Dan Bates / The Herald
Dr. Gary Schillhammer examines 98-year-old Milton "Scoop" McCaulley, a lifetime resident of the Arlington-Darrington area. Schillhammer has practiced for 29 years at the Darrington Clinic.
Gold Hill sits on the east side of Darrington, and that's where loggers Richard Meece and his dad were working in 1985.
Meece, then in his late 20s, felled a Douglas fir that crashed down on top of a nearby maple. He stepped onto the fir log and turned to see the maple tree spring loose and whip back into his face. His jaw shattered into mush. Blood, flesh and broken bones threatened to block his airway.
The crew radioed helicopter owner Anthony Reece, whose wife, Sue, quickly called the town's ambulance and doctor.
It was only the second summer in the logging town for Dr. Gary Schillhammer, a young man who, at that point, had made only a two-year commitment to serve the medical needs of the community.
"I dropped Dr. Schillhammer off on the hill with a radio and the airlift stretcher," Reece remembered.
But there was a complication. The doctor couldn't just send his patient up.
"When he had Richard strapped in, Gary climbed onto the end of the stretcher," Reece said. "He set down behind Richard to keep his head up so he wouldn't drown in his own blood. Gary was hanging on with his elbows, and I was worried about his weight upending the thing."
Reece, who since has made hundreds more mountain rescue missions in the North Cascades, said the day on Gold Hill was the most unnerving of his career as a helicopter pilot.
"The stretcher was just a teeter-totter in the wind. I flew them as close to the ground as I could and set it down in my front yard at the base of the hill," Reece said. "I think Gary got an adrenaline thrill out of it, because since then he's always been ready to go."
Joan and Gary Meece said Schillhammer saved their son's life that day. Richard Meece's jaw was repaired and he returned to logging.
It was a rescue that caused the people of Darrington to realize Schillhammer was willing to risk his life for them. For the doctor, it was a turning point, one that made him reconsider how long he would stay.
"From that day on," Schillhammer said, "the community knew I was for real."
That day, he also became one of the nation's dwindling number of rural doctors.
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In more than 100 years, only a handful of medical doctors have settled down to care for the people of this mountain town, located about 30 miles east of the nearest hospital, in Arlington.
Dr. B.T. Blake arrived in 1906. He was the first to make Darrington his home, working there until the start of the Great Depression.
Dr. Norman Riddle, who served Darrington for 40 years, until about 1970, still holds a place in the hearts of those who remember him.
Riddle Street is where the Darrington Clinic is located. In the late 1950s, the Darrington Clinic Guild held bake sales and tea parties to help pay Riddle's salary and raise money needed for the townspeople to build the clinic from a kit they bought from the Sears and Roebuck catalogue.
In the 1970s, the clinic was staffed by an ever-changing list of nurses and doctors, most of whom were gone within a few years. Then Schillhammer came to town.
"Dr. Schillhammer went to the same medical school as Dr. Riddle, at the University of Vermont," former Mayor Joyce Jones said. "In my opinion, though, Gary has replaced our old Doc Riddle. He has filled those shoes and then some."
Schillhammer, a third-generation physician, earned his undergraduate degree at Dartmouth. After medical school and his residency in Pennsylvania, he faced a commitment to the federal Public Health Service to pay back a scholarship. It required him to serve two years in a rural location. It brought him to Snohomish County in the summer of 1984. He was 29.
"I drove over the North Cascades and down to Darrington," he said. "It was a Bluegrass Festival weekend, a sunny day. Can you imagine seeing Whitehorse Mountain for the first time?"
On the next trip, Schillhammer brought along his wife, Julie, also a New Englander, and their 1-year-old son, Carl.
"We drove up the freeway from Seattle. It didn't seem like there was much population past Northgate. When we finally got to Arlington, I thought, 'Well, it's pretty here.' And then Gary told me we still had a ways to go," Julie Schillhammer said. "The practice has been a series of adjustments and adventures. I always thought we might go back to New England, but we fully embraced living here and our 24-hours-a-day, seven-days-a-week family practice."
