When Nick Lawyer, a physician assistant in Sanders County, Mont. was asked by local leaders to take on the voluntary position of county public health officer, it felt like the right thing to do to serve his community in a crisis.
"I kind of think I was one of the few who expressed any interest in the position who had any reasonable qualifications for the job," Lawyer says.
Lawyer had worked as a PA at the 14-bed Clark Fork Valley Hospital in Plains, a town of about 1,000 people in a relatively remote river cut basin in northwest Montana, since 2013. When he agreed to take on the extra duties, he decided to also begin a master's program in public health at the University of Montana to further boost his qualifications.
Little did he know, those qualifications would soon become a mark on him in the eyes of some local activists.
Starting last winter, when the COVID-19 vaccines were rolled out, Lawyer found himself in the crosshairs of what he calls a small, yet vocal group of extremists. He was surprised, because by then Montana's far right Governor Greg Gianforte had already overturned the state's mask mandate and the state's Republican controlled legislature had passed the only law in the nation banning private businesses from requiring their employees to get vaccinated.
"Although there was no mask mandate, there were no vaccine mandates, there were no health restrictions in our county, people still felt that their rights were being trampled on," Lawyer says.
Several months later Lawyer would lose his volunteer post, becoming just the latest county health officer in the rural state to be forced out, resign or retire early in this pandemic. The problem is nationwide but an analysis by the Associated Press shows a particularly high rate in Montana, with at least 17 officers leaving (Montana has 52 counties).
The departures also come as Montana recently hit a record with its most ever COVID-19 hospitalizations. As the surge from the Delta variant appears to be subsiding in much of the rest of the country, Montana, population one million, is a glaring hold out.
Volunteer health officer called a "petty tyrant"
Things came to a head for Nick Lawyer in Sanders County when he penned an op-ed for several small town newspapers in the region in which he urged people to get the life saving vaccines (only about 40% of the population in Sanders County is fully vaccinated today).
Angry confrontations and protests at local meetings followed. It appeared there was a coordinated campaign of harassment targeted at him.
"It's really disappointing that these people who I've cared for, these people whose kids I've coached suddenly decided that I'm sort of outsider," Lawyer says.
Lawyer grew up in Sanders County. His family goes back five generations. He and his wife are also serve on local boards and he coaches in the schools. Today, he also works in the same hospital his mom once did.
"To see this fraction of our community become so vocally hostile towards me and my family, to threaten my wife and my wife's business, it's really disappointing," he says.
It all came to a dramatic, troubling crescendo in September after an elderly local activist spoke at a county meeting, angry and grieving, saying his 82-year-old wife had died from COVID. He reportedly called Lawyer a "petty tyrant."
"I never met her," Lawyer says. "I actually never provided her any care. But her husband blames me for her death saying that I put up barriers to her receiving unproven measures like ivermectin and other treatments."
The 'bullies won'
After that latest ruckus, county commissioners decided they couldn't do their business anymore because these activists were so loudly and frequently disrupting their meetings. So they asked for Lawyer to resign and he did.
"This is a very good example of where the bullies won," says Travis McAdam, an extremism expert at the Montana Human Rights Network.
McAdam says far right groups have developed a play book for how to disrupt public meetings and the lives of public health officials.
"They're using bullying, intimidation and harassment as political tools," he says.
Extremist group monitors like McAdam interviewed for this story say dark money groups are increasingly making all the training and social media tools readily available online. It's not so much that money is flowing into these communities or targeting certain races or positions, they say, it's more that groups such as those run by Ammon Bundy quickly send out text alerts or use Facebook groups to alert activists to mobilize across the rural Northwest.
"In most cases, no, it's not just a spontaneous thing where a hundred people all the sudden decide to go to the school board meeting that night," McAdam says.
Anti government militants like Ammon Bundy started recruiting and organizing around lockdowns early on in the pandemic, seeking to capitalize on long held antigovernment sentiment against in rural areas.
Lately McAdam points out that Bundy and others have shifted strategy toward actually running for political office and trying to fill seats on health boards and other local organizations. In Sanders County, there are murmurs that one local Bundy sympathizer is making moves to try to take over Nick Lawyer's former health post.
"In some cases, people are much more afraid of their perceived government overreach than they are of the virus," says Diana Lachiondo, a former commissioner and health board officer in Ada County, Idaho.
Last December when she and other members on the state's Central Health District board expressed support for preventive measures like extending mask ordinances, they were confronted by an angry mob that tried to break into the building where the meeting was being held. Protesters also screamed, banged pots and played clips from Scarface outside Lachiondo's Boise home.
Today, she's worried qualified people will no longer step up to serve in these positions.
"That is incredibly sad but also scary because then you're left with, who does step up and what are their aims and motivations if they aren't altruistic," Lachiondo says.
Health officer worries we're heading "down the road of fascism"
The exodus of health officers and others resigning from their posts is not unique to Montana. A New York Times analysis found more than 500 top health officials left their jobs in the last 19 months. In Sanders County, Montana, physician assistant Nick Lawyer says out of the some two dozen local nurses and doctors he's heard of no one who is willing to step up and fill his vacated seat.
Lawyer says the anti-science and anti-expert climate in Montana right now is chilling.
"However genuine in the effort to preserve individual choice and individual right, when we politicize and marginalize expert opinion, that will certainly further push us down the road of fascism," Lawyer says.
And in the shorter term, in Montana, where Lawyer says public health experts are being sidelined, he warns the state will see worse health outcomes. More people will get sick from any number of diseases and they'll die sooner.
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