When We Are Called to Part

An absorbing, affecting, and often funny story of the last years of a vanishing community known as the living grave.

By Brooke Jarvis

The Atavist Magazine, No. 31

Brooke Jarvis is an independent journalist who lives near Puget Sound, Washington. She has written for Rolling Stone, Al Jazeera America, The Washington Post, and Aeon, among others. She is a contributing editor toYes! magazine and a 2013 fellow in environmental journalism at Middlebury College.

Editor: Charles Homans
Producers: Gray Beltran and Megan Detrie
Copy Editor: Sean Cooper
Fact Checker: Megan Detrie
Illustrator: Fabienne Rivory
Researcher: Kelsey Kudak
Source Images: Library of Congress, Hawaii State Archives, Wikimedia Commons

Published in November 2013. Design updated in 2021.

Speeding down the street is a car that I love. A Toyota station wagon—probably from the 1980s, but who can say—that used to be red or maroon but is now mostly gaping, rust-lined holes and sun-bleached swatches of gray and white. The windshield is cracked; since I last saw the car, someone has patched a hole with plywood and covered the top with roofing paper. For a second my breath catches, and I stop in my tracks. Dumb as it is, I hope. But the car is moving too fast, too purposefully down the center of the road. And instead of a pair of sunglasses, white hair sticking out of a visor, and a small, hunched figure with her hand held up to block the sun, in the driver’s seat is a much younger, black-haired woman I don’t know.

I should have realized that the car would still be here. In Kalaupapa, plenty of vehicles keep rolling for years after the salt air and the ingenuity of isolation have left them more plywood than metal. But it’s still a shock. The car is driving, and Gertie is not.

Gertie—Gertrude Kaauwai, known variously as Gertie, Gert, or Girly—hated that station wagon. She’d had to switch to it once her remaining foot deteriorated to the point that, even with her stubbornness and the dexterity gained by more than four decades on crutches, she could no longer climb into her big gray truck. On my first day in the settlement, before I even met Gertie, my new boss pointed the truck out to me on the street and explained that I should get as far out of the road as possible when I saw it coming—usually in the morning, during Gertrude’s food run for her dozens of cats, or in the late afternoon, when she was driving to the bar and would have to squint into the western sun. Just pull into any nearby yard, he said, it’s fine. The disease had gotten to Gertrude’s eyes, and she couldn’t see well at all. If she’d lived anywhere else, she would have been forced to stop driving long before. But Kalaupapa has its own rules.

The settlement, as everyone who lives here calls it, is the only town on an isolated peninsula on a sparsely populated Hawaiian island. Its history began a century and a half ago, when the first boatload of leprosy sufferers arrived—the unwilling founders of what in different times was known as a leper colony, or a leprosarium. Decades after modern medicine neutralized the disease, Kalaupapa is the largest remaining settlement of its victims in the United States.

I’m back visiting for the first time in more than four years, but nearly everyone guesses much less: “How long’s it been? A year? A year and a half?” Time’s passage always feels more uncertain here, more uneven. When I lived in Kalaupapa, I got used to hearing frequent references to patients who had died many decades before, often as if they were still alive. When I was new, and still putting faces to names, I assumed several of them were.

Now I know all too well who’s missing. In a sense, the past four years have been relatively kind to Kalaupapa. During the 12 months I lived here, in 2008 and 2009, we lost nine patients, almost a third of those who remained; since I left, three have died. I heard about them over the phone or by email: Uncle Henry first. Gertrude a year later, on Christmas Eve. Auntie Kay just a few months back. Her things are now boxed up in plywood crates in her side yard, waiting to be shipped to her family on the once-a-year barge.

And someone else is driving Gertrude’s car; someone else is living in her house. No one plays cribbage anymore in the settlement bar, where she used to hold court until the eight o’clock closing time every night. The bar’s owner, a patient named Gloria, tried to ease the transition, rearranging the tables so that no one would have to sit in Gertrude’s old seat. People appreciated the effort, but it was basically futile; her absence was inescapable all the same. These days, with so few patients left, there’s no moving forward after a death in Kalaupapa. There’s really not much moving forward at all.

I used to love to explore the woods outside the settlement, which are filled with evidence of a much bigger town: concrete walkways and front steps that now lead nowhere, glass medicine jars and ceramic doorknobs shining in the mud. Once, a friend and I set out to capture a wild beehive and found our target not far into the forest, inside an overturned, overgrown cast-iron bathtub.

At first I found these discoveries quaint or charming. Like the settlement’s isolation, like its peculiar history, they were half-abstractions, stories to tell when I returned to the outside world. But in time I began to see them as the remaining patients did: relics not just of people they had known, but of a community that had dwindled to just them, and that would not last beyond them. No new patients, and no children, have come in decades; every death is one step closer to the end of Kalaupapa as they have known it.

In a settlement defined by tragedies—parents and children torn apart, years of forced isolation, funeral bells that once rang every day—this is the one that no one expected. The place that no one wanted to create, the place where no one wanted to go, is coming to an end. And even a prison eventually becomes a home, becomes something you mourn.


“Molokai?” the shuttle driver at the Honolulu airport asked. “Why would you go there? They don’t even have a McDonalds!”

This was true, I knew. Molokai—a 38-mile-long island situated between Oahu and Maui—also had no stoplights, barely a handful of restaurants, and a population holding steady at around 7,400 people. Major roads crossed rivers via fords, not bridges; when the rivers ran high, whole sections of the island would be cut off. The local paper would sometimes quote “Uncle Merv” or “Auntie Paula” without giving a last name. It was known as the last Hawaiian island, one of only two in the archipelago that still had a majority native-Hawaiian population. When I arrived at the open-air airport the next day, a hand-painted sign greeted me: “Aloha,” it read. “Slow Down. This is Molokai.”

And the place I was going made the rest of Molokai look like Manhattan. A year earlier, in 2007, during my final months of college in Virginia, I had discovered an ad for an internship with Kalaupapa National Historical Park, which coadministered an unusual settlement on the Kalaupapa Peninsula, on the north side of Molokai. It was home to 28 leprosy patients—the peninsula’s only permanent legal residents and the last remnants of a 140-year-old community that at its peak had housed more than 1,100 people.

