. Mike Parson:
“As disappointed as I am in the failure up to this point to do the hard things that are required of a leader, the time to do something is now,” she said, adding that there are no negative consequences to issuing a statewide mandatory mask order. “To not do something so simple is mind-boggling.”
Given Kenney’s rural background, you might think Parson would listen to her; he tends to listen to people in rural Missouri, who have been vocal in their opposition to mandatory masking.
Some of her patients assure her they are being careful but then mention doing things like attending church services, picking up grandkids from school and gathering with others. On more than one occasion, she’s had to send an ambulance to a coronavirus patient’s home multiple times before they agree to go to a hospital. One of her patients had a stroke and had to wait for hours in a packed ER before getting treated.
“This is not a normal standard of care,” she said.
The reaction in her community and the state she’s adopted has her questioning her place here.
She and her husband have discussed moving out of the state once this pandemic is over — leaving their dream house and the schools where their children are growing up — and finding a place where she feels her work is more valued, her sacrifices appreciated.
“Knowing that there’s a large percentage in my community that doesn’t respect my concerns or knowledge ... you can’t unsee that,” she said.