With less than three weeks remaining before election day, it's time for democracy to get nasty. Or "nastier," as the case may be. As the politicking gloves come off and the verbal blows gravitate southward, it seems appropriate somehow that what may be the nastiest, most pugnacious political melee in the county is going on down in SoHum, where five candidates are duking it out for two seats on the board of the Southern Humboldt Community Healthcare District (SHCHD).

It's a battle divided into two familiar factions -- one touting experience, the other demanding change. And the accusations have been flying: back-stabbing, criminal negligence, lies, self-promotion -- a juicy medley of political epithets. At the center of it all stands current board member/folk singer/activist Darryl Cherney, who, with characteristic hyperbole, described the race as "trench warfare in the streets of Garberville."

Here's how it stacks up: In one corner you have a pair of seasoned veterans: Realtor and former board member David Kirby and incumbent Nancy Wilson. Their party line? Ever since Cherney joined the board in 2006, they say, he's been stirring up unnecessary controversy -- sticking his nose into personnel matters, dredging up the distant past and making dangerous allegations.

In the other corner stand the self-proclaimed agents of change: Judith Gonzales, who was forced to quit her own janitorial business after falling from a ladder onto a 500-pound fountain, and Ed Smith, a retired globe-trotting project manager for the U.S. Agency for International Development. These are Cherney's candidates, recruited by him and the hospital's beloved Dr. Mark Phelps in an attempt to overhaul what Cherney calls "the do-nothing board, the rubber stamp for whoever the administrator is."

(The fifth candidate, longtime Garberville resident Chloe Bear, supports Kirby and Wilson. "I don't even know if I'll vote for myself," she told the Journal.)

The rural south-county medical district -- which consists of a small hospital, a skilled nursing facility, a lab and a clinic -- is no stranger to controversy and hardship. The past 10 years have largely been spent recovering from bankruptcy after the district's chief financial officer proved to be a fraud who'd falsified her résumé and grossly mismanaged district finances. (The FBI investigated and found fishy activities, but ultimately decided they had bigger fishies to fry.) And, earlier this year, the SHCHD commissioned a report from Trinidad consulting firm Bonser Bishop and Associates to address the significant decline in patient visits to the clinic (down 25 percent since 2000), as well as increasing reports of community dissatisfaction.

Despite these troubles, the SHCHD has managed to stay in the black for the past four years, thanks mostly to a voter-approved parcel tax, which generates more than $1 million annually.

Cherney contends that the board of directors, despite his efforts to shake things up, is a lame duck and says the senior administration is unfair to the staff and blind to the needs of the district. While awaiting his turn outside a local barbershop, Cherney unloaded his list of complaints.

"The old board is so atrophied," he said. His real beef started roughly a year-and-a-half ago, following a five-month "honeymoon period" after he and fellow local Mike Thompson (not to be confused with the U.S. Congressman) were appointed to the district board by the Humboldt County Board of Supervisors. (No one else chose to run for the two available seats.)

Cherney took umbrage with the administration for firing a 14-year employee, and he wasn't alone. Two employees quit in protest, as did the president of the hospital's non-profit fund-raising organization, The Phelps Foundation. Cherney, ever the activist, called for a closed board session to allow the disgruntled employees to appeal the decision. "I was trying to introduce mediation into the district," he said.

The board agreed to the meeting, but at the last minute, Cherney was called out of town due to a family emergency.

"My mother got sick and died," he recalled. "I made one phone call to the board president (Steve Bowen) and said, ‘Please hold this agenda item until I get back.'" When Cherney returned to town he found that the meeting had taken place without him. "That angered me," Cherney said. "(The board) took advantage of my mother's death to railroad through a dismissal I had put on the agenda. They stabbed me in the back."

Since then, Cherney has taken it upon himself to be a thorn in the side of the "good ol' boys" he says are running the place. With his righteous indignation firing on all cylinders, he has questioned everything from the clearcutting of trees in the parking lot to the functionality of a recently purchased X-ray digitizer. He says the board and the senior administration can't be trusted to make sound financial decisions, and their poor communication has created friction with the clinic staff.

And in case that's not enough, Cherney says that Kirby and especially Wilson are to blame for the bankruptcy. They were both on the board at the time, and Wilson was chairperson. "By law, the board is responsible for that bankruptcy," Cherney said.

Smith, one of Cherney's chosen, agrees. "I'm ex-Navy," he said, "and when the ship goes down, it doesn't matter if the captain is sleeping below deck; he's still responsible. She (Wilson) was the captain." Smith feels the majority of the board and senior administration are caught in a rut and ill-prepared for the rapidly changing health care system. He has challenged their billing practices and questioned their ability to problem-solve. "The district needs people who can think outside the box and position the hospital to meet whatever comes down the pike," Smith said.

