James Douglas: Southerner pioneers
heart surgery in area
North Carolina native founded cardiac program in Bellingham
by Taylor Williams


Dr. James Douglas came from North carolina to
start a cardiac program at Bellingham’s St. Joseph
Hospital.


Born in a medical family, Dr. James Douglas was destined to be a doctor. For 50 years, his father practiced family medicine and his uncle on his father’s side was also a family practitioner. On his mother’s side, two of his three uncles were general surgeons and the third was a mortician.
“The only other thing I ever seriously considered doing as a career was, up until sixth grade, I wanted to be a veterinarian, and then after that, I wanted to be a doctor,” Douglas said.
Douglas toyed with the idea of going into music, as a fall back if he didn’t get into medical school, but his intention was always to study medicine. In his third year of medical school at Duke University, he decided to be a cardiac surgeon.
“My interest in cardiac really developed when I was in junior high. I did a science project on congenital heart disease,” Douglas says.
At Duke, the third year of medical school is devoted to research. Douglas did his research in cardiovascular surgery. “I was associated with a surgeon then, Bob Jones, who was a very renowned researcher in cardiac surgery and sort of stimulated me to go on into that field,” he says.
Douglas helped pioneer open-heart surgery in Whatcom County when he was recruited by St. Joseph Hospital to start a cardiac surgery program in 1994. He and his wife relocated from Durham, North Carolina, where did his residency and was part of the Duke faculty for five years.
Being a “southern boy,” Douglas traded in the heat and humidity for the rain. Although he sometimes misses the warmth of the south, Douglas enjoys living in Bellingham. Not for the rain, but for the people he works with and serves. “I love it up here,” he said. “I’ve said it before; the biggest asset in Bellingham is the people up here. There are a lot of very kind, very compassionate people. It is a very active place, I like being in community with Western and the University of Washington.”
“It was exciting (to begin a cardiac program). It was done under ideal circumstances. The hospital was very well prepared. They had all the infrastructure supporting a cardiac surgery program here prior to my arrival here,” he says.
During his 12 years at St. Joseph, Douglas watched the hospital grow from a community hospital into a regional medical center.
“One of the big things about having a cardiac surgery program is that it requires such a broad range of very intensive medical care that it forces everybody to up their game,” he says.
“I was fortunate to train at Duke for many years and be on the faculty. I had the opportunity to see the full range of medical care available, not only at Duke, but throughout the world through the contacts that we had. A lot of the things I learned I was able to bring here and increase the level of expectations as to what could be accomplished in certain clinical situations.”
Douglas came from a demanding medical program and, through his high and demanding standards, St. Joseph is one of Solucient’s 100 top hospitals for cardiac care. In 2002, HealthGrades recognized St. Joseph as the number one heart program in Washington.
Simply having a cardiac surgery group at the hospital helped increase the efficiency with which patients moved through the hospital system, from the outpatient to the inpatient setting. The effects of the program have improved standards at St. Joseph.
“Overall, our presence has benefited a lot of services outside of cardiac surgery and I’m very proud of that,” he says.
The cardiac surgery program at St. Joseph is a model for looking at patient outcomes, examining preoperative, operative and postoperative care and seeing how patients do after they leave the hospital.
“Cardiac surgery, in general, across the country, for many years, was the first medical service that was really very carefully and scientifically looked at in terms of outcomes. As a result of the computer systems we have implemented to monitor the cardiac patients here, it has extended into general surgery and other services in the hospital,” Douglas says.

Patti Brettell: Never to late to find one’s calling
Making the change from research and development to neurology

by Taylor Williams

Neurologist Dr. Patti Brettell spent 15 years in the
business world before attending medical school.

