Living on the Peninsula Fall 2010 by Sequim Gazette

FALL 2010

... AND LIVING WELL Pg.15

Seeking quality of life S HHospice focuses on comfort care

Pg.19

IIn the driver’s seat: ‘Healthy U’ teaches heart-failure management skills ‘H

Pg.25

Safety spurs Sequim helipad S

Pg.30

O Olympic Medical Cancer Center ‘Big city’ treatment close to home ‘B

Pg.36

JJamestown Family Health SServing tribal citizens and the community

Pg.41

Digital mammography: D AAdvanced imaging saves women’s lives

Pg.48

All the secrets, right here! A SStaying on a heart healthy path

LIVING ON THE PENINSULA | FALL | SEPTEMBER 2010

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LIVING ON THE PENINSULA | FALL | SEPTEMBER 2010

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26 30

8 44

DEPARTMENTS Recreation 8 Fall Magical mystery tour awaits

New Life 52 Your How do we define vacation?

alongside Duckabush River

54 Events Calendar

18 Fear not?

Heart & Soul

Living End 56 The To sum it up ...

& Entertainment 34 Arts Documenting the dams

The industrial art of Harry von Stark

& Then 58 Now Photographic journal

Gardening 44 Good Far Reaches Farm ... easy to reach

SPOTLIGHT quality of life 15 Seeking Hospice focuses on comfort care

Medical Cancer Center 30 Olympic ‘Big city’ treatment close to home

the driver’s seat: 19 In‘Healthy U’ teaches heart-failure

Jamestown Family Health 36 Serving tribal citizens and the community

management skills

20 Artful living 25 Safety spurs Sequim helipad there’s this to tell ... 26 Now The 16th Annual International Forest Storytelling Festival of Port Angeles

mammography: 41 Digital Advanced imaging saves women’s lives the secrets, right here! 48 All Staying on a heart healthy path planning 51 Regional Peninsula hospitals pursue regional sustainability On the cover: Sol Duc Falls in Olympic National Park is an easy, 0.8-mile hike. Cover photo by Melanie Reed

LIVING ON THE PENINSULA | FALL | SEPTEMBER 2010

Contributors

Jerry Kraft is a playwright, poet and theater critic. He reviews Seattle theater productions for SeattleActor.com and the national theater Web site AisleSay.com. In addition to his writing and photography, he teaches memoir writing at the YMCA in Port Angeles where he lives with his wife, Bridgett Bell Kraft, and their daughters, McKenna and Luxie.

Patricia Morrison Coate is the award-winning editor of Living on the Peninsula magazine. She has been a journalist since 1989 and earned degrees in Spanish from Eastern Michigan University and Indiana University. Coate joined the Sequim Gazette in 2004 as its special sections editor and can be reached at patc@sequimgazette.com.

Viviann Kuehl

has been a landowner and resident of Quilcene since 1982, although her family ties go back to homesteading in Jefferson County in 1905. She has written about the Quilcene community and Jefferson County over the past 20 years.

Mark Couhig has more than 30 years experience as a reporter, editor and publisher. He joined the Sequim Gazette in August 2010. In 2008 and 2009 Couhig served as editor of the local weekly, the Sangre de Cristo Chronicle, which was named New Mexico’s “Best Small Weekly” both years he served as editor. Reach him at mcouhig@sequimgazette.com.

Kelly McKillip always has loved writing and the arts and recently has forayed into combining the two in freelance articles. She has a bachelor’s degree in biology from Marylhurst College in Marylhurst, Ore., and a bachelor’s degree in nursing from Hayward State University in California. She works as a nurse at Olympic Medical Center and volunteers at The Dungeness Valley Health and Wellness Clinic.

Karen Frank received her master’s degree in transforming spirituality from Seattle University. She is a writer and spiritual director in Port Townsend. Reach her at karenanddana1@ q.com or www.yourlifeassacredstory.org.

Ruth Marcus offers leadership and lifestyle coaching in Sequim. She has earned a master’s degree in clinical psychology, a doctorate degree in religious studies and is a certified professional coach. Her Sequim Gazette column appears once a month. She is a published author and writes one-line daily inspirations for a national readership. Visit www.DrRuth Marcus. com or http://open.salon.com/blog/dr_ruth_marcus.

Beverly Hoffman writes a gardening column for the Sequim Gazette that appears once a month. She is an enthusiastic longtime gardener. She can be reached via e-mail at columnists@ sequim gazette.com.

Leif Nesheim was an award-winning reporter and hiking columnist with the Sequim Gazette from 2003-2006. He has a master’s degree in journalism from the University of WisconsinMadison and is the editor of the Montesano Vidette.

Rebecca Redshaw is an author and playwright who worked in the film industry in Los Angeles for 20 years before moving to the Northwest and writing full time. She has published articles and short stories in national publications and magazines. She is working on her third novel. Contact her at www.rebeccaredshaw.com.

P.O. Box 1750, Sequim, WA 98382 360-683-3311 Patricia Morrison Coate: patc@sequimgazette.com

Design: 226 Adams St., Port Townsend, WA 98368 360-385-2900 Fred Obee: fobee@ptleader.com Vol. 6, Number 3 Living on the Peninsula is a quarterly publication. © 2010 Sequim Gazette © 2010 Port Townsend & Jefferson County Leader 6

Melanie Reed is the award-winning lead designer for Living on the Peninsula. She has been a graphic designer for the Sequim Gazette since May 2004. She earned a bachelor’s degree in drawing from Western Washington University and also enjoys painting. Reed can be reached at mreed@sequim gazette.com.

LIVING ON THE PENINSULA | FALL | SEPTEMBER 2010

Fall RECREATION

The Duckabush River courses over boulders, framed by a mossy, shelf funguscovered stump at a trailside campsite.

stretch of trail between the two humps of the Duckabush River Trail is among my favorite valley hikes. It is a sun-dappled moss-floored forest with a magical feeling feel to it that sparks flights of imaginative fancy with each footstep. Though the steep ascent of the Big Hump four miles into the hike promises decent scenic views, the physical exertion sometimes leads me to wimp out and turn back early. Fortunately the valley is pleasant enough to make the excursion worthwhile whether or not Big Hump is climbed. If you haven’t done it, though, the climb is worth it. My wife, Mandy, and I had a little trouble following the trail from the lower stock unloading area to the hiking trailhead so we decided to drive up the unmarked spur on the right, just beyond the stock area to the trailhead. There’s a vault toilet here. Dodge, our youthful border collie mix, visited a handful of hikers prepping for the hike. We waited for them to get started so he could calm down. Story and photos by Leif Nesheim The route begins with a steady climb up an old logging road through thick second-growth forest colored with a delightful array of greens. The trail enters The Brothers Wilderness Area about one mile in.

MAGICAL MYSTERY TOUR

awaits alongside Duckabush River 8

The

The Little Hump peaks at about 900 feet after 1.2 miles before descending into a lovely green valley of lush ferns and mossy maples. This is my favorite part of the hike. The forest floor looks like a blanket of gentle green waves carpeting boulders and logs. There is surprisingly little underbrush and it almost looks tended, like a magical forest garden. Occasionally one is granted a peek-a-boo glimpse of the steep valley walls on either side. Sunlight dapples the forest floor between the trees. The rush of the river echoes on the left. The trail crosses several dry creek beds and several brisk rivulets. In one place, the trail winds between large, mossy boulders the size of cars and small houses. Soon the route runs beside the river — a frothy, boulder-strewn ribbon of aqua-hued water. A pleasant campsite borders the river just before the trail heads to the right toward Big Hump. The steep grade of the hump promises a challenging ascent of nearly 75-percent grade that switchbacks through forested paths of scree and gravel up some 1,000 feet of laborious hiking. To be sure, there are some pretty views of the deep blue water of Hood Canal between green peaks to the west, the twin domes across the river valley shading snow between Continued on Page 10

LIVING ON THE PENINSULA | FALL | SEPTEMBER 2010

Fall RECREATION Traces of high country snow can be seen between peaks south of the Duckabush River from a viewpoint near the top of Big Hump, as seen on a prior hike.

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Duckabush Trail How long: 4 miles to Big Hump. How hard: Moderately easy to Big Hump; moderately hard to top of hump. How to get there: From Sequim: Take U.S. Highway 101 east past Quilcene. Turn west onto Forest Service Road 2510, 3.5 miles south of Brinnon. Drive six miles to the trailhead. The trailhead is well-marked and has a stock unloading and parking area just beyond the stock unloading area on the right. There is a toilet at the trailhead. Leashed pets are allowed. A forest pass is required.

their heights and St. Peter’s Dome rising to the right. But having seen such views before and recalling the abuse the ascent and descent the trail put on our injury- and surgery-weakened knees on our last visit prompted us to forgo the pleasures of the view. Should you choose to make the trek, the trail continues past the top of the hump through a deep old-growth fir forest — the hump stopped the loggers a century earlier, too. The trail switchbacks down the far side of the hump. Once or twice the river shows between tree branches. Though the trail continues onward and enters Olympic National Park, I’ve never gone farther than the popular Five Mile Camp at the bottom of the Big Hump. On our return we noticed some cables left lying to rust alongside the trail beside logged stumps overgrown with moss and nurse logs near the base of Little Hump. We met several other hikers, including some dogs on the return — all of whom Dodge was very excited to meet. Fortunately he was a very good dog and didn’t jump or wiggle too much. Leif Nesheim is an award-winning hiking columnist, former Gazette reporter and editor/general manager of The Vidette in Montesano. He can be reached at lnesheim@ hotmail.com.

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The Duckabush Trail winds through trees and a mossy blanket covering the forest floor. Photo by Leif Nesheim

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The Hospice of Jefferson County team includes, from left, social worker Kolby Mertz, nurse Leslie Redman, hospice director Golda Posey, executive director Keri Johns and chaplain Russ Minter. Photo by Viviann Kuehl

Seeking quality of life Hospice focuses on comfort care

By Viviann Kuehl

onfusion about hospice care is widespread. Hospice is not a place and it doesn’t mean you have to die on a schedule — or even that you’ll die sooner than with traditional care. “Hospice is a scary word,” said Keri Johns, Hospice of Jefferson County executive director. “We are trying to educate the public and have a new foundation to get this valuable service to more people in need of it. Research shows that people who enter a hospice program have a better quality of life and actually live a wee bit longer.” Entering the program does not mean leaving your home. Hospice programs assist terminally ill people, and their families, in staying in their homes to the end of life, with a team of providers making home visits to deliver care. In Jefferson County, Golda Posey, RN, has been heading the hospice team as hospice director since January. She is excited about a new program that aims to raise friends and funds to extend the benefits of hospice services to a broader range of those in need. Community Palliative Care is a program now funded by the Hospice Foundation of Jefferson Healthcare, itself a relatively new organization. The foundation was incorporated in October 2009 and received 501(c)(3) status in

LIVING ON THE PENINSULA | FALL | SEPTEMBER 2010

April of this year. “It’s very exciting to those of us involved,” said board president Michael Kubec. Each of the current seven board members has had a personal experience with hospice that fosters commitment to the program, explained Kubec. Her first husband died of leukemia 25 years ago. “It was incredible to me. Apart from my husband, it was unbelievable the level of care and support to me. I was so well taken care of. People explained things to me. They let me cry, they let me rage, they let me laugh, they let me do all the things you do in a major life transition. It’s the gift that hospice brings to every patient and every family.” “Hospice is a concept based on the belief that each of us can die pain-free and with dignity and have our families attended to,” said Posey.

Dying with dignity The hospice movement started in Great Britain with the idea that there was a much more appropriate way to spend the end of life than dying in a hospital with lots of treatment going on, said Posey. Hospice does not end or prolong life but focuses on quality of life. The program is designed to serve patients

in their homes as they approach the end of their lives and it serves their families as well. In her 35 years of experience in nursing care, Posey saw people at the end stages of life as an oncology nurse and intensive care nurse. “Just because a treatment is available, it’s not necessarily appropriate for the end of life,” said Posey, many of whose patients wanted to spend their last days at home with their families and pets. “Hospice can help someone understand what to do to make that happen.” Hospice became part of Medicare as a result of 1982 legislation and now is covered by most insurances, said Posey. Hospice of Jefferson County is an intermittent care program with services for people at home, serving 25-45 patients in Jefferson County at any given time. “It’s a complex kind of care and difficult to describe. Unless you have had a family member in hospice, people generally don’t know what the program actually does,” Posey said.

Wide-ranging services Typical hospice services include home visits by professionals. A nurse may discuss medical issues and

Olympic Peninsula hospices ■ Assured Hospice of Jefferson and Clallam Counties 1201 Hancock St., Port Townsend 360-344-3258 24 Lee Chatfield Way, Sequim 360-582-3796 ■ Volunteer Hospice of Clallam County 540 E. Eighth St., Port Angeles 360-452-1511 ■ Hospice of Jefferson County (Jefferson Healthcare) 2500 W. Sims Way Ste. 300 Port Townsend, 360-385-0610 Local master metal-sculpting artisan blacksmith Russell Jaqua died in 2006 of amyotrophic lateral sclerosis or Lou Gehrig’s disease. Hospice of Jefferson County helped Jaqua spend his last days at home with his wife, Willene, and their dog Trixie. Submitted photo

medications related to comfort, which may include pain relievers, muscle relaxants, constipation remedies, whatever is needed. A bath aide may help the patient and family with personal care. A social worker may talk about feelings, listen to concerns and share information about resources available in the community. A chaplain may come for spiritual issues. A massage therapist may provide massages to relax a patient. A community volunteer can talk or read to a patient, help with household activities, run errands or provide brief respite care. The hospice program can coordinate equipment, such as hospital beds and oxygen tanks, to make care safer and more comfortable for the patient and family. It can provide respite care of up to five days at Kai Tai, its designated respite care service. To be eligible, an individual must have a life expectancy of six months or less, with cure no longer possible. The focus is on comfort care.

Hospice and more The Community Palliative Care program expands hospice care to include those with a serious life-challenging illness with a life expectancy of up to two years and does not exclude life-extending treatment, said Kubec. The basic services and the personnel administering them are the same in both programs. The difference is in eligibility criteria and funding sources. Most people in the hospice program are on Medicare, said Posey. “The CPC program allows us to provide comfort ser-

vices that Medicare and insurance don’t cover,” she said. “We don’t have unlimited funding for additional services. The more fundraising, the more we will be able to offer.” Kubec hopes that the program will provide a continuum of service and a seamless transition to hospice. “If people know the CPC program, I hope people will be less afraid of hospice and more people will take advantage of the free care and support to caregivers,” said Kubec. “People wait too long to enter hospice because they think it means ‘I’m dying,’ but many more people could benefit from palliative care prior to the time of death.” As an example, a person with emphysema or congestive heart failure or dementia, and their families, still could need help with medical issues well before the final six months of life. Although that six-month measure is necessarily approximate and people can move in and out of hospice depending on how their disease progresses, it can be intimidating, said Johns. People not quite ready for hospice still can benefit from information and support, or may need help with pain and symptom control, said Posey. People with chronic diseases and those who have been in hospice and stabilized could benefit from the CPC program, Posey added. Each individual is different and both programs honor individual choices. Patients and their families have to deal with physical, social and emotional changes, and there are choices to be made for the best quality of life for each patient. Both programs assist patients and families through the changes that occur at the end of life, whether the end

disease continues as expected or not. Bereavement follow-up is available to family members for up to a year after their loved one’s death. “The work we do is important and valuable,” said Posey. “We provide care when cure is no longer available. We are all saddened when someone dies but there’s also a lot of fun, happy moments and decisions about the quality of life. We are truly making a difference in the community.” Although most work of the fledgling foundation has been organizational, they hope to have a fundraising event by the end of the year, said Kubec. “We’re a success if people are coming in earlier and taking advantage of the services sooner, and obviously, if we raise money,” said Kubec. Posey and Nurse Educator Jackie Levin are available to talk to the community, as individuals or in groups, in homes or public meetings, about the program, clinical issues, advance directives and other aspects of the two programs. Hospice of Jefferson County can be reached at 360-3850610. The office is on the third floor of the Madrona Hill Building at 2500 W. Sims Way in Port Townsend. More information is online at www.jeffersonhealth care.org. Look for Services in the top bar, then choose Home Health and Hospice. Also, hospice volunteer training is scheduled for October in Port Townsend. Medicare Hospice Benefits, a booklet by the Department of Health and Human Services, has more information on hospice eligibility and services.

