Their story is our story.
A growing mission
When planning for a new hospital for Bend began in the late 1960s, Sister Catherine Hellmann wanted better, not just bigger.
For years, St. Charles had served well as a community hospital. Babies were born there, sick were tended and the injured mended. But so often critical and complicated cases had to be shipped over the mountains. It was difficult for patients and their families.
Sister Catherine talked about creating a “Mayo Clinic of the West.” It was a big idea. But that idea propelled St. Charles for more than 30 years as it grew from a community hospital to a regional medical center.
By the turn of the 21st century, St. Charles Health System had expanded to provide comprehensive care for the region – based on the philosophy of “keeping care close to home.” It had also assumed a position at the leading edge of medicine on several ronts ranging from oncology to cardiology to the treatment of endometriosis, a challenging disease affecting millions of women. St. Charles also continued to play a role in training tomorrow’s physicians.
Below are profiles of a few key programs, as viewed through the eyes of physicians who helped shape them. Hundreds of physicians have contributed to medical advances in Central Oregon. Here are just a few of the many exceptional doctors that have served here.
Cardiology – Healing hearts in Central Oregon
The man looked like he was going to die. He had suffered an acute heart attack and the pain was intense.
Drs. Tom Combs and Timothy Hanlon, St. Charles Health System cardiologists, knew the man wouldn’t make it unless they did something. For years, treating a heart attack meant making the patient as comfortable as possible and hoping the body healed itself. That wasn’t going to work in this case. Combs and Hanlon identified a blockage in the heart through an angiogram.
They decided the man’s best hope lay in a new and controversial procedure that involved applying a drug directly to the blockage through a tube routed by way of an artery in the man’s groin. It worked.
“He went from looking like he was going to die to being real comfortable,” Combs said. “That was a real dramatic example of how intervention could work.”
Before the mid-1970s, the man probably would have died. Central Oregon heart patients who needed specialized procedures or open heart surgery faced an ambulance trip over the Cascades to Portland, if they could hold on long enough.
When St. Charles moved to its new facility in east Bend in 1975, hospital leaders decided the time was ripe to start a cardiology program. It would prove a key element in the transition from a community hospital to a regional medical center. Demand existed, not just in growing Bend, but from patients from as far away as Burns and John Day. Few reckoned how great the demand was, though, when Combs became St. Charles Health System’s first cardiologist in 1976 and the hospital added cardiac catheterization and angiography facilities in 1977.
“They told me if I did 30 (cardiac) catheterizations a year, that would be enough. I think I did about 150,” Combs said.
Over the ensuing years, St. Charles added a regional EKG network and mobile echocardiography, wen through a period of national leadership in minimally invasive heart surgery procedures in the mid-90s, participated in leading edge research in the treatment of heart attacks, introduced the world’s first mobile electron beam tomography (EBT) scanner for detecting silent heart diesaese, added cariologists and expanded programs for cardiac care and cardiac habilitation. By the early 21st century, there were seven cardiologists on staff, two cardiothoracic surgeons and a hosts of specialized caregivers treating more than 1000 heart patients per year, including the nearly 300 open-heart surgeries. The heart services program had also been repeatedly noted as “among thebest in the nation.”
In characteristic understatement, Dr. Combs summed it up. “We’ve come a long way, from not having a cardiac program to what we have today.”
Endometriosis – helping women from around the world
Millions of women suffer from endometriosis, a condition in which tissue normally found in the uterus grows elsewhere in the pelvic area. It can cause pain and infertility.
Despite this pervasiveness, little was known about its diagnosis and treatment when Dr. David Redwine came to St. Charles in 1978.
Newly out of residency, Redwine was delivering babies and taking shifts in the emergency room. He noticed how frequently women suffered untreated or under-treated gynecological problems.
Endometriosis often can only be diagnosed through surgery. Even then, it’s unpredictable and complex. Rewine started documenting what he found each time he operated.
“After six or seven years, I sat down, literally at the kitchen table, to try and crack the code,” Redwine said in 2002. “What I found was mind boggling. Sixty percent of patients with endometriosis had been either undiagnosed or misdiagnosed because doctors were only looking for black powder-burn lesions.”
The old medical textbooks said the condition showed itself as burn-like lesions on the uterus, but Redwine found it manifested itself in many forms. His discoveries literally rewrote textbooks and put St. Charles on the world map for that branch of medicine. He also developed surgical techniques for removing the offending tissue.
