A physician for all seasons: Dr. Schmitt looks to retirement
Late one late afternoon in mid-January, Dr. Paul Schmitt thought he was near the end of a somewhat quiet but productive day of patient appointments and computerized medical record-keeping.
At 69 he’d recently begun working half-time, looking toward full retirement later this year as a new family physician settles into the Kittitas Valley Healthcare Family Medicine clinic in Cle Elum.
The quiet day was not to be. A nurse practitioner alerted Schmitt that his help was needed with a woman who had begun giving birth, much earlier than expected, while she was driving by Cle Elum on Interstate 90. Schmitt quickly went from his clinic office to the connected Kittitas Valley Healthcare Urgent Care facility where his examination indicated the woman and the baby may be facing medical distress.
“By happenstance, I was the only doctor there that late in the afternoon and had the most experience of those there at the time; the other doctors were out of town,” said Schmitt recently as part of sharing memories of his medical career spanning 48 years. Forty-eight years when counting medical school, interning and then practicing in the Indian Health Service, a branch of the U.S. Public Health Service.
“I hadn’t handled a birth for quite a while, but this baby was coming right now. We had to get to a hospital. I was back in my emergency mode, you might say.”
An advanced life-support ambulance and crew with county Hospital District 2 were summoned for the trip to Ellensburg and the KVH Hospital. In a matter of minutes, Schmitt was back in the saddle of emergency response.
In the “old days” after he came to Upper County in 1977, Schmitt said he and the other local doctors — the late John Anderson and Elizabeth Wise — not only saw their patients by appointments but were on call on a rotation basis 24-7 to respond to serious medical emergencies through the then county Hospital District 2-owned Cle Elum Family Medicine Center.
“I’d done a lot more births when I was younger, maybe 30 years ago, but when I got into the ambulance I was completely calm and composed,” Schmitt said. “I knew exactly what I was going to do to help the patient and what to check in what order; all those years of experience and training just took over.”
The woman, with Schmitt delivering, ended up giving birth to her child safely while in the ambulance traveling on I-90 to the Ellensburg hospital.
“They (the ambulance crew) said the baby came while we were driving through the Elk Heights area,” Schmitt said matter of factly. “I was a bit too busy to notice. Overall, it turned out to be a positive experience for everyone.”
He estimates he’s delivered up to 250 babies in his career and said somewhat wistfully that a safe, healthy birth is for him one of the most enjoyable and satisfying aspects of practicing family medicine.
“What can I say? In most instances a birth is a happy time.”
As he looks over his long years of medical service to Upper County residents, Schmitt said he sometimes grows philosophical “realizing the sands of time have been steadily dropping through the hourglass.” Now, nearing his 70th year, he can no longer stay up all night attending to a medical emergency and still function at his best the next day, he said, and “I think I’m ready to put medicine aside to pursue a lot of things not related to medicine.”
“Looking back on it all, years of growing up and medical work, I have to say it’s been pretty amazing,” he said.
Getting stitched up
Paul Schmitt’s family lived in a suburb of Detroit. His father was a dentist, his mother was a nurse, and he was the fourth of 12 children.
At one point as a youth, Schmitt contemplated following in his father’s footsteps to become a dentist. This changed after he suffered a lacerated finger while a teenager. Dr. Steiner, a close family friend, met Schmitt at his clinic and stitched up the wound.
“I was always outdoors and had my share of mishaps. Watching Dr. Steiner carefully and skillfully suturing my cut, well, it was interesting, it was neat.”
That likely began turning his interest to being a physician. In addition, the daily experience of growing up witnessing the good his parents did for people “was a huge influence.”
“They (his parents) rose through their efforts to become highly respected members of their communities,” Schmitt said. “Education was the key, and they made sure we had opportunities to do the same.”
Schmitt said of the 12 kids in his family, nine have college and advanced degrees and three are doctors; a total of five are in the field of professional health care.
After high school graduation Schmitt knew the path he was to take. He began pre-med studies at the University of Michigan.
He was off and running.