LIVING ON THE PENINSULA | FALL | SEPTEMBER 2010

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Fear not? By Karen Frank

ear not! From Genesis to Revelations, the most common admonishment to human beings is to trust in God and not have a fearful spirit. But I have anxiety attacks frequently. If you’ve never had one, they feel like this to me: I turn out the lights and peacefully lie down to sleep. Immediately I feel like I’m suffocating. I have an overpowering urge to get up and flee to someplace where I can breathe and survive. Does that fear make me a spiritual failure? I grew up an anxious child, with night terrors, and, later, an almost paralyzed approach to teenagers and young adults. Like many people with anxiety disorders or depression, I selfmedicated with alcohol and drugs, which of course only made the problem worse. Nonetheless, I was convinced that I did not need help in solving a problem I saw as a personal character flaw. By the time I was in graduate school, I had to take six months off because I could not sit in a classroom with a closed door. There have been years when I could not drive a car, fly in airplanes or even cross the Hood Canal bridge. As for tunnels, let’s not even think about them for this lifetime. Right now, I know there are other men and women sitting out there in Sequim or Port Angeles unable to leave their homes even to go to the grocery store or visit friends. Like many of them, I’ve tried nearly everything in the book to soothe myself: biofeedback, movement therapy, talk therapy, meditation, prayer, inner child work, voice work, group work and plain old suffering through it all just waiting for the struggle to subside. I tried to pray away my anxiety, let it pass through like a gentle cloud in meditation and generally “spirit” it out of my life. Although no one at my theology school told me to reject medication, I got the picture that a medical solution was a failure, a surrender that would thwart my spiritual growth. Furthermore, from 12-step programs I received the toxic message that dealing with anxiety with medication would lead me back to a life of destructive addiction. But, the only thing that has worked for me (so far) is medication. Why did I resist that solution for so many years?

There’s the stigma, of course, of being labeled “emotionally disturbed” or “mentally ill.” Also, I’m from the Midwest and from a generation that believed we could solve every problem ourselves. Self-reliance and stoicism were key. Added to that were a culture and religious institutions that consider anxiety and depression signs of spiritual inferiority or inadequacy. Fear not! I struggled along in great pain for too many years because of that misguided message. What are we to think when everything from mainstream churches to Oprah’s magazine tells us to replace fear with faith and love and we can’t? How can we trust our own paths and find support for ongoing growth? There is an AA saying that seems appropriate: God doesn’t make any junk. We emerge from the Great Mystery as unique collections of DNA who wend our way through family drama and cultural milieu, always infused with the divine sparks of our origins. No one is unbroken. No one is without scars. We are whole because we contain varying amounts of all qualities and emotions, not because we live each day in blissville. We have limits, boundaries to our world we discover and learn to accept. I can’t sit for a blood test without bursting into tears but I can be present to a woman struggling to make meaning out of a chaotic life. After two hours on an airplane, I’m ready to ask them to please let me out. In the spiritual life, we work with what we have. We cut through the clouds of denial and acknowledge the reality of our finite human existence. All religions vary in their teachings, but being fearless is not the central point of any of them. Buddhism actually encourages us to explore all our emotions and use them to grow.

However, extreme anxiety doesn’t serve our physical survival. It can undermine it. So if you struggle with anxiety or its corollary depression, please get help from psychotherapists or doctors or enlightened spiritual leaders. Anxiety and depression often are lifelong companions. What kind of spirituality can support us when we have to deal with difficult chronic conditions like these? I believe that my spiritual life is healthier, as am I, with my anxiety reduced to a dull roar by medication. So that’s a beginning. My life is bigger. I can refresh myself with the music of Il Divo or with trips to Rialto Beach or Hurricane Ridge. I can play one-on-one water polo to get rid of the “squirrels.” I like to remember what another spiritual director once told me. She said that I should think of anxiety as like waves whipped by the wind on the surface of the water, while in the depths the water is calm. And remember the television series “Touched by an Angel”? It seemed over-the-top, but its central message was consistent and valuable. Whichever angel was dealing with the problem of the day started to glow in an unearthly way and told the people involved, “God loves you!” Not God will love you if …. Not God loves you some of the time when you’re acting right. Not God might love you if you change your whole way of life. God loves you! It’s a good starting point, I think, for those of us with more noticeable cracks and fracture lines in our personalities. We can open up to the Spirit of Life and Love who heals, comforts and travels with us on the long-term journey of our lives. Fear not! Love is available to us just as we are. When we panic, when we despair, we can reach out our arms confident that we will be enfolded to the breast of the One Who Loves, not spurned and told to come back when we are in better shape. God loves you and when you are able to swim deeper into yourself where the surface storms subside, human and spirit touch and you can rest a little bit easier.

Karen Frank is a writer and photographer in Port Townsend. She welcomes your comments and can be reached in several ways: at her website www.yourlifeas sacredstory.org, by e-mail karenanddana1@q.com or through her blog.

LIVING ON THE PENINSULA | FALL | SEPTEMBER 2010

In the driver’s seat: Story and photo by Patricia Morrison Coate

‘Healthy U’ teaches heart-failure management skills

Day

in and day out, cardiac-care specialists at Olympic Medical Center see patients in Sequim and Port Angeles with a diagnosis of heart failure – a decrease in the heart muscle’s effectiveness to pump blood. More often than not, these patients have been in the health care system with serious consequences, such as shortness of breath, high blood pressure and perhaps a heart attack. It is a diagnosis that’s taxing on heart-failure patients, their families and the health care system. In her position as the director of OMC’s cardiac program, Judy Tordini, RN, has seen many patients come to cardiac rehabilitation after their heart muscle has been damaged and that fact weighed on her professionally and personally. The modus operandi for cardiac services nationwide has been to be reactive rather than proactive. Tordini and OMC staff wanted better lives for patients at risk for heart failure — lives in which the latter were in control of their own heart health destinies. “We have a ton of heart failure (diagnoses) and there was not any program around to help — they would wait until they got into end-stage heart failure when there was little we could do to help them. I wanted to have a program so patients would have a choice to control the destiny of their heart disease instead of having their hand forced into the system,” Tordini said. OMC had the ideal candidate to create the program with Tordini — Pat McCollum, the center’s former cardiac rehabilitation coordinator. After a two-year hiatus in Maine, McCollum returned to Sequim to create and manage the “Healthy U” program for patients with risk factors for or who are diagnosed with heart failure. McCollum is an exercise physiologist, wellness coach and yoga instructor and brings all of her areas of expertise to bear in her new position as health promotions/disease management coach. “The medical staff sends us so many patients with this diagnosis, so I went to that pool first and invited them,”

system t Tordini said. “They had been in the system goal al enough that they needed help. The firstt go saffe was to start the program, achieve safe outcomes and build on it. I bet by the he end of the year we’ll have three classes a day — we have the capacity for five or six but we want the program to grow slowly and keep the quality.” “Healthy U” began in July with 15 patients in varying stages of heart failure. They were clinically screened by a nurse and the extent of their disease was plotted on a chart so each person knew and understood his or her status. They also graded on a scale of 1 to 10 their individual levels of motivation to change — a value of 5 was the minimum. “Our challenge is to keep them motivated to make changes so they’ll want to do it every day of their lives,” Tordini said. “The biggest motivation is when people can’t breathe and they decide they want a choice. Each patient picks one goal a week and asks, ‘Am I moving forward or do I need a new goal?’ so it brings the clinical health part into their lives,” Tordini said. Central to the program is motivated self-management and it’s designed to show patients graphically how to stay in the “green zone” and out of the yellow and red zones. Like a stoplight, green means “Go.” Symptoms of heart failure are controlled by following a heart healthy diet, taking medications consistently, weighing and exercising daily. Yellow signals “Caution.” Heart-failure symptoms such as shortness of breath, edema or chest pain call for an adjustment in an individual’s management plan. Red is for “Alert” — heart-failure symptoms are becoming unmanageable without the intervention of the health care system. The group meets three days a week for three months

Judy Tordini, RN, cardiac program director at Olympic Medical Center, displays one of the tools patients use to self-manage their heart failure in her department’s “Healthy U” class.

in the exercise room upstairs in OMC’s Medical Services Building, 840 N. Fifth Ave., Sequim. It takes three months to effect long-lasting behavioral changes, Tordini noted. During the 60-minute sessions, McCollum guides patients in cardiovascular, strength, flexibility and relaxation exercises plus coaches them in steps to manage their disease. “Pat also has expertise in stress management and because she’s a yoga instructor, she coaches the patients on being mindful in their breathing to manage stress instead of them turning to food or other bad habits,” Tordini said. “Patients also are required to meet one-on-one with Pat for a 20-minute coaching session monthly to make their goals achievable.” The program, which is $60 per month and not covered by insurance, already is making a difference. “Since July, 80 percent of the patients have lost weight and avoided problems where they could have ended up in the emergency room or a physician’s office,” Tordini said. “To see people get motivated and want to get well — I just love it!”

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Artful By Rebecca Redshaw

living

Photographic artist Charlotte Watts and author/playwright Rebecca Redshaw met over a cup of tea to discuss the artist’s life on the Olympic Peninsula in the 21st century.

so well. We so underestimate youth AND elders. We get locked into focusing on “money earning” years and money has nothing to do with it. We both are poor artists, right?

CW: What is art? What is life? I brought a card for you.

CW: Yes.

RR: A new image of yours? Beautiful. Ah, the verse is a quote. What is life? It is the flash of a firefly in the night. It is the breath of a buffalo in the winter time. It is the little shadow which runs across the ground And loses itself in the sunset. Crowfoot (Blackfeet), 1919

RR: But we live very nice lives.

I agree with that thought. People seem to be oblivious of the beauty of life around us. It doesn’t necessarily mean brush to palette or word to paper.

CW: And the transitory nature of it means that to be “good” art it doesn’t have to be in a museum on a wall forever or music that has been played for centuries. RR: You brought an enlargement of my nephew Carter’s photo over this morning. Here’s a young boy that never took pictures until he got his cool Droid phone and his dad told him to take pictures while on vacation. Then he takes a picture that is “art” worthy. He captured beauty.

CW: He must have been thinking about these things before hand, composing somewhere. RR: He wrote a eulogy for his mother’s funeral last year that was beautiful. I had no idea he could express himself

CW: Oh, God, yes (laughs). RR: I’m not saying “woe is me” because I don’t have a lot of “things.” I don’t want a lot of things, but in this society, that’s how success is measured. Is your work in the Metropolitan Museum? No. Is my book in every library and on every reading list? No.

CW: No, but some kind of “success” is necessary because that’s how we judge if we’re good or bad, if we’re going to be accepted into that higher echelon. RR: The artist needs the acknowledgement of someone whose opinion is valued. When I won first prize in a literary journal contest, all of a sudden (because there was money attached and I won “first”) I felt validated. I felt good about it! The story “Somebody Special” had been around for years and rejected by lots of people, but someone says they like it and I’m legitimate? You must have had the same experience.

CW: Every few years I feel the need to gather with other photographers and meet with professionals to get feedback and unless I do, the value I place on my work is not very high.

RR: We’ve known each other about 10 years now and I’ve seen your work evolve and change and hopefully my writing has as well. As we progress and try new things, we have doubts, right? We always have doubts. Then there’s the brazen moment where we say, mostly to ourselves, “I know what I’m saying through my art is important. People should pay attention.”

CW: I go back to my work and see the transition over the years, not just technically but my visual approach, I think, “Why wasn’t I in this place 30 years ago? How much better would I be now?” You, as a writer, have always written. RR: Not really. My focus was music and teaching. Even when I was teaching I didn’t particularly write anything. I was never a journalism or English Lit major. After teaching, I got involved in the film industry and my focus was on wherever I was working at the time. I rarely wrote. Someone asked me to write a screenplay one time and I struggled. I couldn’t stand it because it was so monetarily driven: “By Page 10 have ‘this’ happen or no one will pay attention.” I really didn’t start writing until I took a short story course at UCLA Extension. I was in my early thirties.

CW: But you had stories in the back of your head because you wrote your own songs. RR: I did write lyrics and songs but it was always sort of a haphazard thing. It wasn’t my life. I actually think writing is my call, but I didn’t find that out until the last third of my life. “Oh, OK, now I know what I’m supposed to do!” Someone recently commented to me something about my writing and I said, “That’s what I do.”

LIVING ON THE PENINSULA | FALL | SEPTEMBER 2010

CW: A friend of mine from the Peace Corps and I were talking about art and he asked if art was enough for me and I said, “It might be too much. I am consumed.” Maybe it’s an obsession. It’s what I spend most of my time doing and thinking. I’m not sure that’s a totally healthy thing. I don’t know. Could I just “do” art? Acknowledging the difficulties in a relationship actually make it easier to have one. RR: Being an artist is living life on a teeter totter. To really explore our thoughts and our emotions and our visions we need time to sit back and reflect and, oh, yeah, we’re also trying to make a living. And so we take odd jobs for fifty dollars here, a hundred dollars there. And all of that is wonderful, because it’s sort of what we do because it uses the same equipment, but it’s not creative and it absolutely detracts from the time we need to reflect. I look at my old files and there are so many things I want to write that are still there, waiting.

RR: It’s in my wallet. My reaction was funny. I thought, “Well, someone somewhere is reading it.” If you write a best seller like Stephenie Meyer who wrote the “Twilight” stuff and sells millions and millions of books, that small acknowledgement might not necessarily mean anything since she has millions. And, yet, I don’t compare our work because we aren’t in the same literary ballpark. There’s that dollar value thing that is disproportionate to reality. Size really doesn’t matter when it comes to quality. I’ve seen great performances in small venues.

Above: Rebecca Redshaw goes to her office everyday in her backyard. Photo by Charlotte Watts

Our conversation is interrupted by two deer that live in the nearby ravine, their heads barely visible on the horizon.

Left: Photographer Charlotte Watts enjoys experimenting with the tactile nature of photographs. Photo courtesy of Charlotte Watts

CW: Where’s the camera when you need it? That’s a great shot. Yesterday I looked out in the field and saw two deer strolling by. It’s not only about making money.

on my iPod. There’s a tangibleness about it.

RR: Maybe artists in the past have been isolated but by the very nature of sharing your art, you have to be involved in the world. Don’t you think?

CW: The tactile nature of photographs is not simply the image printed but the kind of paper it is printed on. I guess it’s like writing a play and never having it performed. Art requires performance or print or whatever.

CW: When I go to a workshop or a review, other professional photographers offer criticism which is valid. RR: When I send my writing to agents or publishers sometimes they give me feedback and I think they’re idiots if they don’t get it. (laughs) Ultimate praise and ultimate negative criticism aren’t really helpful. I eliminate the top and the bottom and hope someone in the middle gets it. As a playwright, the reward is in the audience reaction. Occasionally, I’ll get a note from someone who is touched by an article or a novel.

CW: I got a card from a couple who came by during the Lavender Festival who spent two hours walking around, looking at my work. RR: People go the Louvre and don’t spend two hours!

CW: (laughs) It was a long time. We just talked about the work and I got a card a few days later. That touched me. RR: I got a card from a reader who read the Gazette piece about my father. It touched my heart because she took the time to acknowledge my work. Oh, and the other day I got a royalty check from Amazon for $10.50. Five people, that I don’t know, bought “Dear Jennifer” as an e-book.

CW: What did you do with it? Frame it and put it behind your desk?

LIVING ON THE PENINSULA | FALL | SEPTEMBER 2010

Here’s an example, Marianne Trowbridge was brilliant in my play, “Four Women” and for years she never made a dime in the theater. I’d love to rent a stage in New York and give her a shot. Wouldn’t you?

RR: Art, in my case, writing, requires three steps: one, the process of sitting down and writing; two, the moment you, as the author, know it’s complete; and three, sharing that work with someone. If you put your photos on a shelf or I put my writings in a drawer and never involve another human being, the value is minimal, I think. And that’s the risk we take and we take it every day and sometimes we can get “beat up” emotionally so we protect ourselves. For instance, you come across as aloof and a little bit of a snob when in reality you are introspective and sensitive. That’s what I see. I come off as gregarious and brazen and yet I am incredibly sensitive and introverted which no one believes. But that’s the perception. Am I wrong?

