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September 1, 2009

Community profile: Seattle, Washington

The shimmering downtown area of Seattle is bordered on one side by the city’s chief harbor - Elliott Bay, an inlet of Puget Sound.
The shimmering downtown area of Seattle is bordered on one side by the city’s chief harbor - Elliott Bay, an inlet of Puget Sound.

The mention of Seattle conjures a near-torrent of associations. The shortlist includes coffeehouses, Cobain, Chihuly, Boeing, Microsoft, Pike Place Market, Space Needle, ecology, Ichiro, island living, ferries - and rain, rain, rain. This is a mere introduction to the many 20th century "faces" of Washington State’s largest city.

The grunge style that made Kurt Cobain famous co-exists comfortably with the violin-flute-horn extravaganzas of the "centenarian" Seattle Symphony and a plethora of other genres. Glass art masterpieces seem to be everywhere, thanks to the unmistakable creations of Dale Chihuly and his followers. And coffee lovers find 256 havens in the downtown area alone, many of them sporting the familiar Starbucks logo.

Some two dozen eclectic neighborhoods add to the mix that has charmed newcomer Nicole White, MD, of Northwest Hospital and Medical Center, among others. White revels in her small community,  Wallingford, because of its neighborly business area and unusual restaurants. The adjacent Fremont charms with its lingering bohemian ambiance. Nearby islands are a draw for other Seattleites, including Benjamin Starnes, MD, whose choice is Mercer Island, in the middle of Lake Washington to the east. He crosses an historic pontoon bridge on his way to work at Harborview Medical Center. With 24 vessels plying 10 routes, the nation’s largest ferry system provides convenient transportation to other islands.

Seattle’s thriving downtown seems to buck the national trend. Besides department stores, shops and restaurants, there are attractions like summer "Out to Lunch" concerts. "Seafair," probably the city’s most popular annual festival, also starts downtown with the Torchlight Parade. Soon a new traffic tunnel will replace the ugly elevated roadway that has divided the waterfront from downtown for 50 years.

Most of the above would certainly amaze the cast of hardy characters who sparked Seattle’s rise to today’s intriguing metropolis. Take for instance Sealth, the Duwamish-Suquamish chief who charged his white friends $16,000 for using his name, unlike 21st-century corporations spending millions to install their names on new stadiums. (Think Safeco Field, where fans flock to cheer Mariners legends Ken Griffey, Jr., and Ichiro Suzuki.)

Nor would the old pioneers expect to see 350 public art pieces enhancing city streets and buildings, 160 in downtown alone. Most memorable: "Hammering Man," a 48-foot black metal "silhouette" greeting Museum of Art visitors.

Seattle “pioneers”

Standout characters along Seattle’s "road to stardom" include David (Doc) Maynard, who left a wife behind in Ohio, made a new life for himself - with a new wife - in the 1850s and became the town’s greatest booster, working his way through occupations from physician to lumber merchant to storekeeper to real estate entrepreneur to lawyer and Indian agent. Along the way, Maynard recruited new settlers and also opened the city’s first hospital - two rooms and a drugstore in a small building. It lasted long enough to treat patients like his friend Sealth, but not much longer. Today, Doc Maynard’s Place, a tavern named in his honor, is the starting point for popular guided tours of the old cellars and tunnels of "underground Seattle" in the Pioneer Square area, where it all began.

"This is one of the most beautiful places in the country.
On Seattle’s best day I think it rivals any place on Earth."

Henry Yesler started a steam sawmill, the city’s first industry, to process lumber from hilltop trees pushed down a steep street known as Skid Road, a.k.a. Skid Row, later a universal term for shabby streets lined with saloons, brothels, and other unsavory emporia. Not surprisingly, the area lived up to that definition for some time, especially during the wild days of the late 1890s Klondike Gold Rush.

The striking Seattle skyline with Space Needle left of center, forefront, and gorgeous Mount Rainier right of center, in the background.
The striking Seattle skyline with Space Needle left of center, forefront, and gorgeous Mount Rainier right of center, in the background.

Seattle’s beautiful views

The hills that helped make Yesler’s enterprise a success are a surprise to some of today’s newcomers. According to one city historian, Murray Morgan, the San Francisco steep hills were such a nemesis to early members of the Seattle Symphony, who were so "breathless" after carrying their instruments up three daunting blocks to rehearsals that they finally devised a pulley system for their cellos, basses, and tympani. These days, locals scoff at visiting complainers: "Sure, the hills are steep. But look at the view."

