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Wednesday, July 19, 2006

Guest Post: Anatomy of Silence


When news of the dead and dying townspeople of Libby, Montana, first made the papers, nearly everyone’s reaction was one of incredulity. How could so many people die and no one notice?

To a degree, it’s because the case of Libby is rather odd from a medical perspective. Most people who are diagnosed with asbestos-related diseases in the rest of the country are identified as such by their doctors partly because of their professions. A guy comes in who is having trouble catching his breath: he made a living as a general contractor or in a shipyard. This tells the doctor the patient may have been exposed to asbestos.

But in Libby, those few people who knew the vermiculite mine was contaminated with asbestos declined to share that information. So when a bank teller or fishing guide or housewife came in with breathing difficulties, the doctor wouldn’t have any reason to suspect asbestos as the culprit. Nevertheless, there were doctors in Libby who suspected something was wrong up at the mine: a couple cases of mesothelioma caught one’s attention:

As Dr. Richard Irons’ hospice program grew, he noticed a curious thing. “I started going to more funerals. And whenever someone from W.R. Grace would die, there would be [mine managers] Earl Lovick and Bill McCaig. And we waved to each other. We’d be there at the funerals. We’d bury these people, we’d go to their gravesites after the funeral and watch them put the caskets down and talk to family members.” He started keeping a list of the dead, a tally of the causes of death. When two cases of mesothelioma showed up, he went to have a talk with Lovick and McCaig.

“I’d say, ‘These people died from various forms of lung cancer. And mesothelioma is associated with asbestos, and there are two of these people. Isn’t that surprising? That’s a very rare tumor.’

“And they said, ‘Well what do you know. We knew about one of these, but gosh, that’s pretty unusual isn’t it? But of course if this was asbestos, we’d have a lot more of those. It couldn’t be that.’

But to complicate things further, Libby was essentially a company town. If a doctor didn’t play ball with the corporation, Irons’ discovered, that doctor would find himself with a thin practice. And so the secrecy continued.

While Grace’s culpability is undeniable, there were people who, had they spoken out, might have mitigated the damage, prevented a few deaths. Chief among these were local physicians. Libby’s tragedy took an unacknowledged pact of silence on the part of Grace, state and federal regulators, and the local medical community. Here’s how the doctors missed the clues: medical.doc 

Andrea Peacock

Livingston, Montana


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