CW: No, that’s correct. CW: Yes. This digitized world has certainly changed the art and I’m not certain it’s for the better. It’s changed the book publishing business and the world of photography. Think about it. For a book never to be held in your hands or for a photographer never to see her picture printed on paper is very strange. It still adds weight to have a work printed, it adds to its importance. The new generation doesn’t have a clue what that’s about, but I think it’s important. RR: As I’m going through my books and CDs to donate to a garage sale, I find there are some I don’t want to give up. If I don’t hold them in my hand, I want to see them on my shelves. I want to look at the cover of a CD not just play it

RR: If we left ourselves raw all the time, we wouldn’t survive; we would be ending it because it’s just too hard. Part of the reason our friendship exists is because we acknowledge that and we don’t have to verbalize it.

Recent Work RR: Both of us have done pieces that we have no logical affinity for; your work depicting the essence of Manzanar (World War II prison camp in California) and my play about Hattie McDaniel (first African-American to win the Academy Award for her portrayal of “Mammy” in “Gone with the Wind.”). You’re not Japanese and I’m not black

or come from slave origins and yet we feel an affinity for our subjects.

CW: It’s about discrimination that we have. RR: How many images of Manzanar do you have in addition to the scrolls already completed?

CW: Many more. I’m also going back to take more photographs. I have four completed scrolls, each with a different image of Manzanar and I’d like to have 12 to 15 total. Each image is printed on a special mulberry paper and then hand-deckled. After that, a backing is made using two colors of bark from Thailand. First the bark edges are deckled, then the photograph is applied to the white bark, then those two are combined with the natural bark, then the scroll is made by turning under all the edges, and finally suspending from a dowel. Each scroll is labor intensive — many hours of work. RR: I know how hard it is to get attention for my work. Right now I’d love to get “Four Women” to Annette Bening. That’s virtually impossible because I’m not in New York or LA and not represented by CAA. Yet, we want someone to represent our work or at least get our work out there. How do you draw attention to this? Where do you send the scrolls?

a black version and a white version because I thought the roles could be interchanged because the play’s about a neighborhood, it’s not about race. It was performed with a multi-racial cast and a black woman in the audience came up to me and said, “How did you know that? How did you get it so right on as a white woman?” Well, we’re artists, observers of life. I don’t have to be a drug addict to write about addicts. I’ve written two suicides stories and I’m still here.

CW: That’s the problem with discrimination. We don’t give the other people credit. You have to be a black person to understand? I have to be Japanese to understand? RR: As artists, we have to be empathetic, otherwise we have nothing.

CW: The difference between a performance piece of yours and my work is that each time your work is viewed, you get to see a different reaction. When people see my work in a museum or gallery, most of the time I don’t get to see reactions to the work. Even if an e-mail is available, people rarely respond or give feedback. CW: Yes, but I think not just artists. Everybody has it in their nature to understand somebody else. RR: I’m not so sure. (laughs)

RR: Last year I read an interview with the late Horton Foote who said, and I’m paraphrasing, “If your work is in a drawer, you’re not doing anybody any good. Get it out there.” That’s when I kicked it into gear, more or less. I’m pleased that Olympic Theatre Arts chose to produce two of my plays as well as the Port Angeles Fine Arts Center. I appreciate the community and the support; however, it’s a small venue for what I feel is a universal message. Especially when you see what’s out there. I don’t think people understand the time and intensity that goes into your photographs, the hours that go into it.

RR: Interesting. Museums are a very sterile environment and often times they create an atmosphere of people watching people observing art.

CW: How do you get people to read your work? RR: When I completed “A Conversation with Hattie McDaniel,” I sent it to two of my friends who are AfricanAmerican. One e-mailed be and said, “Why did you write this?” and the other I’ve never heard from. I’m presupposing, and I know that’s dangerous, that they think “Why are you writing about Hattie McDaniel? What do you know?” The fact of the matter is, I didn’t know, but as a writer I researched and observed and watched and do. When I wrote “Hennessey Street” years ago, I wrote two versions,

CW: It’s the other part of being an artist. You have to get in the trenches and get the work out there and it’s very difficult.

CW: It’s not just the hands-on work. Like your stories, this work has been going on in my head for 30 some years. I will take the scrolls down to the National Park Service at Manzanar or e-mail images of them. I would love to hang the scrolls outside there. I feel it’s absolutely where it belongs.

CW: For Manzanar to get attention, I think I need to meet with the Japanese. I’ll probably first go to the Bainbridge Island community since they were the first group to lose their homes and they’re in the process of building a memorial at the dock where they were taken away. I’d like to show them my work which will be hard because here’s this white person coming in. I’m a little hesitant. RR: It’s like saying, ‘I think I’ll go to a pow wow and then I’ll be a Native.” The reaction most likely would be “What do you know about it?” And yet with your work, there’s an affinity there.

members.” Well, that’s OK, but I guess I feel pretty good about how far I’ve come because I don’t “know” anybody. You don’t either.

CW: OK, maybe more people than we give credit to.

Why Work So Hard? RR: Getting back to your work and submitting it to possible cultural avenues. Does the NEA have any grants with Asian emphasis? A lot of it is who you know. A friend got a grant to make a movie and I said, “That’s awesome. How did you do that?” And she said, “I knew the committee

RR: We’re devoting our lives to this “stuff.” We need that response to go on. It means we’re not just spinning our wheels. People do get it. Sometimes our work makes a difference in lives and sometimes it’s just enjoyable and that’s OK. Since I wrote “Dear Jennifer” I’ve had many different reactions to it and I’ve noted people read it on three different levels; 1: real quick ’cause it’s fast and they say “That’s a nice story,” 2: they remember they lived through those times and relate to the issues, 3: occasionally, a reader will get the inner angst, get the subtleties, get the fact that Jennifer is someone they know intimately well and yet they never hear from her. I have to accept all those perspectives. People must do that with your photography saying, “What a cute picture of a duck!”

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CW: I have to work on two different levels. I have to work on images for the general public and I work on this other level — my very creative work — which I think is more important, but I’m not sure. You know what I mean. RR: If someone pays you for an article or a piece, no matter the price, you still do the best work possible, but you’re never sure of its lasting impact.

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Safety spurs Sequim helipad By Patricia Morrison Coate

The

first rule of on-scene emergency medicine is don’t become a victim. Its corollary is don’t make more victims. Securing surroundings for safety always is uppermost in the minds of EMS personnel as they arrive and assess a scene. This focus on safety extends to readying patients for airlift transport as ground crews transfer critical patients to the care of air crews. When minutes count, any delay in that hand-off cuts into a patient’s “golden hour,” the period of time when post-trauma survivability is at its greatest. It’s about 50 air miles and 20 minutes from Sequim to Harborview Medical Center in Seattle to access high-level trauma care via an Airlift Northwest medical helicopter. “Every time we have an (airlift) emergency, we have to go to the (Sequim) airport or the Sequim ball field,” said Steve Vogel, chief of Clallam Fire District 3, “and sometimes we’ve had to chase kids off the field and get school buses or parents out of the way. It’s a time concern and really stressful for us to keep the site clear and safe,” as paramedics and EMTs ready a patient for transfer. By November, all that will change as Olympic Medical Center will have installed a dedicated helipad on its Fifth Avenue campus. It’s a concept that’s been on the table for five years, said Scott Bower, OMC’s plant operations and construction manager. “When a trauma happens, seconds count,” said Eric Lewis, OMC’s chief executive officer. “For members of the community of Sequim and east Clallam County, the addition of a helipad to Olympic Medical Center’s Sequim campus will be a critical addition to the emergency response services available.” “This project always has been very important to the (OMC) board and also

Eric didn’t like the idea of landing at a football field near kids. That’s what drove this project,” Bower said. “We first started talking about it in 2005 and originally had a helipad as part of the large expansion of the medical services/medical oncology facilities as a bid alternative in the drawings,” Bower explained. “We had some open forums and there was no public objection — people were very excited to have it.” However, because the helipad wasn’t on the campus master plan, city officials decided in 2008 that OMC needed to provide a separate State Environmental Policy Act report, which requires state and local agencies to consider the likely environmental consequences of a proposal before approving or denying it. Finally in 2010, project approval came from the city council and in August, OMC’s board of directors accepted a bid of $109,190 from Primo Construction of Sequim — the engineer’s estimate had been $130,000. “A lot of thought went into the design phase,” Bower said, noting that OMC officials and site architect Airside, Inc. of Greenbank, met multiple times with stakeholders. “We had very in-depth discussions to make sure the helipad will meet the needs of all responders,” Bowers said. “We checked with the ER doctors regarding what situations would call for an immediate fly-out versus stabilizing patients first at OMC. It came down to safety. It will be a private pad and we’ll authorize to the Coast Guard and Airlift Northwest only for emergencies, primarily for flying people out. It’s not going to be a frequently used spot but used to potentially save somebody’s life.” On the 20 acres along Fifth Avenue that OMC has owned since the late 1990s, the helipad will be situated southwest of the Jamestown Family Health Clinic, which

LIVING ON THE PENINSULA | FALL | SEPTEMBER 2010

opened this spring. On its own dedicated road, the 8,100-square-foot area will be secured by a 3-foot fence and will have an elevated 54-foot by 54-foot concrete landing pad. Ground ambulance crews and helicopter pilots, be they from Airlift Northwest or the Coast Guard, will be able to activate the site’s flood and perimeter lights via radio frequency as needed, so there won’t be light pollution. An on-site emergency generator will power the lights and the flight path area, clear of electrical

wiring and trees, is designed with an abort path as required by the Federal Aviation Administration. Vogel is more than enthusiastic about the off-again, on-again project. “My immediate response is ‘thank you!’ To have a designated helicopter pad is something we’ll be able to use for generations. It’s long needed and it’s really neat,” Vogel said. “It’s going to work very well for the hospital and it’s going to work wonderfully for the fire department.”

Graphic courtesy of Olympic Medical Center

Now thereâ&#x20AC;&#x2122;s this to tell â&#x20AC;Ś The 16th Annual International Forest Storytelling Festival of Port Angeles By Kelly McKillip

onnection, continuity and meaning are the golden threads that weave through the age-old art of storytelling. This singular form of human communication may be traced back through each individual life as well as the collective lives of everyone who has been part of a family or community. Much more than dialogues alone, professional storytellers employ various tones, cadences, body language, facial expressions and music to express the deeper meaning of the story.

In the beginning

Top: The flow of festival storytellers is ushered along brilliantly by emcee Pat Peterson. Photo courtesy of Pat Peterson

Above: Storyteller, humorist and musician Kim Weitkamp views storytelling as a wheel. Photo courtesy of Joan Harrell

The story of the Port Angeles Forest Storytelling Festival begins in the early 1990s when Josephine Pedersen put out the call for nearby storytellers to join together. From the efforts of Pedersen and fellow founders Elsa Johnson, Elaine Grinnell and others, the Story People of Clallam County became a reality. Pedersen had worked as a teacher for children in Head Start, as a nurse and a natural history docent, but when she attended her first storytelling class, she thought she had died and gone to heaven. At first, memorizing the tales was difficult, but then she learned to tell them as if they were happening. Johnson had discovered that teaching English as a Second Language to children was best achieved by having them play-act with puppets. When every sense was engaged by the storytelling activity, the youngsters only had to hear a word once to learn it. She also wrote for a grant that allowed the storytellers to perform historical narratives in local schools.

LIVING ON THE PENINSULA | FALL | SEPTEMBER 2010

A member of the Jamestown S’Klallam Tribe, storyteller Elaine Grinnell brought to the group her rich Native American storytelling tradition. By 1995, Pedersen’s idea to create a storytelling festival also came to fruition. The first event took place at the Vern Burton Center using the pool of local talent and attracting a limited number of listeners. The 16th annual three-day festival this October at Peninsula College’s Little Theater will offer five nationally renowned storytellers who entertain, educate and inspire. The audience has grown in numbers as well as enthusiasm as the word gets out that storytelling is very much for adults as well as children and, no matter the age, nothing stirs the soul like being in the presence of a master storyteller.

Right: Kirk Waller believes the face-to-face encounter of storytelling is essential in a world filled with television, computers and video games. Photo courtesy of Van Waller Below: International storyteller Michael Parent’s favorite stories begin with a seed of truth that blossoms with imagination. Photo courtesy of Tom Thurston

The storytellers: Kim Weitkamp Storyteller, humorist and musician Kim Weitkamp views storytelling as a wheel. The hub is what’s said around the dinner table, on the front porch, between couples at night and grandmother to daughter in the nursing home. The spokes represent the variety of performance storytellers such as historic, comic, motivational and tellers of fairy and folk tales. The supports help keep the wheel intact so people will be inspired to remember their own stories and pass them on. Before she ever had thought of performing, Weitkamp used storytelling as a counseling tool in her work as an advocate for at-risk youths. She retired from the emotionally draining job after 16 years wondering how she would make a living. She found the answer two hours from her Virginia home at the National Story Telling Festival in Jonesborough, Tenn. As she went from tent to tent listening to stories full of humor and healing, she realized that this is what she had been doing in her work. During the next six years, she told stories, sang songs and played her guitar in every major festival on the national circuit. She composes her own music such as her latest CD “Penny Candy Love.” Her “heart thing” is the Wrinkles Project, which is a campaign to retain the insights into the past from our seasoned citizens before they are lost, so we may better understand how we came to be the way we are. Learn more about Weitkamp at www.kimweitkamp.com.

Kirk Waller A 2010 recipient of the prestigious J.J. Reneaux Emerging Artist Grant from the National Storytelling Network Program, Kirk Waller describes storytelling as the oldest art form in the world. It is the dialogue in our lives that encompasses the powerful magic that communicates emotion, history and culture. Waller vividly remembers the day he realized that storytelling was what he was meant to do. He picked up a

LIVING ON THE PENINSULA | FALL | SEPTEMBER 2010

for adults and children confo stantly plugged into televist si sion, computers and video ga games. Waller is the storytelling di director of the Stage Bridge Se Senior Theater Company in O Oakland, Calif., which seeks to recruit and train storyteller ers 50 years and older. He se seldom leaves the Bay Area as he is a single parent of his tw two young sons since his wife di died of breast cancer three ye years ago. He is very much lo looking forward to his first vi visit to Washington. Sample a taste of Waller’s st storytelling at www.kirk w waller.com.

Michael Parent

book to read one of the many stories he had told to youths at recreation centers and day camps, when he realized he knew the tale by heart. Putting down the book, he began relating the story in his own words. Thoroughly engaged and laughing, the children offered feedback, which in turn changed the story. Invitations to perform began to pour in and he responded, adding mime and musicality to the mix. Eventually he was hired through a grant from the Fair Housing Authority in Marin, Calif., to tell stories of diversity and equality to elementary school children. He sees the face-to-face encounter of storytelling essential

Original, folk and fairytale storyteller and songster, Michael Parent points out that human beings are in a narrative mode most of the time. We narrate to explain what happened, justify behavior, make a point in an argument or just say who we are. Overheard conversations in the grocery check-out line often will reveal an ongoing story dialogue. Our stories are basic and essential and utilize both parts of the brain. The right brain creates the images and the left side puts them in a narrative order that makes sense. Information received in this way sticks to us. Parent came by storytelling naturally, descending from French-Canadian ancestry in Quebec where the tradition is more oral than literary. He tells of his grandfather’s brother, Uncle François, who needed to come to America for work to support his wife and many children but had only enough money for a train ticket to the next town. He bought his ticket, bread, ham and mustard and sold sandwiches during the trip to other passengers. From the proceeds, he bought a ticket to the next village, repeating the efforts for a week until he arrived in the U.S. He then worked double shifts for a year until he had enough money to send for his family. These marvelous kitchen table stories of resourcefulness were good for the family to hear. As a high school English teacher, Parent often used stories to make a point. Relating incidents around his characters Jerry Jaboni and Abigail Dinnerpail worked much better than using himself as an example, which immediately clamped his students’ mental doors shut. His favorite stories begin with a seed of truth. Perhaps the initial incident lasted only 15 seconds but with imagination a 20-minute tale will blossom. Some of his best stories come from his listeners as when a preschooler asked

him many years ago to tell a story about a water monster in Loch Ness. The request inspired him to write a story that he still tells today. Visit Parent at www.michaelparent storytelling.com.

