by David Brooks
He had a good many years at his new company, he said. It was an extraordinarily creative place. He was part of decision making at the highest level. “Every employee from technician to manager was hot for the new, exciting stuff,” he went on. “So, as far as buzz and daily environment, it was far and away the most fun I’ve ever had.” But it wasn’t perfect. “I remember I called in the head marketing guy and I said, ‘I want you to give me all the information you can come up with on when people buy one of our products—what software do they buy, what business are they in—so I can see the model of how people are using the machines.’ He looked at me and said, ‘I have no idea about that.’” Where was the rigor? Then Starkweather had a scheme for hooking up a high-resolution display to one of his new company’s computers. “I got it running and brought it into management and said, ‘Why don’t we show this at the tech expo in San Francisco? You’ll be able to rule the world.’ They said, ‘I don’t know. We don’t have room for it.’ It was that sort of thing. It was like me saying I’ve discovered a gold mine and you saying we can’t afford a shovel.”
He shrugged a little wearily. It was ever thus. The innovator says go. The company says stop—and maybe the only lesson of the legend of Xerox PARC is that what happened there happens, in one way or another, everywhere. By the way, the man who hired Gary Starkweather away to the company that couldn’t afford a shovel? His name was Steve Jobs.
PETER HESSLER
Dr. Don
FROM The New Yorker
IN THE SOUTHWESTERN CORNER of Colorado, where the Uncompahgre Plateau descends through spruce forest and scrubland toward the Utah border, there is a region of more than four thousand square miles which has no hospitals, no department stores, and only one pharmacy. The pharmacist is Don Colcord, who lives in the town of Nucla. More than a century ago, Nucla was founded by idealists who hoped their community would become the “center of Socialistic government for the world.” But these days it feels like the edge of the earth. Highway 97 dead-ends at the top of Main Street; the population is around seven hundred and falling. The nearest traffic light is an hour and a half away. When old ranching couples drive their pickups into Nucla, the wives leave the passenger’s side empty and sit in the middle of the front seat, close enough to touch their husbands. It’s as if something about the landscape—those endless hills, that vacant sky—makes a person appreciate the intimacy of a Ford F-150 cab.
Don Colcord has owned Nucla’s Apothecary Shoppe for more than thirty years. In the past, such stores played a key role in American rural health care, and this region had three more pharmacies, but all of them have closed. Some people drive eighty miles just to visit the Apothecary Shoppe. It consists of a few rows of grocery shelves, a gift-card rack, a Pepsi fountain, and a diabetes section, which is decorated with the mounted heads of two mule deer and an antelope. Next to the game heads is the pharmacist’s counter. Customers don’t line up at a discreet distance, the way city folk do; in Nucla they crowd the counter and talk loudly about health problems.
“What have you heard about sticking your head in a beehive?” This on a Tuesday afternoon, from a heavyset man suffering from arthritis and an acute desire to find low-cost treatment.
“It’s been used, progressive bee-sting therapy,” Don says. “When you get stung, your body produces cortisol. It reduces swelling, but it goes away. And you don’t know when you’re going to have that one reaction and go into anaphylactic shock and maybe drop dead. It’s highly risky. You don’t know where that bee has been. You don’t know what proteins it’s been getting.”
“You’re a helpful guy. Thank you.”
“I would recommend hyaluronic acid. It’s kind of expensive, about twenty-five dollars a month. But it works for some people. They make it out of rooster combs.”
Somebody else asks about decongestants; a young woman inquires about the risk of birth defects while using a collagen stimulator. A preacher from the Abundant Life Church asks about drugs for a paralyzed vocal cord. (“When I do a sermon, it needs to last for thirty minutes.”) Others stop by just to chat. Don, in addition to being the only pharmacist, is probably the most talkative and friendly person within four thousand square miles. The first time I visited his counter, he asked about my family, and I mentioned my newborn twin daughters. He filled a jar with thick brown ointment that he had recently compounded. “It’s tincture of benzoin,” he said. “Rodeo cowboys use it while riding a bull or a bronc. They put it on their hands; it makes the hands tacky. It’s a respiratory stimulant, mostly used in wound care. You won’t find anything better for diaper rash.”
