There are a lot of challenges to living in the Florida Keys. The biggest is the cost of living. But even some people who can afford to live in the Keys are leaving anyway for another reason — the lack of access to medical care.
Deb and her husband have lived in the Lower Keys since 1989. She remembers her first visit to the islands.
"It was every place I'd ever been that I loved. Like Nantucket ... and New Orleans," she said. "It just reminded me of a lot of wonderful places."
But after 30 years in the Keys, Deb, an artist, is packing up her studio and getting ready to leave town. (We're not using her last name because she and her husband don't want people to know their house is going to be empty.)
As she and her husband get older, she said they can't get the medical care they need here.
"We're sad to be leaving, really sad," she said.
She’s spent three decades inspired by her subtropical surroundings. Now, they’re headed for the desert, in California.
"Palm Springs right now, I don't know why, but it's very affordable," she said. At least compared to the Keys.
And their scouting trip showed other advantages.
"When we were driving around, we saw a lot of medical centers," she said.
It was not like the Keys, where going to see a specialist or having surgery or a medical test can be a whole ordeal.
"We sort of were getting tired of going to Miami for health care," Deb said. That's about four hours each way.
They love their eye doctor in the Keys, "but he doesn't do surgery," Deb said. "So if we needed surgical procedures, we had to go to Miami."
A couple summers ago, she had an ear problem. She couldn't get an appointment in the Keys for a month, so she got a recommendation for a doctor up in Miami.
"He saw me right away and that was terrific," she said. But she had three follow-up appointments — more trips to the mainland. Then her husband had a back problem and also wound up seeing someone in Miami.
"It's driving to Miami, staying over one night or two nights or whatever it takes, and then coming back - it's a chore," Deb said.
Four hours on a two-lane road
Nobody's keeping track of how many people leave the Keys because of access to medical care. But it's a common story. Ray Baker and Joe Viana lived in Key West for 29 years and they loved it.
"There's no place on Earth like Key West," Baker said.
But they both have heart conditions.
"It was a lot of trips to Mount Sinai," Viana said.
Viana said that meant two days for every appointment, since they weren't up for the roundtrip in one day.
"It was a long drive, and it was getting more and more difficult as we got older," he said. "Four hours on a two-lane road and it's terrible when you get stuck behind a truck pulling a boat."
Last summer they decided to start looking for a place on the mainland and they found one right away. It's in a retirement community in Pompano Beach. In November they moved into a two-bedroom condo.
"There's a registered nurse on call all the time — in fact he was just here, taking blood pressure and stuff," Viana said. "And it's on the eighth floor, so we don't have to worry about any flooding. Or iguanas or chickens or roosters. We can't have a dog, unfortunately. Or we can't have a big dog — we like labs."
They can't have a big dog, but they have a lot of choices now when they need medical care.
"There's the Cleveland Clinic, which is a huge medical facility here. Holy Cross, we haven't even been to Holy Cross yet," he said. "We went to the Broward Medical Center, which is closer. It's a much bigger facility than Key West. I don't know if you've ever been into the emergency room at Key West hospital, but it's not the greatest in the world."
Everyone’s really friendly in their new community in Pompano Beach, they said. Viana plays bridge a couple times a week. Baker's hoping to start a chess club.
"It's like living on a cruise ship," Baker said.
But they still miss their old life in Key West, where they were both really active. Baker helped start the Community Foundation of the Florida Keys. Viana volunteered with theater and music groups.
But it's the people in the Keys that they miss most.
"You go to a concert or you go to the theater and you always run into somebody you know. You go to the grocery store, you always run into somebody you know. And that's not the case here," Viana said. "I feel much more safe and comfortable here, but I miss all our friends in Key West. "
WLRN's Caitie Switalski contributed to this report.