By Diana Brement,
JTNews Columnist
With H1N1 so much in the news these days, I wanted to talk to someone on the front lines of fighting this new virus, and settled on Gary Goldbaum, M.D., MPH, health officer for the Snohomish Health District.
Before getting to the flu, I needed a short course in public health.
“My agency is not a department of county government,” Gary explained.
Like most health departments, “it is an independent health jurisdiction,” he said, like a water or school district, reporting to its own board of health. (Health departments that serve large urban areas are usually an exception, reporting to county government, like King County’s.)
In addition to supervising the normal activities of the district — including restaurant inspections and disease-outbreak management — Gary says, “I think of myself as physician to the community.” Caring for patients is his job, but his patients are the 697,000 residents of Snohomish County.
So, on top of all his regular work came word this past April of a new flu in Mexico, followed by the first death on U.S. soil of a toddler visiting from that country.
“All of a sudden we had kids in the U.S. who were affected,” he says. It proved “an unusual strain,” which continued — to the shock and dismay of public health officials — to spread around the Northern and Western hemispheres through spring and summer, when the flu usually disappears.
Gary and staff got to work, adding long days and weekends to their schedules, “an exhausting effort,” he says, but “a remarkable demonstration of the public health community’s ability to respond efficiently, effectively” to a new virus. “
We had plans in place for dealing with a flu pandemic,” he said, but they had hardly ever been implemented. He finds it “truly remarkable” that the bug appeared in April, was identified in July, and new vaccines were available four months later.
Parallel to this, the district was dealing with the financial crisis that has affected almost all of us either personally or professionally.
“My life [was] already full,” Gary says. “For the past 18 months it’s been more full.”
He’s had to lay off more than one-quarter of his staff since January and additional layoffs may come if the state further cuts funding.
“My agency has been devastated,” he says.
Fortunately, the warm spring and summer brought people outside, which in turn brought a respite in new cases, giving the district the opportunity to plan for the autumn months ahead.
“We were optimistically skeptical,” scheduling a mass vaccination clinic on Oct. 31. In actuality they put 10 clinics in place by Oct. 24. The district worked closely with the emergency management and medical communities in the county to run those clinics.
“It was really a coordinated effort,” he says.
Gary, started out as a family practice doc, but “I love public health,” he says, and he eventually developed a specialty in AIDS. After studying epidemiology at the Centers for Disease Control, he came to Seattle for a Master’s in Public Health from the University of Washington. He worked at King County public health for 18 years before moving to his current position three years ago.
He traces his interest in public health to a crisis in his own family. When he was a child his family moved to Denver so his father could be treated for tuberculosis at National Jewish Hospital, a leading sanatorium at the time. His parents encouraged him to go into medicine (“no surprise there,” he wrote in a follow-up e-mail) and while studying in Denver, “I often thought about my father’s illness.”
“I’ve also been intrigued and influenced by Jewish practices that focus on prevention,” including regular hand washing and bathing, and avoiding foods that in the past posed risks of food-borne disease, such as pork (trichinosis) and shellfish (typhoid).
Given a few minutes of soapbox time, Gary would like to make us more aware of how public health is responsible for our good health. Compare our country to places where children die of “completely preventable diseases before the age of 5,” and you see the role prevention plays in overall health.
“The medical community [is] helping to save lives, but public health [is] there trying to prevent people from getting sick,” he says.
An avid bike rider, Gary bike commutes as much as possible, riding to a bus stop in Seattle and taking the bus to Everett. He’s done the Seattle-to-Portland and Seattle-to-Vancouver rides a number of times, occasionally with his daughter Caitlin. He is married to Judy Unger and their son Shane is studying theater management at Syracuse University. The family belongs to Temple Beth Am.
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Keith Gormezano, “Dr. QuickBooks and Quicken,” has been nominated for the City of Seattle mayor’s small business award and a local Better Business Bureau Torch Award. Keith specializes in teaching other small business owners the intricacies of those and other financial and accounting software. You can find more about Keith’s work at drquickbooks.webs.com.