Dr. Peter A. Rasmussen
August 29, 1945 - November 3, 2015
An admittedly self-centered tale
I got my B.A. from the University of Illinois, Urbana, and my M.D. from the University of Illinois, Chicago. For this I must thank the good taxpayers of Illinois who paid the lion’s share of the expense, not because I was brilliant, and not because I was needy, but back in the sixties, citizens thought that investment in higher education was a good investment in the future. My Internship and Residency in Internal Medicine was at Presbyterian, University of Pennsylvania in Philadelphia. I then practiced Internal Medicine for three years in Philadelphia, Bucksport, Maine and finally in Dexter, Maine. This experience taught me that my true professional interest was the care of the dying. Dying of cancer in the 1970’s was horrible. Medical leadership felt that avoiding addiction was more important than relieving pain. Hospice had not yet been accepted in America. The AMA took a strong position stating that care of the dying should be done by family members and fraternal clubs. There was no role for doctors once chemotherapy and radiation lost their usefulness.
The best way to prepare myself to care for the dying was to become a Medical Oncologist, a cancer doctor. I did my Medical Oncology fellowship in Miami, Florida, and then moved to Salem in 1980, where I hung out my shingle and started a solo practice of Medical Oncology. Soon I recruited partners and the practice eventually grew into Hematology Oncology of Salem, which is the only practice of Medical Oncology in the Mid-Valley.
When an early form of Hospice in Salem collapsed in conflict between nurses, the Board and the Marion County Health Department, two citizens and I fashioned a resurrection of The Willamette Valley Hospice, and I served for many years as its unpaid Medical Director, steering our way through to Medicare Certification.
I left that position to become the President of the Salem Hospital Medical Staff. Other medical related positions included President of the Marion/Polk County Medical Society, Chairman of the Board of the American Cancer Society, Oregon Division, and Board member and Officer of the Mid-Valley IPA Independent Physician’s Association.
I have always been an extreme introvert. It has never been easy to get close to me. I attempted to tackle this weakness by working at the Pentacle Theatre, doing some acting, but a lot of things behind the scenes. Eventually I joined the governing Board and served as its President. With this experience I overcame some of my extreme fear of public speaking and thoroughly enjoyed the team effort of creating theater.
I must take a moment to describe a remarkably productive group at Salem Hospital, the Medical Ethics Committee, whose routine function was to help resolve conflicts between physicians and patient’s families over unwanted or futile medical treatments of terminally ill hospital patients. When the AIDS epidemic hit in the early 1980’s, we recommended policies to prevent the fear-based discrimination that patients faced.
Our EMTs approached the Ethics Committee with one of the saddest examples of misguided medical legality. When a patient was known to be approaching death from a disease no longer responding to medical treatment, many wished to die in the comfort of their own home surrounded by loved ones. For some this setting was a Nursing Home. If EMTs were summoned, either in a moment of panic, or to help control uncomfortable symptoms of dying, the EMTs were legally required to try to save a life. Even if the patient had an Advance Directive requesting NO CPR, and the spouse pleaded with the EMTs to allow the loved one to die naturally and peacefully, the EMTs were legally required to perform the unwanted, painful and costly CPR and ambulance ride to the hospital. We initiated a first-in-the-nation legal document, called a P.O.L.S.T that is a doctor’s order to NOT perform CPR. This P.O.L.S.T. Physician’s Order for Life Sustaining Treatments is now used by over ninety percent of Nursing Home patients in Oregon and has been adopted by over twenty other states.
When the political question of Physician Aid in Dying began to make its way into ballot measures in Washington and then California, it was clear to me as Chair of the Medical Ethics Committee that the people of Oregon would soon have to make this difficult decision. We presented a series of public forums to air the pros and cons. After finding no physician willing to speak of the pros, that task fell to me. My very public position proved quite distressful to many of my patients and I apologize for adding this discomfort to the stress of their cancer diagnosis. The Oregon Death with Dignity ballot measure passed, but implementation was delayed by legal maneuvering. When it finally appeared that the law would go into effect, President Bush had his Attorney General declared that any physician participating in a physician aided death would lose his DEA license, which is needed to prescribe narcotics and other strong comfort medications. Clearly this would make it impossible to practice cancer care, so I sued Attorney General John Ashcroft. My case was joined to those of a pharmacist, several patients, and the State of Oregon, and together made our way to the U.S. Supreme Court - where we won.
As you might imagine, this ended any future work I might do in Hospice. It was also quite unpopular with Salem Hospital and my partners at Hematology Oncology of Salem, causing no end of strife and consternation on all sides. But by this time I had become a strong advocate for the right of a patient to make his own medical decisions without interference from the government. This was a hard time for all, and for the discomfort I caused my good friends and fellow healthcare professionals I am truly sorry. However, my actions were driven by my belief that patient’s needs come first, and I have not changed that view.
After Hospice and Palliative Medicine became a recognized medical specialty, I became the first mid-valley physician to become Board Certified. At the hospital, I and many others worked for years to improve the pain and comfort management for patients, first as what we rather inelegantly called “The Pain Team,” later the “Comfort Care Team,” and finally the “Palliative Medicine Service.”
When I retired in 2009, I found a wonderful group at Willamette University’s Institute for Continued Learning ICL. For years, almost all my reading and studying was medical, but now I was free to learn many new things. And this group put up with my introversion and made me very welcome.
This thing called life is quite a gas, and mine has been filled with many advantages and good people. As an atheist since age 20, I hope that people will save their prayers for others, and use their money to help their neighbors across the street and across the world. I only hope that all can be as blessed and happy as I have been.
And a final note –
To my wife Cindy, my daughter Gretchen and my son Keith – Thank you for enriching my life in ways I could never have imagined. I love you dearly.
DEMOGRAPHICS. I was born in Elmhurst, Illinois on 8/29/1945 to Alva Janet Lukey Rasmussen and Richard James Severn Rasmussen. My siblings are Gary David of Garden City, Michigan died 2007, John Severn of Bartlett, Illinois, Bruce Arthur of Menominee Falls, Wisconsin, and Joyce Lynn Rasmussen DiBacco of Greensboro, North Carolina. Cindy Ann Rasmussen is my wife, and my children are Gretchen Higgins, 28 and Keith Brandtjen, 25.
FROM THE FAMILY: Please feel free to send letters, stories or memories of your time with Peter to Virgil T. Golden Funeral Service, 605 Commercial St SE, Salem, OR 97301. In lieu of flowers or gifts, please make a donation to support of the efforts of the Willamette Humane Society or The Willamette Valley Hospice.