At the time, my friends were applying for consulting jobs in Washington, and when we spoke about our post-graduation plans, I held up the Kalaupapa job as evidence that there were too many interesting opportunities out there, that it would be a shame to settle so soon and so nearby. It was more rhetorical device than plan, though: I never really believed I’d actually end up in Molokai, boarding the little nine-seat Cessna for a seven-minute flight over the edge of the earth.

Residents sometimes explain Molokai’s geography by comparing it to a shark. The southern shore, with its low beaches and shallow reefs, is the belly. Halawa Valley, at its eastern tip, is the nose, and the long beach of Papohaku in the west is the inner curve of the tail. In between are grasslands, farms, and a rainforest cut by deep valleys. Protruding from the island’s north shore—the shark’s dorsal fin—is the Kalaupapa Peninsula.

Looming over the peninsula is a cliff, known to locals as the pali. It formed about 1.5 million years ago, when a landslide sent a third of Molokai crashing into the sea. The break left the island’s north shore a sheer, impassable wall, 3,000 feet high in places—the tallest sea cliffs in the world. Millennia later, the eruption of a small volcano formed a flat peninsula at the base of the cliff. Only incidentally connected to the larger island—“topside” Molokai, as it’s known locally—the peninsula is five square miles of land surrounded on three sides by deep ocean and on the fourth by the chiseled face of the pali. In the winter, storms swell rivers and stir surf, cutting off all ocean access and, periodically, trail and air access as well. The peninsula is an island within an island, a tiny, solitary world of its own.

The plane skimmed briefly over houses and fields, and then the land simply stopped. The earth turned 90 degrees, from flat cow pasture to sheer cliff, and there was nothing below us but crashing waves, thousands of feet down. For a moment, I was afraid that the plane would drop, too, simply fall out of the sky. Instead, we flew along the western coast of a low peninsula, rising subtly to the lip of a deep crater in its center. I registered a forested interior, a jagged, rocky coast on the far side, and, close at hand, a small grid of roads and buildings extending from the beach. We landed on a thin airstrip at the very tip of the peninsula, the plane pulling off the tarmac and parking on the grass in front of a one-room airport and a lighthouse. A few miles to the south, the cliffs we had just crossed faced us, deep green, furrowed, and imposing. Of topside I could see nothing—just a few distant trees at the cliff’s edge. We were sealed in: the tropical-paradise version of a snow globe.

In the 1860s, the peninsula’s unique geography caught the eye of the Hawaiian government. A series of newly introduced diseases—measles, influenza, smallpox, whooping cough—had ravaged the islands, and now leprosy, an even less-understood scourge, had arrived. A chronic bacterial infection, leprosy is rarely fatal, but the disfigurement and pain it causes have long made it one of humanity’s most feared and misunderstood diseases. The bacterium that causes it fares poorly in the body’s warm core, so it primarily attacks hands, feet, faces, eyes, and skin. Numbness and paralysis lead to unnoticed and untreated burns or cuts, and sometimes to infection and amputation. Hands begin to “crab,” or close up, and bones and tissue break down and are absorbed by the body. Victims may lose nasal cartilage, gum tissue and teeth, even eyelashes and eyebrows. Blindness, too, is common.

Terrified Hawaiian officials looked to the peninsula as a natural prison, a place to quarantine sufferers from the general population. The peninsula’s milder western coast, known as Kalaupapa, was already occupied by a native village, so the first boatload of patients who arrived in 1866 were deposited at Kalawao, the barren, windy eastern coast. (By some accounts, early patients were made to swim to shore, so great was the ship captains’ fear of infection.) The patients were dropped off with few provisions and no medicine, and expected to grow their own food in spite of their health and the harsh environment. Ten of the first 12 to arrive died within two years. The peninsula earned dire nicknames: the painful shore, the living grave.

Change came slowly. Help arrived first in the form of family and friends of the condemned, then religious workers, and, much later, government employees. They were known as kokua—“helper” in Hawaiian, but a word that eventually came to refer to anyone who lived in the settlement but wasn’t a patient. The most famous kokua was a young Belgian priest known as Father Damien, who came to minister to the patients in 1873. He helped build not just a church but also a clinic, homes, and a cistern. He made a point of sharing bowls and pipes with patients and counting himself as one of them. “We lepers,” he would write. Damien eventually contracted the disease himself and died 16 years after he arrived in Kalawao. Gandhi later claimed him as an inspiration; in 2009, the Vatican canonized him as a saint.

Gradually, the settlement was relocated to the calmer Kalaupapa side of the peninsula, replacing the village, and the state began to take a more active role in its management. Supplies and care dramatically improved, but dehumanizing treatment continued. Many houses still have wooden boxes on their porches, built there so kokua could leave meals for patients—then called inmates, as those accused of having leprosy were arrested and put on trial—without having to go near them. Fences separated the patient and staff areas of the settlement, and endless rules governed when, where, and how those inflicted with the disease could interact with others. The building where families could visit their incarcerated loved ones had a chain-link fence running down the middle.

Some patients underwent involuntary tests of experimental medicines; some were sterilized. Those who had children were separated from them. Newly arrived patients, even young children, were told that they would never leave Kalaupapa—that they would die there. “This is your last place,” one patient recalled being told.


I stepped off the little Cessna that first morning, sweaty and conspicuous in the winter clothes and pallor I had carried with me from the mainland. My new boss, Steve, met me in his truck to drive me back to the settlement. My job was to prepare for the mandated closure of the peninsula’s only landfill by setting up composting, recycling, and waste-prevention programs. Everything we couldn’t figure out how to deal with would have to be flown out at high prices or trekked out on the back of a mule. Trash lady, essentially, but like everything here, made much more complicated—and to my mind at the time, more glamorous and exciting—by separation from the outside world.

Living in Kalaupapa, I’d been warned, meant knowing the math and measurement of isolation. One bar, one post office; a care home for the patients, a cafeteria for workers. Bread was delivered by plane from topside on Mondays to the little state-run store in town. Vegetables arrived Wednesday morning and milk on Wednesday afternoon. (Don’t buy too much or people will talk about it, I learned. Don’t be late or you won’t get any.) One barge a year, an occasion that was celebrated like a holiday. It offloaded food, gas, cars, lumber, and other supplies onto the tractor-tire-lined pier that jutted into the bay and left carrying old appliances and junked cars that were finally beyond saving.

