PeaceHealth Peace Island Medical Center, established to serve residents and visitors on San Juan Island in the far northwest corner of Washington, opened its doors to patients on November 26, 2012. Among the many art works in the facility, located in Friday Harbor, is a 60-foot mural, created by local artist Annie Howell-Adams and based on historical photographs, numerous interviews, and Ms. Howell-Adams's extensive research. The mural provides a visual journey through some highlights of medical care for islanders from pioneer days to the second decade of the twenty-first century. This is the story (based on text from an explanatory brochure) that the mural illustrates -- a brief narrative of representative details from more than 150 years of compassionate healthcare by medical professionals and residents in this isolated rural community. A sampling of the mural panels accompanies the essay.
The Early Years on San Juan Island
San Juan Island was a popular home for Lummi, Coast Salish, and other Native American groups who fished the salmon-filled waters, cultivated and harvested camas roots, and utilized the island's resources for thousands of years before British and American settlers began to arrive in the mid 1850s. For a number of years, military doctors and local residents with healing skills were the only help available when illness or injury occurred among the island's sparse population of farmers and sheepherders. In 1859, at the beginning of a joint British-American military occupation (the 12-year, temporary solution to a dispute about which government had jurisdiction over the San Juan Islands), a small hospital, brought plank by plank from the military post at Bellingham, was built at American Camp on the southeast corner of the island but soon replaced by a larger six-bed structure. British personnel were treated at their camp at Garrison Bay on the northern end of the island. British surgeons filled in for American doctors when needed, and both British and American military doctors also occasionally treated pioneer families.
Among the early settlers on the island were Lucinda (1836-1916) and Stephen (1829-1909) Boyce, who arrived in 1860 after disappointment in the Fraser River area gold fields in British Columbia. For many decades Lucinda served as doctor, midwife (she delivered more than 500 babies and never lost one) and nurse, not only on San Juan but on other islands as well. By horse or buggy, or even by rowboat or cedar canoe, sometimes through winter cold and storm over treacherous waters, she ministered to settlers and Indians alike while raising 11 children of her own and later fostering a number of Indian children.
By 1891 more medical help was available from doctors practicing in Friday Harbor and Roche Harbor on San Juan Island, as well as from physicians on Orcas and Lopez islands. Among them was "Mrs. Dr. (Agnes) Harrison" (1861-1949), as she was known, notable as one of the first women physicians in the country, who, with her husband Dr. I. M. Harrison( 1856-?), provided medical care at the Roche Harbor Lime and Cement Company on the north end of San Juan Island before moving to Orcas Island in 1907. They continued to minister to islanders into the 1920s.
After years of medical practice in Hawaii, Dr. Victor Capron (1868-1934), came to San Juan Island in 1898. He maintained an office in Friday Harbor (the county seat and only large town) on the eastern shore of the island and served Roche Harbor residents and company employees as well. He had the first telephone line installed on San Juan Island in 1901 to connect his Friday Harbor and Roche Harbor offices, had extensive dairy-farm operations on San Juan Island and the mainland, invested in a number of island enterprises including an early electricity-generating plant, served two terms as mayor of Friday Harbor, and represented the island in the state legislature. He had the first motorcycle and the second car on the island. His portable x-ray machine was powered by the wheel of his car, and he is known to have performed brain surgery in his office.
In the first decades of the twentieth century, a pharmacy opened on the island, and several physicians, both resident on the island and visiting from the mainland, offered their services, but it became clear that more healthcare was needed for the growing population. An important new medical service became available for islanders when, in 1920, Laura Bella Perry (1872-1943) opened her home in Friday Harbor as a recovery and maternity facility. In a comforting, family atmosphere, she cared for those who were ill or had had minor surgery or were delivering babies. Food was provided by the garden and milk cow out back. Ethel Perry (1891-1980), one of the six Perry daughters (known as the "Perry Peaches"), also practiced as a midwife.
