Dr. Frank James is an American – his citizenship is significant to this story – and the health officer for Washington state’s San Juan County. He is also a professor of public health at the University of Washington. James is a member of Whatcom Docs, a group of physicians that formed two years ago when it learned of a proposal to ship up to 48 million tons of Wyoming coal through Bellingham. It would mean 50 kilometres of coal train running along the shores of Puget Sound per day. From an initial core of about 140 interested physicians, Whatcom Docs has since grown to 215 members.