After 24 years of driving veterans to their medical appointments, Jeff Snow knows pretty much every back road in Vermont and most of New Hampshire.
"When it comes to remembering street names, I just automatically go to them now," Snow said as drives toward the border between the two states.
Snow manages a fleet of 14 vans for Disabled Veterans of America. As in many parts of the country, DAV operates a volunteer shuttle service that runs regular trips to Vermont’s only Department of Veterans Affairs hospital and to local outpatient clinics.
"Some of our vans have put on 200 miles just getting here," he said, "and they do go out the back roads."
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On a recent morning, Snow picked up veteran John Scherer from his dialysis appointment in Lebanon, N.H. The appointment was in a tucked-away office plaza, where Sherer had been receiving treatment for the previous few hours.
Sherer's a matter-of fact-guy who served in the Army in the late sixties. As he's gotten older, he's had some serious health issues.
"I'm in stage five kidney failure," Sherer said as he got into the car. "Kidneys are not cleaning out the bloodstream."
Sherer needs dialysis three times a week. But living in small-town Vermont makes it hard for him to get to treatment. Vision problems prevent him from driving, and there's limited public transportation. Dialysis starts early in the morning, so he takes a taxi to get there.
"I have to be there at 6:00, and let's face it, nothing's running," Sherer said. "So a taxi fare from my house is $20 a day or $60 a week."
DAV volunteers pick him up when he's done with his appointment, and that saves him the taxi fare for the trip back home.
It's not a perfect solution - but it helps.
Even with long drives, many vets prefer VA doctors
Robert Burke, director of the Vermont Office of Veterans Affairs, said a lot of the state's veterans rely on the VA's Choice Program. It allows veterans who live more than forty miles from the nearest VA hospital to get care in their community. The VA then reimburses their healthcare provider.
But Burke said participating providers often have long wait times, so a lot of vets opt to travel to the VA hospital in White River Junction, Vt. instead.
That can be hard, he said, especially for veterans who live near the Canadian border.
"You can't go to Canada for your healthcare," Burke said. "You have to go south."
But Burke said one advantage is that Vermont is a lot smaller than many other rural states. You can drive from one end to the other in about three and a half hours.
"It's a long way," he said, "but if you're getting good care, you'll do it a couple of times a month."
Sherer is familiar with those long drives. He used to live in Bethlehem, N.H., about 90 miles from the VA hospital. He remembers the first time he used the DAV van service back in 2001. He was really sick, and he didn't know why.
"I got into the van; I could barely walk," Sherer said.
A volunteer driver hightailed it from his house to the hospital, but it still took more than an hour to get there. Sherer was rushed into the emergency room.
"I was in the last stages of congestive heart failure," he said. "So if it wasn't for the DAV services you wouldn't be talking with me today."