A kindred spirit
At the beginning of his medical school training he met a junior coed studying psychology, Cindy. They discovered they both liked small-town living and with being close to the beauty of the outdoors. In addition, their studies both focused on helping people.
They married later and together traveled to Seattle where Schmitt was involved in a rotating internship at Swedish Hospital. There he was immersed into obstetrics and cardiology, with work also at Children’s Hospital and in the emergency room at Harborview Medical Center.
For three years he also worked with the Indian Health Service in Shiprock, N.M. as a senior in medical school, an arrangement that had the government assist in paying for his medical school bills in exchange for a set number of years in medical service to the Navajo nation.
“Our work in Shiprock with the Navajo was a great introduction to the real work of medicine,” Schmitt said. “We had a huge workload and used interpreters with many of our patients.”
A high birth rate among the Navajo kept midwives and medical staff busy along with medical concerns related to some of the social issues faced by the tribe. Navajo co-workers invited Schmitt and his wife to participate in their social gatherings, and the couple made lifelong friends among the medical professionals there and still keep in touch.
As the end of medical school and interning neared, the couple agreed they wanted to live and practice in a small town and settled on Roslyn because it reminded them of the rural Colorado mountain towns they had visited and where they enjoyed mountain and forest-related outdoor recreation. It was also close to skiing at Snoqualmie Pass.
“We wanted a four-season environment and access to outdoor activities and a community where could make a difference.”
The couple moved to Roslyn in early 1977, and Schmitt began general medical practice at the Cle Elum Family Medicine Center, coming to Upper County through the sponsorship of the National Health Service Corps. He joined the hospital district-owned center (also having an emergency area) alongside the late Dr. John Anderson who had arrived a year earlier.
Upper Kittitas County had been targeted by the service corps as a serious doctor-shortage area where Schmitt and Anderson’s work would make an immediate difference in the access to medical care.
Schmitt said the community’s “oldtimers rolled out the carpet” and made them feel part of the community right away.
“We were immediately welcomed and embraced by some key members of the local community,” Schmitt said. “The welcoming and friendly attitude, and the relative diversity of Roslyn appealed to us. That’s where small towns have it over cities when you’re working in this field.”
The Schmitts quickly got to know many of the residents as friends, including Kent Verbeck, Jim Ash, Gail and Gary Berndt and many others.
Gary Berndt, now 69, came to Upper County in 1973 to work with the state Department of Natural Resources and also worked with Schmitt while Berndt was a commissioner with county Hospital District 2. Berndt said he helped interview Schmitt way back then for a much needed second general practitioner position at the center.
“We were having a very hard time keeping doctors at the clinic for any length of time; for a while before Dr. Anderson came we didn’t have any doctors for what seemed like a long period,” Berndt said. “My wife worked at the clinic at that time and saw the great need first hand. It just seemed right for me to become a hospital district commissioner and try to be part of a solution.”
Another doctor was needed and Dr. Elizabeth Wise was hired, coming to the center in 1981, also through the National Health Service Corps. She continues to practice in Cle Elum.
Wise was an employee of the medical center for a time, but then became part of the medical practice partnership of Anderson and Schmitt, which later took over the medicine center.
A transaction in 2005 through Hospital District 2 sold the practice to Kittitas Valley Healthcare. The clinic is now KVH Family Medicine-Cle Elum. Anderson died in 2009 and at that time Schmitt took many of Anderson’s patients.
“I have to say that those three doctors stabilized and vastly improved health care throughout the Upper County community when we really needed it,” Berndt said. “They did this by their unwavering commitment and service to all the folks, and because of their round-the-clock care in those early years. Together they did the hard work that created a foundation upon which we could, together as a community, really build up health care locally.
“Early in their practice they were, basically, all-the-time docs.”
Hospital District 2 commissioners and its director, with community support, sought the financing that led to build the family medicine clinic that Berndt remembers was dedicated in 1980. It had also had an associated emergency area. Schmitt delivered the Berndt’s daughter, Kate, soon after the clinic dedication.