Besides the barge and the expensive Cessna flight, the only other reliable way in or out of Kalaupapa was a brutally steep three-mile trail that led to topside Molokai. Its 26 switchbacks zigzagged up the cliff face like a scar, sun-beaten and dusty in the summer and pitted with thick mud in the winter, and always covered in fresh mule shit from the caravan that brought tourists down for the short daily tour of the settlement.

Workers came to know its uneven steps by heart. Many of them made the journey once or twice a week, either to visit their families topside—only employees and full-time volunteers were allowed to stay in the settlement for more than a few days at a time, and children under 16 were prohibited from visiting at all—or to avail themselves of services that were unavailable on the peninsula. (I once gasped my way up the trail with a 102-degree fever after bodysurfing into a rock and contracting a staph infection; as the signs at the top of the trail warn would-be visitors, there are no medical services for non-patients in Kalaupapa.) One mechanic managed to make it all the way down from topside with a motorcycle, carrying rather than riding it around the sharpest turns. A year after I moved away, a bridge near the top of the trail was washed away in a landslide, rendering the settlement inaccessible except by plane for nearly seven months.

Steve took the paved road that led away from the airport along the beach toward the settlement, rumbling over the cattle guards meant to control the goats, boar, and axis deer that had overrun the island. The strip of land between the road and the ocean, I saw, was filled with graves—field after field of them. Headstones were wildly tilted in the sandy soil, some collapsed into rubble piles or reduced to jagged fragments of metal rusting in the salt air. One tomb was held in the embrace of a large tree that had grown around it.

Many of the graves had no headstones at all, just white wooden crosses with names stenciled in black paint. These were clearly among the most recent memorials. The earth beneath them was still heaped up, still decorated with bedraggled stuffed animals and faded plastic flowers, unopened beers with rusty caps. Behind the wheel, Steve caught me gaping. These, he pointed out, weren’t even all the marked graves—there were large and small cemeteries all over the peninsula, some only recently reclaimed from the forest. And the known graves accounted for only a small percentage of what the settlement’s induction numbers suggested must be here.

A few small wooden cottages started to appear along the road, trucks or ATVs parked in their yards. As we pulled into the center of town, Steve pointed out the churches, the administrative offices, the one-pump gas station, and the store that overlooked the curving concrete pier. Homes fanned out from the tiny downtown in a loose grid—one-story cottages on short stilts, most built from the same handful of blueprints.

Steve dropped me off at Bay View Home, a complex of long, pale yellow buildings whose porches looked west over a row of palm trees, Kalaupapa’s shallow bay, and the receding face of the pali. Bay View had once been a dormitory for blind patients but now housed park workers and the occasional volunteer. On my new porch were a couple of wheelchairs, covered in spiderwebs like the rest of the building. There was also an oddly shaped platform that I later learned was a chair for patients to sit on while sores on their feet were treated and dressed. The last patient to live in the complex, I was told, was a man known as Uncle Peter (Auntie and Uncle are terms of respect for the elderly in Hawaii), who had died only a few weeks earlier. I inherited the task of feeding the cats he had left behind—Tom, Blackie, and Hoover—plus a family of mooching mongooses, all of which congregated on the porch of his abandoned building at mealtime.  

Bay View sat near the edge of the settlement, one of the last buildings on the way to the trail. From the center of town it would have been easiest to walk home by cutting through a round, mown field next to the care home than to stick to the more circuitous road. But in the center of the field lay the rubble and twisted metal remnants of a hospital—it had been destroyed in a fire when both of the settlement’s fire trucks malfunctioned at the same time. Remembering the unmarked graves, I stuck to the road and didn’t cut corners. For weeks I wouldn’t walk anywhere that wasn’t paved.

The Hawaiian word for taboo is kapu. Unlike its English counterpart, the term hasn’t had its ominous religious connotations washed away by overuse: It means the kind of disrespectful behavior that can follow you for the rest of your life, and beyond. I didn’t learn the word for weeks or months, but I felt it right away, on my first day in Kalaupapa. I knew enough of the settlement’s history to understand that there were invisible rules governing everything around me, but not enough to know what they were or how to avoid breaking them.


On Steve’s advice, my first act as a new resident of the settlement was to go to the bar. There were a surprising number of gathering places in town, given the tiny population, most of them holdouts from a time when the patients were younger and more numerous. There was a slowly collapsing pool hall overlooking the water; a stone pavilion the Lions Club had built on a rocky stretch of beach in the 1950s; a dusty social hall that had once hosted movies (the reels carried down from topside by mule), dances, and visiting celebrities such as Shirley Temple and John Wayne. But these were only sporadically used. The bar, I was given to understand, was an institution.

The front of the bar was an open porch, covered by a slanting roof held up by pillars of cinder blocks. A handsaw with the words “Fuesaina Bar” painted on it hung outside. That first day, I found the place packed; a cow in the pasture above the pali had chewed through the settlement’s TV cable. (This, I soon learned, was more or less normal. Kalaupapa’s electricity, phone service, and sad little dribble of an Internet connection would cut out for days and sometimes weeks at a time.) People crowded around a collection of folding tables and chairs set out on the cement floor.

One corner of the porch was protected from the wind by a thin wall, its windows shielded with wooden slats rather than glass. A tiny white-haired woman in dark sunglasses, a visor, and a knitted cardigan pulled over a polyester button-down was sitting with her back to the window, presiding over a game of cribbage. She had a bandage on one leg, which had been amputated at the shin, and an orthopedic walking cast on the other. A pair of crutches leaned against the wall by her chair. Her fingers were almost entirely gone. When it was her turn to shuffle, she spread the cards across the table and stirred them around with an eraser-tipped stick grasped between the nubs of her fingers and her palm before gathering them back up. This, I knew, was Gertrude.

Gertrude drove her gray truck to the bar at four o’clock in the afternoon every day. She never drank, but she was still the place’s best customer, the one whose presence kept things hopping. A few years earlier, she had stopped coming to the bar at night because she could no longer see well enough to drive home in the dark. Without company or a game to count on, other people stopped coming as regularly, just drifted through or got beer to go. Finally, Gertrude’s neighbor, a historical preservationist for the park named Richard, agreed to ride his bike to the bar every night at eight and drive her home in her truck. Cribbage became a nightly ritual and the bar an axis of the settlement’s social life.

