When Austin, Indiana, made national headlines in 2015 William Cooke was the only doctor in the tiny town of Scott County for his HIV outbreak. In his new book Canary in the coal mineHe describes the opioid addiction and needle sharing that led to the crisis. And he hopes to make us aware of the consequences of a phenomenon that is now national.
“It’s supposed to be a warning,” says Cooke of the book that was written with Laura Ungar. “Across America there are racial and socio-economic fault lines. We need to see them to fix them. “As the Austin public health crisis deepened, Cooke’s small family health practice was brought to the national stage. Canary in the Coal Mine is a report on how Cooke learned to better serve his patients, including a meeting with the then government. Mike Pence, whom Cooke implored to legalize a needle exchange program. The book highlights people whose lives have been changed by drug addiction and poverty. Some suffer from a lack of routine care with treatable diseases beyond help. Almost everyone carries the shame and stigma of using drugs, trapped in an addiction cycle that they cannot break on their own.
Cooke, who grew up in New Albany and Jeffersonville, is the same age as Ryan White, their birthdays a day apart. White’s HIV diagnosis, evasion from the community, and death in 1990 all impacted the way Cooke thinks about patient care. “Given the stigma and backlash in the community, it really impressed me as a Christian,” says Cooke. “I’ve always felt that compassion is needed to make people feel safe and connected. I see my role as listening to people, reshaping their story so they don’t feel so helpless or bullied – playing an active role in their own story. “His parents, Carolyn and Bill Cooke, were his role models for perseverance. Both attended IU Southeast as children, where his father studied psychology and his mother studied nursing. His mother, who dropped out of high school at 16, retired and quit at 24. She became a doctor and now practices medicine alongside her son in Austin.
Although progress has been made in Cooke’s small town, the challenges posed by COVID-19 have made life difficult for the already vulnerable population there. During the initial lockdown, visits to virtual clinics helped, but not for those who lacked internet access and apartment security. The clinic delivered food and medicine to patients and checked in over the phone. In 2015, isolation was a factor for many Austin opioid addicts. Quarantined during 2020, many fell behind. Now, in another difficult time, Cooke’s beliefs see him through. “I don’t think there is an alternative,” he says. “I’ve failed over and over again. I tell patients and my children, the only time you really fail is when you refuse to get up. “