Expanding Healthcare Services to Islanders
During the Great Depression years of the 1930s, additional medical services became available with funds provided through federal and state economic-recovery programs. Among them was a county nurse position with responsibilities for examining school children, making home visits, doing pre- and post-natal exams and counseling, and providing first-aid instruction and other services as well. Several nurses worked to improve the health of islanders during this period, but best remembered was Elsie Scott (1898-1983) who, in 1938, transferred from Alaska to San Juan County to become the county public health nurse. During her long career in the San Juan Islands she inoculated 600 children against diphtheria and educated residents of Friday Harbor about boiling their polluted drinking water. She emphasized preventative care and provided emergency services throughout the islands, often transported from one island to another by the Coast Guard. When she discovered that women in labor on the ferries often did not make it to the hospital on the mainland before delivery, Elsie put together obstetric kits to be kept available on the ferries and trained crew members how to use them. She also sometimes assisted Dr. Thomas Judge (ca. 1909 -1954), a European-trained physician and surgeon, the only San Juan Island doctor throughout the 1940s, known as "the first flying physician of Friday Harbor." And she encouraged local young women to train for nursing work. As was noted in her obituary in a local newspaper, "Her dedicated, imaginative approach to preventative healthcare in a rural, sparsely populated island county gained her statewide and national recognition." In 1947, CBS national radio aired "Lantern in the Dark," a broadcast based on Elsie Scott's life.
Dr. Malcolm Heath (1913-1989) answered an advertisement for a physician to take over the practice of retiring Dr. Judge in 1950. By 1956 Heath had raised the $23,000 necessary to build the island's first clinic, the Islands Medical Center, at the corner of Reed and Rhone Streets in Friday Harbor, just north of the center of town. He met patients two days a week on Orcas Island and served Lopez Island as well. One day a week he performed surgery at St. Joseph Hospital in Bellingham, and, when needed, he traveled to outer islands by plane, Coast Guard cutter, or local fishing boats. He soon was flying to patients around the county, too, not daunted (perhaps reflecting his World War II experience as a paratrooper) by having crashed his first plane shortly after acquiring it. He served as county medical officer for 20 years and finally retired from practice -- for the second time -- in 1980. He has been called San Juan County's last country doctor.
Better transportation to take seriously ill patients off the island had become available after World War II, when Roy Franklin (1924-2011), who began regular passenger service to and from the island in 1948, offered his services and his airplane for medical air transport. Dr. Heath; his assistant, public health nurse Ethel Dale (1907-1998); and nurse Betty Nash (1925-2018), one of the San Juan Island young women whom Elsie Scott had encouraged to take up nursing, worked as first responders in the field and with Franklin for more than 20 years, treating islanders in the community and assuring professional and efficient care to those who had to be taken to mainland hospitals.
In 1966 a new mode of healthcare became available on the island with the opening of the first nursing home, the Islands Convalescent Center, by Gale (1926-2009) and Doreen (1946-2004) Carter. This much-needed facility (San Juan was the last county in the state to have a nursing home) offered long-term and recuperative care in a warm, supportive setting. Residents were encouraged to maintain their interests and activities including gardening on the property, which had the added benefit of supplying fresh produce for resident meals. Also housed at the Islands Convalescent Center was the island's Cadillac ambulance, so medical emergency calls were directed there for rapid response and patient transport to town or to the airfield.
The Inter Island Medical Center
Dr. Heath served during a period of advances in medical technology and practice for a growing island population. By the early 1970s the clinic on Reed Street was no longer adequate to serve the community; a larger facility and more healthcare services were needed. Gale and Doreen Carter, strong supporters of efforts to improve island healthcare, generously donated property on which to build a new medical center on Spring Street, the main artery through town, next door to the Convalescent Center.
The Inter Island Medical Center began serving the community in 1976 and continued to be a vital hub of island healthcare until 2012. With better diagnostic tools, rapidly changing technology, and a growing staff, the IIMC offered islanders diverse and caring medical services.