The bar had been owned by a number of patients over the years and had operated under a number of names. In the back room was a counter where Gloria Marks, the current owner, leaned over a ledger, tallying items sold. There was an ice cream freezer, a rack of chips and snacks that all seemed to be flavored with li hing mui—a salty dried plum popular in China, Hawaii, and not much of anywhere else—and a refrigerator stocked with Budweiser, Bud Light, Heineken, and mini bottles of cheap wine. There were old photos of Gloria and her husband, Richard Marks, Kalaupapa’s last sheriff, still living then but mostly unable to leave the care home. You could still see his resemblance to the younger man smiling from the cover of a yellowing magazine displayed in the bar.

There were postcards for sale, a whole stack of them featuring a cloud formation that looked vaguely like the face of Father Damien. As in most of Kalaupapa, there were also cats by the dozen, chasing geckos, fighting each other, reclining on the unoccupied chairs. The cats belonged to Gertrude, if the word can be used to describe the naming and regular feeding of otherwise feral animals. There was Crooked Tail, named for obvious reasons, and a thin, mustachioed cat she called Hitler.

Gertrude walked me through the rules of cribbage, banging her shuffling stick on the table when I made mistakes in counting points. When it was my turn to shuffle, I shyly told the table I wasn’t very good at it. “You got hands!” Gertrude cried. She brusquely instructed me in a method simpler than the one I was trying but still out of reach for her. I shut up and shuffled.

Gertrude’s nickname when she was younger was Spitfire. She refused to go to school after seventh grade and would take off to “the backside”—the wild, uninhabited part of the peninsula east of the settlement—on horseback any chance she got. After losing her foot in her thirties, she used her crutches to do things that made the doctors furious, climbing the trail—it was fenced off at the top in those days—and navigating the boulder-strewn beach that led to a deep valley carved into the cliffs. She siphoned gas out of people’s cars and hid it in drums in the woods, for no other reason than to do it. She was angry a lot. Much of her anger had to do with her first two husbands, both of whom, she told me, became abusive. She cursed people out, broke up relationships. She freely owned up to having been a general pain in the ass.

Gertrude told these stories readily, matter-of-factly, not long after we met, before I had seen much of her stubborn side myself. Of all the patients, she was perhaps the most open to new people, the easiest to get to know. Anyone, no matter how temporary their stay in the settlement, was welcome to join her for cards, to call her Auntie and ask her about her life. You’d find out right away if she thought you were being rude or an idiot—rolled eyes, slow head-shaking and muttering as she focused intently on her cards—but you’d get plenty of chances to do better. And once she got to liking you, she’d rib you mercilessly about your cribbage playing, shriek at your comebacks—in the right mood, she especially loved jokes about her disability—and add your little bottles of bad wine to her bar tab. But heaven help you if you failed to show up for cards for a few days.


Gertrude would often cover her mouth with her hand while she talked, hiding the effects of the disease. She’d sometimes refer to herself as an ugly old lady—though even into her seventies, she was also an enormous flirt. She was convinced that there were rumors around town—I never heard them from anyone but her—about her “going around” with several young male workers in the settlement. When Richard, her neighbor and close friend, then in his fifties, had a fight with his girlfriend, Gertrude asked both of them, “Is it me?”

Gertrude first came to Kalaupapa in the early 1940s, when she was 11 years old. The doctor didn’t tell her she had leprosy—she insisted that she contracted it only after arriving there. Instead, she told me, the doctor said she was going to live with her mother, who had been sent to Kalaupapa some six years earlier, leaving her family behind on Maui. Gertrude had been told only that her mother was sick and in a hospital; she didn’t remember hearing the words “leprosy” or “Kalaupapa.” Her father had remarried, to a woman Gertrude said abused her, including by burning her with a hot iron. She welcomed the move but had little notion of where she was going.

When Gertrude arrived, she met a young woman and embraced her, convinced it was her mother. But Gertrude’s mother was already dead. The woman was a patient named Sarah Benjamin who took it upon herself to mentor the young girls who were sent to the settlement. “I could be your mother,” she told Gertrude.

In Gertrude’s recollection, after a few months in Kalaupapa the doctors decided she wasn’t sick after all and tried to send her home. She was so terrified of returning to her stepmother that she prayed for what she called “the sick.” Eventually, it came. “I started to get lumps all over my face, in my mouth, all over my belly,” she told me. “Lumps that hurt so much. Nobody can touch you. It was so painful.”

She prayed again: “Jesus, I asked you to give me leprosy. But not like this!” And she believed she heard a voice in response: “You asked for it, my child.” From that time on, she said, “I came sick, sick, sick. I was all, they called it, bust up.” For several years, she was frequently bedridden with pain.

At the time, doctors were still treating leprosy sufferers by injecting them with oil extracted from the seeds of the chaulmoogra tree, a remedy for skin conditions used for centuries in Asia. The injections were painful but arguably a lesser evil than the nausea-inducing practice of taking the oil orally; one doctor wrote in his autobiography that more than one patient told him they’d rather have leprosy.

In 1941, however, doctors at a leprosarium in Louisiana discovered that a recently synthesized drug called Promin could actually cure the disease. Promin required frequent, painful injections, but its advent marked the beginning of leprosy’s gradual retreat from the fearsome place it had occupied in the popular imagination since biblical times. In the 1950s, a pill treatment became available, and by the 1970s drug trials were under way for the treatment still used today, a multidrug regimen that can cure leprosy on an outpatient basis. Today, those who begin taking medication early in the disease’s onset may not experience any noticeable effects at all, and even longtime sufferers can avoid passing it on.

But for those who came to the settlement before the arrival of effective drugs, it was a wringer. Patients who had arrived as children would later describe their terror upon first seeing the settlement’s residents, their faces and extremities ravaged by the same disease they had contracted. I once asked Gertrude what was the biggest change she’d seen the settlement undergo in her years there. “The patients,” she said. “They look more clean.”