Don Colcord was born in Nucla, and he has spent all of his sixty years in Colorado, where community-minded individuals often develop some qualities that may seem contradictory. Don sells cigarettes at his pharmacy, because he believes that people have the right to do unhealthy things. He votes Democratic, a rarity in this region. He listens to Bocelli and drives a Lexus. At Easter, the Colcord family tradition is to dye eggs, line them up in a pasture, and fire away with a 25-06 Remington. A loyal NRA member, Don describes shooting as essentially peaceful. “Your arm moves up and down every time you breathe, so you control your breathing,” he says. “It’s very similar to meditation.” He was once the star marksman of the University of Colorado’s rifle team, and for many years he held a range record for standing shooting at the Air Force Academy.
Calmness is one reason that he has such influence in the community. He’s short and slight, with owlish glasses, and he seems as comfortable talking to women as to men. “It’s like Don looks you in the eye and the rest of the world disappears,” one local tells me. Faith in Don’s judgment is all but absolute. People sometimes telephone him at two o’clock in the morning, describe their symptoms, and ask if they should call an ambulance for the two-hour trip to the nearest hospital. Occasionally, they show up at his house. A few years ago, a Mexican immigrant family had an eight-year-old son who was sick; twice they visited a clinic in another community, where they were told that the boy was dehydrated. But the child didn’t improve, and finally all eight family members showed up one evening in Don’s driveway. He did a quick evaluation—the boy’s belly was distended and felt hot to the touch. He told the parents to take him to the emergency room. They went to the nearest hospital, in Montrose, where the staff diagnosed severe brucellosis and immediately evacuated the boy on a plane to Denver. He spent two weeks in the ICU before making a complete recovery. One of the Denver doctors told Don that the boy would have died if they had waited any longer to get him to a hospital.
At the Apothecary Shoppe, Don never wears a white coat. He takes people’s blood pressure, and he often gives injections; if it has to be done in the backside, he escorts the customer into the bathroom for privacy. Elderly folks refer to him as “Dr. Don,” although he has no medical degree and discourages people from using this title. He doesn’t wear a name tag. “I wear old Levi’s,” he says. “People want to talk to somebody who looks like them, talks like them, is part of the community. I know a lot of pharmacists wear a coat because it makes you look more professional. But it’s different here.” He would rather be known as a druggist. “A druggist is the guy who repairs your watch and your glasses,” he explains. “A pharmacist is the guy who works at Walmart.”
He keeps watch-repair tools behind the counter, and he uses them almost as frequently as he complains about Walmart, insurance companies, and Medicare Part D. Since 2006, the program has provided prescription drug coverage for the elderly and disabled, ensuring that millions of people get their medication. But it’s also had the unintended effect of driving rural pharmacies out of business. Instead of establishing a national formulary with standard drug prices, the way many countries do, the U.S. government allows private insurance plans to negotiate with drug providers. Big chains and mail-order pharmacies receive much better rates than independent stores, because of volume. Within the first two years of the program, more than five hundred rural pharmacies we
nt out of business. Don gives the example of a local customer who needs Humira for rheumatoid arthritis. The insurance company reimburses $1,721.83 for a month’s supply, but Don pays $1,765.23 for the drug. “I lose $43.40 every time I fill it, once a month,” he says. Don’s customer doesn’t like using mail-order pharmacies; he worries about missing a delivery, and he wants to be able to ask a pharmacist questions face-to-face. “I like the guy,” Don says. “So I keep doing it.” Don’s margins have grown so small that on three occasions he has had to put his savings into the Apothecary Shoppe in order to keep the doors open.
He is, by the strictest definition, a bad businessman. If a customer can’t pay, Don often rings up the order anyway and tapes the receipt to the inside wall above his counter. “This one said he was covered by insurance, but it wasn’t,” he explains, pointing at a slip of paper on a wall full of them. “This one said he’ll be in on Tuesday. This one is a patient who is going on an extended vacation.” Most of his customers simply don’t have the money. Each year, Don writes off between $10,000 and $20,000, and he estimates that he is owed around $300,000 in total. His annual salary is $65,000. Over the course of many days at the Apothecary Shoppe, I never saw a customer walk in whom Don doesn’t know by name.
