Health Director Making Waves Thorburn’s Career Marked By Blunt, Passionate Style

She is the anti-politician, a wash-and-wear woman in a faded blue corduroy suit who has a talent for giving her opinion, regardless of the consequences.

She treated killers in San Quentin and surfed under the Golden Gate Bridge. She went on to develop a health-care system for Hawaii’s prisons - and later blew the whistle on inhumane treatment in the same prisons.

Dr. Kim Thorburn, who is 47, took over the top spot at the Spokane Regional Health District in June.

Since then, she’s dealt with a hepatitis outbreak, tuberculosis and the difficult health issues of smoking and AIDS.

“People should listen to her,” says Dan Foley, a Hawaii lawyer who has worked with the American Civil Liberties Union to track conditions in Hawaii prisons. “Take her seriously, because she is good. But she’s not afraid to ruffle some feathers. She certainly did here. But she had to, to get things done.”

Her tenure in Spokane is described in cliches: She hit the ground running, jumped on a moving train, suffered baptism by fire.

Thorburn’s handling of the hepatitis A outbreak divided public health officials and helped earn Spokane the reputation as hepatitis capital of the free world.

In November, she threatened to call a county emergency to force food handlers to get vaccinated against the disease - a move that initially angered the food industry.

Almost three weeks ago, Thorburn created more hysteria when she advised people in Spokane County to consider getting vaccinated against the virus.

That announcement hit the national media. It also rankled the convention and tourism industry and went against advice from other doctors, including the state’s chief epidemiologist.

Thorburn is a small, athletic woman, a surfer who still hasn’t lost a tan baked by a lifetime in the sun. Her office is a shrine to public health, complete with a pink condom lei from Hawaii, hand-washing bumper stickers and a Planned Parenthood wine glass with candy inside.

She’d like to ban outdoor tobacco advertising in Spokane County. She’s not afraid to raise the topic of fluoridating the city’s water supply. And she’d like to work on preventing violence and sexually transmitted diseases.

In private - well, there really is no private for Thorburn. She’s unrelentingly open and impossible not to find.

“She gave me about 44 different phone numbers to get ahold of her - very prompt, always returned phone calls,” says Stuart Ellison, who last year was president of the Spokane Restaurant and Hospitality Association, an organization that got off to a bumpy start with the doctor.

“She’s been great to deal with, from my perspective.”

‘The Croaker’

Thorburn, who grew up near Fresno, Calif., went to medical school in San Francisco with the goal of serving the underserved.

When Terry Allen met her during their first year in school, she was the editor of the school newspaper and had just written an article with the headline: “Professors take money from drug companies.”

Soon after, the two went to a coffee and tea with the dean of the medical school.

When they got to the front of the line, the dean looked at Allen’s companion. “Oh. So you’re Thorburn, huh?” the dean said gruffly.

“I thought, ‘What have I got myself into?”’ Allen says now. “It’s been pretty much like that the whole time I’ve known her.”

Allen and Thorburn have been together since college, but married only a year ago. Allen is a doctor at Eastern State Hospital.

Thorburn interned at San Francisco General Hospital. She loved working with patients who were homeless, who had problems, who weren’t as lucky as she was.

She picked prison work because the clientele was similar to a public hospital. One of her patients in San Quentin was Lawrence Singleton, the man sentenced to death in Florida for killing a prostitute 20 years after he raped a girl and chopped off her forearms in California.

Thorburn’s parents worried for her safety in prison, so she invited them to spend a day with her at work.

“I never forget my mom leaving and saying, ‘They’re people. Just like you and me,”’ Thorburn says. “Everybody needs to be recognized for their dignity. I’m a passionate advocate for human rights for all human beings.”

Inmates in San Quentin dubbed Thorburn “The Croaker,” an old-time reference to prison doctors, because inmates often don’t see the doctor unless they’re ready to croak. She still wears a belt buckle emblazoned with a surfing frog that inmates made for her.

She tries to take Dec. 10 off each year, the anniversary of the Universal Declaration of Human Rights.

Thorburn, who opposes the death penalty, was one of 13 doctors who sued the California Department of Corrections and San Quentin, asking the court to end physician participation in executions. The lawsuit is in limbo after being thrown out of court.

The ACLU once asked her to review the medical conditions at the Los Angeles County Men’s Central Jail.

She wanted the jail to test every inmate for tuberculosis - a recommendation the Los Angeles County Sheriff’s Department says would double the jail’s tuberculosis budget to almost $20 million.

“Kim is not very sympathetic to cost,” says Dr. Armond Start, the director of the National Center for Correctional Health Care in Wisconsin, who’s known Thorburn since the early ‘80s. “If you’ve got an outbreak, and you know you can control it with an available medicine or vaccine, she says use it.”

Paying a professional price

The health-care system in Hawaii prisons was never really a system before Thorburn.

Conditions were so bad that the ACLU sued Hawaii prisons and won a federal consent decree to improve prison conditions and health care.

Thorburn was hired in 1987 at the University of Hawaii School of Medicine. The university contracted with the state to provide Thorburn as prison medical director.

“She brought correctional medicine kicking and screaming into the light in Hawaii,” says June Kahalewai, Hawaii’s acting health care division administrator.

In Hawaii, Thorburn is described in superlatives by supporters, in careful words by the people she butted up against, and as controversial by the people who only read about her.

“I found her very dynamic, someone to speak out, stand her ground,” says Jo Kamae Byrne, who worked with Thorburn on a sexual harassment committee in Hawaii. “It was refreshing. She was willing to take a risk and step out, and she paid a professional price for that.”

At first, there were no bad waves. Thorburn had a supportive director. She got rave reviews from federal court monitors enforcing the consent decree. Staff members loved her.