After the medicine arrived, it took years before state authorities were convinced that it was safe to shut down the quarantine and allow the settlement’s residents to return to the world that had expelled them. When they did, they considered closing Kalaupapa altogether. But there was the population of current patients to consider—many of them were disfigured or disabled and unused to the outside world, where the stigma attached to their disease had not been erased by its cure. So in 1969, the state decided that patients could choose to leave or to stay—to live out their lives in the only home many had known since childhood, protected from prying eyes and supported by the state, free to travel as they wished. Embracing the isolation that had once been imposed on them, hundreds stayed. But no one new would come.

And so Kalaupapa became a place frozen in time. The community continued to exist, but it could not grow, only slowly erode away. Support staff came and went, and life went on as it does in many small towns, with gossip and grudges and parties and romance. But year by year, the population of patients—to whose lives Kalaupapa’s current reality is unyieldingly tied—grew older and ever smaller.


Most of my Kalaupapa days began in the predawn darkness in a dank cement building that had once been the settlement’s police station and now housed the maintenance department. (My office had been a holding cell.) I’d gather with the rest of the maintenance staff—a plumber, a carpenter, groundskeepers, a mason, a couple of electricians—for a morning meeting, then spend my day trying to figure out the logistics of getting rid of the settlement’s waste or keeping it from accumulating in the first place. I drove a trash trailer around town, sorted cans and baled cardboard. You learn a lot about a place from its trash—for example, that there’s no isolation Internet shopping can’t breach.

Many patients, I discovered, were generally suspicious of the recycling and composting programs—they would have been an even tougher sell if not for the imminent closure of the landfill—and of newcomers in general. They found it hard to keep up with the revolving door of temporary workers, making friends only to have them leave; some had lodged complaints with administrators to ask for less-frequent turnover. I set out to prove that I was serious about being a part of the settlement community, helping plan dinners and parties and an Easter coconut hunt, showing up regularly for cribbage and craft nights and the recently instituted volleyball games. I joined a group that cleaned out the old social hall, scrubbing the ancient movie screen until decades of grime ran off in thick brown drips. The old system of mule-delivered reels was easily replaced with an LED projector and a Netflix subscription, and suddenly we had the only active movie theater on the entire island.

And I started going to church. I wasn’t religious; I went at first simply to meet people I hadn’t yet encountered. But when a church’s entire congregation consists of seven people, attendance can’t politely be a one-time thing.

Kalaupapa had two active congregations, one Catholic and one Protestant. The Catholic church, St. Francis, had the more robust membership—perhaps not surprising for a place whose most famous former residents are a priest and a nun. (Both Father Damien and Mother Marianne, a nun from Syracuse, New York, who ran a hospital for leprosy patients in Honolulu before coming to Kalaupapa in 1888, were sainted in the years after I left.) Unlike the Protestant church, it also had a full-time clergyman, a tiny Belgian octogenarian priest named Father Felix.

But I was raised Presbyterian and never quite figured out when to stand or kneel during Mass, so that first Sunday morning I joined the handful of congregants at Kanaana Hou, a yellow building whose churchyard was ringed with a stone wall and overgrown bougainvillea. We gathered on the church stoop a few minutes before eight, facing the hale kahu, or minister’s house, which had stood empty for years. Once every few months, a visiting minister would come to preach at Kanaana Hou, but usually it was up to the congregants to run things. This meant that services were short, simple, and often personal—and that I found myself in the unexpected situation of really liking church.

When everyone was gathered, someone pulled the rope to ring the heavy bell in the steeple. We entered together, singing along as a park worker named Richard—the man who drove Gertrude home from the bar each night—played “When the Saints Go Marching In” on his recorder. Church Cat, a sleek, orange fellow who looked decidedly less inbred than most of his settlement peers, waited for us inside, stretching in the sunlight in the center aisle.

That week it was up to Pali, an 81-year-old patient and the church’s de facto deacon, to lead the service. He’d outsourced some songs and readings to other attendants in advance. Other songs he chose on the fly from the church’s English and Hawaiian hymnals, challenging Richard to accompany us or strumming and drumming along himself—he was missing fingers on his right hand—on his perpetually out-of-tune guitar.

Pali, short for Edwin Lelepali, was the life force of the church. Born in Honolulu, he’d been diagnosed with leprosy at ten and sent to Kalihi Hospital on Oahu. He was transferred to Kalaupapa shortly after the Pearl Harbor bombing, sent in a cattle boat along with a large group of mostly child patients to join the settlement’s more than 400 residents; the state figured Kalaupapa would be safer. Like the other patients, he’d been sent there against his will, but when his father visited a few years later, he told him that he’d fallen in love with the place. Instead of the crowded streets of Honolulu, there was hunting, fishing, camping, and the Boy Scouts. He wouldn’t go back to Honolulu if he could.

Years later, Pali helped lay the pipeline that carried water to the settlement from a nearby valley. You could occasionally find his name scratched in sidewalks, floors, or other cement-pouring projects he’d helped with. By the time I met him, he’d buried two wives and countless friends in the graveyard by the beach. He also buried a series of dogs beneath a row of elegant headstones. “Akamai: The Best Watch Dog and Loved,” read one of them. At Kanaana Hou, he oversaw the offerings, the annual bingo game, and the meals after funerals.

When it came time for the sermon, Pali stood up, put his hands in his pockets, and spoke briefly and obliquely about struggling with temptation. We closed, as the congregation always did, by singing the first verse of “Blest Be the Tie that Binds,” the same hymn that punctuates Thornton Wilder’s Our Town:

Blest be the tie that binds

Our hearts in Christian love.

The fellowship of kindred minds

Is like to that above.

After the service, Pali stopped me. “You’ll be here next week, yeah?” he asked. The next week, he asked the same thing. A few weeks later, he told me that the following Sunday it would be my turn to lead the service.