Heather McNeil As a third-generation storyteller, Heather McNeil didn’t realize until she became a librarian that not all families told and acted out stories and walked around repeating favorite phrases in their households. To her further dismay, not all families talked about their history or knew the meaning of their names. McNeil grew up entranced and believing every word of her grandfather’s wonderful stories. As a Shakespearian professor and natural storyteller, he understood that the power of those great sagas was in speaking them and he took the trouble to memorize the lines. A performance storyteller for 30 years, McNeil has seen many people who are immersed in technology amazed by the power of listening and laughing in a group to-

gether. They remember what is said and repeat it at home. She recommends putting away the technological devices for a while and taking the time to speak and listen to each other. She invites adults to relate to their children and grandchildren what life was like when they were 5 years old. Storytelling is the best way she knows of to understand other walks of life and to honor and acknowledge each other. Because she is busy as the youth services manager at the Deschutes, Ore., Public Library and an author, McNeil does not actively promote herself as a storyteller. She was spotted by festival artistic director Rebecca Hom, who heard her tell a vampire tale at an Oregon

event and persuaded her to come to the peninsula. McNeil is looking forward to her first visit to Port Angeles with her 12-year-old daughter. She has authored two books: “Hyena and the Moon: Stories to tell from Kenya” and “The Celtic Breeze: Stories of Otherworld Scotland, Ireland and Wales.”

Laura Simms

After graduating from college in 1967, storyteller and activist Laura Simms began working as a director and teacher in experimental theater in New York. She taught actors and actresses how to break down the fourth wall (the invisible wall between actor and audience) and enthralled her younger students with the telling of Russian fairy tales. Inspired by natural historians such as Joseph Campbell and Margaret Mead, Simms says she came to understand how important epic singers and storytellers are in their communities. The direct relationship with her audiences is what she loves. She feels the living connection and reciprocity in this special type of theater that engages the audience and invites them to participate fully. Listeners leave her performances refreshed and reminded of The direct connection she their own stories. Simms finds that storytelling makes people experiences with her audience is what Laura Simms more sensitive to each other and the world. She loves about storytelling. loves other cultures and is involved in several Photo courtesy Kent Miles

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humanitarian efforts around the globe such as her recent work in Haiti with the International Medical Core Psychiatric Clinic. Read more about Simms at www. laurasimms.com.

Emcee Pat Peterson The flow of performances in the festival is ushered along brilliantly by emcee Pat Peterson. She has been a professional storyteller for more than 25 years and actually sees the tales she weaves so well. Listening to the radio as a child first spurred her love of story. She became a storytime reader when her son was young and then worked with a mentor as she learned to tell stories to adults. Peterson says there is nothing like the wonderful exchange of energy back and forth in a festival. Eye contact is made and a connection created that causes the listener to say: “That reminds me of ….” She loves the role of emcee, which gives her the opportunity to interact with the storytellers and the audience. Peterson is an active member of the Story People and the Seattle Storytellers Guild. You will find more information about her at www.seattlestorytelling.org.

About the festival The festival succeeds because of the hard work of the members and board of directors of the Clallam County Story People. Festival director Cherie Trebon organizes

and keeps the event ticking. Artistic director Rebecca Hom finds and negotiates the talent. The 2010 festival will be at the Peninsula College Little Theater, 1502 E. Lauridsen Blvd., Port Angeles, from Oct. 15-17. In addition to storytelling performances, a master class in the art of storytelling will be held Friday and four of the storytellers will be teaching workshops on Saturday. Other activities including children’s concerts, a silent auction and raffle will be offered. A schedule of events, directions and information about the Story People may be found online at www. dancingleaves.com/storypeople.

A happy ending: Popular humorist and storyteller Andy Offutt Irwin, who performed in 2009, said it was a great treat to come to the Port Angeles festival. He describes Peterson as the best emcee he ever has experienced and so funny that he wasn’t sure he could stop laughing when it was time to go on stage. He added that it was wonderful to tell his stories in a comfortable indoor theater with a happy, receptive and well-trained storytelling audience.

Heather McNeil finds that storytelling is the best way to understand other walks of life and to honor and acknowledge each other. Photo by Steve Prull

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‘Big Cit y’ Treatment Close to Home By Rebecca Redshaw it comes to our health, we all want the very best treatment possible. If we’re lucky, we won’t have to travel far from home (at great expense and inconvenience) to receive top-notch care. Rest assured, we’re lucky on the Olympic Peninsula. The Olympic Medical Cancer Center, a fusion of medical and radiological oncology services in Sequim, is part of Olympic Medical Center’s expanding service to the community. Established in 2003 in the Thomas Family Cancer Center, it has made many positive changes in the past few years to raise its status to be on a par with major treatment centers.

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Staff Walking into the cancer center is hardly reminiscent of old hospital facilities with sterile white walls and harsh fluorescent lighting. The foyer/ reception area is spacious and if it’s necessary to wait for a few moments, the inside windows look out onto a lovely garden. But pleasant atmosphere aside, patients and family members usually have a high level of anxiety at their first appointment. Tara Lock is the cancer center’s director. She has a bachelor’s degree in business and philosophy and a master’s degree in hospital administration. Previously employed in Seattle hospitals, she has relished her work here in Sequim and in the past year and a half brought a unique perspective to first impressions. “I want patients to walk in here and breathe and

say, ‘I’m here; they’re going to help me’ versus ‘I’m so afraid.’ I grew up in a hospital environment. My mother was an administrative assistant and I went to work with her every day from the time I was 6 years old until I finished middle school. The coldness I remember is so profound, I’ll never forget that and I don’t ever want to have that. It’s so easy when you work in this field to become numb to it. Being in a smaller community gives us the ability to have intimacy and warmth because the patients we see at the front desk are the patients we see at the grocery store.” Until recently a patient with special needs, unrelated to their physical health, met with the center’s patient navigator who facilitated transportation or prescriptions or any number of practical concerns. The job description of “patient

Far left: Olympic Medical Cancer Center’s medical oncology unit offers five open chemotherapy infusion bays and six private ones. Pictured are Kay C. Hobbs, medical nurse supervisor, left, with employee Jacky Loehr. Above and at left: The exterior and waiting area of the Thomas Family Cancer Center. Right: John Engstrom, chief radiation therapist, stands next to the center’s linear accelerator used to deliver radiation to cancer tumors.

LIVING ON THE PENINSULA | FALL | SEPTEMBER 2010

Kummet explains, “Our center provides care that meets the needs of the vast majority of cancer patients and we are happy to work with any of the specialized centers that can meet all of a patient’s needs. We have staff specially trained to assist cancer patients and have access to support services from all of our community health care providers.” It’s impossible to write about the Olympic Medical Cancer Center without emphasizing not only the strong sense of community, but the high Left: Lynn Elmenhurst, RN, level of competency that this and Rena Zimmerman, proportionately small, rural MD, work closely together. community has achieved. In addition to a support Below: Patients receive staff of more than 30 medical state-of-the-art radiation treatment with OMCC’s personnel, two physicians linear accelerator. recently have been recruited

Full-scope cancer care Unlike other cancer treatment providers, Olympic Medical Cancer Center has co-located both radiation and medical (chemotherapy) oncology under one roof, making treatment more convenient. OMCC utilizes the latest technologies to ensure our patients receive the best possible cancer treatment available. Compassionate and specially trained radiation and medical oncology staff operate industry-leading systems and sophisticated medical equipment in a comforting environment, the Thomas Family Cancer Center, in Sequim. In addition to the services offered locally, Olympic Medical Center’s affiliation with the Seattle Cancer Care Alliance brings the resources of three internationally renowned institutions to our community: Fred Hutchinson Cancer Research Center, University of Washington Medicine, and Seattle Children’s Hospital. Through our partnership with the SCCA, patients have access to clinical trials; offering patients access to the latest drug, immunologic and molecularly targeted cancer therapies before they become widely available. For more information on the Seattle Cancer Care Alliance, visit www.seattle cca.org. Reprinted from www.Olympic medical.org.

navigator”” has h bbeen expanded d d to complement l the h integrative medicine philosophy of treating the whole patient — body, mind and spirit. Lock elaborates. “Now that we have hired Susan Clements, a licensed social worker (MSW), I’ve revamped that program so that she sees every single patient regardless of financial need. Just because somebody has money in the bank doesn’t mean he’s OK with his treatment or understands what is available in terms of education. The PN also sits in on chart rounds with the medical staff and listens to what the clinicians are saying regarding patient treatment. She’s the one who may bring attention to the fact that the patient may not, for example, have anyone at home to change dressings. Dr. Zimmerman is in tune with the PN and what she can do in determining the patient’s emotional and stability levels in being able to handle the treatment.” Dr. Rena Zimmerman, a board-certified physician with a fellowship in integrative medicine, is the medical director of radiation oncology at the center. She was instrumental in restructuring the patient navigator’s focus when she started at the Sequim center less than a year ago. “Hiring an MSW was one of my goals. The center needs a patient navigator to, for example, get a gas card, which is great, but the National Comprehensive Cancer Network says you have to have a psycho-social support system as well. It’s important not to just treat the cancer, but to support all the patient’s needs. If a patient is anxious and I’m not addressing that issue, I’m not treating the whole cancer patient, the whole person.” The center reaches out to other parts of the local medical community and, when applicable, to other major medical support systems. A member of the Seattle Cancer Care Alliance, the center has access to its clinical trials and can access information online at medical sites. As director of medical oncology at the center, Dr. Thomas

to help address the increasing patient population. Dr. Erin Nelli works directly with Kummet and Dr. Christopher Williams in medical oncology and Dr. Michael Shevach, recently recruited from Florida, will work with Zimmerman in radiation oncology. “The center in Sequim continues to provide a community standard of care treatment for cancer patients in their local setting,” said Kummet, who arrived in 2006 and has witnessed the growth of the center firsthand. “The biggest change has been our surprise at the increase in our patient population. By the second year of our function, we had already outgrown our space and a remodel two years ago to expand clinical capabilities has been shown to be still not enough to meet demand. We did not expect to be as busy as we have been.”

New equipment In order to do quality work, the best medical practitioners need the best equipment. The center recently installed a state-of-the-art, wide-bore CT scan simulator that allows the staff to prepare and plan treatment with 3-D software while the patient rests comfortably at home. The virtual simulation technique lets the dosimetrist (radiation technician) dedicate

LIVING ON THE PENINSULA | FALL | SEPTEMBER 2010

as much time as needed to each treatment plan without patient discomfort or anxiety associated with standard simulator units. The wide-bore CT and special computer software are used to plan intensity modulated radiation therapy for treatment of solid-tumor cancers in all areas of the body, including prostate, breast, abdomen and head and neck. It helps physicians see precisely and in great detail where a tumor is located. Zimmerman explains the process. “I meet with the patient for a consult which includes the oncology nurse. If we decide the patient needs radiation therapy, radiation teaching occurs. There’s a lot to do before he or she is actually put on a machine for treatment. A return visit is necessary for a “simulation” where we determine the position a patient needs to be in. This is the same process for any kind of cancer.” “A lot of hours go on behind the scenes. The patient just meets (with us) in the beginning and for the simulation. After everything happens, the dosimetrist gets involved. He does the actual treatment plan and then there’s the physicist who then checks the treatment plan, so there are many levels of quality that go into the process.” Zimmerman’s enthusiasm for the wide-bore CT scan is obvious. “It’s an unbelievably nice piece of machinery. The hospital went that extra step (with this equipment), which should be beneficial for a long time. That showed foresight on their part. Now it’s all right here at the center. This machine allows us to put people in comfortable treatment positions and to better pinpoint areas. It is state-of-the-art and the only one on the peninsula. Poulsbo doesn’t have it. Are we looking to be better? Yes, we are. Patients come first, but upto-date equipment is essential.”

Integrative medicine If, like the song lyrics go, “everything old is new again,” then the concept of integrative medicine shouldn’t come as a total surprise. And, yet, Olympic Medical Cancer Center is one of the few rural hospitals in the country to follow the lead of much larger institutions in incorporating its principles in the practice. Zimmerman completed a fellowship in integrative medicine and is excited about the alternatives it offers her patients. “I am a board-certified radiation oncologist but recently I became involved with integrative medicine, that’s the total healing that takes into account traditional medicine — radiation and surgery — and combines that with the best of alternative therapy —

like acupuncture, mind/body medicine and nutritional therapy. With this hat on I would see the future as state-ofthe-art, traditional medicine, the machines plus the whole nine yards, combined with the best of alternative therapy. I would like to see a truly integrated oncology program.” Director Lock is encouraged by the forward thinking and support that the hospital board has shown for the incorporation of legitimate alternative treatments. “The value of integrative medicine is coming to the surface but mostly big-name hospitals like the Cleveland Clinic are doing it. For OMC to be onboard is outstanding. Very, very few physicians have duel training like Dr. Zimmerman. It’s such a small percentage because of the small number of programs offering training coupled with the time and commitment it takes to become an MD. It takes a strong desire to look at alternatives.” The staff at the center is committed to treating the whole patient and Kummet adds a very practical codicil for the future. “I would like to see health care reform take place that enables patients to receive an appropriate level of care with a minimum of red tape insurance hassles, both from the patient’s perspective and on the part of our staff.”

Life choices Even though the center is expanding its staff and increasing its technical capabilities, there always will be situations that will call for specialty procedures, such as a bone marrow transplant or m neurosurgery, that only n aare available in a large m metropolis like Seattle. However, close profesH ssional relationships are maintained and patients m h have the option of cooordinating treatments with physicians located w eelsewhere. So many residents w who have relocated to the

Above: Katie Orth, R N, Director Tara Lock, MHA, and Lynn Fosket, RN/OCN, busy at work. Right: Deanna Piper, RN, checks the vitals of “patient” Susan Cooper, OMCC office supervisor.

LIVING ON THE PENINSULA | FALL | SEPTEMBER 2010

World-class cancer care is here on the North Olympic Peninsula Olympic Medical Cancer Center provides the latest cancer technologies and treatment options right here at home. Comprehensive cancer care services include: ■ Radiation oncology, including external beam therapy and intensity modulated radiation therapy (IMRT) ■ Medical oncology (chemotherapy) ■ Hematology ■ General oncologic surgery at Olympic Medical Center ■ An on-site, Class-A pharmacy ■ PET/CT scanners ■ Support services, including nutrition, physical therapy, social services and home health ■ Access to clinical trials ■ Resource library with access to reference and support information ■ A patient navigator to personally assist patients undergoing cancer treatment

Olympic Peninsula have done so because of the overall superior quality of life offered by living in a less populated area. The staff at the cancer center live and work here because they also recognize the advantages of living in a caring community. “My past is with large metropolitan centers,” said Kummet. “Olympic Medical Cancer Center is truly an entity that is created and supported by our community. It fosters a sense of this being a hometown health center where patients are more than just a number getting a service. All of our staff are well aware of the support that our center gets from this community.” Zimmerman has practiced medicine for 25 years and, before committing to the OMCC last year, was recruited by one of the most respected establishments in the country. She chose to practice in Sequim. “My decision was influenced by the opportunity to develop an integrative oncology program and II’ve been really impressed by administration’s aacknowledgement of quality of life issues for pphysicians, which is part of the integrative ppiece. You have to have a healing environm ment that includes the caregivers. OMC is so ggood at that. So many places there’s not that cconnection with family and community that I think is critical. When family events come u up, people are there. That is different than h high-pressure medical environments.”

O Olympic Medical Cancer Center is at: 8844 N. Fifth Ave., Sequim, WA 98382 FFor more information call, 360-683-9895.

