Twin Falls

During my last year of residency in Long Beach, my husband John and I agreed that we didn’t want to stay in Southern California anymore. The reasons have faded into the misty past, but in general we felt that it was too crowded. I had visions of either starting my own lab, or at least finding a situation where I could build my pathology department without anybody telling me what I could and could not do. John wanted to manage my lab.

Two situations with potential presented themselves. One was a community hospital in Paso Robles, a lovely medium-sized town in central California surrounded by live oaks and rolling hills. The pathology group in nearby San Luis Obispo was only too happy to offer me whatever coverage I might need. Everyone there was excited about acquiring me, and made me an offer I couldn’t refuse.

Then I found out that the lab was actually owned by the lab manager. That was a deal breaker for me, because I would be responsible for the lab in the eyes of the medical staff and the regulatory agencies to which I would have to answer, but I’d have no authority whatsoever. John wanted me to buy the guy out so that we could run the lab instead, but when I suggested that to the medical staff, they informed me that they were quite happy with the way things were and didn’t want to change anything.

So I turned them down.

Then I got a call from a recruiter about a small doctor-owned hospital in Twin Falls, Idaho that wanted its own pathologist instead of sending everything to the county hospital.  This was the opportunity I’d been waiting for; the opportunity to build my own pathology department.  Back then, in 1977, Twin Falls was predominantly agricultural, with a population of 26,000 and two traffic lights.* It’s high desert, at an altitude of 4100 feet, and not nearly as pretty as Paso Robles. But it did have two hospitals, a brand-new community college and a fairly new suspension bridge over the scenic Snake River Canyon replacing the old toll bridge, and was only 80 miles from Sun Valley. It also had a sugar factory in which sugar beets were converted into White Satin. When we stepped off the plane, the air smelled like manure. It took me back to the way my hometown, Cooper Mills, Maine, always smelled in the summer, and I knew I was home.

The day that John and I left our Long Beach house for the last time was the day Elvis died. It was also the day the hospital in Paso Robles called and said they’d still not found anyone for the pathologist position and would I please reconsider?

I said no.

So over the next 24 years at the Twin Falls Clinic & Hospital as a solo pathologist, I built my department from scratch, and we finally achieved accreditation by the College of American Pathologists in 1997. But it was short-lived.

In 2002, due to increasing unfunded mandates from the federal government, we were forced to sell out to the county hospital, Magic Valley Regional Medical Center, and I joined their pathology group. In 2006, the county hospital was bought out by the St. Luke’s Health System, based in Boise, who built us a beautiful new hospital. St. Luke’s Magic Valley is a 250-bed tertiary care hospital, in contrast to the 40-bed hospital I’d started out in.

John never did get to manage my lab, which ultimately led to our divorce, in 2004.

Twin Falls now has a population over 40,000, which is expected to reach 50,000 in 2020.* There are numerous traffic lights now. We have a mall, a Costco, a Walmart. There are 2 high schools. The scenic Perrine Bridge is now a mecca for countless base jumpers.  Numerous industries other than the sugar factory have made Twin Falls their home, including Chobani Yogurt. But it only has one hospital now.

This is the background for my Toni Day mysteries, and Toni herself is loosely based on me and my own adventures as a solo pathologist in a rural setting. The old hospital, Perrine Memorial, is loosely based on the Twin Falls Clinic & Hospital, and the new one is loosely based on St. Luke’s Magic Valley.

Some of Toni’s adventures have started out as situations that I have actually been in, but none of my adventures have ever included putting my life in danger to track down a murderer. Those are all products of my overheated and lurid imagination. Indeed, my first three books featured villains based on persons in my life that I really wished I could kill. Since I couldn’t do it legally, I did it cathartically by writing about it, and felt much better.

*To find out more information about the population of Twin Falls, Idaho, please visit: http://worldpopulationreview.com/us-cities/twin-falls-id-population/

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Why I became a pathologist and how it affects my writing

In my series of Toni Day mysteries, Toni Day is loosely based on my own career as a pathologist in a small rural hospital in Twin Falls, Idaho. But how did I get there?