After 15 years working in research and development, Dr. Patti Brettell had the distinct pleasure of being the oldest student in medical school. Switching out her business degree for a profession as a neurologist 11 years ago was not an easy task, but it was something she knew she had to do.
“I don’t think I was ever prepared for the emotional stamina it takes to make a change like that,” she says. “The stamina to lose income and watch your retirement get frittered away, wonder if you are ever going to be good at this thing when you used to be good at something else. It requires a great deal of faith and knowing at the end, what you do will help other people.”
Over the age of 40, Brettell decided to attend Chicago Medical School and now works for St. Joseph Neurology Associates. In 2004, she became the first neurologist in Bellingham.
“What really attracted me (to Bellingham) was the high caliber of medicine that is practiced here. I always wanted to (practice) more rural medicine, but had some trepidation about getting into places where, as a neurologist, all my consults would say, ‘we can’t figure out what’s going on’ and that is so not the case in this community,” she says.
Brettell, who was living in Sacramento, CA., and did her residency at University of California at Davis, found St. Joseph Hospital in a medical journal. After an interview with an Everett clinic fell through, she called St. Joseph and asked for an interview.
Brettell’s son lives in Seattle and she wanted to get back to the area, but didn’t know anything north of the city existed until calling about job openings.
After getting the job two years ago, Brettell helped develop the medical group and has watched it grow with the addition of two more neurologists.
“When I first started here, my goal was to get some neurologists here so we could answer the phone. Basically, get the consults in. Our next goal is to figure out how we are going to cover all the specialties we have to,” she says.
Although the office sees all patients, each physician is attempting to develop some expertise in a different area, in order to more effectively help the community, she says. Brettell’s special interests are Multiple Sclerosis and movement disorders, such as Parkinson’s disease.
In medical school, Brettell created friendships with MS researchers and became fascinated with the pathology and science behind MS research. The love of the science and the understanding that perhaps she can help prevent a person from being in a wheelchair fueled her desire to help the community.
“I’ve always had passion in everything I ever did. MS is so compelling to me because it’s so debilitating and hits young people,” she says. “There is nothing more heart wrenching than seeing a 20-year-old, like I did, who came in unable to walk and she was going to get married on Saturday. She came in on Wednesday and she has one of the worst (cases of) MS I’ve ever seen in my life. When you see that, it’s hard not to realize you can impact someone’s life.”
The young woman went to Las Vegas and got married, Brettell says. She was able to walk down the aisle, with the help of steroids prescribed by Brettell.
In the near future, Neurology Associates is planning to move into a new building. Along with the expansion, the practice is kicking off plans to become a primary stroke center, a service Bellingham does not currently have.
“I think there are other needs in the community that we have yet to identify and we’ll be working with the medical director at the hospital to understand what those needs are and be able to add staff as we feel we need to do so,” she says. “That is our mission and the mission of the hospital, to just serve the community. We never lose sight of that.”
Brettell entered the field of medicine because she had an overwhelming desire to be of service to the underserved, she says. Her ideals have been a perfect fit with the mission of St. Joseph Hospital.
St. Joseph is an all-commerce hospital; meaning if the patient cannot pay, the hospital will still provide service, says Nicci Noteboom, public relations specialist for St. Joseph.
“(The ability to pay) is a big issue for a neurologist. If you have a neurological problem, it is likely to impact your ability to work and if you can’t work, you can’t get insurance. So if I want to see movement disorder (patients), you don’t want to just restrict your patient base to people who can pay. It isn’t why we went into medicine,” Brettell says.
Making the decision to change careers in the middle of life, is not an easy task, but Brettell knew her decision could make the difference in someone’s life.
“Now, I’ve never been happier,” she says. “I really support anyone in making any life change. I always say it’s good for your neurons. It creates neurological sprouting and potentially staves off Alzheimer’s, but it is not for the pale of spirit at all.”

Cary Kaufman: National recognition, personal attention
Bellingham breast surgeon at forefront of profession

by Taylor Williams

Dr. Cary Kaufman is a member of many national
organizations devoted to the fight against breast
cancer and has written more than 20 articles on
the subject.