From the viewpoint of  Starnes, "This is one of the most beautiful places in the country. On Seattle’s best day I think it rivals any place on earth." At Harborview Medical Center, operated by the University of Washington (UW) Medical Center, Starnes is chief of the vascular surgery division. He quickly took advantage of the "mountain opportunities" offered by the Olympics and Cascades that loom near the city. "I climbed Mt. Rainier for the first time last summer," he says. "It was a religious experience. I carried a 60- pound pack for seven hours through snowfields to Camp Muir and then climbed to the summit. You leave at midnight and hit the summit at 6 a.m. It’s just spectacular, one of the coolest things I’ve done in my life."

Back in the "lower world," Kathleen Lin, MD, shares Starnes’ awe for nature’s surroundings, especially in a huge urban area. "It’s just beautiful out here," she says, "waking up and seeing the mountains and the water every day." Not only that. "There’s less of a New-York-minute feel, and that’s refreshing. There’s a lot more attention to stopping and smelling the roses." Lin knows of what she speaks. Medical school and a fellowship focusing on fertility issues for both men and women kept her in Philadelphia and New York for 10 years. There she developed a surgical technique to restore male fertility. Now she uses this unique skill in addition to treating women patients at the UW Medical Center.

"At Monday meetings I like to ask my colleagues what they’ve done for the weekend. Invariably, they go outside. Nature is just such a part of their lives, and there’s so much more (of it) that’s accessible out here," Lin says. She also enjoys Seattle’s "good mixture of nature and cultural events. Some other cities have tons of culture, but it’s very hard to get out into nature. Right here we have tons of parks (locals call them the "Emerald Necklace"), and they vary from being very manicured to where you feel like you’re in the woods. Yet they’re right here in the middle of the city."

A traditional sailing vessel bobs on one of Seattle’s many waterways.

A traditional sailing vessel bobs on one of Seattle’s many waterways.

Going, going…green

Seattleites are determined to preserve the "purity" of their hometown. The earliest "green" impetus came from an unexpected source - railroad magnate James J. Hill. In a 1909 speech at the Alaska-Yukon-Pacific Exposition, he exhorted fellow Americans: "Will you realize what this country must become when stripped of its forests, the washing away of the soil, the inevitable changes in climate? If you do, your earnest work for forest conservation will begin today."

It didn’t happen quite so soon, but today it’s almost impossible to over-report on the green movement. The current "mix" includes some 90 percent water-powered, carbon- neutral electricity derived from area dams. The city also purchases wind power, and a new garbage-to-electricity purchasing program will begin in October. There are benefits other than improving the environment. "We are consistently in the top five cities with the lowest utility rates in the country," says Brian Surratt, the city’s business development director.

Hill would be happy to know about today’s almost literal forest of tree-friendly organizations. City government oversees urban forest plans, parks, neighborhoods, and utilities. At least seven other organizations promote tree-friendly activities - mandating 800 new trees for each of the next nine years, maintaining a list of recommended trees for homeowners, championing proper tree care, advising on power-line-friendly trees, giving trees to residents, and sponsoring planting parties. The Heritage Tree Program "honors" historic and unusual trees.

On the coercive side, it’s illegal for a homeowner to cut down more than three of the shade beauties per year. Starnes says, "If you cut down a tree around here without a license, it’s almost like killing somebody."

In 2005, Mayor Gregory Nickels took the lead in a Climate Protection Initiative that now encompasses more than 900 mayors of other cities who have signed on to such protocols as emission reduction targets set by the Kyoto Agreement. Other local goals include clean energy, light conservation, expanded transportation choices, "green" buildings, and a bike master plan. Low-energy bulbs and home energy kits have been distributed to thousands of residents.

Hospitals are heavy environmental players, too. "I think everybody’s trying to be a lot more ecologically responsible," says Karen Peck, the director of marketing/public relations at Northwest Hospital and Medical Center. Recycling statistics have become part of the hospital’s year-end report to the community.

Some residents see an Orwellian "plot" behind certain regulations, such as the blogger who commented, "Next: raise taxes for the garbage police, shopping bag police, tree police…" Starnes is among the majority that seems to agree with the "green" concepts, especially when he contrasts recycling with the norm during his service as a U.S. Army physician in Germany. "Everybody recycled," he says. "If you didn’t, the waste management people had the right, under German law, to throw your trash all over your front yard."