That week was the end of April, which meant that we left Kanaana Hou as the congregation always did on the last Sunday of each month, driving across the peninsula to hold an unusually solemn service inside Siloama, the church’s predecessor from the days when the settlement was on the Kalawao side. The congregation was formed in 1866, the same year the first patients arrived, and the church building dedicated five years later. The building—a white one-room chapel with a narrow steeple that stood out against the dark green cliffs—had been rebuilt or restored more than once, but it was a reminder that our current congregation was the latest, and perhaps the last, in a direct line that began with some of the first patients to be sent there. There were large tombs in the churchyard, a thick Hawaiian-language Bible on the altar, and an outhouse with the “patient” and “kokua” signs left intact from the days of strict segregation. On the wall behind the altar was a plaque, installed in the 1950s by another Kanaana Hou congregation. It read:








One Sunday morning that spring, a tiny dark-haired woman in glasses, a visor, and a colorful muumuu got up to speak. Catherine Puahala was one of Kanaana Hou’s most dedicated congregants, but she had lately been sick and unable to attend church; she now stood with the help of a kokua from the care home. Catherine was 81. She couldn’t keep on weight and was always cold; she spoke that morning about how delicious the warmer air felt, how glad she was not to have to wear a sweater, how blessed we all were that God made the world so good. Other days in church, she spoke passionately about her neighbors abusing their dogs. They weren’t—she’d begun to hallucinate the howls of animals at night and was tortured by them.

Like Pali, Catherine had lived in Kalaupapa since just after Pearl Harbor. She’d had a happy marriage to a man named Jubilee, one of the long-deceased patients I’d at first assumed was still alive, so often did I hear people talk about him. I saw her mostly at church or at community parties, often dressed in bright colors, a visor pulled low over her face, her arm almost always intertwined with someone else’s. Once, someone asked if she and a pretty young nurse were sisters. “Different mothers!” Catherine quipped.

Earlier in life, Catherine had worked with leprosy-patient advocacy groups both on and off the island. The disease had not been kind to her hands, face, or vision; of all the patients I knew, she had perhaps the most noticeable physical damage. Her smile might not have been recognizably happy to people who didn’t know her, but you could hear it when she spoke. Her voice was somehow both slurred and precise, her enunciation exaggerated to make up for the effects of tissue damage and numbness. But the kindness and happiness that suffused her words were audible—the real version of what actors in commercial voice-overs strive for. We called her Catherine the Great.


For decades, there was no firm plan for what would happen to Kalaupapa once the last patient was gone. The National Park Service, which started operating on the peninsula in 1980, at the behest of patients who wanted the settlement’s history preserved, began formally drafting one only in 2009. Crafting the plan required striking a delicate balance: preserving the peninsula’s historical seclusion and sacred status while gradually opening it up to the outside world.

Kalaupapa and its residents had been a source of international fascination for the better part of a century—largely on account of Father Damien, whose story was the subject of books and films as early as the 1930s. As the process of canonizing Damien and Sister Marianne advanced in Rome, reporters and miracle seekers alike began to make pilgrimages to Kalaupapa. Over the course of a few decades, the settlement’s patients went from having their outgoing mail fumigated to receiving audiences with Pope John Paul II.

Ever since the patients of Kalaupapa had begun determining their own future in the late 1960s, however, they had carefully guarded their privacy. Many of the modern rules that keep Kalaupapa so isolated—the ban on children, the limits on outside visitors, even the prohibition against surfing (for fear that if residents could surf, outsiders would be tempted to sneak down the trail) had come not from administrators but from the patients themselves. Now the residents of the changeless town found themselves asked to face—and weigh in on—the imminent end of their world. Many simply wished that it would not end, that nothing would change. No development or commercialization, no hotels or camping. Many of them opposed the idea of unescorted visitors, or of visitors staying overnight; a few wanted to maintain the ban on children.

But the end was coming in any case. One of my Bay View Home neighbors was a park employee named JJ, whose job was to tag and organize items that would one day be displayed in a Kalaupapa museum—likely after the patients were gone and more visitors allowed to come. He was cataloging aloha shirts and orthopedic shoes, rosaries and photographs and wheelchairs, musical instruments and specialized tools designed by patients to make everyday tasks easier: opening a soda can, holding a spoon, turning a key, cutting with scissors. Eventually, the curatorial project claimed the foot-dressing chair from the Bay View porch, the one we used to sit on to watch the sunset. It was strange to see it years later, tagged, filed, and de-spidered in a temperature-controlled room filled with furniture and shelves of old prostheses, one of them with a shoe and sock still on it.

Inside a gray curatorial cabinet in another room, beneath a piece of protective white muslin, hung an old Kalaupapa Lions Club T-shirt that I was pretty sure was identical to ones still being worn around the settlement. On a low shelf, I noticed a cinder block that a resident had used to keep a car’s broken hood from flying open—it was painted with a dancing cartoon dog and the words “Hold Down Da Hood.” It reminded me of a smooth, round rock I used to pass on my way to the trail, painted with the slogan “Smile—It no broke your face!” I’d always loved the rock—when I went back to the mainland, I kept a photo of it by my desk—but now its paint had chipped away to illegibility. How, I wondered, do you decide what to preserve and what to let deteriorate? How do you decide when an object has finished its active life and is ready for a museum?

It’s an odd thing to preserve history as it’s still being lived, and surely odder to be a living, breathing character in that history. Early on, I’d expected the patients to be eager to share their stories of the past, their opinions about the way they’d been treated. But they often preferred the small-town gossip of the present, what we called the coconut wireless: who was annoyed with whom, who was getting hired or fired, who drank too much at a party, whether the grass was being mowed often enough, whose visitors caught too many fish.

The community meetings that were held monthly by the Patient Advisory Council, the park superintendent, and administrators from the state Department of Health tended to run toward similar matters. Once we spent at least ten minutes gravely discussing eggs: Why did the store run out last week, and what could we do to keep that from happening again? We spent another 15 minutes debating which dogs were well behaved, which were in heat, and which should probably be kept on leashes. One week administrators sent around an official memo reminding everyone not to park their car in the middle of the street just because they’d run into someone they wanted to talk to.

One day in July, Auntie Catherine the Great announced that she didn’t think she’d be making it until Christmas that year. To the rest of us, her health seemed no worse than usual, but she was adamant. Christmas was her favorite holiday, and she wanted to have one more. So one sunny summer day, a group of patients and kokua gathered at her house to eat a Christmas feast of turkey, dressing, and cranberry sauce. We hung twinkling lights, and a worker dressed as Santa. Catherine grinned as we sang our way through her favorite carols.

A week later, Catherine died after being medevaced to a hospital in Honolulu. Jennifer, a park employee who was a close friend of Catherine’s, came to the Bay View kitchen, where I was on my lunch break, to deliver the news, then hurried out to start prepping programs for the funeral. Catherine would be flown back to Kalaupapa for burial.

