She is the anti-politician, a wash-and-wear woman in a fadedblue corduroy suit who has a talent for giving her opinion,regardless of the consequences.
She treated killers in San Quentin and surfed under theGolden Gate Bridge. She went on to develop a health-care system forHawaii's prisons - and later blew the whistle on inhumane treatmentin the same prisons.
Dr. Kim Thorburn, who is 47, took over the top spot at theSpokane 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 Hawaiilawyer who has worked with the American Civil Liberties Union totrack conditions in Hawaii prisons. 'Take her seriously, becauseshe is good. But she's not afraid to ruffle some feathers. Shecertainly did here. But she had to, to get things done.'Her tenure in Spokane is described in cliches: She hit theground running, jumped on a moving train, suffered baptism by fire.Thorburn's handling of the hepatitis A outbreak dividedpublic health officials and helped earn Spokane the reputation ashepatitis capital of the free world.In November, she threatened to call a county emergency toforce food handlers to get vaccinated against the disease - a movethat initially angered the food industry.Almost three weeks ago, Thorburn created more hysteria whenshe advised people in Spokane County to consider getting vaccinatedagainst the virus.That announcement hit the national media. It also rankled theconvention and tourism industry and went against advice from otherdoctors, including the state's chief epidemiologist.Thorburn is a small, athletic woman, a surfer who stillhasn't lost a tan baked by a lifetime in the sun. Her office is ashrine to public health, complete with a pink condom lei fromHawaii, hand-washing bumper stickers and a Planned Parenthood wineglass with candy inside.She'd like to ban outdoor tobacco advertising in SpokaneCounty. She's not afraid to raise the topic of fluoridating thecity's water supply. And she'd like to work on preventing violenceand 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 ofher - very prompt, always returned phone calls,' says StuartEllison, who last year was president of the Spokane Restaurant andHospitality Association, an organization that got off to a bumpystart with the doctor.'She's been great to deal with, from my perspective.'`The Croaker'Thorburn, who grew up near Fresno, Calif., went to medicalschool 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 anarticle with the headline: 'Professors take money from drugcompanies.'Soon after, the two went to a coffee and tea with the dean ofthe medical school.When they got to the front of the line, the dean looked atAllen's companion. 'Oh. So you're Thorburn, huh?' the dean saidgruffly.'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, butmarried only a year ago. Allen is a doctor at Eastern StateHospital.Thorburn interned at San Francisco General Hospital. Sheloved 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 apublic hospital. One of her patients in San Quentin was LawrenceSingleton, the man sentenced to death in Florida for killing aprostitute 20 years after he raped a girl and chopped off herforearms in California.Thorburn's parents worried for her safety in prison, so sheinvited 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 berecognized for their dignity. I'm a passionate advocate for humanrights for all human beings.'Inmates in San Quentin dubbed Thorburn 'The Croaker,' anold-time reference to prison doctors, because inmates often don'tsee the doctor unless they're ready to croak. She still wears abelt buckle emblazoned with a surfing frog that inmates made forher.She tries to take Dec. 10 off each year, the anniversary ofthe Universal Declaration of Human Rights.Thorburn, who opposes the death penalty, was one of 13doctors who sued the California Department of Corrections and SanQuentin, asking the court to end physician participation inexecutions. The lawsuit is in limbo after being thrown out of court.The ACLU once asked her to review the medical conditions atthe Los Angeles County Men's Central Jail.She wanted the jail to test every inmate for tuberculosis - arecommendation the Los Angeles County Sheriff's Department sayswould 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 inWisconsin, who's known Thorburn since the early '80s. 'If you'vegot an outbreak, and you know you can control it with an availablemedicine or vaccine, she says use it.'Paying a professional priceThe health-care system in Hawaii prisons was never really asystem before Thorburn.Conditions were so bad that the ACLU sued Hawaii prisons andwon a federal consent decree to improve prison conditions andhealth care.Thorburn was hired in 1987 at the University of Hawaii Schoolof Medicine. The university contracted with the state to provideThorburn as prison medical director.'She brought correctional medicine kicking and screaming intothe light in Hawaii,' says June Kahalewai, Hawaii's acting healthcare division administrator.In Hawaii, Thorburn is described in superlatives bysupporters, 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 herground,' says Jo Kamae Byrne, who worked with Thorburn on a sexualharassment committee in Hawaii. 'It was refreshing. She was willingto take a risk and step out, and she paid a professional price forthat.'At first, there were no bad waves. Thorburn had a supportivedirector. She got rave reviews from federal court monitorsenforcing the consent decree. Staff members loved her.When Hurricane Iniki hit Hawaii in 1994, a prison on theisland of Kauai had to be evacuated. There was no water, noelectricity.Thorburn called the prison's health care administrator, TonaDonigan, and asked what she could do. A tree had fallen onDonigan's home, and Donigan jokingly said she could use a chain saw.'When she got off the plane, she was wearing 1960s stylejeans with embroidery on them and boots and carrying a chain saw,'Donigan says. 'She brought me a canteen of ice water and a box ofpastries. 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 haddisagreed 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 cavitysearches and the confidentiality of inmates' medical records. Alongwith Allen, who was also a prison doctor, she accused guards oftorture.Finally, in 1996, the department decided not to renew itscontract with the university. That meant Thorburn would have toreapply 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 abusedprisoners.The department investigated her allegations, says Iranon, whohas since retired. 'We were concerned,' he says. 'It's not like weweren't doing anything.'Thorburn continued to work at the university. She also earnedher master's degree in public health and began looking at joboptions that weren't behind bars.Off to SpokaneSpokane 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 areserved man, always impeccably dressed. While he stuck up for mostof his staff, he avoided the public eye.Beare retired in July 1996 but stayed in a part-time roleuntil a permanent replacement could be found. A search committeecouldn't find worthy candidates at first.Beare met Thorburn at a convention in New York, committeemembers say. Three candidates, including Thorburn, were flown toSpokane for interviews.'The others - they hedged their bets,' says CountyCommissioner John Roskelley, then chairman of the health board.'Dr. Thorburn didn't take the easy way out. She just said what shethought, her opinion.'She started work June 2. In less than two weeks, she wrote aletter 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 thecounty board of health in public. The monthly meetings were oftenyawners, attended by maybe a single newspaper reporter.Now, there are TV cameras and a gaggle of local media, justwaiting for Thorburn to commit news.She has publicly confronted the board of health on issuessuch as condom ads in gay newspapers and standards for temporaryfood workers.'We probably got off to kind of a rough start because she israther a proactive person,' says health board member PhyllisHolmes, who also is on the Spokane City Council. 'But I seeprogress.'At the last board meeting, on March 19, members formed acommittee to evaluate Thorburn's performance. That's typical forany appointed government official, although Beare was neverevaluated.In Spokane, Thorburn and Allen have traded surfboards forsaddles. They own two horses, Travis and Bojangles, on 5 acres nearNine Mile Falls. They brought four dogs from Hawaii, including onenamed Harley Davidson.Thorburn says she spends a lot of her time outside of workwith her horses. She also studies ballet, trying to prove somethingto 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 andAllen left on a 10-day vacation to ride mountain bikes in DeathValley.After all the ado over hepatitis, it was a break she welcomed.'She tends to not want to compromise,' Allen says. 'We've hada lot of discussions about that. If she feels strongly aboutsomething, she'll stick to her guns.'