A streetcar of the South Lake Union Trolley makes its way through downtown.

A streetcar of the South Lake Union Trolley makes its way through downtown.

Technology in Seattle

At least two things about Seattle surprised Rod Oskouian, MD, a neurosurgeon with Swedish Medical Center, which traces its roots to 1910, when 10 Swedish-American businessmen financed a 24-bed hospital run by fellow immigrant Nils Johanson, MD. Today, the Swedish "empire" includes three facilities. Its research ranges from perinatal work to charting relationships between migraines and tears in the heart. The first dedicated cancer treatment center west of the Mississippi opened there in 1932, and its current Breast Care Express provides early diagnoses for women in outlying areas.

Oskouian grew up in Seattle, but upon returning after 15 years of education, he was astounded by the growth of the city itself - and by the fact that it’s "probably the most technology-driven city in the country," thanks in great part to the presence of Microsoft. Another Oskouian discovery… "Most people don’t know this, but Seattle is also a big center for video game [development and production]."

After a residency and three years as an assistant professor of surgery at New York University, White admits to being wary about leaving behind the big-city scene to join her business-owner husband in what she perceived as a lesser center of civilization. Now, eighteen months later, she’s become a confirmed Seattleite. Professionally, she’s been able to expand her two specialties - bariatric and esophageal surgery - at Northwest Hospital. She and a colleague, Peter Billings, MD, were first in the state to use a new technique, ExophyX, for treating acid reflux. It’s a non-invasive, incisionless procedure using instruments on a scope to create a new valve from existing tissue.

Statistics on the Emerald City

Statistics on the Emerald City

Seattle’s growing healthcare field

In the healthcare field, several surprises waited as well, including its exponential growth. Oskouian says, "More than in any other city, healthcare is consumer-driven. People will go on the internet, and they will look up every single doctor. They ’doctor shop.’ They never did that on the East Coast. In Seattle, they’ll see five or six different doctors and then make decisions."

Not only that, "I have to have a whole educational folder for them because they have so many questions, and they might add an extra appointment to discuss it." Oskouian attributes the difference to a "younger community and many people with jobs requiring higher education. Sometimes they actually pay out-of-pocket, and it doesn’t seem to make a difference whatsoever, because they think it’s worth it."

As one of about 25 practitioners in his group, he’s able to concentrate on his own specialty, spinal surgery. He’s also been gratified by the collaborative spirit that seems to be growing, at least among neurosurgeons, although a number are still wary about protecting their own practices. "The doctors who have formed relationships with us feel they have benefited tremendously. One of them says his practice is busier than ever. He thinks his patients feel like they’re getting two different opinions for the price of one."

Resplendent with medical research

Another surprise for Oskouian was the stupendous amount of medical research taking place in Seattle. Five of Seattle’s six major hospitals, plus the well-known Fred Hutchinson Cancer Research Center, are engaged in - and collaborating on - mind-boggling quantities of projects and clinical trials.

The beehive of hospital-based research has played a leading role in attracting more and more biotech companies. Currently, 55 companies and 7,600 employees call Seattle home, and the city continues its efforts to accommodate the industry. One region of focus is near Lake Union, where future plans include a streetcar to connect the facilities. In hospital-based research, UW has to be the hands-down "champion" - consistently ranking among the top five American educational institutions receiving National Institutes of Health (NIH) research funding. Its faculty includes five Nobel Prize winners.

As long ago as 1961, UW was making news in innovation. That year it opened the world’s first multi-disciplinary pain clinic, which became a model for diagnosis, study and treatment. Other pioneering Pacific Northwest procedures followed - first kidney, heart, and liver transplants, then setting the enduring protocol for multi-stage treadmill testing to evaluate heart problems.

UW is also known for its community- based training and interstate collaboration in medical education, probably in conjunction with a commitment by all the hospitals to provide patient treatment throughout the five-state region of Washington, Wyoming, Alaska, Montana, and Idaho (WWAMI). Harborview, for instance, operates the sole Level One WWAMI trauma center. "If you put all those states together," says Starnes, "they comprise 27 percent of the U.S. land mass and 12 million people." He is involved in five clinical trials.

