For decades, residents of the North Fork and Shelter Island facing one of medicine’s most time-sensitive emergencies had little choice but to endure a race against geography.

A suspected stroke patient in Orient, East Marion or Shelter Island often faced a lengthy ambulance ride to Riverhead, Southampton or, in some cases, a helicopter flight to Stony Brook University Hospital. Every minute lost increased the likelihood of permanent brain damage, disability or death.

On Wednesday, Stony Brook Eastern Long Island Hospital officials, emergency medical personnel, elected leaders and community supporters gathered outside the Greenport hospital to celebrate a milestone they say will fundamentally change that equation: the official ribbon-cutting for the hospital’s new Joint Commission-certified Primary Stroke Center and the unveiling of a new mobile stroke unit designed to bring advanced stroke diagnosis and treatment directly into the field.

The ceremony marked the culmination of a years-long effort by hospital leadership, physicians, nurses, EMS partners and donors to establish a level of stroke care previously unavailable on the North Fork.

‘Time is brain’

“Time is brain, that is the mantra of stroke centers: time is brain,” Stony Brook Eastern Long Island Hospital Chief Administrative Officer Paul Connor told the crowd. “Before our program got certified, if you had a stroke and you were living out here, it’s going to take you 35, 45 minutes — even longer in the summer — to get to Riverhead or Southampton. Now you’re there in 15 minutes, maybe 10 minutes.”

Connor said the need for the program was driven by both demographics and distance.

The North Fork and Shelter Island have some of the oldest populations statewide, with roughly 40% of residents age 65 and older, the age group most vulnerable to stroke. At the same time, the region’s rural geography creates significant challenges when every minute counts.

“Literature tells us that 75% of strokes happen in individuals who are 65 and older,” Connor said. “We happen to have the oldest population per capita in the state of New York.”

‘Flicking a switch’

The hospital’s designation as a Primary Stroke Center means patients can now receive rapid evaluation, imaging, treatment and stabilization close to home. The designation also relies heavily on telemedicine technology, allowing neurologists from Stony Brook Medicine to evaluate patients remotely in real time.

“Our last neurologist was here in 2017,” Connor said. “That doesn’t mean we’re not searching for a neurologist. We are. But we are using technology and telestroke to bring you the best neurologist to the bedside by flicking a switch.”

Dr. William Wertheim, executive vice president of Stony Brook Medicine, said the achievement “represents access, equity, quality and lifesaving care close to home. Every single minute matters to life, to brain function and to recovery.”

He said that strokes affect nearly 800,000 Americans annually and remains the nation’s fifth-leading cause of death.

“This designation helps ensure that patients experiencing stroke symptoms can receive rapid evaluation, diagnosis, treatment and stabilization right here in the community.

‘Every second counts’

The new mobile stroke unit parked outside the hospital served as a visible reminder of how stroke care is evolving. Equipped with advanced diagnostic technology and connected to Stony Brook Medicine’s comprehensive stroke network, the unit can begin the process of identifying and treating strokes before patients even reach the hospital.

For local emergency responders, the new designation is expected to have an immediate impact.

Ed Boyd, president of the North Fork Volunteer Rescue Squad Association and chair of the Suffolk Regional Emergency Medical Services Council, said ambulance crews have long faced difficult choices when transporting stroke patients.

“Previously, when encountering a patient exhibiting signs consistent with a stroke, our choices were limited. Either helicopter transport to Stony Brook University Hospital if the helicopter was flying, or ground transport to Riverhead.”

Both options consumed precious time. Using Southold Fire Department as an example, Boyd said a stroke transport to Riverhead often ties up an ambulance crew for more than two hours, “compared with just over an hour for transport to Greenport.”

The new center also allows local EMS agencies to return to service more quickly and remain available for additional emergencies.

Boyd also used the occasion to reinforce how to recognize stroke symptoms, pointing to the “BE FAST” slogan displayed on either side of him at the podium and on the rear doors of the mobile stroke unit:

Balance loss.

Eyes — sudden vision changes.

Face drooping.

Arm weakness.

Speech difficulty.

Time to call 911.

“It’s up to each and every one of us to summon help immediately at the first sign of a stroke,” Boyd said. “Every second counts.”

‘Overwhelming’

Among the most compelling moments of the ceremony came from Southold resident Juan Ibanez, who suffered a stroke on Jan. 15 and became one of the hospital’s early stroke patients.

A retired Marine who served 20 years and completed four combat deployments, Ibanez described the experience as one of the most frightening moments of his life.

“When I got to the front desk and explained what was happening, the woman there calmly handed me a clipboard and said, ‘Someone will be right with you,’” he recalled.

Before he could begin filling out paperwork, a nurse moved him into treatment.

“Within seconds, my shirt was off and what felt like 30 people were suddenly in the emergency room,” Ibanez said. “Looking back now, it felt overwhelming, but everyone remained calm and professional, which helped me keep calm.”

He praised the hospital staff for their teamwork and urgency.

“The medical professionals here at Stony Brook Eastern Long Island Hospital are some of the finest healthcare professionals I could have ever hoped for,” he said.

The ceremony also included proclamations from Suffolk County Legislator Greg Doroski and members of the Southold Town Board, who praised the project as an example of what can be accomplished through partnerships among healthcare providers, donors, volunteers and government officials.

“Having this here in the community is vital, and it’s not just to the residents of our community,” Doroski said from the podium. “It’s to the residents of Suffolk County who spend time out here, and to the tourists who come out here, because seconds matter, and having this resource in our community benefits us all.”

‘Crystal clear thinking’

The event concluded with presentation of the hospital’s annual Crystal Clear Thinking Award, which recognizes exceptional clinical judgment during time-sensitive medical emergencies.

This year’s recipient was Nancy Williams, director of physical therapy, whose quick recognition of a critical medical situation helped trigger a rapid response.

Accepting the award, Williams deflected attention away from herself.

“I was doing my job,” she said. “I was in the right place at the right time, but I can’t do my job without everyone here doing their job.”