When Hurricane Iniki hit Hawaii in 1994, a prison on the island of Kauai had to be evacuated. There was no water, no electricity.

Thorburn called the prison’s health care administrator, Tona Donigan, and asked what she could do. A tree had fallen on Donigan’s home, and Donigan jokingly said she could use a chain saw.

“When she got off the plane, she was wearing 1960s style jeans with embroidery on them and boots and carrying a chain saw,” Donigan says. “She brought me a canteen of ice water and a box of pastries. I’ll tell you something. No water ever tasted so good.”

Other stories aren’t as happy for the doctor. The same year, Thorburn’s supportive boss retired. George Iranon, who Thorburn had disagreed with, was promoted to the top spot.

Thorburn went home that day and told Allen: “It’s the end. They’re going to get rid of me.”

She clashed with department administrators over body cavity searches and the confidentiality of inmates’ medical records. Along with Allen, who was also a prison doctor, she accused guards of torture.

Finally, in 1996, the department decided not to renew its contract with the university. That meant Thorburn would have to reapply for the job she’d held for nine years.

She felt she was being forced out. She quit, Thorburn says, because she felt she couldn’t continue in a system that abused prisoners.

The department investigated her allegations, says Iranon, who has since retired. “We were concerned,” he says. “It’s not like we weren’t doing anything.”

Thorburn continued to work at the university. She also earned her master’s degree in public health and began looking at job options that weren’t behind bars.

Off to Spokane

Spokane had a difficult time finding someone to replace Dr. John Beare at the helm of the health district.

Beare was a giant in Washington public health. He was a reserved man, always impeccably dressed. While he stuck up for most of his staff, he avoided the public eye.

Beare retired in July 1996 but stayed in a part-time role until a permanent replacement could be found. A search committee couldn’t find worthy candidates at first.

Beare met Thorburn at a convention in New York, committee members say. Three candidates, including Thorburn, were flown to Spokane for interviews.

“The others - they hedged their bets,” says County Commissioner John Roskelley, then chairman of the health board. “Dr. Thorburn didn’t take the easy way out. She just said what she thought, her opinion.”

She started work June 2. In less than two weeks, she wrote a letter to the editor of The Spokesman-Review about youth smoking. She’s since written four other letters, about bats and rabies, hepatitis A and E. coli.

John Beare just didn’t do that. He also didn’t question the county board of health in public. The monthly meetings were often yawners, attended by maybe a single newspaper reporter.

Now, there are TV cameras and a gaggle of local media, just waiting for Thorburn to commit news.

She has publicly confronted the board of health on issues such as condom ads in gay newspapers and standards for temporary food workers.

“We probably got off to kind of a rough start because she is rather a proactive person,” says health board member Phyllis Holmes, who also is on the Spokane City Council. “But I see progress.”

At the last board meeting, on March 19, members formed a committee to evaluate Thorburn’s performance. That’s typical for any appointed government official, although Beare was never evaluated.

In Spokane, Thorburn and Allen have traded surfboards for saddles. They own two horses, Travis and Bojangles, on 5 acres near Nine Mile Falls. They brought four dogs from Hawaii, including one named Harley Davidson.

Thorburn says she spends a lot of her time outside of work with her horses. She also studies ballet, trying to prove something to an old dance teacher who said she should pursue something else. She writes essays, reads and hikes.

The day after the most recent board meeting, Thorburn and Allen left on a 10-day vacation to ride mountain bikes in Death Valley.

After all the ado over hepatitis, it was a break she welcomed.

“She tends to not want to compromise,” Allen says. “We’ve had a lot of discussions about that. If she feels strongly about something, she’ll stick to her guns.”

, DataTimes ILLUSTRATION: biography, profile Color Photo

MEMO: Two sidebars appeared with the story: 1. Resume Work history: Kim Thorburn taught at University of Hawaii School of Medicine, 1987-1997. Ran health care in Hawaii prisons, 1987-1996. Chief medical officer, California Institution for Men, Chino, Calif., 1986-1987. Chief medical officer, California Rehabilitation Center, Norco, Calif., 1985. Staff physician, California Institution for Men, Chino, 1983-1984. Staff physician, Neumiller Hospital, California State Prison at San Quentin, 1980-1983. City physician, San Francisco City and County Jail Medical Service, 1979-1980. Education: Master’s in public health, University of Hawaii, 1997. Medical degree, University of California at San Francisco, 1976. Bachelor’s degree, Stanford University, 1971. Other interests: Board of directors, Physicians for Human Rights, 1989-present. Board of directors, Amnesty International USA, 1991-1996.

2. What others think about Thorburn “It’s not as if she came into a tea party. She came into a very demanding time in Spokane.” Dr. Paul Stepak, epidemiologist with the Spokane Regional Health District. “The damage has been done. We’d just like to let it go away and regroup.” Hartly Kruger, president of the Spokane Area Convention and Visitors Bureau, about Thorburn’s suggestion that everyone in Spokane consider getting a hepatitis A vaccination. “There are maybe 25 people considered the real leaders in the field, the thinkers, the reformers, on the cutting edge of prison health care. I think Kim is one of them.” Alvin J. Bronstein, former director of the National Prison Project, which helped recruit Thorburn to the Hawaii prisons. “People from Spokane called me and said, ‘What can you tell us about Kim Thorburn?’ I said, ‘You don’t want her. She’s awful. She’s terrible.’ I said, ‘I’ll tell you why I’m saying that. I don’t want her to leave. I want her to stay. Kim Thorburn is just a class person.”’ Jonathan Won, executive director of the Hawaii Medical Association. “Since she left, it’s been hell.” Tona Donigan, health care administrator at Kauai Community Correction Center.