Dan Bates / The Herald
Dr. Gary Schillhammer is back home with his wife, Julie. The Schillhammers built their home with a view of Whitehorse Mountain.
For a time, logging accidents accounted for about a third of Schillhammer's emergency calls. There are fewer now as logging has declined, but mountain rescues are still part of the job.
During the first 14 years in Darrington, Schillhammer had help from nurses and office staff. Now he is joined a few days a week by an advanced registered nurse practitioner. The Clinic Guild built a heliport at the back door, and the town of Darrington secured a community development block grant to expand the small clinic, which is now part of the Cascade Valley Hospital system.
"When I first got here, I dipped my own X-rays. Now it's all digital," said Schillhammer, now 58. "I don't have the same number of emergencies, but I'm still prepared to deal with any trauma, from cardiac problems to casting broken limbs."
Seth Nations came to see Schillhammer last week about a small skin infection. Nations, 32, is a member of one of the many logging families who moved to Darrington from North Carolina. He's known "Doc" for as long as he can remember.
Schillhammer rolled his exam stool back and forth, grumpy with his new computer system. "Speedy, huh?" said the doctor. Nations sat back, smiled and waited while Schillhammer emailed a prescription to the pharmacy down the street.
"Gary is the best doctor we could ever hope to have in Darrington," Nations said.
Unfortunately, he could be Darrington's last.
The number of new physicians going into primary care or family medicine continues to decline nationwide. Rural locations are hardest hit.
According to experts in rural health at the University of Washington School of Medicine, the primary care workload will rise 30 percent by 2020, yet the number of primary care doctors will increase only 7 percent. The Rural Health Research Center at the UW expects that the number of students who choose careers in rural family medicine likely will remain far below the amount required to replace the region's rural doctors when they retire.
"I absolutely believe we need to help medical students willing to commit to rural family practice," Schillhammer said. "A rural doctor has to be smarter and more dedicated, but you should not be expected to do it with a huge debt and less compensation than other specialties."
To encourage medical students to consider rural family medicine, Schillhammer has been involved for about 20 years with the Western Washington Area Health Education Center in Seattle, which sends medical students out to study at rural clinics.
"Gary is one of our long-term teachers and one of our most respected and requested," said Jodi Perlmutter, director of the center. "There are few solo doctors in Western Washington anymore, and Gary does it all. He brings our students everywhere he goes, even on hiking trips."
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There are too many stories to tell about Schillhammer's 29-year, cradle-to-casket medical practice. Nearly everybody in town has one.
He's delivered hundreds of Darrington babies at the hospital in Arlington and a few more at the clinic. He's been present at the deaths of many old-timers.
A no-nonsense, straightforward guy, Schillhammer gets emotional about the passing of people he's known now for half his life, the hard-working loggers, the World War II veterans and the mothers of his friends. Darrington Mayor Danny Rankin and his brother, Randy, lost their 83-year-old mother, Ann, in January.
"Mom loved Gary," Randy Rankin said. "He's been an extension of our family."
"Not just us," Danny Rankin said. "Lots of people consider him family. I will tell you, though, Gary has spent many important days in our company."
It's all part of belonging to a community, said Schillhammer's friend Greg Newberry, a Darrington schoolteacher.
Schillhammer is the guy who gives the sex ed talk to the sixth-graders, and he provides physicals for student athletes at a reduced fee, Newberry said. When possible, Schillhammer attends the home games at Darrington High. He walks the football field sidelines with his emergency pack at hand.
When a basketball player fell and split open his chin, the physician stitched up the fissure and got the kid back to the gym in time to start in the second half.
Newberry and Schillhammer have taken many high school students up to the summit of Whitehorse Mountain, where "their view of home is changed forever."
