Like this town of fewer than 100 residents, Dr. Robin L. Titus is of another era, a throwback. She’s a family practitioner who makes house calls--one who chose rural medicine at a time when rural doctors are increasingly scarce.
She kept a promise she made as a student to forgo a lucrative big city practice and follow in the footsteps of another woman, who years before had seen in Titus the makings of a country doctor.
The 37-year-old Titus is up at 5:30 a.m. and starts seeing her first patients two hours later. The living room of her 70-year-old home is the waiting room. A front bedroom in the white, two-story home has been converted into her office and examining room.
After spending mornings in Wellington, she drives 28 miles along a twisting country road through a narrow river canyon flanked by spectacular cliffs to another old two-story home in the little town of Yerington, where she has her second office. Outside both offices are signposts that read: “Dr. Robin L. Titus, M.D. Family Practice.”
Wellington, located at the foot of towering mountains in Smith Valley, is 75 miles south of Reno. Yerington is in Mason Valley, the next valley over.
This is ranch country. The valleys have a combined population of about 4,000, and Titus is the only full-time doctor here. Her patients come from 50 miles around.
Working an average of 10 to 12 hours a day, she sees 35 to 50 patients each weekday. Her fees are modest. She is also the health officer for sparsely populated Lyon County, chief of staff at the South Lyon County Hospital in Yerington and head of the county’s 28-bed nursing home.
Wellington’s century-old mercantile and general store--a relic of the past with its pot-bellied stove, stacks of cowboy hats, Levis, flannel shirts, food and general merchandise--is a good place to hear local views on any subject, including the town doctor.
“Dr. Robin is the life and breath of this rural area. We have lots of little kids and lots of older people, and she’s needed by them and everyone else around here,” said mercantile customer Norma Petersen.
“She gives us a feeling of security. We’re really lucky to have her. We run her ragged. I don’t know how she does it. She’s a bundle of energy,” she said.
Store clerk LaShele Renner, 36, couldn’t resist chiming in, “Any time anybody for miles around has sniffles, Robin knows.”
“I don’t know how we would survive without her,” added Postmaster Sue Dechambeau, 40.
It was Titus’ predecessor, Dr. Mary Fulstone, who urged a high school senior named Robin Titus to think about studying medicine.
Titus said Fulstone told her, “ ‘Someone must take my place. You should be that person.’ ”
Titus worked 40 hours a week as an undergraduate to pay her way through the University of Nevada, Reno. The Lyon County Board of Commissioners voted to lend her the $28,000 she needed to complete three years of post-graduate medical education.
In return, she promised the people of Lyon County that she would come back home to follow in the footsteps of Fulstone, who retired in 1980.
The area was without a doctor until 1984, when Titus opened her practice in Wellington.
“I could have joined the Public Health Corps or the military and had my education paid, but that would have taken me away from Smith Valley,” Titus said.
“To me, this is heaven. I have no intentions of ever leaving. I want to be another Dr. Mary. So I accepted the loan from the county, which I have paid back,” she explained.
Fulstone died in 1987 at age 95.
“The area could easily use two more physicians. But we haven’t been able to attract other doctors to this isolated place,” Titus said.
“I’m lucky. I have a lot of energy. But I can’t go on forever working the hours I do. As it is, I take off on weekends with my family every opportunity I can. If I’m to last as long as Dr. Mary, I better get some help,” she said.
The hazards of modern medical practice touch even this rural area. Two years ago, Titus quit delivering babies because the cost of her malpractice insurance soared to $30,000.
“I couldn’t afford the premium. Women from around here now go to Reno and Carson City to have their babies,” she said.
She spoke of her tremendous satisfaction for “the way people appreciate what I do.”
“You know, I have four generations of patients, aunts, uncles, cousins, everyone from all over the place. I know them all.
“I do all the pre- and post-natal. I see them shortly after they come into the world, and I’m with them when they die. If patients are seriously ill, I send them to a specialist until the specialist can’t treat them anymore. Then they come back to me.
“It is much better to die with a friend than with unknown people. There has to be somebody there for you. I sit there and hold their hands when they die.”