The tropical weather and the absence of a morgue meant that there was usually little time for mourning before everyone had swung into action, dropping the day’s work for the familiar tasks that follow a death. Maintenance workers took the old backhoe out to the field by the beach and dug a grave in a pre-chosen spot. They assembled the simple, wooden coffin from a supply that administrators had ordered long before. Nurses dressed the deceased in the outfit that, while living, he or she picked out, packed in a bag, and stored in preparation: burying clothes. They applied makeup, maybe placed a favorite stuffed animal in the coffin. In death as in life, Kalaupapa residents often wore sunglasses, to cover drooping eyelids.

When Catherine died, it was my job to make plumeria leis to drape over her coffin and pick bougainvillea to pass around in bags at the graveside, so that everyone could toss a flower before the sandy dirt was shoveled back in. As I left the Bay View building to pick flowers, I found Jennifer still on the porch, sobbing. The porch was being repainted, and one of the maintenance guys had left a radio on. It was playing a song by Sarah McLachlan that Catherine used to ask Jennifer to play over and over on her ukulele.

I’d worn black to my first funeral in Kalaupapa—for a patient named Elaine, who’d once owned the bar and who chose to be buried in a sequined dress—and stood out ridiculously in the sea of aloha shirts. The next time I was out of the settlement I bought my own, knowing that there would be more occasions to wear it. By the time I left the next spring, seven more patients would die; Catherine was the first of them I was close to. It was shocking to see her in Kanaana Hou, the place where I’d known her best, lying in an open coffin and somehow looking nothing like herself. We sang “Blest Be the Tie that Binds,” the same hymn we sang at the end of church services every Sunday, but this time we sang the later verses, too:

We share each other’s woes,

Our mutual burdens bear.

And often for each other flows

The sympathizing tear.

When we are called to part

It gives us inward pain

But we shall still be joined in heart

And hope to meet again.

Electric drills emerged to screw the lid onto the coffin. Men hoisted it into the settlement ambulance, a hand-me-down from another island still labeled “Johnson Atoll.” Everyone headed out to the cemetery by the beach, where the backhoe stood ready to scoop the dirt back into its place: a grave in front of Catherine’s husband, Jubilee.

We were engrossed in the graveside service when one of the settlement’s fire trucks rolled up. Without asking anyone else’s permission, Kalawaia, a park carpenter, had decided to borrow it to pay tribute. He sent an arc of water over the grave toward the ocean. The sun turned it into rainbows.


Gertrude hated going to the care home to get the dressings changed on the end of her leg and her remaining foot. But the disease had left her with little feeling in her extremities, so she didn’t notice when her foot became infected late that summer, straining against her bandages. By the time anyone discovered what had happened, her whole lower leg had turned black.

She was sent to the hospital in Honolulu, where doctors wanted to amputate. Losing one foot, however, had been quite enough for her. “You send me back!” she told the doctor once she found out the plan. He warned her that she was likely to die. “Well,” she said, “if I die, I die in my house, and in my place, where I love. That’s alright with me.”

Back at the settlement, Gertrude treated herself with a plant she called “Hawaiian medicine,” the precise nature of which she kept a secret from everyone but the settlement cook she trusted to gather it for her. Amazingly, her leg got better. While it healed, she stayed away from the bar—she couldn’t use her crutches and hated to be seen in a wheelchair. Instead, I’d visit her little green-trimmed house in the afternoons. We’d look at old pictures and watch TV, and I’d help her cut up steak and open cans of food for her cats. Without the distraction of cribbage, she was free to talk, and I took the chance to ask her about some of the things the patients rarely seemed to want to discuss.

Not long before, a state senator had come to the peninsula to deliver a resolution passed by the legislature, 142 years after the first patients came to Kalaupapa: a formal apology for the way they had been treated. The resolution recognized the patients and their families “for their sacrifices, for thinking more of the public than of themselves, for giving up freedom and opportunities the rest of society takes for granted, for rebuilding their lives with pride and dignity, for overcoming prejudice and discrimination, and for consistently reaching out to others in need.”

I asked Gertrude what she thought of the resolution. She said she didn’t need an apology—if patients hadn’t been quarantined, she said, “people like you folks that don’t have the sick” would have gotten it. I considered debating this point with her. In fact, when the Hawaiian government decided to exile leprosy sufferers to Kalaupapa, the risk was lower than anyone knew: Leprosy is far less contagious than was once believed, and an estimated 95 percent of people are genetically immune (though the percentage is lower among native Hawaiians and some other ethnic groups). But I didn’t. Instead, I asked Gertrude about the part of the apology that said the people of Kalaupapa had “been remarkably resilient and have responded to their situations with kindness, generosity, and forgiveness rather than anger, bitterness, and despair.” This seemed like a pretty good summary of what I found most impressive about the patients, I said. Gertrude replied that the legislators must not have talked to the bitter ones.

To explain her own lack of bitterness, Gertrude would often talk about her third husband. When Gertrude’s second husband was dying, he asked his cousin Barney to look out for her. Before long, Barney asked Gertrude to marry him. She said no; he wasn’t a patient, and she couldn’t believe he could really want her. But he kept asking, over and over again, for more than 15 years. In 1995, at age 63, she relented. “He didn’t wait even a few minutes,” Gertrude told me. “He just went to the priest and told him he’s going to marry me.” They were married in Father Damien’s church in Kalawao. Barney taught her not to be ashamed of how she looked, to have patience with those who stared on their visits to the mainland. Most of all, she said, he was kind to her and taught her to be kinder to other people. Though he’d been dead for years, she still credited him with her wide circle of friends, the joy of her current life.

There was a big turnout for Gertrude’s first night back at the bar. Good news is so rare in the settlement that it demands celebration, and we’d all been worried about how the crumbling edifice of Kalaupapa would withstand a Gertrude-sized hole.

It was around this time that I decided to extend my time in Kalaupapa. My initial contract was up after six months, and I’d been unsure of how much longer I should stay. Some of the kokua I knew had come for short contracts and ended up living there for decades, becoming passionate experts in the minutiae of Kalaupapa history. Although I loved our little community, I was also 23 years old, and I felt the horizon getting stiflingly close. But Gertrude’s near miss had reminded me how fragile the Kalaupapa I knew was. I couldn’t leave and expect to find it again.