In between the long days of examination and adding one more consult with a recently diagnosed breast cancer patient to the list, Dr. Cary Kaufman is also a member of every American breast care organization, engages the community in breast health awareness and actively researches new breast surgery techniques.
He was born in Los Angeles and attended medical school at University of California at Los Angeles. For 15 years he worked as a general surgeon and slowly developed expertise in breast disease, coming to specialize in breast surgery.
“Breast disease versus other areas of medicine requires a lot of talk, a lot of discussion, a lot of empathy and a lot of concern by a surgeon and a lot of those qualities don’t go along with every surgeon,” Kaufman says.
Throughout his years in Long Beach, CA., oncologists and primary care physicians would send breast cancer patients to him because he had a reputation of compassion and concern for the whole patient.
“A lot of surgeons see a gall bladder with stones and they say ‘take it out.’ They see cancer in the colon and they say ‘let’s just take it out.’ There is little discussion, but the anxiety and stress (for patients) that occurs with this field (breast disease) is particularly high,” he says. “It can’t be answered with, ‘well, you decide if you want a mastectomy or a lumpectomy and call me next week.’ It doesn’t work that way. It has to be cared for and the discussion has to be sensitive and that takes time.”
As the director of the Bellingham Breast Clinic, Kaufman’s idea of taking care of his patients goes beyond examining and operating.
Once a month, he hosts a radio show on KGMI that promotes public breast health awareness. Kaufman informs the public of advances in breast health and occasionally brings on guests, such as radiologists, to talk about digital mammograms or psychologists, to talk about the emotional impact of breast disease.
“(The radio station) asked me to be on (a show) once for a talk about breast cancer and (I) kept doing it to keep people aware,” he says.
To further reach out to the community, the Bellingham Breast Center sponsors a breast cancer art show called, “Reaching for the Light.” Persons affected by breast cancer display works of art along with statements from the artist describing the impact of breast cancer on themselves and their families.
Kaufman was president of the National Consortium of Breast Centers from 2001-2004. The organization of over 800 breast centers, including Bellingham Breast Center, holds conferences, which Kaufman speaks at, networks and provides education for breast disease professionals.
“Under his watch, the organization almost doubled in size, now representing breast centers from every state in the Union,” says Leslie Jacobson, a psychiatrist who works with Kaufman. She runs support groups for individuals coping with breast cancer.
Since 1998, Kaufman has written more than 20 published peer-reviewed articles using original research, on a variety of topics associated with breast disease. One of his articles involves Cryoablation, or freezing of breast lumps.
“Most surgeons are protective of their turf. They don’t want surgery to go away as a skill (or) method of treating patients. Research and making progress to the future ignores those concerns,” Kaufman says.
“As breast cancers get smaller and smaller, it’s possible they (will become) so small you can do the Star Wars thing, zap it and it goes away because you can target and eliminate it. (Cryoablation) is like that. A needle (is inserted) into the cancer and the tip of the probe freezes the lump, which kills the cells. (All while) the patient is awake.”
Kaufman’s research provides a “non-surgical way of doing surgery,” he says, that decreases the amount of anxiety the patient experiences.
His research is in the process of being approved by the Food and Drug Administration for a nation-wide study using his device to assess its effectiveness in eliminating cancer.
“So many people in Bellingham feel you have to go to Seattle to get good care. It’s the only place where you get university, academic level care. (You) have to go to the University (of Washington) or Fred Hutch (Research and Cancer Center) and the fact is that’s not true,” he says.
“We are doing stuff here they aren’t even doing. We are also doing everything just as well.”
When Kaufman moved to Bellingham with his wife to get out of the L.A. smog in 1994, he never thought he would get to practice in a niche field of medicine.
“Coming to a small town I thought I would have to do a bigger variety of things, but I’ve narrowed it to only breast disease,” he says. “I’ve also expanded (my) practice. My primary interest is to take care of people (and) that gives me a tremendous amount of satisfaction,” he says.



Edwin Stickle: Family physician delivers
Former aircraft mechanic has thriving practice in Sedro-Woolley

by Taylor Williams
\
Dr. Edwin Stickle, a former airplane mechanic, is
one of the few family doctors who delivers babies
in Skagit County.


