was depressed after losing her brother to COVID-19. Ryan Cole in July 2022 letter to Washington Medical Commission Why no second opinion before invasive surgery? The complaints about Cole’s diagnoses indicate that both patients had symptoms and abnormal test results that prompted their health care providers to order the biopsies Cole used to diagnose the patients. If the Washington Medical Commission decides to take disciplinary action on Cole’s license in that state, it is possible that Idaho’s medical licensing board could apply that action to Cole’s license here, as “reciprocal” discipline