In response to the far-flung patient base, he says, the "prehospital" system started in Seattle. "It’s hard to get over [our many] waterways without having to drive sometimes for six hours. We established Medic One and Airlift Northwest, and we get patients into the hospital very expeditiously both by helicopter and fixed-wing - or, the old-fashioned way, from downtown by ambulance. From places like Montana, it takes four to six hours, but medic helicopters have whole teams of caregivers, including vascular surgeons. Harborview surgeons see the worst of the worst from all over the region, we have such a deep bench in terms of capability."

"There’s less of a New-York-minute feel, and that’s refreshing.

There’s a lot more attention to stopping and smelling the roses."

Seattle’s other two large hospitals have made their marks in interesting ways. "Hospital, Research, Foundation" is the tagline for Seattle Children’s after five name changes since its founding in 1907. Since then, its mission has multiplied to more than 60 specialties, including cranial facial reconstruction and organ transplants. Its Level IV Infant ICU makes it a crucial part of the WWAMI "family." Spokeswoman Louise Maxwell says, "We incorporate a lot of telemedicine" - for good reason. "We need to reach families as far away as native villages in rural Alaska."

Children’s Research Institute has been a consistent leader in related NIH funding. Both medical disorders and socially related behavior are part of its agenda. Recent studies centered around (1) use of e-mail by physicians to head off dangerous consequences among teens using social networking sites; (2) comparing effectiveness of a new drug versus placebo in reducing repetitive behaviors among autistic children; and, (3) confirming suspicions that "audible television" impedes young children’s vocabulary development as well as conversation with adult caregivers.

Unlike Seattle’s five other major hospitals, Northwest, White’s employer, does not have a research arm, but it has pioneered a number of procedures. It partnered with UW in heart treatment programs and added some unusual features. One of them, "Easy Street," looks more like a museum exhibit than a hospital setting, but it’s actually a total therapy environment for patients, mainly stroke victims, to relearn hundreds of everyday skills - everything from negotiating street curbs and filling grocery carts to sliding into cars and restaurant booths.

Top 10 Seattle spots

    1. No visit would be complete without a trip up the iconic Space Needle. Built in 1962 to commemorate the World’s Fair, it has been a tourism mainstay ever since. Tours run seven days a week year-round. An upscale restaurant and observation deck reside at the top - taking one hour per each rotation.
    2. Next door to the Needle, on the Seattle Center campus, resides the award-winning Pacific Science Center. Replete with handson science fun for the whole family and a gigantic IMAX screen (showing everything from Harry Potter to documentaries on the North Pole), there’s something for everyone.
    3. Also on the Seattle Center campus, the Experience Music Project (EMP) and the Science Fiction Hall of Fame (SFM) have drawn over five million visitors since opening a few years ago. Dedicated to the "exploration of creativity and innovation in popular music," the EMP provides a tactile museum experience. A one-of-a-kind museum, the SFM covers the genre of Science Fiction from multiple angles, including writers, movie makers, music, and of course the bastions of science fiction, Star Trek and Star Wars. One admission ticket gets you into both and special days of the year admission is free.
Seattle Zoo

Seattle Zoo
    1. Located just out of the city (but easy to get to via public transit), is the Woodland Park Zoo. At nearly 100 acres, the Zoo, located in the Greenlake district of Seattle, is a popular destination for locals and visitors alike, hosting over a million guests per year. The Zoo celebrated its centennial anniversary in 1999, making it one of the oldest zoos on the west coast. Seattle also has a large aquarium, located on the waterfront. A City Pass is available where for one considerably discounted price, you receive tickets for the Zoo,  Aquarium, EMP/SFM, Space Needle, Science Center, and a waterfront cruise.
    2. Seattle International District (Chinatown)

      Seattle International District (Chinatown)

      Dedicated to sharing Asian cultures, the International District (also called Chinatown), is located in the general area of downtown and the waterfront. Within its authentic Asian atmosphere you will find lovely museums, fabulous restaurants, and a wide variety of shopping. Different festivals happen throughout the year, including a special open-air market on summer evenings.