ARTS Entertainment

Documenting the dams

The industrial art of Harry von Stark By Patricia Morrison Coate Photos by Harry von Stark

ver since he was a young amateur photographer in the early 1970s, Harry von Stark has been drawn to documenting pieces of the past, whenever and wherever he saw them. In 2007, he embraced photography as his life’s work. As von Stark followed news about plans to demolish the 1913 Elwha and 1927 Glines Canyon dams on the Elwha River in Clallam County, he felt compelled to chronicle their demise — focusing on both their historical and artistic value. Passionate about patina, von Stark defines it as “what time does to things.” He scans his environment for “something that’s weathered and has stood the test of time. I just like the way it looks and I think age brings character,” he explained. “I contacted the Parks and Recreation Division of the Department of Interior and lobbied them for me to take photographs of the dam removal and restoration project. I’m kind of dogged at times,” he said with a knowing smile. “I interviewed with them and they agreed, so I started shooting at the powerhouses. I had an artistic and documentary goal and I told them from the start I would document what they wanted and do my artistic stuff, too.” Blessed seemingly with the ability to envision a frame and account for variables of light, form and composition, von Stark sees beauty in everyday items — patterns, lines and colors that others miss. His vision was none less acute in capturing the

Photos by Harry von Stark Top: “Blue” Above: “MainLine” Opposite page: “Torque” Right: Photographer Harry von Stark, left, and Jake Seniuk, executive director of the Port Angeles Fine Arts Center, display one of von Stark’s exhibit images.

What: “Harry von Stark: Elwha Echoes — Future Relics of the Elwha Dam” photography exhibit Where: Port Angeles Fine Arts Center, 1203 E. Lauridsen Blvd., Port Angeles When: Oct. 17-Nov. 28; hours 11 a.m.5 p.m. Wednesday-Sunday through October; 10 a.m.-4 p.m. through November. Artist’s reception 2-4 p.m. Oct. 17; the public is invited.

LIVING ON THE PENINSULA | FALL | SEPTEMBER 2010

“dead dinosaurs” — the machines that powered the dam — from their massiveness to their details. As he spent hours photographing and then crafting each image, von Stark said he could feel the spirits of the men who built and ran the machines nearly a century ago and felt he was channeling their pride in workmanship. Of one image, he said, “I looked out the window and understood I’m one of the last — no one will ever see that scene again.” Von Stark so believed in the inherent beauty of his industrial images and their value to others that he proposed mounting an exhibit to Jake Seniuk, executive director of the Port Angeles Fine Arts Center. “Harry had been lobbying me for sometime and this seemed to be the right moment with the dams coming down (in 20112012),” Seniuk said. “The added interest of this particular subject photographed as a time machine was a beginning point for me (in considering an exhibition). His printing them on metal is especially appropriate because it shows how an artist pushing a medium adds extra dimension to his work.” Von Stark let the scale of the dramatic images speak to him and lead to the size of their presentation. Some are up to 5 feet wide, others are 30 inches by 30 inches, and all are printed on stiff aluminum panels with the ink infused into the metal, heightening their industrial quality. The exhibit, called “Harry von Stark: Elwha Echoes — Future Relics of the Elwha Dam,” will feature about 25 works on display Oct. 17-Nov. 28 at 1203 E. Lauridsen Blvd. in Port Angeles.

ARTS Entertainment

“Harry’s prints at this scale and on this material have a lot of presence as art objects as well as for their historical interest,” Seniuk said. “In this project, there’s been both documentation and artistry in play and it’s been wonderful to combine them at the same time. The artistic work is what my ‘candy’ was,” von Stark said.

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JAMESTOWN FAMILY HEALTH Serving tribal citizens and the community “We offer OB/GYN services that “Jamestown Family Health is a freeat no Story and one else in this area can off er, ” Riley standing medical practice,” said Bill y said. photos by Riley, director of health services for the The goal of family practice is to serve the Jerry Kraft

Jamestown S’Klallam Tribe. “We do not get money from the government through Indian Health Services nor from casino revenue. Our business model is built on being a self-sustaining, independent practice. This business was built like any other business; we went to the bank, borrowed the money and built the business. We get no casino money or other government support and we are doing very well. Our mission is to provide high-quality health services to the community. Our priority is to make sure tribal citizens have that access, but we also serve the entire community.” Since opening its practice in Sequim at the site of the former Virginia Mason clinic in 2004, Jamestown Family Health has grown from three physicians to its current staffing of 10 physicians and seven nurse practitioners. On May 17, they moved into their beautiful, spacious new location at 808 N. Fifth Ave. In addition to clinical services, they have facilities for exercise and rehabilitation and programs to improve the health of their tribal citizens and other patients.

whole family and that includes care for newborns, toddlers, children, adolescents and adults of all ages. The OB/GYN clinic provides women’s men’s health care and obstetrics for pregnant women as well as preventive care for all ages. It also provides family planning services.”

Focus on access Another important offering of Jamestown is access to immediate health care. “Because we have so many physicians and providers, even if your doctor is not available on that day, we can still get you in to see someone. That means same-day service for practically everything and that’s a real benefit of our practice,” Riley said. “It can be a bit of a challenge sometimes, but when people are sick

Above and below: The waiting room at Jamestown Family Health is generously decorated with Jamestown S’Klallam artworks.

A symbiotic relationship The relationship between Jamestown Family Health and Olympic Medical Center also is quite separate. Although they bought the property they occupy from OMC and lease some areas in the building for laboratory and radiology use to OMC, the two enterprises are completely independent. Having the lab and radiology capability on-site is advantageous to Jamestown patients. Of course, like all practices, some patients are referred to other providers and specialists in other facilities, including OMC. The focus for Jamestown is on family practice and primary care. One of the specialties at the clinic is OB/GYN care, provided by Drs. John Burkhardt, Stephen Bush, Cynthia Brook and nurse practitioner Carole Kalahar, ARNP.

LIVING ON THE PENINSULA | FALL | SEPTEMBER 2010

Jamestown Family Health Clinic Bill Riley is the director of health and human services for Jamestown Family Health. His focus is on providing comprehensive health care to all tribal citizens and the rest of the community.

they should be able to get in to see a doctor right then.” Jamestown provides such procedures as cardiac stress-testing, casting and minor surgery. Geriatric care is provided both on site and in nursing home or assisted-living settings. Their practitioners can manage chronic medical conditions and disease, and refer patients for hospital care to Olympic Medical Center in Port Angeles. The clinic also provides 24-hour emergency services to tribal citizens.

Phone: 360-683-5900 FAX: 360-582-4800 Address: 808 N. Fifth Ave., Sequim, WA 98382 Hours: Monday-Friday, 8 a.m.-5 p.m.

In May 2010, Jamestown Family Health moved into its beautiful new facility at 808 N. Fifth Ave. in Sequim. The totem pole in front is yet another representation of the connection to the history and culture of the Jamestown S’Klallam Tribe. Photo by Jay Cline

Better health for tribal citizens Since 1996, Jamestown has been a “self-governance” tribe, which means it has taken the responsibility of providing health care to tribal citizens. “Prior to 2004, we didn’t have a clinic and our tribal members would have to go to Neah Bay for services,” Riley said. “Now that we do have a clinic we’ve taken it on ourselves to ensure that every tribal citizen in Jefferson and Clallam counties has health insurance, either through their employers or through us. Tribal citizens now have, essentially, 100-percent health care coverage. That’s still the basis of our health system.” Because Jamestown Family Health is focused on family medicine, it also is affiliated with the University of Washington’s Department of Family Medicine and some of its physicians are university faculty members. The clinic serves as a rural training center for physicians from the university’s Family Medicine Residency Program. That helps maintain the quality of care that the clinic staff and physicians provide. Participation allows Jamestown resident staff a satisfying teaching role. It also provides ongoing educational opportunities and online resources. Riley is responsible for overseeing the health clinic, the dental clinic and the health insurance program for Jamestown Health. He has been in the position just over 10 years and has overseen the enormous growth of services. I asked if there were any unique needs in health care for tribal citizens and he replied, “Really not. They just

LIVING ON THE PENINSULA | FALL | SEPTEMBER BERR 22010 0 10

37 37

need access to health care, like anyone else. We see the same problems with chronic diseases as in the general population and that’s why we have some of the exercise facilities and so forth.” The downstairs of the building, with its large and handsome waiting area, is almost entirely devoted to examination rooms and medical areas, while the upstairs contains offices for administration, community health nurses, an aerobic exercise area, locker and shower rooms and offices for other benefit programs. “Because we self-insure, we are focused on encouraging people to exercise and stay healthy, both because it’s better for them and because it’s better for us,” Riley said. The addition of Jamestown Family Health to the medical services of Sequim and the North Olympic Peninsula is a tremendous benefit to tribal citizens and to the community as a whole. The focus on high-quality family medicine means more people can be seen more promptly and their health and wellness maintained more efficiently. Longer, happier, healthier lives for Jamestown S’Klallam tribal citizens and better health care availability for everyone else. It’s quite an ambition and quite an achievement. Dr. Stephen Bush, an obstetrician/gynecologist, and Laura Little, a certified medical assistant, visit with patient Danielle Lawson in the OB/GYN pod. Photo by Patricia Morrison Coate

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Right: Kacey Eichacker is the program supervisor for women’s imaging services at Olympic Medical Center. She oversees the implementation and use of digital mammography in Port Angeles and Sequim. Below: The key to successful treatment of breast cancer is early detection, something made much more likely for many women through the use of digital mammography.

DIGITAL MAMMOGRAPHY: Advanced imaging saves women’s lives “Early detection and better detec- Free clinic Story and photos tion of breast cancer is the key to an means access by Jerry Kraft

increased chance of survival,” said Kacey Eichacker, program supervisor for women’s imaging services at Olympic Medical Center. One of the most important new tools for getting earlier and more accurate diagnosis is the use of digital mammography in place of film or analog mammography. “Everyone is going to digital imagery,” Eichacker said. “And now our patients don’t need to go to Seattle to get them. We are providing the service here and that means more women in our community are being better served.” A year ago, OMC was given an initial grant of $375,000 from First Federal to install digital mammography equipment and to train the technicians. OMC now has three machines to provide diagnostic screening in Port Angeles and Sequim and more advanced diagnostic imaging through the Diagnostic Imaging Center at OMC, Port Angeles. They also have made considerable efforts in community outreach through partnership with First Federal and organizations such as Soroptimists, Operation Uplift and “Pink Up Port Angeles.”

LIVING ON THE PENINSULA | FALL | SEPTEMBER 2010

For example, a free breast health clinic this past June provided diagnostic screenings for 20 women in Port Angeles and two of them discovered they needed further treatment. Early detection of cancers is central to the improved recovery rates. According to a study published in Thee American Journal of Roentgenolnology (2009), digital mammography graphy increased detection rates from m 4.1 cancers per 1,000 women with fil film screenings to 7.9 cancers per 1,000 women imaged using a digital mammography system. While self-breast exam still is a valuable technique, the newer imaging technology can discover growths long before they would be palpable — and many that would

not be readily visible on film im imagery. Physicians can zoom in and out of the breast images a contrast can be lightened and a darkened. Through an inand v verting feature, physicians can r reverse from black to white, an vice versa, to help detect and m microcalcifications. Digital im images also give better visibility th breast, particularly near the of the l skin line, chest wall and in women with de dense breast tissue. With early diagnosis of breast cancer, women can achieve up to a 95-percent recovery rate. g In addition to greatly improved image qualit and d the th ability bilit to t digitally di ity enhance those images, the new technology greatly increases the ease of storage and transmission of those images. Instead of someone physically carrying bulky X-ray films from one office to another, digital images can be transmitted instantly from one site to another, one physician to another. That

Cancer Institute. The good news is that death rates have been declining since 1990 and that decrease is believed to be the result of earlier diagnosis and improved treatment. For many women, it also may be the result of the increased availability of digital mammography.

The importance of being local Among the many reasons that Olympic Medical Center has moved exclusively to digital mammography and bone density screening is the recognition that many women on the Olympic Peninsula previously had to go to Seattle for this technology. Providing the service locally not only would increase the convenience but also the number of women who could get access to this important procedure. While fewer than 10

makes collaboration among physicians and other technical experts much easier and provides the patient with all the advantages of a centralized big-city medical facility regardless of where they live.

Swifter diagnosis and treatment Parallel to early detection is early treatment, and digital imagery not only makes it easier to get in for the test but it significantly reduces the time between taking the image and having it interpreted by your physician. According to Eichacker, OMC is averaging a three-day turnaround from the initial finding to diagnosis, as opposed to 7-8 days with film-screen imaging. That same efficiency in data transmission means that the length of time between your initial imaging and any subsequent testing, biopsy or advanced treatment also will be shortened. Because the images are transmitted instantly there also is less chance of misdirection or filing errors and it allows for much more efficient tracking of the entire course of treatment for the patient. That’s critical for maintaining the follow-up and thoroughness of the complete diagnosis and treatment for breast cancer. Many women avoid getting a mammogram because of the momentary physical pain of the procedure and digital mammography doesn’t really provide relief from that compression of the breast. “I think women need to really ask themselves if the brief discomfort is worth risking their life,” Eichacker said, “It is not pleasant, but it is much less unpleasant than the advance of the disease.” Breast cancer is the most common non-skin cancer for women and the second leading cause of cancer-related deaths in the United States, according to the National

percent of facilities nationally offer digital mammography, the strong support of OMC and local organizations have made it available here. There also are a number of local organizations that make it available to women without health insurance or the financial means to afford it. Everyone’s efforts are directed to serving as many women as possible and getting them the earliest and best diagnosis available. At the present time, two of the three digital mammog-

raphy machines are used only for screening, the initial imaging. If anything questionable is found on that initial imaging, the patient is sent to the diagnostic imaging center at OMC in Port Angeles where a radiologist can be present during additional testing and the patient can be informed immediately if further imaging or biopsy is needed. The radiologist on site actually has six monitors on which he or she can view the mammograph, and because it is digital, the image can be enhanced immediately, the contrast lightened or darkened or the area of interest magnified. The intention for the program in the coming year is to open an additional diagnostic center in Sequim.

Earlier identification, earlier intervention Already, digital mammography in this area is discovering five cancers per 1,000 patients, while the national average is 3.7 per 1,000. That means many more women are discovering their breast cancer earlier, having earlier intervention, much less radical treatment and much higher recovery and longevity rates. A physician should recommend how often and at what age women have screenings, but the access to this advanced and highly effective technology is available to women in this area whatever their economic status. The newer technology also makes the process somewhat less uncomfortable and the vital advantage of early diagnosis and treatment makes that brief period of discomfort more than worthwhile. The free cancer health screening and community support organizations also make this affordable for many more women. The digital technology allows the medical center to more effectively track the patient’s progress through every step of diagnosis and treatment. With the local availability of the advanced technology of digital mammography, thousands more women can have diagnosis, treatment and recovery to lead longer, healthier lives. Olympic Medical Center is actively making that available to more and more women on the Olympic Peninsula.

Top left: Digital mammography, the latest technology in breast cancer diagnosis, is available both in Port Angeles and Sequim, with further diagnosis and treatment in Port Angeles. Above: Debbie Brady, imaging services representative, registers patients for a wide variety of imaging services, including digital mammographies, at the Olympic Medical Services Building in Sequim.

LIVING ON THE PENINSULA | FALL | SEPTEMBER 2010

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LIVING ON THE PENINSULA | FALL | SEPTEMBER 2010

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GOOD Gardening

Far Reaches Farm ... Easy to Reach BY BEVERLY HOFFMAN, PHOTOS BY DAVID GODFREY

Itâ&#x20AC;&#x2122;s

inevitable. Plant lovers will find their way to Far Reaches Farm. A fellow plant lover passed on its name to me, in the whispered tones we use when we find a special site to visit. Kelly Dodson and Sue Milliken, owners of the garden/ nursery, specialize in regionally appropriate plants for shade gardens. Some of the specimens look exotic but nevertheless will thrive in our climate because Kelly and Sue have collected seeds from similar eco-systems. They have designed and landscaped a shade display garden housed under an immense Zen-like cedar slatted roof and the structure is wrapped with shade cloth. Visitors get to see the mature plants and visualize how they might work in their own gardens. Giant lilies (Cardiocrinums), whose scent perfumes the entire structure, grow over 12 feet tall, a helpful note in planning a garden! To sit in their shade garden and listen to their vision of their land, as well as to hear their sense of purpose in their seed-collecting trips, challenges one to think in new paradigms. So far they have created part nursery and part sanctuary. In one passage of Kellyâ&#x20AC;&#x2122;s blog, he remembers a particular day a grieving family sat in the garden, their tightened muscles relaxed, and they left with the knowledge

Above: Succulents grow on top of the gazebo roof and add a textural interest to the area. Right: Rosa sericea ssp.omeiensis f. pteracantha (Winged rose) is from China and the thorns, backlit by the sun, look like stained glass.

