Tangier Island is remote. Far out in Chesapeake Bay, it is an hour and a half by ferry from the eastern shore of Maryland. Each morning, Tangier's fishermen head their little boats toward deep water, leaving behind them only the ghostly outlines of pitched rooftops visible through the morning fog.

At just about this time—6 a.m.—Helen Jane Landon shuts the front door of her Tangier Island house and walks across the dew-drenched lawn to her bicycle. "Doctuh Jane," as she is known, is the only medical practitioner on the island. And on one recent morning she had a 6:15 appointment with 29-year-old Wayne Crockett, a descendant of the island's first settler, John Crockett.

Wayne had a tooth he wanted pulled, and Jane is qualified to pull and fill teeth in an emergency. During the 11 years she was a medical missionary to Pakistan she pulled more than 500 teeth. This time she told Wayne that root canal work was needed and made an appointment for him to see Dr. William Turner, a dentist who visits each Friday.

Like all but four people who live on Tangier, Jane's genealogy goes back to John Crockett too. Because islanders rarely leave, there has been a good deal of intermarriage—along with congenital abnormalities. In 1961 medical researchers discovered an uneven distribution of cholesterol in two children from the same family. The malady, attributed to heredity because the parents of the children had common ancestors, found its way into medical encyclopedias as "Tangier Disease."

The islanders have other troubles too. Because the men work in the damp sea air and gather nightly in the dank stores to tell fish stories and smoke, there have been outbreaks of tuberculosis. The traditional high cholesterol diets have caused chronic obesity in the women and early death for everyone. The life expectancy for men is 59 and 69 for women—considerably below national averages.

To complicate these problems, after 1957 when Dr. Charles Gladstone retired, the islanders were frequently without medical help. Over the next 12 years three doctors came and left. In 1969 a man who claimed to have been educated in Leningrad, and who boasted he could do anything but heart transplants, filled in—but left after a week or so when he was unable to produce a license.

By that time, Helen Jane Landon had earned a midwifery degree in Pakistan (she also holds a similar degree received later from Johns Hopkins). The town then begged her to come back home and run the $26,000 medical clinic.

In 1970 she returned and agreed to work four days a week on the island. She works 40 hours, Tuesday through Thursday, as a midwife on the mainland. Since her return there have been no more cases of tuberculosis, and her weight-reducing clinic on Saturdays has been a tremendous success. Although her zeal for healthfulness has earned respect, a few backsliders think she's a little too intolerant. Says one, "Jane don't seem to pay you no mind unless you've flossed your teeth and lost a pound or two."