Gonzales, Cherney's other nominee, speaks in language pulled straight from the presidential campaign. She says she's not a politician but an outsider, "just an ordinary community person" who is concerned for the welfare of the district. "I have the energy and strength to make some major changes," Gonzales said, "and we need changes big time." Specifically, she suggests pursuing more grants and easing the burden on the hospital's overworked, understaffed nurses.

A major component of the Cherney/Smith/Gonzales campaign is their call to recruit full-time doctors from outside the area. Currently, the district utilizes a service known as "rent-a-docs," paying part-timers to come to town for a few shifts each week. The Cherney gang believes that a permanent stable of physicians -- men and/or women who build bonds with the community, living and working there full-time -- is essential to good health care.

Most recently, Cherney has ruffled feathers by shining a spotlight on a current district employee with a criminal past. Many staff and community members say he's harassing the poor woman and using her as a political ploy. But Cherney insists it's relevant because it shows the board hasn't learned from its mistakes. "Nancy Wilson is deaf to all criticisms that affect our finances and health care," Cherney said."We have a different set of problems today, but it's the same mentality. Nancy is deaf and so is Dave Kirby."

Not surprisingly, Wilson and Kirby see things differently. Kirby doesn't argue that this race is about the status quo versus change. "But I go with axiom, ‘If it ain't broke, don't fix it,'" he said. "And I don't think it's broken."

From Kirby's perspective, Cherney is little more than a "loose cannon" making waves for his own aggrandizement. "He decided to make himself a white knight for a group of disgruntled employees and contractors -- people with an ax to grind. But Darryl is in there for Darryl," Kirby said. "I totally disagree with his approach, and I think he threatens the future of the institution."

Kirby served on the board from 1998 to 2006. When he stepped down, he was hopeful that the new blood would serve the board well. But in the past year he has grown increasingly concerned with Cherney's actions. He disagrees with Cherney's prescription for the district's future, particularly his call for full-time doctors.

"It's been done," Kirby said. It doesn't work, he explained, because the district would need at least four doctors to ensure that the ER is staffed at all times, and there's just not enough clinic work left over to justify the full-time salaries of all four. Plus, he said, "nobody can afford to live here anymore unless you're growing dope."

Despite the parcel tax revenue, Kirby sees financial trouble on the horizon. With the likely prospects of reduced funding for Medicaid, cuts in the state budget and increased health costs overall, Kirby says the district is going to have to fight for every penny. "I just feel like I've got a good idea what the model looks like to get us through," Kirby said. "Running around hiring people you can't use isn't part of it."

But the biggest motivating factor for Kirby -- the thing that really gets him steamed -- is Cherney's crusade against Wilson. "I can handle myself," said Kirby, who protests that he was not on the board when the fraudulent CFO was hired, that in fact he was brought on to help get rid of her, which he did. "Darryl's a blip on my radar. But to attack Nancy Wilson, who's been the stalwart, really the only board member with medical experience ... for him to badmouth her really pissed me off."

At 77, Nancy Wilson talks about the district's turbulence and controversies with a grandmotherly generosity. She recalls having to cut programs after the bankruptcy and speaks with pride about helping return the district to fiscal solvency. And she rejects the notion that the bankruptcy was her fault.

"I was not personally responsible," she told the Journal. "There's been a lot of time spent going over board records, trying to come up with assumptions and accusations. The administration had a lot of closed meetings I wasn't aware of." She paused, then reasserted, "I don't know why that would be my fault."

Wilson and Kirby say it couldn't have been their fault since the board is responsible for hiring and firing only the chief administrator -- currently Fortuna resident Debbie Scaife, who's retiring in June. The chief administrator and the human resources department are in charge of employment for rest of the staff, Kirby said.

"That is a flat-out lie," Cherney countered. His haircut complete, Cherney returned the Journal's phone call from the confines of his parked car. With proselytizing fervor, he read from local healthcare district law in the California Health and Safety Code, which states that health district boards do indeed have the authority "to determine the number of, and appoint, all officers and employees and to fix their compensation." Cherney said the board has simply passed the buck to the paid staff.

Upon reflection, Wilson later admitted the board probably does have that authority. "We've never looked at it that way," she said. "I think, abstractly, the board could do that, but we wouldn't want to."

Therein lies the problem, says Cherney. With his chosen candidates in place, he promises that the board would reclaim its rightful powers and set the district off in a new direction.

Not if Wilson and Kirby can help it. "Nancy would like to have gone down the road," Kirby said. "But she feels like me: If we let Darryl get any more power, (the district) is gonna go downhill."

Regardless of the outcome, Kirby feels that the all this election hubbub will ultimately have a positive effect on the SHCHD. "It's good," he said. "People are starting to pay attention. I doubt we'll ever again have an uncontested election."