Nancy Petersen, a St. Charles nurse, helped Redwine promote his findings about diagnosis and treatment. First patients, then physicians, started seeking him. St. Charles Health System established its Endometriosis Treatment Program in 1986.
Dr. Redwine became an international authority on endometriosis. By 2002, he had published 29 peer-reviewed articles, 28 textbook chapters and 20 videos on the topic. Surgeons from all over the world traveled to learn his techniques. Redwine credited his success and that of the pgoram on the freedom and encouragement administrators gave doctors to explore.
“Every day I’d wake up excited wondering, ‘what new thing am I going to learn about endometriosis, or what new surgical technique am I going to develop.’”
Taking on cancer
Where you find people, you find cancer.
That’s a sad fact. But for years, those living in Central and Eastern Oregon had limited access to essential treatment.
While some surgeries were performed locally when Dr. Richard Woods came to St. Charles in 1965, little else ould be done. Radiation therapy verged on science fiction. Woods had to send patients to Stanford for that level of care. Oncology as a specialty didn’t exist yet because few cancer drugs had been developed.
Wood never planned to become a cancer specialist. He had trained in hematology, the treatment of blood disorders. When pharmaceutical labs started developing chemotherapy drugs in the 1970s, that made Woods the logical choice to administer those drugs. Though he never became certified in oncology, Woods practiced in that field for 15 years until retiring in 2001.
Advancements in medicine and technology, coupled with a commitment to caring for the people of the high desert, propelled St. Charles to become the cancer treatment center for the region. St. Charles got its first linear accelerator with the opening of the Central Oregon Cancer Treatment Center in 1982.
Many diagnostic and treatment improvements followed.
“You have to keep up with the state of the art,” Woods said. “You need to be willing to change regularly.”
Peggy Carey, director of the St. Charles Regional Cancer Program, agreed. “We always get things when they’re new. We’re very cutting edge.”
Innovations also included development of the Women’s Health Coalition of Central and Eastern Oregon, the Sara Fisher Breast Health Project, the Navigator program – wherein breast cancer survivors assist women going through treatment – and a range of support services. St. Charles has also been active in cancer research and the general shift toward early detection and even prevention.
“We’ve gone from treating the disease to treating the whole person,” Carey said.
By the early part of the 21st Century, St. Charles had two medical oncologists, two radiation oncologists and 17 surgeons, as well as certified cancer nurses, all involved in cancer treatment. Approximately 1,200 new cancer patients were coming each year.
Tomorrow’s doctors
As St. Charles’ cancer, endometriosis and cardiology programs were developing, a fourth leg of the organization’s evolution into a regional medical center was initiated: professional education.
In 1981, Dr. Keith Harless, a pulmonary and critical care specialist, started St. Charles’ first formal clinical training program for medical students. It brings fourth-year medical students from Oregon Health and Science University to Bend for a four-week rotation in critical care.
Students evaluate and follow patients – completing dictation and notes; talking with nurses, patients and families; and even completing medical procedures under supervision of physicians.
“The reason the rotation got started is I like to teach,” Harless said.
He is a clinical associate professor of medicine in pulmonary and critical care with OHSU, as well as a physician with St. Charles and Bend Memorial Clinic. In the process, he has earned the Howard P. Lewis Distinguished Teaching Award from the Oregon Chapter of American College of Physicians and the American Society of Internal Medicine, as well as other teaching honors from OHSU.
Harless said working with students energizes him and the other physicians in the program. The students are well on their way to becoming physicians. Their science knowledge and skills are sharp and up-to-date; they’ve already completed general medicine and surgical rotations at OHSU as well as a family practice rotation in a rural hospital; and they’re full of enthusiasm. The critical care clerkship allows them to delve deeply into a specialized area of practice.
“I think what I get, and what other physicians get, is the inquisitive, bright student asking questions,” Harless said.
With the help of a wide range of dedicated physicians, by 2002 St. Charles also offered rotations in cardiology, orthopedics and emergency medicine, as well as a surgery rotation for physician assistants.
Harless estimated 85 students had gone through the critical care rotation over the years.
According to Harless, the medical center reaps several benefits from the program, not the least of which is that several students who have gone through the program have returned to join the medical staff. The program has also helped get the word out into the medical community about St. Charles.
“I think the most significant thing is many students we have go away respecing St. Charles and Bend medicine in a way they wouldn’t have otherwise known,” Harless said.