    3. A year-round open-air bazaar, the Pike Place Market is the oldest such market in the country at 102 years old and boasts hundreds of stalls, shops, and restaurants, from funky to chic. No self-respecting Seattle movie leaves out shots of this celebrated landmark.
    4. Seattle was built on a badly drained mudflat. Shortly after the city’s founding, locals realized it needed to be built up higher. Knowledge and implementation do not always go in tandem, however, and it took some years before it happened. When it did, it created a chaotic situation because people had to change streets via ladder! But in time, entrances were moved, sometimes as much as 35 feet up. Eventually, the old city was buried. A large zone is still preserved and available for a fascinating 90-minute tour, called Underground Seattle, starting in the historic Pioneer Square district.
    5. Close to Pioneer Square is the home of Seattle sports. Don’t miss Qwest Field, home of the NFL team, the Seattle Seahawks, and Safeco Field, home of the Mariners. An architectural marvel, Safeco offers stadium tours, so you get your baseball fix even if the Mariners are not playing.
    6. To truly enjoy the city, spend a day on the Seattle waterfront. At the base of the stairs to the Market, the picturesque district offers restaurants galore, featuring fresh caught seafood. Many unique shops (selling all things Seattle) are mingled with interactive activities such as the Aquarium, Qwest and Safeco Fields, and a thriving marine trade, led by the Washington State Ferries (WSF).
Seattle Washington State Ferries

Seattle Washington State Ferries
  1. WSF is the largest fleet in the country, and the third largest in the world. Servicing the islands and peninsulas of the greater Puget Sound area, there are around 30 regular runs. Hop a ferry from downtown Seattle to Bainbridge Island, where you can spend an enjoyable afternoon sightseeing before heading back with a spectacular view of the Emerald City in all its glory. When you catch that view you’ll know what the Seattle locals know - there’s no place like home.
- Sandra Tallarico is a freelance writer and editor from the Greater Seattle area.

Many industry "firsts"

Virginia Mason Medical Center came into being in 1920 thanks to the odd coincidence that its two founding physicians had daughters with the same name. Since its modest beginning, the center has developed into a 336-bed facility with almost 500 physicians and a network of area clinics, not to mention numerous "firsts" in the region and/or nationally. Among them: first hospital west of the Mississippi to use insulin for diabetes patients and to give an EKG; first lithotripsy to treat kidney stones; first use of teleradiology to treat offsite patients; and, first bilateral cochlear implant surgery.

Most recently, the hospital opened its Headache Clinic in response to research showing that headaches are the second greatest cause of lost workplace productivity. In 1999, its Benaroya Research Institute became "one of the few research institutes in the world dedicated to finding causes and cures to eliminate autoimmune diseases including type 1 diabetes, arthritis, lupus, MS, and scleroderma."

Any negatives?

Coming from a big city, it was a jolt for White to learn she needed a car. It surprised Lin, too, who hadn’t driven for 10 years, thanks to the superior bus and subway systems in New York and Philadelphia. One bad surprise for Lin, "Public transportation here is great during rush hours, but after that things really slow down. Waiting for a bus that comes once an hour after 6:30 p.m. was a real adjustment for me."

Considering Seattle’s watery surroundings, it’s no big surprise that the maritime industry is a top business generator, with 45,000 employees in King County and $4.1 billion in revenues. A mammoth shipping industry was spurred on by the Lake Washington Ship Canal, built in the early 1900s to link Puget Sound, Lake Union, and Lake Washington. The new waterway system turned Seattle into a peninsula and eventually into the home of the largest and strongest maritime cluster on the West Coast. Almost 500 related businesses include shipbuilding/repair, marine goods and services, seafood processing, and cold storage. The cruise ship business is a more recent boon, bringing some 345,000 visitors to the area every year.

Of course, for visitors - and newcomers - the word "water" takes on another connotation, as in rain. "The weather can get you down," says Oskouian. "If you look at the people who are really happy, it’s the ones who go to Hawaii or Palm Springs for breaks." Not only that, but, "being of Middle Eastern blood, I actually have to have a sunburn or suntan once a year."

Starnes has an opposing viewpoint. "It actually rains more in St. Louis and New York on an average-inch basis. In Seattle, it’s more of a mist or a fog. It doesn’t come down like a big fat rain where a drop hits you on top of the head and runs down your scalp." In fact, he says, "Locals joke that people who carry umbrellas are the tourists."

To clinch his argument, he pulls out all the stops. "It says something that two of the richest men in the world - Bill Gates and Paul Allen - choose to live here. They could live anywhere in the world that they want to."

Eileen Lockwood is a freelance writer and regular contributor to UO’s Community Profile department.



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