Diane LaDuke - ReportWire

FRANCONIA, N.H. (AP) — For more than two decades, residents in this tiny tourist town in the shadow of the White Mountains knew they could just drive a few minutes down the road to their community health center for a physical, a Vitamin B-12 shot or to get checked out for a case of the sniffles or high blood pressure.

But that changed last month, when this site of the Ammonoosuc Community Health Services in Franconia closed.

Employees at Ammonoosuc Community Health Services pack up the reception office as the clinic closes for good, Thursday, Oct. 23, 2025, in Franconia, N.H. (AP Photo/Robert F. Bukaty)

The Franconia Range of the White Mountains dominates the landscape, Wednesday, Oct. 22, 2025, in Sugar Hill, N.H. (AP Photo/Robert F. Bukaty)

The nearly 1,400 patients, who are often older and with more health problems than others in New Hampshire, will have to drive farther for their health care — a tricky prospect for some, especially during the winter months. More importantly, they will lose the close-knit bonds they forged with staffers like Diane LaDuke, who greets everyone with a smile from her perch at the front desk.

Marsha Luce, a patient at Ammonoosuc Community Health Services, delivers food to a Head Start program, Thursday, Oct. 23, 2025, in Littleton, N.H. (AP Photo/Robert F. Bukaty)

Marsha Luce, a patient at Ammonoosuc Community Health Services, wears a mask to avoid spreading her cold while volunteering at a local church, Wednesday, Oct. 22, 2025, in Franconia, N.H. (AP Photo/Robert F. Bukaty)

Marsha Luce, left, a patient at Ammonoosuc Community Health Services clinic, speaks with a friend while doing volunteer work at a community church food pantry, Wednesday, Oct. 22, 2025, in Franconia, N.H. (AP Photo/Robert F. Bukaty)

Marsha, left, and Kirk Luce, both patients at Ammonoosuc Community Health Services, prepare dinner, Thursday, Oct. 23, 2025, at their home in Franconia, N.H. (AP Photo/Robert F. Bukaty)

Town Hall stands behind a pair of colorful maple trees, Wednesday, Oct. 22, 2025, in Franconia, N.H. (AP Photo/Robert F. Bukaty)

On the center’s last day, longtime patient Susan Bushby, a 70-year-old housekeeper, stopped by to check her blood pressure — and to get a hug from LaDuke. Bushby had come to rely on LaDuke’s comforting words over the years and admits she is worried about finding the same kind of reception when she goes to one of Ammonoosuc’s other centers.

Susan Bushby, right, a patient at Ammonoosuc Community Health Services, and her son, Steven, sit in their home, Tuesday, Oct. 21, 2025, in Lisbon, N.H. (AP Photo/Robert F. Bukaty)

“I just really like it there. I don’t know, I’m just really going to miss it. It’s really hard for me to explain, but it’s going to be sad,” Bushby said.

Susan Bushby, a patient at Ammonoosuc Community Health Services, lights a cigarette at her home, Tuesday, Oct. 21, 2025, in Lisbon, N.H. (AP Photo/Robert F. Bukaty)

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Exhausted from working several weeks straight at a nearby inn, Bushby was talking about the center as she relaxed on her couch at her modest home in Lisbon. She often ends her day with cigarette and a glass of champagne. An avid angler, Bushby’s house was filled with photos and other Native American memorabilia and her dog Smiley was a constant presence.

A fisherman casts for trout at Pearl Lake, Tuesday, Oct. 21, 2025, in Lisbon, N.H. (AP Photo/Robert F. Bukaty)

Susan Bushby, a patient at the Ammonoosuc Community Health Services, offers an apple to deer passing through her backyard, Tuesday, Oct. 21, 2025, in Lisbon, N.H. (AP Photo/Robert F. Bukaty)

As she talked about the center closing, Bushby had a basket of apples on the kitchen counter ready for the deer that show up in her backyard almost every day. She joked that the center’s doctor, Dr. Melissa Buddensee, doubles as her therapist at times because she “listens to her where other people don’t.”

For another patient, Marsha Luce, it’s mostly about ensuring her husband gets the kind of care he had come to rely on over the years. Recovering from cancer that resulted in him losing part of his left ear and jaw, Luce worries about longer waits to see his doctor and the loss of relationships built up over decades in Franconia.

Susan Bushby is weighed during an appointment at Ammonoosuc Community Health Services, Tuesday, Oct. 21, 2025, in Franconia, N.H. (AP Photo/Robert F. Bukaty)

Receptionist Diane LaDuke, right, shares a laugh with longtime patient Susan Bushby at Ammonoosuc Community Health Services, Tuesday, Oct. 21, 2025, in Franconia, N.H. (AP Photo/Robert F. Bukaty)

Susan Bushby looks at her medical paperwork after an appointment at Ammonoosuc Community Health Services, Tuesday, Oct. 21, 2025, in Franconia, N.H. (AP Photo/Robert F. Bukaty)

The family, who moved to Franconia about 25 years ago, live in an old farmhouse that they renovated. Much of Luce’s time is spent caring for her husband, including keeping track of his appointment dates and all the various medications he needs to take. She also is a regular presence in the community, playing mahjong weekly with friends at the library and volunteering with the Head Start program.

Having to switch to another health center, she said, puts at risk the trust she and her husband have built up over the years at Ammonoosuc.

An exam table is moved onto a trailer on the final day of operation at Ammonoosuc Community Health Services as the clinic closes for good, Thursday, Oct. 23, 2025, in Franconia, N.H. (AP Photo/Robert F. Bukaty)

“It’s going to be hard,” said Luce, who was wearing a mask because she had a cold. “It’s a relationship that you can talk to people and you tell them something and you go, yeah, well, I’ve had cancer. Oh, let’s see. Oh, yeah. There it is in your chart. Do you know what I mean?”

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This is a documentary photo story curated by AP photo editors.

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