Ch23 - Big city - Little city "Woz" comes to grips with KC's public health length & breadth

CHAPTER 23 BIG CITY - LITTLE CITY December 1980

Dear Neighbor, I am writing to encourage your child’s participation in a universitysponsored lead testing program. Last year a girl from here registered 37 when 10 or fewer is required to be non-toxic. Her pregnant mom also registered a dangerously elevated lead concentration. The Preservation Association will sponsor chemical doctors to perform blood draws ahead of analysis. (No charge!). Please bring your child to the St. Francis School gymnasium this Saturday.

God Bless!

Connie Guzman

Dr. Beers originally contacted the Woz who petitioned Brooklyn to enlist Racer in what Beers termed a letter project. Racer shortly drafted a letter for Consuelo’s signature. He had apparently been enlisted for more than valeting the Jarrell-Ash or even organizing Andy’s jail release.

A space shuttle Enterprise’ photograph dated September 17th 1976, depicted James Fletcher, NASA’s administrator standing

beside Star Trek’s Captain Kirk and Spock. While lead-acid storage batteries weren’t part the Star Trek set, they had been critical to America’s moon landing and other space outcomes. Storage batteries consumed ninety percent of the production of refined lead, the balance headed for ammunition, paints or fuel. If its history belonged to antiquity, lead’s 20th century uses spread across automotive, aeronautical and even computer applications.

The city’s chief health officer, Dr. Beers, accepted that a new public health crisis would arise each Monday morning. Equipped with minimal resources, Beers’ work force learned to overcome many obstacles. Their director embraced gerunds and nouns, allying and allies, but was selective in his choice of allies, recognizing non-allies, charlatans really, could give public health a bad name.

While alternative medicine providers were often helpful, their tree included broken branches and some bad apples. Across unrelated diagnoses, pseudo-scientific chelationists arm-waved patients toward infusion-based chelation therapies, a term nearly rhyming with charlatan.

Missouri was standing by its problem, maybe on one, too. By 1980 Show-me miners had extracted seventeen million tons of lead ore, most mined near the earth’s surface. Education authorities wondered whether Missouri children from Herculaneum or even Festus were at an intellectual disadvantage because they breathed bad air or because they hailed from a non-mainstream places.

Nobody knew.

The adolescent Brian Wozniak’s cousins had referred to him as Woz - the Brainiac. So when he first referred to Brooklyn, Mel and Racer his Brainiacs, that actually conveyed respect. The load for lead testing slid from Dr. Wozniak to Professor Brooklyn and then onto the shoulders of a weed sprayer recently turned velo-chemist. Racer questioned if he were a human valet umbilical-ed to a demanding instrument. The Jarrell-Ash delivered, transforming dozens of blood drawtubes into clinically-relevant data.

Unlike railroad chemistry, drawtubes possessed names, similarly named Garcia and Rodriguez, plus an occasional Brown or Washington and with war’s end, some Tranh’s and Vu’s. Across

December 1980 Woz was increasingly awakened by nightmares of sick kids being funneled into phony chelation clinics.

Blood lead analysis requests originated not only from Kansas City clinicians but from those in nearby Grandview, Missouri.

Thus, M.D.’s from Tonganoxie, Kansas joined D.O.’s officed in Peculiar, Missouri in requesting lead analyses.

Frustrated by more requests than resources, Woz drove to Main street’s Gallup Map Company, seeking maps appropriate to a residential lead sourcing exercise. Woz requested the salesperson assemble three sets, suggesting Woz was perhaps an urban geographer.

Perhaps unclear about the clerk’s larger-is-smaller comment, he opted for 1: 10,000-scale maps. The clerk bonus-ed Woz with three boxes of red, yellow & green pins.

Passing by Kansas City’s R.H. Macys, Woz parked and entered, purchasing three pairs of Isotoner gloves for New York-residing Wozniak’s. Perhaps homesick for New York he studied the store’s mistletoe greenery surrounding painted red berries. Dr. Wozniak and the pharmacy assistant assembled three identical map-pin sets.

Unfolded, the 1:10,000-scale Gallup maps could have doubled as area rugs, explaining of the clerk’s larger-is-smaller comment. Woz dispatched the pharmacy assistant with individual map sets and duplicate notes for Brooklyn and Mel. 25+ units lead (Pb) contamination – Red pin 11-24 units Pb contamination - Yellow pin 10 or fewer Pb contamination - Green pin While the assistant couriered map sets to Brooklyn and Mel’s offices, Woz answered incoming calls. By the time the assistant returned he had red-pinned forty Kansas City households, ones where one or more children displayed toxic lead concentrations, defined as greater than 25-units.

Yellow-pins colored ninety more addresses, homes where children possessed intermediate yet troubling 11-25-unit readings.

Green-pins extended to two hundred other addresses; three hundred children living there registered fewer than 10-units, meriting mostly post card reminders to their parents for them to remain vigilant.

He fretted that the Centers for Disease Control might drop red and yellow values in favor of more restrictive values. (Ed: These guidelines are all obsolete in a present context but are listed as applied in 1980).