San Juan Island Emergency Medical Services
By the 1970s it became clear that a separate group of trained medical first responders was needed to aid islanders and support local physicians. Frank Wilson (1946-2004) became the first administrator of the fledgling Emergency Medical Services (EMS) and, following protocols modeled after those at St. Joseph Hospital, developed the organization into an important medical-service provider for the community.
At first the emergency medical responders had to cope with a variety of challenges. The electrical system of the first EMS vehicle, for example, was kept charged by plugging it into an extension cord extending out through the window of the county sheriff's office.
However, with intensive training to national standards, improved equipment and technology, and the recruitment of dedicated local volunteers, San Juan Island EMS has earned a reputation for skilled patient care. Today, when necessary, patients are transported to Peace Island Medical Center for evaluation and treatment in the emergency department and possible evacuation by helicopter, fixed-wing aircraft, or boat when advanced mainland medical procedures and attention are required.
The PeaceHealth Story
While the first island settlers were receiving needed medical care primarily from dedicated fellow residents, the increasing demand for medical services in much-more-populous Bellingham prompted a group of concerned citizens in 1888 to invite the Sisters of St. Joseph of Peace in New Jersey to come west and establish a hospital to serve the local loggers, mill workers, fishermen, and their families. Two young nuns arrived and raised $1,800 in subscriptions (a $10 subscription entitled the bearer to a year's treatment at the hospital) to open the first 30-bed facility staffed by seven nuns and a cook. Early records show that patients came from throughout the mainland area around Bellingham and from the San Juan Islands as well. In 1901 the hospital moved to a new $21,000, 53-bed facility also built through subscriptions from as far away as Alaska. Establishing a training program for nurses was an early priority at the new St. Joseph Hospital, and the first class was opened in 1906. Years later, Elsie Scott on San Juan Island introduced a group of local young women to the cadet nursing course at the hospital. Six students from Friday Harbor enrolled in the three-year program.
St. Joseph Hospital moved in 1966 to a new facility in Bellingham on Ellis Street (the hospital's current location). Over the years major expansion projects have included new surgical suites, many more patient rooms, a cardiovascular center, a cancer care center, a joint replacement center, and an emergency and trauma center. St. Joseph Hospital (now PeaceHealth St. Joseph Medical Center) has, since its founding, provided care for generations of islanders needing surgeries and advanced medical services unavailable on the islands.
In 1976 the Sisters of St. Joseph of Peace decided to consolidate the western healthcare ministries and facilitate work with lay colleagues by forming a not-for-profit system, Health and Hospital Services, which was renamed PeaceHealth in 1994. PeaceHealth and its medical groups now operate hospitals, medical offices, chemical-dependency services, home-health services, medical laboratories, and other services in the states of Washington, Oregon, and Alaska, primarily in rural communities.
A New Era Begins
Medical diagnostics and treatment have come a long way from the experiences of the island settlers in the 1850s. Dedicated physicians and other medical personnel along with islanders committed to improving local healthcare have worked hard over the years to assure that this rural, isolated community has had the best medical care possible. In the first decade of the twenty-first century it became clear that the 30-year-old Inter Island Medical Center, with its aging infrastructure and limited space, could no longer meet the medical needs of a growing population or offer the most recent developments in diagnostic services and medical practice.
After extensive community research and investigation of possible partners in medical care delivery, the San Juan County Hospital District #1 Board entered into an agreement with PeaceHealth to build and operate a new PeaceHealth Peace Island Medical Center in Friday Harbor which is now able to offer greatly expanded clinic services, an array of technologically advanced diagnostic procedures, 24-hour emergency care from specialty-trained physicians, out-patient surgeries, cancer care, and short-term hospital stays. The legacy of more than 150 years of medical care on San Juan Island is a source of community pride, and services continue to evolve to meet current and future needs.