LIVING ON THE PENINSULA | FALL | SEPTEMBER 2010

GOOD Gardening

Left: Kniphofia ‘Cobra’ is commonly called Red-Hot Poker or Torch Lily and has an intense orange flower tinged with yellow at the end of strong upright stems. It usually will do well in coastal areas. In cut-flower arrangements, it is stunning.

Above: Asplenium scolopendrium ‘Undulatum,’ a selection of Hart’s Tongue Fern, loves moist shade and is found in tropical and subtropical climates.

they could move forward. That same day a man proposed noticed and celebrated increased avian activity, especially to his future wife. Far Reaches seems to have a graciousness rails and killdeer. They use organic materials as much as that opens new doors for visitors. possible and have used hazelnut shells, which are a byprodSue and Kelly chose the name of the garden to sym- uct of an Oregon shelling plant, for their pathways and as bolize their venture. Both of them sold the nurseries they a top dressing for young plants. owned and moved a far reach to begin afresh in Port They have melded a botanical garden approach, Townsend. Sue had visited the town years earlier and had growing their own plants from seeds they collect in our felt a physiological response to its visceral energy. They surrounding area as well as in distant countries, with a knew that as middle-agers, they’d have to reach deep inside scientific approach that they hope will be of botanical and to work physically as hard as they’d need to in order to horticultural importance. Often they experiment with persist in their vision. various parameters to observe germination. When they The name Far Reaches also implies the seed-collecting see a new plant self-sow in happy abandonment, they selftrip to China where they met and both fulfilled long-time edit that specimen, knowing it might become invasive. As dreams of gathering seeds at the foothills of the Himalayas. they search for seeds, they scour for new species or for an Interestingly, too, is that the word “reach” is a nautical term, existing species with better growing conditions, or existing apropos to Port Townsend, that means sailing across the in higher elevation, or with better color. It is those seeds winds. they gather. When they bought their 6.5 acres in 1997, they vowed Sometimes they collect a solitary seed or only a to run their business and their lives in tandem with the handful rather than ravishing thousands of seeds environment rather than against it, lessons both sets of or bulbs and sendingg them to the states, as some parents instilled in them. Sue’s brother is a coastal ecologist early collectors did in the past. They have hired and it seemed a natural step for Sue to major in biology and a part-time propagator, gator, Jason Scott, formerly then to become a homesteader in Vermont. Kelly lived on of iconic Heronswood ood in Kingston. Duane the opposite coastline in Fife and as a child spent countless West, also a key figure ure at Heronswood, hours on forays observing wildlife in the tide flats. When generously shares special ecial treasures industrial development paved over his playground, he from his own garden n with Sue remembers his deep sadness. and Kelly. As agronomists they choose to use no pesticides and herbicides growing their plants and have formuThe owners, Kelly Dodson lated a sensible soil mixture so that any runoff won’t and Sue Millikin damage the adjoining wetlands, where they have

As avid seed collectors, they look to the future, to an indefinite time when an ecosystem might be destroyed because of overdevelopment or perhaps through a ransacking damage of a manmade or natural catastrophe. If that moment occurs, saved seeds that have been labeled and stored have the potential to be returned to their origin, germinating into new life and new hope for a decimated area. Kelly and Sue met on a life-changing seed-collecting trip in 1997 to the Yunnan province in China, a mountainous area with hundreds of lakes and rivers in a forested land. They saw more than 70 species of rhododendrons, including an ancient tree-like rhododendron with possibly five other species living on its trunk. Kelly had romanticized seed collecting as a young child when his mother and grandmother brought seeds “from far out there”— Oklahoma and Kansas, which they then planted in western Washington to

LIVING ON THE PENINSULA | FALL | SEPTEMBER 2010

GOOD Gardening

A sculpted and bronzed Zulu Daisy seed pod, created by David Eisenhour, is tucked amid the plants.

see how they’d survive in a coastal climate. He also had read Ray Lancaster’s “Plant Hunting in Nepal” and felt it was a Shangri-La experience he’d never realize. And yet, his dream came to fruition at the epicenter of plant biodiversity, where over half of China’s 30,000 species grew. In a second expedition to Nagaland in Northeast India, Kelly and Sue experienced a culture in a remote village that never had seen Western people before. In a little village atop

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a hill, the natives lived with no electricity. Sue remembers meeting a group of teenaged girls singing, weaving melody and harmony together, just as their mothers used fiber to create baskets. They remember how bright the stars were that night when no electricity diluted their grand luminescence in the sky. They felt a seismic shift in themselves as they realized richness in other cultures. Kelly and Sue continue to expand their world through seed collecting, just as they continue to be visionaries about their land. Should they plant an alpine garden? Maybe a xeriscape? Should they expand the shade garden structure with the help of their good friend Jolly Wahlstrom who continues to dream his new ideas, one of which is the recycled glass grass in the pond. Also, note Jerald Mize’s sedum gazebo. At present, they take only an occasional break so a dinner at day’s end in the shade garden offers sanctuary to them. Amid plantings, David Eisenhour’s sculptured pieces (www.eisenhoursculpture.com) add interest. He studies seeds through a microscope, makes a number of drawings, chooses a final design and then builds a mold with intricate detailing. He journeys to a foundry in Walla Walla where he pours steel, pewter or bronze into the mold. His work is in the Bellevue Art Museum and the U.S. National Arboretum, plus other places mentioned on his website. Kelly and Sue work feverishly but with joy. They have their two Mexican street dogs, Canela and Callie, who sit by their sides as the two dreamers stretch their minds to Far Reaches.

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LIVING ON THE PENINSULA | FALL | SEPTEMBER 2010

GOOD Gardening

Far Reaches Farm 1818 Hastings Ave. Port Townsend, WA Check website (www.farreachesfarm.com) for open days and hours of operation. For information, e-mail: info@farreachesfarm.com Proprietors: Sue Milliken and Kelly Dodson

Driving directions: Head into Port Townsend and take a left on Sheridan Street just past the QFC. Go 3/4 of a mile and find a stop sign on 19th Street. Go straight through that until you come to the next stop sign, which is Hastings Street. Turn left and go 1/3 mile and you will see the farm’s polka dot mailbox. The demonstration shade garden with wood slats filters light and adds a Zen-like feeling to the space.

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Dr. Davies is accepting new patients His office is located at 321 N. Sequim Ave., Ste. C. (360) 683-4850

LIVING ON THE PENINSULA | FALL | SEPTEMBER 2010

1-800-422-7854 • Phone: 452-7278 • Fax: 417-0122 2058 W. Edgewood Dr. • Port Angeles 47

All the secrets, right here! Staying on a heart healthy path By Viviann Kuehl hl hl

the cost of health care rises, medical co-payments are increasing. Doctors and nurse practitioners are at a premium in virtually all communities but more so in local rural areas. The good news is you can rely on yourself for good health, at low cost, according to Dr. Joseph Buchman, a board-certified cardiologist with a career spanning more than 50 years. “Medicare entitlements are shrinking in health care,” said Buchman. “Self-reliance is called for nationally and you are encouraged to take charge of improving your health and vascular risk factors.” Drawing on his experience, the latest medical research and an understanding of rural life as a Brinnon resident, Buchman developed a plan for fitness and lifestyle change. Risk factors can be addressed through sensible, individualized plans, notes Buchman. Retired from the Mother Joseph Cardiac Clinic at Swedish Medical Center in Seattle, Buchman gave up private practice to devote himself to preventive consulting. “I believe strongly in preventing disease before it advances to symptoms,” he said. “Primary prevention is when you have no existing condition and that covers 50 percent of the population. Half the people have no health issues that they know of, and that is silent disease.“ About 60 percent of the population has no inkling of harboring progressive advancing vascular disease, notes Buchman. “Vascular disease, including diabetes and hypertension, accounts for 90 percent of our health care costs in 2010,” said Buchman. “People need to develop selfreliance and adherence to programs with no expense but a pedometer and blood pressure readings. Those can be done at home, a community center or at a health professional’s office.”

Risk factors “Self-reliance starts with knowing your risks,” said Buchman. “Most importantly is being able to evaluate your silent risks of heart attack or stroke that may occur in the next five years in very high-risk individuals,” said Buchman. “These evaluations, based on 2010 guidelines, can all be done virtually without cost and you don’t need a physical to do this evaluation,” said Buchman. “Physical exams are expensive and generally unrewarding, as 70 to 90 percent of all you learn about yourself has taken place in your first or second good annual examination.” You can make accurate risk assessments on your own using simple, research-based tests, noted Buchman. Results can be shared by e-mail reports with a health professional to enhance care.

Family history Looking at patterns of disease in your family is an important clue to risk. Family heart health histories are simple using a score card, Internet program or simply by drawing a family tree and noting known factors such as heart attacks, high blood pressure, smoking, high cholesterol or low HDL, diabetes or abnormal sugar, strokes, angina and bypass surgery for each individual and the age they occurred. “Doing your family history scorecard can be motivational and bring the family closer together in an effort to fill it out accurately,” said Buchman. “This could be done at the dinner table or at family gatherings.”

Waistline Waistline measurements are a simple but accurate indicator of risk. Waist measurements, taken just at the top of the hipbone, greater than 35 inches for women and 40 inches for men usually speak to serious obesity, a hallmark of

metabolic syndrome. In the all-too-common metabolic syndrome, obesity is associated with early blood sugar elevations, poor cholesterol/ HDL and high blood pressure. “We estimate that 40 percent of our general population has this association,” said Buchman. “It’s the silent disease.”

evidence-based information in the last several years.” All of these three determinations are available at very low cost, but they are sentinels, mainstays of risk factor multipliers and call for further evaluation, noted Buchman.

Professional tests: Plaque Blood pressure Blood pressure is the classic indicator of cardiovascular diseases. “Eventually 60 to 90 percent of baby boomers will have hypertension as they age, so you can see that this is commonplace in a majority of us,” said Buchman. Easy access to blood pressure levels can be found at your local pharmacy. For example, discount and grocery stores have booths where your blood pressure can be checked without cost and they are available all the time, said Buchman. “It would be good to get a morning and afternoon blood pressure recording and note them down so you can discuss them eventually with your health care provider if medication or further care is indicated,” said Buchman. If your blood pressure is not within the normal range, borrow or buy a home blood pressure machine at your local pharmacy to collect more baseline readings. Wrist models are easy to self-manage and can be left at the bedside or accompany you to your exercise sessions, as these readings immediately record rise with your activity. “As we age, the blood pressure changes and the difference between the first reading, or systole, and the second, or diastole, spreads out,” explains Buchman. “This is the pulse pressure and this probably leads to stiffening and hardening of arteries and plaque formation. A normal pulse pressure is under 60 millimeters of mercury, systolic minus the diastolic. This is all new,

“Knowing your lipid factors and presence of plaque is vital in knowing who is at high risk,” said Buchman. “However, most plaque is small and only a warning sign. Presence of plaque can most easily be determined by ultrasound. Plaque in the carotid artery is indicative of plaque in 90 percent of your arteries elsewhere.” Plaque analysis is most inexpensively done in hospitals, churches and community centers by itinerant testers, periodically seen in local newspaper ads as Lifeline Screening, said Buchman. When done in a physician’s office or hospital, they are expensive and often too detailed for plaque identification. These reports should be sent to your health care provider for detailed interpretation. “It takes a few minutes to do and can be very helpful in determining who is severely affected by family history and who isn’t,” said Buchman. “Silent disease is when you have plaque in blood vessels and it may be several years before you have a heart attack or stroke.”

Cholesterol Most of us have had physical exams at one time or another and may know our cholesterol number but we are vague about good or bad cholesterol. “The best way to find out if you are out of line is to subtract your good cholesterol from your total cholesterol,” said Buchman, “The magic number is 132 and the guide to further risk. The triglyceride

LIVING ON THE PENINSULA | FALL | SEPTEMBER 2010

level being above 125 mg percent speaks to diabetic risk and obesity effects on your chemistries.” Too much emphasis is put on just the cholesterol and cholesterol does not add to the problem by itself in most of these milder cases, said Buchman. Interestingly, the triglyceride level falls in a matter of weeks with a regular and mild exercise program, he noted. There are kits in pharmacies for determining triglyceride and good cholesterol levels but they are not as accurate as a central laboratory.

Blood sugar Pharmacies sell finger-stick blood od sugar kits for diabetics, but a single determinaerminaation at intervals may be all you needd too know if you are pre-diabetic. A blood sugar over 104 is considered ered er ed d pre-diabetes, explained Buchman. Y You ou don’t have diabetes until blood sugar ar is is in the 115-120 range. Put these facts into the guidelines lin nes for age-related normal values andd you yoou can see where you stand. Use the he ddata aatta from your last physical exam for guides guide des in your individual profiles. Although gh theyy may have been several years old, they hey will be very useful for comparison to current values. As you approach diabetes, your blood sugar gradually rises on almost a year-by-year basis. These are essentially risk factor multipliers and should not be considered as a determination. If you have both, your risk goes up 20 fold.

to the two best things you can do to prevent dementia.” Low levels of vitamin D can be determined through laboratory blood tests and should be treated with daily vitamin D dosing, available in nonprescription, over the counter, pills or drops to prevent loss of cognitive powers, said Buchman.

When to seek health care If you develop chest pain or chest tightening on effort, you should report to your health care provider immediately. If pre-hypertension or pre-diabetes are present, or you have a family history, or your numbers are out of line, you should sc che hedu dulle le a vi vvisit isit ttoo yo isit your h ealt ea lth h ca care re ppror ro schedule health

Waistline measurement is a risk indicator if over 35 inches for women or 40 inches for men. The measurement should be taken just above the hipbone.

“Ac u “Actually, “Act one diet is ideal for all cco conditions, ond n i except for kidney failure,” said ssaaiid d Buchman. “This is the diet for hypertension, hyyp h diabetes and arte-

South County Medical Clinic Nurse Practitioner Merrily Mount checks Office Coordinator Candace Frye-Taylor’s blood pressure. “Blood pressure is a vital sign that should be monitored, either at home or through an office,” said Mount.

vider. These are risk factor multipliers and any two should bring you to a program of diet and exercise. Other complaints are minor and may not have the intensity that requires a health care visit, but if you have worrisome symptoms and complaints, you should see your health care provider rather than try to self-diagnose. “Your symptoms could just be ones of low blood sugar, which may be an early sign of diabetes, or a mild depressive disorder. This can be evaluated by your finger-stick

LIVING ON THE PENINSULA | FALL | SEPTEMBER 2010

fish or poultry, and use oil, sweets, salt and alcohol sparingly. Nuts, seeds and legumes should be eaten four-five times weekly. Details are available at dashdiet.org. “Salt restriction is now being emphasized at schools, restaurants and in label reading at your supermarkets,” said Buchman. “Over the next five years, salt restriction is aimed at a reduction to 2½ grams a day from current levels of around 5 grams a day. Graphic representations are available online and behind the counter of all McDonald’s and other fast food servers. Those with elevated blood pressure or a high body mass index may need a modified diet.”