“It’s just a cost of doing business in a small town,” he says. “I don’t know how you can look your neighbor in the eye and say, ‘I know you’re having a tough time, but I can’t help you and your kid can’t get well.’”
Settlers originally came to this remote place because they desired an alternative to capitalism. During the 1890s, a group called the Colorado Co-operative Colony hoped to build a utopian community in the region. Its Declaration of Principles explained that market-oriented competition makes it “almost impossible for an honest man or woman to make a comfortable living, and that a co-operative system, if properly carried out, will give the best opportunity to develop all that is good and noble in humanity.” (The history of the colony and its values is described in a 2001 dissertation by Pamela J. Clark at the University of Wyoming.)
At the end of the nineteenth century, socialist communities weren’t uncommon in the West. The arid landscape required extensive irrigation systems, and principles of shared labor made sense to people who were inspired by the theories of Karl Marx and Robert Owen. Anaheim, California, was settled through a cooperative water venture, as was nearby Riverside. Others failed but left idealistic names on the map: Equality, Freeland, Altruria. The Colorado Co-operative Colony published a newspaper called the Altrurian, which tracked the progress of the colony’s founding project, an eighteen-mile irrigation ditch that was intended to carry water from the San Miguel River. Settlers also planned to do away with debt, interest, and rent. The Altrurian dreamed of a glorious fixture: “If a small colony of outlaws and refugees could build Rome and maintain the state for twelve hundred years, who could guess what a well organized colony of intelligent Americans may accomplish.”
Within a year, they held their first purge. Ten members were expelled for being too communistic, and after that the newspaper often published aphorisms that clarified theories. (“Communism may be co-operation, but co-operation is not necessarily communism.”) By the winter of 1898, settlers were running out of food. (“Competition is a product of Hell; Co-operation will make a paradise of earth.”) In 1901, a member of the board revealed that the colony was bankrupt. A former president committed suicide. (“So long as you think of yourself alone, you cannot be a good cooperator.”)
Eventually, the settlers abandoned the principle of shared labor and contracted out to private work crews. In 1904, water flowed through the completed ditch; six years later, they decided on the name Nucla, after nucleus. The socialist dreams were never realized, but the irrigation canal continues to function today. And there’s still a Colorado Cooperative Company, which employs a full-time “ditch-rider” to monitor the system. His name is Dean Naslund, and both his father and his grandfather worked on the ditch. Like most Nucla residents, Naslund doesn’t talk about his ancestors in terms of sociopolitical theories. (“They called him Daddy Joe. He kinda cowboyed. He liked to hop around. Maybe play cards all week sometimes and then work a little.”)
Nucla has a reputation as a tough town. It boomed in the 1950s and 1960s, when the region’s uranium mining and processing thrived. But the nuclear industry collapsed after the Three Mile Island accident, in 1979, and the population continues to drop in Nucla and its sister town of Naturita, which is four miles away. In both these towns, the per capita income is less than $14,000 a year, a little higher than half the state figure, and only 8 percent of the adult population holds a college degree. This year, the school board decided to switch to a four-day school week because of lack of funds. There’s only one restaurant in Nucla, one hamburger joint in Naturita, and one bar for both towns. It’s called the 141 Saloon, named for the state highway that passes through Naturita. On a Thursday night I’m the only customer, and the bartender, a woman named Casey, tells me that she just bought a three-bedroom house in Nucla for $53,000. That’s a mortgage of $250 a month.
“Only problem is the siding is asbestos,” she says.
“Is that a big problem?”
“It’s not a problem as long as you don’t touch it. Asbestos lasts forever.” She leans on the wooden bar. “What’ll it be?”
“What do you have on tap?”
She smiles and says, “Only thing we got on tap is Jägermeister.”