It all started when I was six and had my tonsils out. I told my father I wanted to be a nurse when I grew up. The ensuing conversation went something like this:

DADDY: “A nurse?! What for? Do you know what nurses do?”
ME: “Take care of people in the hospital?”
DADDY: “They do whatever the doctor tells them to do. You’ve never done what you were told in your entire life. Why don’t you become a doctor instead?”
ME: “But Daddy, I’m a girl.”
DADDY: “So what?”

This, in 1951, from a man born in 1890, had quite an effect on me. Daddy was clearly a man ahead of his time; and he never stopped supporting me when people asked me what I wanted to be when I grew up and snickered at my answer.

Unfortunately, Daddy didn’t live to see it all come true, because he died when I was ten: but my mother never stopped exhorting me to work hard in school and keep my grades up, to get scholarships, because that was the only way I could ever go to college since she couldn’t afford it on a secretary’s salary.

So I kept my grades up, and got four scholarships that paid for my first year at Occidental College in Los Angeles. During the four years I was there, I had a job as well. Unfortunately, it wasn’t all that easy to keep my grades up, and I graduated with a 3.0 average, 3.3 in my major, not good enough to get into medical school. I watched in dismay as a brilliant girl in the class ahead of me failed to get into medical school with a 4.0 average. Summa cum laude. Phi Beta Kappa. I wasn’t even close.

I took the MCAT and aced it. I also took the Graduate Record Exam, just in case I ever wanted to go to graduate school, and aced that too. Then, after graduation, I enrolled in a medical technology internship at the Long Beach VA Hospital, while going around interviewing at medical schools. My brother, who lived in Virginia, insisted that I apply to Georgetown, and I did just to shut him up.

To my surprise, I actually got into not one but two medical schools, the University of California, Irvine, and …wait for it…Georgetown.

My brother was not happy that I stayed in California, but he had to admit my reasons were good. UCI offered financial aid, Georgetown did not. Besides that, I had a boyfriend and a car, and I wanted to keep both.

So I went to UCI, and worked my way through as a medical technologist at Long Beach Community Hospital, where I met my future husband, John Munro, also a med tech.

One day, a fellow tech who had been hired more recently than I, asked why we did certain things a certain way, when he had been taught differently. As a part-time employee, I wasn’t qualified to tell him that, nor could I do anything about it. In order to do anything about it, I would need to have my own lab, and to for that I would have to be a pathologist.

So I became one. John and I were married in my first year of residency, and when my residency was finished, I got a job at the Twin Falls Clinic & Hospital, a small rural doctor-owned clinic and hospital in Twin Falls, Idaho, and the rest is history. (For more, check out my blog: My inspiration for the Toni Day Mystery series).

As a practicing pathologist, my writing contains realistic and believable medical and forensic information, with the medical jargon softened by Toni explaining it to her husband Hal, much as I used to explain it to John. Most people don’t really know what a pathologist is or what we do, or they think all we do is autopsies. I hope my writing gives them an idea of what hospital-based pathologists do all day.

Actually, hospital autopsies are quite rare nowadays, because of advanced imaging techniques that give radiologists the capability of sampling just about any part of the body with a needle. But when I first came to Twin Falls in 1977, I did quite a few autopsies, in funeral homes because our hospital didn’t have a morgue. All the forensic autopsies from Twin Falls County went to the county hospital, but I ended up doing forensic autopsies for the surrounding Jerome, Cassia, Minidoka, Gooding and Blaine counties.

Luckily for me, that came to a screeching halt when the county hospital bought us out and I joined their pathology group. After that, all forensic autopsies went to Boise, and they still do.

But in the 24 years at the Twin Falls Clinic & Hospital, I got plenty of fodder for my books, and I’ve just barely begun to use it.