What about Racer and the Jarrell-Ash laboratory? Recognizing Racer had already paced the Jarrell-Ash through five hundred dry, ash and atomize cycles, Woz wondered how much longer a donated instrument and a repurposed velo-chemist could support a city-wide screening program.

Viewing the pinned maps he observed that some neighborhoods were littered with dangerous red’s while others were dominated by green-yellow’s. He further puzzled over the significance of single, isolated red surrounded by many green’s?

His misgivings about moving to a smaller place were replaced by fresh worries about funding a lead screening program suitable for a geographically-enormous city, one stretching across four Missouri counties, plus two more across the Kansas state line.

Neither medical school nor residency training had prepared him to conduct a broad public health campaign. Reducing children’s lead exposures would likely require expertise beyond what two oddball profs and a collection of pharmacy students could provide.

He further regretted not attending a Monday night jazz jam session as Dr. Miles had suggested. But didn’t Les say he had led a successful public health effort in Alabama and George, one that had linked blue jean dyeing with urological cancers.

Woz ignored an incoming poison center call to initiate one of his own. Dr. Les, Brian Wozniak here. Are you with a patient?

The upbeat Les redirected. No, but do you have your nickels linedup for future canteen visits?

Following a mutual chuckle, Woz posed a request. If you are available, I could use some help.

Les set a time. We’re finishing rounds so I’ll be back in forty-five minutes with your favored steaming hot coffee on the percolator.

Woz’ contemplated two stops ahead of one with Les. Stepping into Mel’s office, he spotted a Sanborn fire map alongside Mel’s field notebook and an unopened pin box. Rather than examining ferns or preparing a lecture, Mel pored over a coffee table book, one entitled Kansas City Homes & Architecture.

The Woz posed two questions, the first more pleasant than the second. How’s it going, Mel? Made any map-pinning progress?

Mel’s response was more of a question than a report. Dr. Woz, did you know that pyramidal-roof homes were first constructed after the railroads arrived here, designs differing from gable-and-wings.

Failing to understand Mel’s pyramidal-roof home comment, Woz snapped. Prof, I hoped you would devise diagrams or statistical models that would help us predict lead hot spots, contaminated homes and problem neighborhoods. How about doing that before expanding your architectural pursuits.

Noting Woz’ frustration, Mel defended his approach. We need a hypothesis, one correlating housing type and age with elevated lead concentrations. Otherwise, we’re guessing. My training is to formulate and test hypotheses.

With Mel’s use of the training term, they had reached common ground. Whether Woz understood Mel’s botanical background or whether Mel appreciated the nuances of residency training wasn’t Not wishing to offend Mel, Woz attempted damage control.

Please let us know soon, Prof, Racer and the Jarrell-Ash lab are currently overwhelmed and we are exhausting very limited resources.

Mel softened, attempting an explanation. I’ve visited nearly one hundred properties, home to more than three hundred children and performed follow-ups at each of Racer’s red-pinned addresses.

Woz regretted his heavy-handed approach. Mel, I’m a physician and not a statistician, so we’ll leave all that up to you.

They shook hands and Woz departed, but not before noting a bookshelf dominated by heavy 1930-era Polk directories and fire maps. Brooklyn’s office was only steps removed. Given a Saturday, Woz was surprised to find Racer and Brooklyn there checking results.

Brooklyn’s map was pinned with both residential red pins and what he termed red-tasseled industrial entries, ones applicable to Armco Steel, Leeds auto repair and the Olympic Speedway.

Before Woz could even knock, Brooklyn broke into an antsy monologue, trying to justify his red-tasseled industrial entries, before oddly switching to Olympic Speedway experiences.

Here’s what I told the Olympic mechanics, sixty grams of a lead compound furnishes nearly twenty grams of elemental lead in each gallon.

Dr. Wozniak, where do you think that goes? Well, first it goes in the air and then it goes into little kids’ lungs.

Gauging Woz’ disappointed expression, Racer lowered his eyes, recalling his attempt to treat a ten thousand-mile railroad outfitted with only a hand-me-down weed sprayer, a popcorn prankster and a miscalculated purchase order.

Shaking his head, Woz departed, Walking toward Les’ office, he recalled Les’ canteen-based comments the previous summer regarding building trust where none previously existed.

Thanks for your time, Les. I don’t need a urology consult but you may be able to help. Didn’t you say you assembled an interdisciplinary team for your azo-dye work, that blue jean chemical disease study?

Les followed. Yes, our efforts were hampered by claims we were screening them for sexually transmitted diseases as opposed to anticipating and detecting early stage bladder cancer.

Woz explained. Here’s my dilemma. I’ve assembled a team, a chemistry professor who serves as our industrial hygienist and a botanist with a statistical background, but, unfortunately, their approaches don’t have much in common. The chemist favors a distance-from industry approach while the botanist attempts to match high-level exposures with housing types. Would you look at their preliminary findings and let me know what you think.

Dr. Les applied humor. Leave their report and I’ll let you know what I make of your colleagues work. By the way, why haven’t we seen you at a Blue Room jam session? Get your priorities straight!