By the time Don Colcord was eight years old, he knew that he wanted to be a druggist. He grew up in Uravan, a mining town near Nucla, and his mother was a clerk in the pharmacy, where Don liked to hang around and watch the druggist. As a teenager, he began breaking into the place. Along with some friends, he stole beer, Playboy, and condoms. (“The condoms went to waste.”) When the boys finally got caught, they were forced to pay for the goods by working at the store for twenty-five cents an hour, “Everybody knew why you were there,” Don says. “It was probably the best thing that happened to me.”
During his teenage years, Don shared a room with his brother, Jim, and one day he found a magazine hidden under the bed. It featured photographs of naked men. When Jim came home, Don asked, “Is this yours?”
“Yes,” said Jim, who didn’t seem embarrassed. He took the magazine back, and neither of them mentioned it again.
Jim was three years older than Don. He was six feet three and well built, but he didn’t enjoy sports or hunting, like most local kids. He spent a lot of time by himself, and in high school he became an excellent student. He was a source of disappointment to his father, who nagged at Jim to behave like a normal boy. In 1972, a couple of years after Jim left for college, he sent his family a letter explaining that he was gay and that he knew his father would never accept it. He asked them not to look for him; he was leaving Colorado for good. And for the next twelve years nobody heard from Jim.
At the age of eighteen, Don married his high school girlfriend, Kretha; eventually, they settled in Nucla and opened the Apothecary Shoppe. In 1983, Don’s father died, and one of the first things his widow did was hire a private investigator. The detective found Jim in Chicago, where he was a clerk in the county court. He said he’d had a feeling that something had happened back home.
The following year, Jim made a four-day visit to Nucla. He went for long drives with his mother, who told him that she had always known he was gay and that she was sorry she hadn’t been able to change his father’s attitude. In the evenings, Jim and Don sat up late talking. One night, Jim told Don that he had been infected with HIV, and that his doctor said he was likely to develop full-blown AIDS. Jim told Don where he wanted his ashes scattered. And he asked him to visit Chicago, where Jim lived with his longtime boyfriend.
That year, they talked frequently on the phone. But whenever the topic of a Chicago visit came up, there was always a reason Don couldn’t go: he was too busy at the store; his son and his daughter had school activities. Kretha tried to persuade
him to make the trip, but he never did.
When Jim died, one of his colleagues telephoned with the news. She sent the ashes in a box, with a copy of Jim’s will, some awards from work, and a few photographs. One of the pictures was taken at Wrigley Field, where Jim stands with his boyfriend in front of a GO CUBS sign. When Don looked at the photograph, he realized that he knew virtually nothing about his brother. He had seen Jim for all of four days in the past decade; he didn’t even know his boyfriend’s name. And he understood the real reason that he hadn’t made a trip to Chicago. “I was angry with myself for not being comfortable in a house where two men were sleeping together,” he says. “I didn’t want to see two men kissing each other. It wouldn’t bother me now, but it did then. I really regret it.”
Along with his mother and his younger sister, Don scattered Jim’s ashes at the juncture of the San Miguel and the Dolores Rivers. The Dolores flows from the south, where it crosses the great salt dome of Paradox Valley, and the water is saline and has no fish. If you swim there, you float as if you were in the ocean, a thousand miles away.
The last doctor in Naturita died fifteen years ago. There’s a small health clinic, and recently it contracted with a doctor in another part of Colorado to visit two days a week. But the mainstay is Ken Jenks, a physician’s assistant who is on call twenty-four hours a day. Jenks has lived in rural Colorado for a decade, and during that time he has learned that electrical tape is harder to remove from a wound than duct tape. Twice he has had patients suffer cervical fractures and drive themselves in to the clinic rather than wait for an ambulance. It’s not unusual for somebody to sign out of the clinic AMA—against medical advice. A couple of times, Jenks has told heart attack victims that they needed to be evacuated by helicopter, only to have the patients decline because they believed they could get there cheaper. Jenks signed the forms, unhooked the IVs, and the patients got into their pickups to drive the two hours to a hospital. “And they made it,” Jenks says. “So they were right!”