Adding another six months meant time to get the recycling program up and running, to go hunting with my fellow maintenance workers and learn how to butcher wild boars, to watch the winter bring waves that turned beaches from sand to rock, winds that stripped stop signs from their posts, and rain that turned the pali into a series of gushing waterfalls. It meant more parties and more funerals. Gloria’s husband, Richard, the former sheriff, died in December. In February, Kuulei Bell, a patient and Kalaupapa’s former postmistress, who’d once hung a lei around Pope John Paul II’s neck despite being instructed to hand it to an aide, passed away in a Honolulu hospital. We learned of her death at church on a Sunday. Pali, as I’d often heard him do, began counting the remaining patients—who was in Kalaupapa and who was in the hospital, who might be the next to go. That was the same day I’d told him I’d be leaving the settlement in a month’s time. I squirmed with the guilt of being the latest person to leave him behind.

In my last few weeks, I hiked to the deep lake inside the crater at the center of the peninsula—a trip I had saved, thinking that leaving something unseen would make the insular peninsula seem bigger than it was. I let the little shrimp that live in the water nibble my toes, thinking of the patients’ tales of diving in the lake in their younger days. When I left, I told everyone I’d be back—probably the next winter, I said. I told Gertrude that I’d see her again soon.

But once I was gone from Kalaupapa, time started speeding up again. Soon nearly two years had passed. Then one gray winter day, I received a phone call.


Gertrude died on Christmas Eve in a Honolulu hospital, not in her home after all. But she would be buried in Kalaupapa. She had been adamant that she didn’t want a funeral, and my friends who went told me it was a strange, spare graveside vigil. People started telling stories about Gertrude, until a kokua interrupted: This wasn’t what Gertrude wanted, she said. So people dispersed. I’m sure some of them ended up back at the bar, sure that it seemed empty and wrong without her.

It was a common observation that kokua were the ones who cried at funerals. Patients tended to be more stoic—they’d been to so many. In the 1940s, Gertrude used to say, there were sometimes two or three a day; she went to every one. I once asked her how she felt about the eventual end of the patient community in Kalaupapa, the end of the world in which she had lived nearly her entire life. She told me she couldn’t imagine Kalaupapa without the patients. “If God gon’ bless me to live yet, in those years,” she said quietly, “it’s going to be very sad for me.”

I didn’t manage to visit Kalaupapa again until last summer, more than two years after Gertrude’s death. Seventeen patients were still living then, but only eight of them were in Kalaupapa. The rest were mostly in the hospital; Norbert Palea, the youngest at age 72, was in prison for smuggling methamphetamine back to Kalaupapa after going to Honolulu for medical treatment. Kanaana Hou’s regular congregation was down to four people. Richard had become an official registered member—concerned that the church that had been started in 1866 would end with her and Pali, Auntie Kay, another dedicated patient member, had asked him to join before she died.

Pali was still running things, though somewhat less ebulliently than I remembered, and still counting patients. “You think they’d keep this place open for just one?” he asked one day as we went riding to the airport in his truck. He’d been repeatedly assured that Kalaupapa could be his home as long as he lived, but lately he’d been asking this question. He was still refereeing volleyball games on Wednesdays and Saturdays. People had started to call the game Paliball, and I heard a kokua compare it to cribbage and Gertrude: It was hard to imagine it continuing without him.

There was a new effort under way to sterilize the cats, and while you still saw them sleeping most everywhere, including all over the warm, silent streets after dark, they were noticeably fewer and even seemed less mangy. High-speed Internet had finally arrived in Kalaupapa, via a very long cable that snaked over the cliff and down along the trail. The bar was quieter at night than I remembered it.

Late one night, a group of young workers played video games on the big screen in the social hall. There was music blasting and a cooler of beer right next to an interpretive exhibit about Mother Marianne. “It used to be so raucous down here, I don’t think the patients would mind at all,” one woman said. “I think they’d be glad somebody’s still having a good time.”

One day I hitched a ride to the airport and walked back to town through the graveyards along the beach. Nearly five years after Catherine’s funeral, the sand was still heaped up on her grave. The name on her wooden cross was faded and partially obscured by dozens of leis made of beads, yarn, and fake flowers; unopened Heineken bottles sat at its base. Nearby I found the new graves of Auntie Kay and Uncle Henry.

On the edge of the beach, in an area where I had never attended a funeral, I found Gertrude’s grave, surrounded by its own little rock wall. Her cross, too, was piled with leis, and a forest of plastic flowers populated by ceramic figurines and seashells crowded around it. The cribbage board we used to keep score was sticking halfway out of the sand, its bright paint worn away to bare gray wood.

I didn’t think I’d cry, but the wholly expected shock of finding a cross with Gertrude underneath it overwhelmed me, and I did. I sat for a while and watched the waves, the ironwood trees swaying in the trade winds, the afternoon light on the pali. It hadn’t occurred to me to bring anything to put on the graves, and now I was sorry.

The graveyard was nicer than it used to be: Richard had found some money to repair the headstones that had fallen over or been split apart by rusting metal. As usual, the beach by the graveyard was empty of people, though a few monk seal pups had hauled out on the sand—a highly endangered species enjoying a recent renaissance, taking up residence on the quiet beaches of Kalaupapa. Watching them reminded me of my first hike up the trail to the top of the pali. From high up the cliffside, I watched a humpback whale float, still, on the surface of the bay. After a time, she began to thrash about so violently, she disappeared in the roiling water. Then something that looked from a distance like a small gray bullet shot out of the waves: a whale calf taking its first breaths.

My last morning in the settlement, I went around hugging people and promising, once again, to be back soon. Finally, I put on my pack and headed for the trail. There’s an overlook at the top, just before it cuts away from the pali and toward the topside road. The view of the peninsula from there is a common image on postcards and in books and brochures about Kalaupapa. In person, though, you can see the movement: a truck headed to the salt pools on the lava cliffs north of Kalawao, a tiny, unidentifiable person walking on the black sand beach. I tried to guess by the location and color of the cars who was home, who was visiting the store, who was taking their dogs out for a ride in the pickup truck. I needed to get going, but I kept turning back for one more look.