Exercise FFitness Fi itn tnes e sp plan: diet

Vitamin D “Of course, this information about heart attack and stroke also applies to Alzheimer’s in its earliest form,” said Buchman. “Data just released in July of this year shows the vitamin D effect in improving decline in cognition and memory. A combined study done on nearly 1,000 patients for six years at the National Institute of Aging in Bethesda, Md., England and Italy, along with data obtained from the ongoing Nurses Health Study, which involved several hundred thousands of nurses in the whole U.S., shows vitamin D effects. So we have reliable information that vitamin D reduces the incidence of Alzheimer’s. That and exercise are probably

blood sugar, or talking to your family and peers if you feel fatigued when you awake in the morning, which is a very good sign of depressive disorder in the early stages,” said Buchman. “If your blood pressure is greater that 160 at rest, or over 185 with exercise, you should be seen sooner. Earliest treatment prevents true diabetes and hypertension from developing. “The above are solid but rough guidelines and your own judgment may bring you to come in if there is a marked change in how you feel or how your family perceives you, how you look, how you feel,” Buchman said.

rial sclerosis. It’s for everyone, although there are some modifications for those with heart problems that indicate a high potassium diet.” The DASH diet is simple, proven to reduce blood pressure and based on an eating plan rich in fruits and vegetables, and low-fat or nonfat dairy. “This is the diet that the American College of Cardiology, the American Society of Hypertension, the American Diabetic Association and the College of Sports Medicine recommend,” said Buchman. “Portion size determines if it will be weight-reducing for you, but it’s hard to lose weight if you don’t exercise.” The daily eating plan for 2,000 calories is to consume 2½ cups of vegetables, 2 cups of fruit, 3 cups of low-fat milk or dairy, 6 to 8 ounces of grains, 6 ounces of lean meat,

The evaluation of your exercise abilities doesn’t require an expensive EKG test, nor a nuclear or echocardiographic exercise test, said Buchman. If you are symptom free, just a simple walk-around test at a school track can be a guidepost to measure your improvement as you follow an exercise plan. “The exercise program is simple,” said Buchman. “A person self-evaluates and chooses a program. It can be done independently, but it’s most effective with a small group of people with similar needs. Check with friends or the fitness centers in your area. If that’s not possible, there are various programs on the Internet that are available. A person can report on the Internet, and the programs will keep track of progress, which can be e-mailed to a health professional’s office.” Physical fitness levels are established through a few simple indicator tests: a sixminute walk, a stair climb and evaluation of pulse and blood pressure. These will be your earliest baselines, to be improved upon with your exercise program. “These are things everybody can do,” said Buchman. “If people have existing heart problems, they may need additional professional help, but it doesn’t require lots of medical appointments. A person should be able to see a doctor or nurse practitioner on a once-a-year basis.” Exercise should be done three times a week for a half hour at a time as a minimum.

Walking is simple, free and readily available, and improves cardiovascular health while strengthening bones. A goal of 10,000 steps, or four to five miles a day is recommended. Incorporating a routine like walking to the post office into your day is an easy way to keep fit.

Pedometers are available to measure the number of steps you take in a day, which is useful in developing a suitable exercise program. Buchman prefers one with a seven-day memory so it will keep your records easily. This data easily can be sent to your health care provider via the Internet. Download once a month or every two months on programs such as thecarrot.com, patientslikeme.com, MyPyramid Tracker.com, keas.com, Revolution Health.com or healthbutler.com. “Your best new friend would be in the Internet programs that will help you keep your records, so that when you make your one visit a year to your health care professional, you will present your achievements at a short visit rather than a long one, or even at a fiveyear interval,” said Buchman. “These are just practical simple things that will keep you away from the expense of doctor visits.”

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Drugs can be adapted into a healthful plan, said Buchman. “Exercise, weight reduction and behavior modification can reduce your blood pressure without medication. The reality is only a small percentage of people need medication. However, if medication is indicated, it is well-tolerated and is available to all of us at low cost, from $10 to as much as $25 per month. Medicating blood pressure early is essential because hypertension leads to stroke and heart attack.” Statin drugs are distributed to all people in Britain with any vascular risk factors. “There’s a common belief in Jefferson County that people think they are allergic to statins,” said Buchman “Statin drugs are much, much safer than anyone thinks and there are ways to minimize allergy-type reactions. They are the basic, most important drug in reducing risk and inflammation. Aspirin use is also important and I teach how to handle it without stomach upset.”

“What we are trying to do is help people become self-reliant regarding cardiac risk, to recognize and evaluate the amount of risk they are at, then motivate them to follow a healthy program. That’s the goal of this, to be consistent in following a program of lifestyle change,” said Buchman. “People can recognize they may have a heart problem if they follow the program. “I know the community. They are far removed from a hospital that can take care of cardiac emergencies. They need to know their risk factors. “If you develop self-reliance and know how to address these critical risk factors at virtually no cost and develop new health habits with exercise, you are really reducing strokes, high blood pressure, Alzheimer’s and kidney failure. That’s what this is all about and it can be done for virtually nothing.” That’s good news for individuals, their families, neighbors, providers and the government.

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LIVING ON THE PENINSULA | FALL | SEPTEMBER 2010

Left: Jefferson Healthcare, Port Townsend Inset below: Forks Community Hospital Lower right: Olympic Medical Center, Port Angeles

Peninsula hospitals pursue regional sustainability By Patricia Morrison Coate

The

health care industry in America is huge, but as in politics, all health care is local. The chief executive officers of the Olympic Peninsula’s three hospital districts believe health care resources could be regional, too. For the past two years, CEOs Eric Lewis, Olympic Medical Center, Port Angeles; Victor Dirksen, Jefferson Healthcare, Port Townsend; and Camille Scott, Forks Community Hospital, have been meeting to discuss the concept of regional planning among their hospital districts. “It became a focus and a priority for all three CEOs to meet to discuss opportunities where regional planning could serve to benefit all three community hospitals’ patients,” said Rhonda Curry, OMC’s assistant administrator for strategic development. The question was and is, “What can we do together to ensure we have the best quality and choice on the North Olympic Peninsula?” “The emphasis has been on meeting to discuss future health care challenges and pulling on the strength of each hospital district to serve their communities better, with expertise shared,” Curry said. “We are three geographically distinct hospitals yet our CEOs are committed to the process of thinking regionally instead of just individually. We all believe this is the model for sustainability.” Both Forks Community Hospital with 17 beds and Jefferson Healthcare with 25 are categorized as critical access hospitals in their communities. OMC is a Level 3 trauma center with 80 beds. All three offer outpatient services as well. “Each hospital is unique because it is a reflection of its individual community, but the unifying factor that drives all three hospitals is that they are community hospitals, which is a different model than for-profit hospitals,” Curry explained. “Health care decisions are made at the local level and the success of each hospital benefits the residents who live there. At Olympic Medical Center, we know we have many patients from Jefferson County and Forks, so it makes

LIVING ON THE PENINSULA | FALL | SEPTEMBER 2010

sense to think and plan regionally where it benefits patients. “If patients can get treatment in their local area, that’s the best choice. But when they can’t, it makes sense to have that regional coverage versus going to Seattle or Tacoma,” Curry explained. “The first focus on regional planning has been the Olympic Medical Cancer Center and treating patients in Forks and Jefferson County. In a way, Sequim is centrally located and it’s the only cancer center on the Olympic Peninsula with radiation therapy and medical oncology under one roof,” Curry said. “OMC has made the decision to invest heavily in the cancer center to meet a need

Although Curry gave no specifics on which services will be part of a regional plan, she said expectations are that in the next five to 10 years, all three hospitals will remain independent, financially sound community hospitals offering the highest quality of services requested by the region’s residents. “There will be a lot of work going on as we look at electronic medical records and Accountable Care Organizations, a way of structuring how hospitals deliver care in the future.” As the CEOs continue to meet and discuss health care on the Olympic Peninsula, Curry said she sees it as a good thing for patients. “From a patient’s perspective, it would be reassuring to know that the CEOs are talking with each other as they plan for the future. As a patient, it would be incredibly reassuring to know that our hospital boards and CEOs are proactive in working together for sustainability and success for each of the community hospital districts.”

that continues to grow in Jefferson and west Clallam County.” Curry added that the hospitals have shared physician resources over the past five years via individual agreements between the specialists and the hospitals. For example, she said, “Some of OMC’s surgeons have been contracting with Forks and in the future there will be a much heavier emphasis on regional outreach by our cancer physicians in Jefferson and west Clallam County.”

YOUR NEW Life

How do we define vacation? When

I was a child, vacations were day trips to the zoo — a 45-minute drive to Madison from my small hometown in southern Wisconsin. Mother packed cheese sandwiches, apples, cookies and soft drinks. Dad filled the cooler with ice, then wrapped a blanket around it for extra insulation. The old patchwork blanket would become our picnic ground cover at the zoo. The Kodak Brownie was an essential part of the gear. It’s a wonder that parents take children on road trips. With four siblings stuffed in the back seat, I remember the invisible boundary lines — “Don’t cross this line!” was whispered, followed by a glare. Mother grinned from the front seat, reminding us, “You kids get along, or we’ll turn around and go home.”

Fortunately for us, we made it to the zoo. But I remember bargaining with my brothers, “You sit in the middle for a while,” I begged. If I was convincing enough, the contract had to include that I would leave the window down. We didn’t have one of those fancy cars with air-conditioning. I thought zoo trips were vacations until Father announced we were taking a twoweek trip circumnavigating Lake Michigan. He hitched up a rented tent-trailer to the family car and off we went into a blazing hot muggy Midwestern summer day. The road map covered Mother’s lap as she assumed the role of navigator. At the northernmost point of the Michigan peninsula, we spent five days at a lakeside cottage. While its picturesque lake was not as impressive as Lake Michigan,

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in my 7-year-old imagination, I was on a movie set. I loved the idea that we had our own dock. Surely we had become rich and famous — how else could Father have afforded this vacation? Smothering myself in mosquito lotion topped with suntan oil, my skin glistened. I smelled like an outdoor test tube. This was the vacation of vacations. I was in heaven. How did you define vacation when you were a 7-year-old? Did it include a tent, wasps circling your picnic table, bears raiding your campsite? Or maybe you remember floating down a river in an inner tube? Back then, roadside rest areas were considered a modern convenience — especially for traveling families. “Hold it just another few minutes, son,” Father told

By Ruth Marcus

my brother. “I’m sure the rest stop is just around the next curve.” Motion sickness was a common backseat phenomenon in our travels and often I was the one who became car sick. On many trips to Northern Wisconsin to visit Grandmother, we stopped while I gagged up whatever breakfast I had eaten. * * * * * * Living in Midwestern farm country, the closest body of water was the bathtub. Beachcombing and bodysurfing were unknowns. When I reached college age, my definition of vacation expanded wildly to include Daytona Beach for spring break: White sand, bodies lathered in suntan lotion being cooled by the waves of the Atlantic

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LIVING ON THE PENINSULA | FALL | SEPTEMBER 2010

surf — fun in the sun. Iced drinks and guys with buffed up abs and biceps brought on our chorus of oooh’s and ah’s. Our mission was to see who could get the darkest tan before returning to school. When I moved to San Francisco, my definition of vacation expanded again to include clanging cable cars and squawking seagulls. A swirling cape of fog creeping and crouching like a silent intruder in a Hitchcock movie filled me with dazzling suspense. I never tired of experiencing my senses spring fully alive in Chinatown, a jazz club or at Ocean Beach. Listening to the eerie sounds of foghorns bellowing somewhere near the Golden Gate filled my soul with comfort. San Francisco was my 30-year, non-stop vacation — a place I loved sharing with others. Yes, I think I even left a bit of my heart there. That was then. Now we see a wild array of adrenalin-pumping vacations. Zip lining, skydiving, hang gliding, bungee jumping, wind surfing and an ever-expanding list of extreme sports spell rave vacations for some. Not me.

Looking upward at Half Dome in Yosemite and imagining myself scaling it, was enough of an adrenalin rush for me. And, the walk to any of the park’s numerous waterfalls took my breath away. You get the idea. Everyone has a most memorable vacation. What’s yours? Finding the perfect spot for fly-fishing? Floating down the Thames? Sipping tea in Thailand? Or holing up in a cabin on a cliff while the ocean roared below? Mine would be when I celebrated my 50th birthday at Yosemite National Park. A vacation of contrasts. Cold winter noses warmed by a toasty fire at the Ahwahnee Lodge where family and friends had joined me in late February. It snowed and snowed and snowed even more. A winter wonderland. Stepping out into the night air, the silence enveloped us. Branches bowed low with the weight of wet snow. Not one of us whispered a word. Silently, as if in sacred procession, we carefully lifted one foot after another — each person following the same footsteps. Making our way to an open field, we formed a circle — lying

on our backs, faces up to catch the huge snowflakes. In silent unison, our arms and legs began gliding back and forth, silently creating snow angels as we were dusted with the wet, white wonder of fresh falling snow. The silent magic gave way to spontaneous laughter and the sweet humming of “Let It Snow, Let It Snow, Let It Snow.” Being gifted the exquisite beauty of Yosemite in winter, melded with charades, laughter, singing and drinking hot stuff from warm mugs that warmed our chilled fingers — this was my vacation of all vacations. I’m not too old to consider redefining vacation again and again. Autumn leafseekers hit the road, longing to behold a palette of gold, amber, cinnamon and saffron. Those who travel in the spring seek out flowing maple syrup, hillsides of daffodils and streets lined with cherry trees in blossom. Perhaps everyone has a favorite season for vacations. Some, longing for a change from their usual sense of home, take off in RVs or seek the perfect spot for pitching a tent. Some trek up mountains while others cruise the sea. Some fish. Some shop. Some photo-

YOUR NEW Life graph — fast and furious. I love every kind of diversity, the many ways to satisfy that hunger to taste and hear, smell and experience something new. I believe we’re all adventurers at heart who long to break the monotony of ordinary life. We can happily spend time strolling along the Dungeness River or biking the Discovery Trail or hiking the seemingly endless trails that weave through the beautifully varied landscape of the Olympic Peninsula. Here, it doesn’t take much to create a vacation. What spells vacation for you? For me, vacation is a state of mind that I can create every day — even if it’s only for a moment in time.

Ruth Marcus offers Leadership & Lifestyle Coaching. For classes and retreats, visit www.DrRuthMarcus.com or e-mail Rmarcus@olypen.com.

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Events CALENDAR EC Sept. 17-19, 23-26, 30, Oct. 1-3 • “Arms and the Man.” 7:30 p.m. Sept. 1718, 23-25, 30, Oct. 1; 2 p.m. Sept. 19, Sept. 26, Oct. 3. Olympic Theatre Arts, 414 N. Sequim Ave., Sequim. 683-7326.

Sept. 18 • Reach for Hospice — 1 p.m. John Wayne Marina, Sequim. The 18th annual Sequim Bay Yacht Club Reach for Hospice sailboat race. Benefits Hospice of Clallam County. 360-5820471 or www.reachforhospice.org; • Community Walk for Health — 8:30 a.m. registration, 9 a.m. walk and Olympic Medical Center health screenings at Trinity United Methodist Church, 100 Blake Ave., 683-0610; • Quilcene Community Fair and Parade — 294714 Highway 101, Quilcene. 360-764-3361, quilcene.com; • South County Classic Cruisers Car Show — Quilcene, 360765-3250; • “Swinging Vegas is Back,” 8 p.m., Port Ludlow Bay Club. Sponsored by Port Ludlow Arts Council. 360-4372208, plvc.org.

Sept. 19 • Lost in the Woods Mountain Bike Race. Anderson Lake State Park, lostinthe woods@gmail.com; • Annual Farm Tour & Harvest Celebration, sponsored by WSU Jefferson County Extension, 360379-5610, ext. 200 or Jefferson.wsu.edu.

Sept. 19-Oct. 24 • Fall Night Cap Series — Point Hudson Marina, sponsored by Port Townsend Sailing Association, www.ptsail.org.

Through Oct. 17 • Journey Stories, a Smithsonian Institution traveling exhibit. Jefferson County Museum, 540 Water St., Port Townsend. 360-385-1003.

Sept. 24 • Port Angeles Symphony Pops Concert, 7:30 p.m. at Sequim Community Church, Sequim. 360-457-5579 or pasymphony@ olypen.com.

Sept. 24-26 • Dungeness River Festival, 10 a.m.4 p.m., River Bridge Park, Sequim. 6814076; • Port Townsend Film Festival,

uptown and downtown Port Townsend. 360-379-1333, www.ptfilmfest.com.

Sept. 24-Oct. 10 • Port Angeles Community Players. “Smoke on the Mountain.” FridaysSaturdays at 7:30 p.m., Sundays at 2 p.m. 1235 E. Lauridsen Blvd., Port Angeles. 360-452-6651

Sept. 25 • Incredible Edible Festival 10 a.m. At Boys & Girls Club, Sequim. 683-6197 or www.sequimchamber.com. • Third Annual Oktoberfest, 6-9 p.m. at Masonic Hall, 622 S. Lincoln St., Port Angeles, $30, $35 at door, 417-3418; • Port Angeles Symphony Orchestra Pops Concert — 7:30 p.m. Vern Burton Community Center, 321 E. Fifth St., Port Angeles. 360457-5579 or pasymphony@olypen.com.