“Paul has the keen ability to listen carefully and evaluate all the factors as he listens,” Berndt said. “He is always seeking the right decision and the right action for himself, his family, his patients and his community.”
When there’s been divisive controversies in Upper County, Schmitt has been at times a calming influence that encouraged the community to step back, Berndt said, and take a more thoughtful approach to reach a resolution.
Berndt said he knows well that look Schmitt gives him in the examining room that is followed by Schmitt quietly saying, “Gary, right now I’m not being your friend; right now I’m speaking to you as your doctor.”
“I really respect and honor that,” Berndt said. “I’m getting the straight talk I need for my health whether I want to hear it or not. There’s no holding back, no sugar coating because my doctor is a longtime friend.”
Family support and calling
Back in the early days the three doctors also worked as emergency room doctors, Schmitt said, with ambulances bringing patients to the Cle Elum center at all hours of the day and night. The emergency treatment area was staffed by a registered nurse after hours.
It was professionally interesting and challenging but put pressure at times on Schmitt’s family life. He missed out on family outings, basketball games and more. Schmitt said there is no way he could adequately serve the community’s medical needs without the everyday support of his family, especially from his wife.
“Family medicine in a small town, well, it’s a calling. Not unlike someone being called by the Lord to serve in some way,” Schmitt said.
He and his family also got support from a wide number of the area’s citizens who realized in the early years how important it was to keep a good doctor practicing in a small community. Schmitt chuckles a bit as he says his street in Roslyn got plowed fairly soon after heavy snowfall because people knew he needed to get away quickly and safely to respond to emergencies.
“That’s a kind of reward, but there are so many intangibles, rewards that come in bits and pieces through the years,” Schmitt said. “The friendships, the neighborly help and heartfelt concern when there’re life struggles ... You end up touching so many lives. For me it’s great not to be anonymous.”
Schmitt for more than 20 years, with the help of family members, organized The Runner Stumbles run, conducted in connection with Cle Elum’s Pioneer Days celebration during the Fourth of July holiday. He said each of his three sons served on the Cle Elum-Roslyn School Board as a high school student representative in their senior years.
“We didn’t push, but we made it clear that stepping up in leadership and being involved in the community was important for all of us,” Schmitt said. “There was an expectation that they work to excel.”
For many new doctors there may not be strong, immediate incentives to put down roots in a more rural community like Upper Kittitas County, Schmitt said. There’s an ongoing effort to create more financial incentives to attract new physicians, but Schmitt said it shouldn’t always be about money. It’s also about the non-monetary rewards.
“Like the great setup I have with working and having outdoor recreation at my doorstep,” Schmitt said. “In 40 minutes during summer or fall I can be at Cooper Lake and, maybe, take a two or three-hour hike to clear my mind.”
Being on the ground floor, so to speak, to impact local health care and emergency services for the good, Schmitt said, also is a reward for him living and working in Upper County.
Former Roslyn Volunteer Fire Department Chief Jim Ash, always looking for dedicated personnel, came to Schmitt and his wife’s home a week after they arrived in Roslyn. He asked Schmitt to consider joining the department.
Schmitt became a full-fledged firefighter responding to alarms when he could with his heavy turnout clothing and helmet. He also learned to drive department trucks and helped in training many emergency medical first responders.
Schmitt retired from the department when he turned 65.
“You know, when you get to be 60 or 65 your legs may not have the resiliency they had when you were younger for this kind of service,” Schmitt said with a chuckle.
He acknowledged it’s hard to sum up 40 years of medical work and the benefits he’s received from a rural medical practice, but said with humor, “As you know we don’t have to deal with much traffic.”
Upon further reflection, he said people in rural areas like Upper County look after each other and help each other out when needed.
“We respect each other’s privacy, too,” Schmitt said. “From a medical perspective, being a family doctor in a rural community is one of the most interesting and challenging jobs in medicine, in my opinion ... Our patients are our friends and we know them well. That is the beauty and draw of being a family doctor. I have also benefited by having great partners: Dr. Elizabeth Wise and the late Dr. John Anderson.”