Earlier this fall, Dr. Edwin Stickle received a phone call from the emergency room physician at United General Hospital in Sedro-Woolley. He was asked to come in and deliver a baby. United General does not deliver babies. Stickle is a family physician, which by today’s standards is not expected to deliver babies either, but he does.
“It is very common for a family doctor not to deliver babies. The way things are going, family doctors are working in their office.” Stickle says.
When Stickle came to Sedro-Woolley 10 years ago, all the doctors in the clinic delivered babies and about half the family doctors in Mount Vernon delivered babies. “Now it is down to myself and about eight (family) doctors in Mount Vernon,” he says, “and there are five OB/GYN’s who deliver babies.”
When the emergency room doctor called the on-call obstetrician in Mount Vernon he was advised not to move the pregnant woman because her cervix was fully dilated and the baby was in the breach position, a dangerous situation for both the mother and child.
“At that point, the OB/GYN told the emergency room doctor the right thing, which was ‘don’t send her anywhere, you have to deliver her right there’.” Stickle says.
Stickle was then called in to help the emergency room physician, despite having never delivered a breach baby.
“We did it together, and the baby did very well,” he says.
With the rise of malpractice suits, many family doctors stopped going to the hospital all together, let alone deliver babies anymore. This puts a strain on obstetricians, who are few and far between. Even though others have given it up, Stickle is still in because the need is apparent.
Stickle started out with an aviation degree and became an airplane mechanic. He attended medical school at Loma Linda University in California, after deciding that the aviation industry had too many layoffs.
“Have you ever noticed that Boeing lays everybody off every eight years or so? Well, the whole industry does that. If you are a pilot or mechanic, whatever you are, if you are one of the junior people, every few years you go through a layoff,” he says. “I looked around me, saw that and thought ‘what can I do that’s not going to be laid off?’”
United General Hospital recruited Stickle 10 years ago. At first, he didn’t want to come to Washington, but was persuaded when he was told his salary would be enough to pay back the $140,000 in medical school loans he had incurred.
“You have to find a job that pays that off no matter how much you want to help people,” he says. “We have trouble getting enough doctors (to Skagit County) because the pay is so much less. It’s hard to describe that without sounding like you are whining, but that’s reality.”
Although Stickle could earn more in Chicago or California, he stays in Skagit County regardless of income because he likes living in the area.
Stickle spends his days doing a variety of tasks. He is the medical director of both Skagit Hospice and the Life Care Center nursing home, along with his practice at the hospital. Last year, he received his board certification in hospice medicine. Day-to-day diversity is crucial to Stickle, who enjoys a broad range of medical disciplines.
“Family doctors, myself included, tend to get bored if they are doing just one thing. I don’t know if that means they have ADD (attention deficit disorder) or if it means they are unusual,” he says.
“Most doctors these days just want to do one thing. They drill down narrowly, specialize as tight as they can get. They are only comfortable if they have mastered something. Family doctors, as a rule, don’t master one single thing that well. They know a lot about a lot and not everything about one thing.”
With the lack of doctors in the area who deliver babies, Stickle continues to do it because he enjoys the added variety to his practice and knows that if he doesn’t, “then who will?”

Anesthesiology
Kenneth L. Bachenberg, M.D.
Craig Derby, M.D.
Matthew J. VonFeldt, M.D.
Jessica R. Yoss, M.D.
Bellingham Anesthesia Associates
2980 Squalicum Parkway, #105
Bellingham, WA 98225
360.647.3377

Breast surgery
Cary S. Kaufman, M.D.
Bellingham Breast Center
2940 Squalicum Parkway, #101
Bellingham, WA 98225
360.752.2229

Cardiology
Peter A. Beglin, M.D.
North Cascade Cardiology
2979 Squalicum Parkway, #101
Bellingham, WA 98225
360.734.2700

Cardiothoratic surgery
James Douglas, M.D.
Cardiothoratic Surgery Clinic
2979 Squalicum Parkway, #303
Bellingham, WA 98225
360.756.6800

Chiropractic
Brian Covey, D.C.
Natural Way Chiropractic
2000 North State Street
Bellingham, WA 98229
360.671.1710

Randal Hill, D.C.
Bellingham Spinal Care
1633 Birchwood Avenue, #102
Bellingham, WA 98225
360.715.8722

Theresa Murry, D.C.
Robert Curtis, D.C.
Broadway Family Chiropractic
1810 Broadway
Bellingham, WA 98225
360.734.9525

Jeffrey F. Rindal, D.C.
Northwest Chiropractic Clinic
1601 William Way, Ste. A
Mount Vernon, WA 98273
360.424.8115

Dermatology
Jan P. Dank, M.D.
Dermatology & Laser
Center NW
3614 Meridian, #200
Bellingham, WA 98225
360.676.1470

Dentistry
Jason L. Hilde, D.D.S.
Hilde Family Dentistry
120 E. George Hopper Rd., #120
Burlington, WA 98223
360.707.5353

Emergency medicine
Ming Lin, M.D.
James D. Martin, M.D.
Lanny F. Sokol, M.D.
Ralph E. Weiche, M.D.
Eric D. Williams, M.D.
NW Emergency Physicians
2901 Squalicum Parkway
Bellingham, WA 98225
360.738.6765

Endocrinology
David J. Turk, M.D.
Madrona Medical Group
4545 Cordata Parkway
Bellingham, WA 98226
360.738.2200