Sept. 25-26 • Mushroom identification workshop, Tri-Area Community Center, 10 West Valley Road, Chimacum, www.oly mushrooms.org or 360-477-4228; • West End Thunder races — 8:30 a.m.-6 p.m. both days, Forks Municipal Airport, 1500 S. Forks Ave., Forks.

Sept. 26 • Olympic Peninsula Bike Adventure — 9 a.m. at City Pier, Port Angeles. 60, 25 and 10 miles. Benefits the Olympic Discovery Trail; 360-417-4557, info@ olympicdiscoverybike.com or www. olympicdiscoverybike.com.

Sept. 29-Oct. 2 • Heritage Days — Forks, info@forkswa. com.

Oct. 1 • First Friday Lecture, sponsored by the Jefferson County Historical Society, 360-385-1003, jchsmuseum.org. Port Townsend.

Oct. 1-2 • 28th Annual Kinetic Skulpture Race — sponsored by Port Townsend Kinetic Konsortium, 360-379-4972, ptkinetic race.info.

Oct. 1-3 • Annual Gem & Mineral Show — 9

a.m.-5 p.m. Friday-Saturday, 9 a.m.-3:30 p.m. Sunday, call for location. Sponsored by the Clallam County Gem and Mineral Society of Sequim. 360-681-2323 or www.olympicrocks.com; • North Olympic Fiber Arts Festival — 9 a.m. Sequim. 360-681-2257, renne@uniqueasyou.com or www.fiberartsfestival.org;

Oct. 2 • Harvest Celebration Farm Tour — Sequim-Dungeness Valley; 360-6810169; • PT Shorts, “In a Café: Stories by Mary Lavin, Alice Munro, and Amy Hempel,” sponsored by the PT Arts Commission and Key City Public Theatre, at 7:30 p.m. Pope Marine Park Building, Port Townsend. keycitypublictheatre.org.

Oct. 2-3 • LaPush Last Chance Salmon Derby — 4 a.m.-3 p.m. Saturday, 5 a.m.-3 p.m. Sunday.

Oct. 7 • Girls Night Out in downtown Port Townsend, sponsored by Port Townsend Main Street Program, 360-385-7911, www.ptmainstreet.org.

Oct. 8-10, 15-17, 22-24

Oct. 16 • Port Angeles Symphony Chamber Orchestra — 7:30 p.m. at Sequim Worship Center, Sequim. 360-457-5579 or pasymphony@olypen.com; • Centrum gala dinner and auction, 800-838-3006, 360-385-3102, ext. 116, mary@centrum. org. Port Townsend; • Sprout Touring Film Festival — films/videos by, for and about people with developmental disabilities, Port Angeles High School auditorium, 304 E. Park Ave., Port Angeles, 452-9244.

Oct. 17 • Olympic Peninsula Mycological Society 2010 Wild Mushroom Show, noon-4 p.m. Sequim Elks Lodge, 143 Port Williams Road, Sequim, olymushrooms.org or 360-477-4228.

Oct. 21 • Comedy Night. — 8 p.m. at Key City Playhouse. 360-385-7396. keycity publictheatre.org. Port Townsend.

Oct. 21-31 • Hauntownsend “Carnival of the Twilight” at Jefferson County Fairgrounds, hauntownsend.com, theexproject.com. Port Townsend.

• Musical Cabaret: “Here’s to the Ladies! The Women of Tin Pan Alley,” produced by Key City Public Theatre, 360-3857396, keycitypublictheatre.org. Port Townsend.

Oct. 24

Oct. 9-10

Oct. 28-31

• Dungeness Crab and Seafood Festival — 10 a.m.-5 p.m., City Pier, 350 N. Lincoln St., Port Angeles. Old-fashioned crab feed; 360-457-6110, scott@crab festival.org or www.crabfestival.org; • Winery tour and poker run, North Olympic Peninsula wineries, info@ olympicpeninsulawineries.org or 800785-5495.

• Quartango — tango, jazz, opera, waltz and jigs, beginning at 3 p.m. at the Bay Club. Sponsored by Port Ludlow Arts Council, 360-437-2208, plvc.org.

• Jazz Intensive at Fort Worden State Park, sponsored by Centrum, centrum.org/ jazz. Port Townsend.

Oct. 29-30, Nov. 4-6, 11-13, 19-20 • “A Simple Thing” by Maggie Brown. Paradise Theatre School. 360-643-3493, theparadisetheatreschool.org. Chimacum.

Oct. 15 • Port Angeles Symphony Chamber Orchestra — 7:30 p.m. at Holy Trinity Lutheran Church, Port Angeles. 360-4575579 or pasymphony@olypen.com.

Oct. 30

Oct. 15-17

Oct. 31

• 16th annual International Forest Storytelling Festival — 7:30 p.m. kickoff Friday, Peninsula College, Port Angeles. 360-417-5032, forestfest@yahoo.com or www.dancingleaves.com/storypeople.

• Downtown trick or treat in Port Townsend, sponsored by Port Townsend Main Street Program, 360-385-7911, ptmainstreet.org.; • Port Townsend Community Orchestra, fall concert at Chi-

• Port Townsend Community Orchestra. 7:30 p.m. Chimacum High School auditorium, porttownsendorchestra.org.

LIVING LIVINGON ONTHE THEPENINSULA PENINSULA | | FALL | SEPTEMBER 2010

macum High School auditorium, www. olympus.net/community/ptorchestra.

Nov. 5 • First Friday Lecture, sponsored by the Jefferson County Historical Society, 360-385-1003, jchsmuseum.org. Port Townsend.

Nov. 6 • A Taste of the Peninsula — 5 p.m., Port Angeles. Benefit for the Y-ARTS community art program. 360-452-9244 or getta@ccfymca.org; • Port Angeles Symphony Orchestra — 7:30 p.m. at Port Angeles High School auditorium, Port Angeles. 360-457-5579 or pasymphony@ olypen.com; • PT Shorts, “The Humor of Holiday Dining,” 7:30 p.m., Pope Marine Building, Key City Public Theatre, 360385-7396, keycitypublictheatre.org. Port Townsend.

Nov. 13-14

Nov. 27

• Passport International Wine Tour. Wineries on the Olympic Peninsula. 800-7855495. www.northolympicwineries.com

• Santa’s Coming to Town — noon2 p.m. at Bank of America Park, Sequim. Holiday music. 360-683-6197 or www.cityofsequim.com; • Merchants’ Holiday Open House in downtown Port Townsend, sponsored by Port Townsend Main Street Program, 360-385-7911, ptmainstreet.org.

Nov. 19-21 • Teen Lab, contemporary works about their generation, Key City Playhouse, 419 Washington St., Port Townsend, 7 p.m. Nov. 19-20, 2:30 p.m. Nov. 21.

Nov. 19-Dec. 5 • Port Angeles Community Players. “Meet Me in St. Louis.” Fridays-Saturdays at 7:30 p.m., Sundays at 2 p.m. 1235 E. Lauridsen Blvd., Port Angeles. 360-4526651.

Nov. 20

Dec. 2-5, 11-12 • Holiday Sampler — “The Little Match Girl” by Hans Christian Anderson. Produced by Key City Public Theatre, 360-385-7396, keycitypublictheatre.org. Port Townsend.

Dec. 4

• Holiday Arts & Crafts Fair — at Port Townsend Community Center, sponsored by Port Townsend Arts Guild, 360379-3813, ptartsguild@yahoo.com.

• Handmade Christmas Fair — 9 a.m.3 p.m. at Sequim Prairie Grange Hall, McLeay Road, Sequim; 360683-7021; • Annual Twinkle Light Holiday Parade — 6:30 p.m., downtown Forks; • “The Wizard of Oz Unplugged” — Pope Marine Building, Port Townsend, keycitypublictheatre.org; • Port Townsend Community Orchestra. 7:30 p.m. Chimacum High School auditorium, porttownsendorchestra.org.

Nov. 26-28

Dec. 3-5

• WordPlay Reading Series — “Intimate Exchanges: Volume 1,” 7 p.m. Nov. 11, 8 p.m., Nov. 12, keycitypublictheatre.org. Port Townsend.

• Festival of Trees — Vern Burton Community Center, Port Angeles. Friday dinner, auction and gala. Saturday and Sunday, open to the public. 360-417-7144 or bruce@omhf.org.

• Sequim Community Christmas Chorus — 7:30 p.m. Dec. 3; 2 p.m. Dec. 4-5. Sequim Bible Church, 847 N. Sequim Ave. 683-1355.

Nov. 13

Nov. 26-28, Dec. 2-5, 9-12

• 16th Annual Wine and Cheese Event — 7-9 p.m. at Forks Elks Lodge. Gala sponsored by the Forks Chamber of Commerce benefits the Visitor Information Center; info@forkswa.com.

• “The Thwarting of Baron Boligrew.” 7:30 p.m. Nov. 26-27, Dec. 2-4, 9-11; 2 p.m. Nov. 28, Dec. 5, 12. Olympic Theatre Arts, 414 N. Sequim Ave., Sequim. 683-7326.

Nov. 6-7 • Jeffco Holiday Fair — 9 a.m.- 5 p.m. Saturday, 10 a.m.-4 p.m. Sunday at Jefferson County Fairgrounds, Port Townsend. 360-385-1013, www.jeffcofairgrounds. com; • Port Townsend Woodworkers Show, 360-316-9480, 360-440-7660, www.splintergroup.org.

Nov. 11-12

• Holiday Nature Mart, 10 a.m.-4 p.m. Dungeness River Audubon Center, Sequim. rcoffice@olympus.net, dungenessrivercenter.org.

Nov. 26-27

Dec. 9-11, 16-18 • Holiday Sampler — “The Eight: Reindeer Monologues,” by Jeff Goode. Produced by Key City Public Theatre, 360-385-7396, keycitypublictheatre.org. Port Townsend.

Events CALENDAR EC Dec. 9-12, 16-19 • “Jalopies,” written and performed by Mark Cherniak, at the Paradise Theatre School, 360-643-3493, theparadise theatreschool.org. Chimacum.

Dec. 11 • Port Angeles Symphony Orchestra — 10 a.m. dress rehearsal, 7:30 p.m. concert. Port Angeles High School auditorium, 304 E. Park Ave., Port Angeles. Holiday concert. 360-457-5579 or pasymphony@ olypen.com; • Olympic Art Festival. 10 a.m.-5 p.m., 40 Washington St., Quilcene. 360-765-0200 or 360-531-2015. www.olympicartgallery.com.

Dec. 11-12 • Chimacum School Arts and Crafts Fair. 10 a.m.-4 p.m. Chimacum High School, 91 West Valley Road, Chimacum. 360732-4015.

Dec. 12 • “A Broadway Christmas.” 3, 7 p.m. at the Bay Club. Sponsored by Port Ludlow Arts Council, 360-437-2208, plvc.org.

Dec. 14-15, 21-22 • Holiday Sampler – “Seven Poor Travelers,” adapted from Charles Dickens. Key City Public Theatre, 360-385-7396, key citypublictheatre.org. Port Townsend.

Dec. 20 • Sequim-Dungeness Christmas Bird Count, Midnight to midnight. Call 6814076 or e-mail rivercenter@olympus. net.

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LIVING ON THE PENINSULA | FALL | SEPTEMBER 2010

THE Living END

To sum it up ... In

this issue of Living on the Peninsula we’ve provided a look at local health care options. To wrap it all up, let’s ask perhaps the most important question regarding our health care system. How good is it? The answer: pretty darn good — and getting better all the time. There are two aspects to consider. On the federal level, Congress recently passed the Patient Protection and Affordable Care Act, or Obamacare, as it’s more commonly called. This massive and massively ambitious new law will fundamentally revise health care delivery throughout the nation. As written, the law leaves some questions unanswered. In many cases, the law simply calls for the creation of new panels to discuss and advise on needed changes. But the early signs for health care reform look promising, especially for those served by Medicare and for the uninsured, including those who today are uninsurable. Marjorie Stewart, the Clallam/Jefferson Counties coordinator for the Statewide Health Insurance Benefits Advisors (SHIBA) program, describes two of the more immediate improvements. Under the new law, those who are covered by Medicare now will receive a number of preventive care services with “no cost sharing by the patient.” In plain English, that means you pay nothing. If you now have Medicare prescription drug coverage, you will receive this year a tax-free, one-time rebate of $250 if you reach the “doughnut hole” in coverage. (Note: this is automatic. Don’t be taken in by scammers who say they will file for you.) Stewart agrees there is a great deal more to learn and encourages everyone to take advantage of the free advice provided every Tuesday by volunteers at the Sequim Senior Activity Center. These highly trained advisors are available from 10 a.m-noon. Stewart says it is particularly important that all Medicare clients drop by this year between Nov. 15 and Dec. 31 to look over changes in the law. “You should look at the plans every year,” she says.

Hope for the uninsured Washington Basic Health is a state-sponsored program providing low-cost health care coverage through private health plans. Unfortunately, some 70,000 Washingtonians are on a waiting list to sign up. Beginning this year, they will have two new options for finding insurance. As opposed to Washington Basic Health, these plans aren’t subsidized. But they do provide reasonably priced options

By Mark Couhig

for purchasing up to $100,000 in health care coverage. Under one plan, participants can sign up for a preferred provider plan, while the other allows for the use of “outof-network” health care professionals. Both plans require that you fill out an extensive questionnaire — as in 28 pages extensive — and you can be turned down. If you’ve been turned down and if you’ve been uninsured for more than six months, you can turn to the state’s new, subsidized high-risk pool. This new “Pre-existing Condition Insurance Plan” is managed by the state’s current high-risk pool, the Washington State Health Insurance Pool (WSHIP), and is funded through a $102 million federal grant. There are two plans available to those who qualify — one has a $500 deductible and the other has a $2,500 deductible. The cost to you is determined by your age and whether or not you smoke. More good news: Children under 26 can be covered under their parents’ insurance plan. As Stewart notes, that’s true even if the child has a job or is living elsewhere. They’re eligible for this coverage even if they’re married.

The local scene The health of our local health care system also is improving. Gene Burwell, clinic manager for the Jamestown Family Health Clinic, says the chronic shortage of doctors on the North Olympic Peninsula is less acute than when he arrived in Sequim just three years ago. The clinic has played a significant role in expanding the number of practicing physicians. As Burwell notes, his organization is perhaps two and a half times larger than when he arrived. Despite the rapid pace of growth, Jamestown still is signing up new patients, including new Medicare patients. Burwell says the tribe recognizes there is a shortage of physicians, and as a result, has instituted some innovative new recruiting efforts. Several of the semi-retired physicians in the community have been coaxed into working part time. “We’re flexible,” Burwell said.

Burwell also praises Washington’s laws regarding nurse practitioners. He notes that in some states these highly-trained professionals are required to work under the direct supervision of a physician. In Washington they are allowed to practice on their own and that helps alleviate the shortage of family practice/primary care doctors. The real shortage on the peninsula, says Burwell, lies with mental health care professionals. Burwell notes the issue is growing across the U.S. Burwell also is enthusiastic about the Accountable Care Organizations created under the new federal law. These may provide funding with broader applicability and may help move health care into the 21st century. As Burwell notes, insurance companies now pay doctors only for in-office visits. Doctors can provide assistance via the phone or e-mail, but they can’t get paid for it. It’s possible the new funding mechanism will allow doctors to bill for consultations via e-mail. That’s often a great deal more efficient than the current system. If you want to find out more about the new Medicare rules and the new insurance plans, you might begin with your doctor. Or visit with one of the volunteers available Tuesdays at the Sequim Senior Activity Center, from 10 a.m.-noon. SHIBA advisors also are available at the Jefferson Tri-Area Community Center, 10 West Valley Road in Chimacum, from 10 a.m.-noon the second and fourth Tuesdays of each month. For advice in Port Angeles, drop by the Senior Center from 9-11 a.m. Fridays. The consultants are found in the computer room of the center at 328 E. Seventh St.

LIVING ON THE PENINSULA | FALL | SEPTEMBER 2010

business