Schillhammer also serves as master of ceremonies for the Darrington talent show. He and the mayor sponsor an annual cribbage tournament, with all the money going to the community center, the historical society, the skate park or whatever the current need is in town.
When he heads out for excursions in the woods with friends, Schillhammer often says he must make a quick stop by a patient's house. One time it was to pull a fishhook out of little girl's eyelid, Newberry said.
Schillhammer has left guests at his house to ride with the ambulance down the valley to the hospital. He diagnoses patients while they shop at the grocery. He takes calls in the middle of the night. He's gone down to the bars late in the evening to patch up the brawlers. The doctor also is known to have stitched up hens and dogs.
"Most people feel comfortable enough to call Gary on his personal cellphone," Newberry said. "It's truly amazing."
One morning, Greg and Julie Newberry got a phone call from Schillhammer.
"I'm on the top of Whitehorse and I am waving to you," said the doctor, an avid outdoorsman. "Look through your scope. I'm going to jump."
Sure enough, Julie Newberry said, there was Schillhammer, strapped to a parasail and ready to go.
"He took a flying leap, got caught in a thermal and soon found himself hundreds of feet above the summit," she said. "He started to drift the wrong way and I decided to call Anthony (the helicopter pilot)."
The Newberrys and others joined the search for Schillhammer, who had crash-landed in a tree in the Boulder River Wilderness. He had to climb down and walk out.
"Finally, he called. I told him I thought he was on his way to Granite Falls," Julie Newberry said.
"Oh," Schillhammer replied. "You know I don't like Granite Falls."
What the doctor really wants, he says, is to be known for his outdoor skills. He is an experienced whitewater kayaker. Schillhammer also likes to climb, ski, snowboard, hunt, fish, camp and mountain bike. His kids learned early that vacations were never about sitting around. His wife has threatened him with homelessness should he fail to bring all their children home from a potentially dangerous mountain-climbing adventure.
Being outdoors is part of the balance, Schillhammer said.
"I believe work is life," he said. "I like my work. It's what I am and what I'm about. But I have to keep it all in balance: my family, my work and myself. I taught my children that we need hard workers, that contributing to your community is essential and that taking care of yourself is a must."
Schillhammer's pursuits rubbed off on his kids. Carl, now 29, is doing his orthopedic surgery residency in New York. Eliza, now 26, is a nurse studying at UW Medical to become a doctor, too. Skye, his 22-year-old son, is a geology major at Eastern Washington University and a professional slopestyle and downhill mountain biker.
"I would never have been able to make it here without my staff, the clinic guild and my wife," Schillhammer said. "When the kids were growing up, my family ate together every night at 8 p.m. It was important. Julie made it all possible."
Julie Schillhammer is on the list of regular substitute teachers at the school, where she previously volunteered when her children were students.
"Life was rough sometimes. I think about having three little kids and a woodstove to feed," she said. "But we developed strong relationships with the people of Darrington and life here has always been pretty exciting."
Being the family doctor in Darrington has been his "dream job," Schillhammer said.
"It is a small town, however. My kids suffered under the magnifying glass because they were the doctor's children. People wanted pain pills prescribed and I wouldn't do it. Not everybody likes me," he said. "But I truly love what I do and where I'm at. It means a lot that most people here trust me enough to include me in their lives.
"I have no plans to retire. I will keep opening the clinic door for as long as I am able, or until I don't have fun anymore or I'm not effective."
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Schillhammer is a health nut, but he ordered a fishburger and fries the other day at the Burger Barn on the east end of town. He likes to support local businesses.
The Burger Barn was packed with locals. The only place to sit was outside at the picnic table.
"Hey, Doc. Where you going on your day off tomorrow?" asked one man.
"Going up Whitehorse. Camping and then snowboarding down in the morning," Schillhammer said.
"Well, we'll be praying for you, Gary," said Les Hagen, the pastor of Glad Tidings Assembly of God.
Outside, Schillhammer smiled.
"I think they pray for me every day."