Family practice
David P. Dickson, M.D.
Dickson Medical Clinic
500 Front Street
Lynden, WA 98264
360.354.4200

Robert R. Jacobsen, M.D.
Burlington Boulevard Clinic
1162 So. Burlington Boulevard
Burlington, WA 98233
360.757.9030

Margaret A. Jacobson, M.D.
Squalicum Family Medicine
3015 Squalicum Parkway
Bellingham, WA 98225
360.733.1484

David D. Shilling, M.D.
Creelman & Shilling Clinic
712 South Burlington Boulevard
Burlington, WA 98233
360.757.0027

Edwin Stickle, M.D.
United General Hospital
2000 Hospital Drive
Sedro-Woolley, WA 98284
360.856.6021

Gastroenterology
Gary M. Belcaster, M.D.
Madrona Medical Group
4545 Cordata Parkway
Bellingham, WA 98226
360.738.2200

Barry Levenson, M.D.
Northwest Gastroenterology
2979 Squalicum Parkway, #301
Bellingham, WA 98225
360.734.1420

General surgery
Keith J. Vander Griend, M.D.
Vandergriend & Hill Parkway
Surgical Center
2940 Squalicum Parkway, #204
Bellingham, WA 98225
360.733.0070

Internal medicine
Anne T. Fox, M.D.
SJMG Hospitalists
2901 Squalicum Parkway
Bellingham, WA 98225
360.756.6841

Michael J. Geist, M.D.
Martha Gillham, M.D.
Madrona Medical Group
4545 Cordata Parkway, #2A
Bellingham, WA 98226
360.738.2200

Naturopathic medicine
Pat Elliot, N.D.
Elliot Health Care Associates
1155 North State Street, #610
Bellingham, WA 98225
360.647.0228

Nephrology
Williams E. Lombard, M.D.
Mount Baker Nephrology Associates
410 Birchwood, #200
Bellingham, WA 98225
360.734.9233

Neurology
Patti J. Brettell, M.D.
St. Joseph Neurology Associates
2950 Squalicum Parkway, #B
Bellingham, WA 98225
360.756.6870

Obstetrics/Gynecology
Hull Cook, M.D.
1600 F Street
Bellingham, WA 98225
360.671.8086

Occupational medicine
Peter Ambrose, M.D.
Whatcom Occupational Health
3015 Squalicum Parkway, #220
Bellingham, WA 98225
360.676.1693

Oncology (radiation)
David Kantorowitz, M.D.
Skagit Valley Hospital
1415 East Kincaid
Mount Vernon, WA 98273
360.424.4111

Ian L. Thompson, M.D.
NW Washington Radiation Oncology Associates
3217 Squalicum Parkway
Bellingham, WA 98225
360.715.4144

Ophthalmology
Christopher D. Kullas, M.D.
Bellingham Eye Physicians
2979 Squalicum Parkway, #202
Bellingham, WA 98225
360.676.8663

Orthodontics
Paul M. Halgren, D.D.S., M.S.D.,
P.L.L.C.
2210 Kulshan Way
Mount Vernon, WA 98273
360.336.3436

Orthpaedic surgery
Stacia A. Smith, M.D.
Northwest Orthopaedic Surgeons
1500 Continental Place
Mount Vernon, WA 98273
360.424.7041

Pain management
Way Yin, M.D.
Interventional Medical Associates of Bellingham
2075 Barkley Boulevard, #110
Bellingham, WA 98225
360.527.8111

Pediatrics
Josie Lee, M.D.
Madrona Medical Group
4545 Cordata Parkway
Bellingham, WA 98226
360.738.2200

Les M. Richards, M.D.
Fidalgo Medical Associates
1213 24th Street, #100
Anacortes, WA 98221-2595
360.293.3101

James L. Troutman, M.D.
Madrona Medical Group
4545 Cordata Parkway
Bellingham, WA 98226
360.738.2200

Pulmonology
Donald F. Berry, M.D.
Janet Seltzer, M.D.
Madrona Medical Group
4545 Cordata Parkway
#L2, Ste. D
Bellingham, WA 98226
360.738.2200

Sports medicine
Patrick M. Lyons, M.D.
Kenneth M. Oates, M.D.
Northwest Orthopaedic Surgeons
1500 Continental Place
Mount Vernon, WA 98273
360.424.7041