Ch. 8 - Poison Center Visitors

CHAPTER 8 POISON CENTER VISITORS April 1979

Racer watched a young physician he had seen at time or two at the

college struggle with what appeared to be an Atala Pro bicycle frame he was removing from the car’s trunk. Their newest customer also recognized Racer as a science department lab assistant, making the K-L-W role a bit of a surprise.

Addressing Kern at the store’s door, the young doctor took a conversational lead. Good morning, my name’s Brian Wozniak and I witnessed how comfortable you were with wheelchair-fitting. Since moving to here I haven’t ridden my Atala. Could you check it out its brakes and tires, derailleurs and shifters?

Kern motioned to Racer, believing he might like to meet their newest customer, the Atala’s owner. Kern time-estimated repairs.

We’re working on a seven-ten-day repair schedule. Given we may need some Campagnolo bits, how would a week from Wednesday work for you?

That’s fine. To simplify spelling, why don’t you print the repair tag as Woz, my nickname? Instead, Racer lettered the claim check as overhaul – complete, Brian Wozniak, MD, University Hospital.

A New York transplant, Woz was a more of a bikie than George and Racer knew. Years prior on Sunday mornings an adolescent Woz had joined Central Park’s pace lines, clusters of below-the-waist identically-attired cyclists sporting black shorts, white athletic socks and matching cleats although their colorful jerseys were more attributable to New Jersey delis, the Police Athletic League and bubblegum merchants, including the Brooklyn brand.

Woz’ parents insisted Brian, their sole child, don a cycling helmet, one constructed from three-front-to-back rubbery strips sewn into a thick leather hat band. As fans of TE Lawrence, they were certainly saddened to learn of Lawrence of Arabia’s tragic end, attributable to a motorcycle-related head injury.

Woz watched Racer climb a ceiling-mounted ladder, placing the Atala alongside a F-U-J-I race bike. Viewing the young lab assistant working a second job, he reviewed some of his commitment. The week prior Woz’ assistant presented him with a bulky questionnaire originating with the American Association of Poison

Control. Scanning across fourteen required response fields, Woz puzzled over two new requirements, consulting resources in botany and industrial hygiene, noting that he would need to submit resumes for nominated subject matter experts he nominated.

While relatively young by physician standards he had already witnessed a stream of changes that created a strikingly different practice environment. Scheduled charges of $875 for gall bladder removals and $350 for labor and delivery had become extinct.

Lyndon Johnson’s Great Society ushered in a new era, one featuring contracted fees. A key development for poison control centers was passage of the 1973 Emergency Medical Systems Act, also called E-M-S-A (Public Law 93-154), providing funds for both burn and poison control units. On a local basis hospital administrators regarded them as financial loss producers.

The Kansas City Fire Department and associated local 42 championed new-created burn units. Firefighters waving empty mount-out boots at Wornall and Ward Parkway intersections encouraged pocket change donations.

While telephone directories typically included a listing for poison control, it followed those applicable to Police and Fire, and sometimes even the Time and Temperature number. Oddly, 911-call reimbursement for police and fire did not extend to poison control.

Prior to 1957 Kansas City hospital care split between patients accommodated at General Hospital No. 1, for whites, and No. 2, non-whites. Dr. J. Edward Perry’s Provident-Wheatley Hospital augmented No. 2’s service. But features of the 1973 E-M-S-A subtly pushed health care toward an integrated model.

Poison control answering protocols resembled practices in other emergency call centers. Poison control telephones were hosted by assistants, often senior pharmacy students, managing easier calls by relying upon a microfiche-based Poisondex database and microfiche reader. Microfiche searching in some ways compared to the job of a theater usher, matching lettered and numbered locations to pertinent references.

Drug-related poisoning management was much more medicallyadapted than industrial chemical poisoning management.

Industrial categories were often too broad, generic entries for all

hydrocarbons - volatile or all metals, heavy, clumsy shoehorning attempts at best. Dioxane, a solvent, differed by only two letters from dioxin, one of the world’s most toxic substances. Benzine meant petrol in the UK although a single letter change denoted benzene, a potent leukemia-causer.

Woz speculated that botany and industrial hygiene expertise had already proven useful elsewhere. While toxic plant example matched a botanical scenario he wasn’t sure what an industrial hygienist either was or did.

Fanning through the form, Woz encountered a section entitled locating subject matter experts, one that hinted the botanical expert would distinguish toxic from edible mushrooms. A nearby paragraph noted that Certified Industrial Hygienists or CIH’s were employed by government agencies causing him to wildly speculate that the C-I-H business originated with the C-I-A and the Dulles brothers.

Similar to the three-letter C-I-H designation, Dulles issues consistently favored either triplet phrases, brothers John Foster Dulles and Allen Welsh Dulles plus the agency they devised, the Central Intelligence Agency. Woz weirdly reasoned that the C-I-H requirement could involve a C-I-A super spy? Regardless, he needed two locate two consultants and devise a means to pay them.

The last time Dr. Wozniak had engaged in a scientific search for answers had occurred as he lettered W-O-Z-N-I-A-K on an exam paper. Since then he had tried to adapt himself to a narrow corridor in which the inter- of disciplinary could mean an internist having a hallway conversation with a surgeon.

The form’s consultant resume requirement was also problematic.

Less the resume requirement, he reasoned he could turn a sponsored faculty club lunch into a couple of phone numbers of somewhat willing experts.

So on a Saturday afternoon that should have been his day of, Woz applied a popular decision-making approach, stewing, until late afternoon sun created lengthened shadows there. He shortly shut his door and drove home. Reaching a converted Forest avenue flat, that had decades earlier served as a No. 2 hospital room, the

Woz chuckled. For Saturday night he would be KO-W0Z, all shortwave, no titles.

Monday morning necessitated case follow-ups accompanied by a numbing cascade of meetings. With each came realization that the form’s fields remained blank. Lacking additional stewing options he chose to phone the science department. Good morning, this is Dr. Wozniak. Could you tell me who could advise me regarding botany and chemical exposures?

While her first instinct was to take a number, Office Lady pursued a more aggressive solution. It’s true she heard the doctor part, it’s true she also heard the botany term, but past these elements, Woz’ inquiry generated an alternative bizarre meaning.

A big fan of Dick Van Dyke and Danny Thomas reruns, she persisted through show credits announcing Dick Van Dyke wears BOTANY 500 suits and Mr. Thomas’ wardrobe furnished by BOTANY 500.

Office Lady’s fondness for those suave entertainers possibly explains a conversational detour. Did I hear you right? You need a professor to remove a chemical stain from your BOTANY 500 suit?

Skilled in clinical calming, Dr. Wozniak redirected. No thank you, my suit is fine but I need someone to identify mushrooms, toxic plants and poisonous berries. Office Lady’s shortfalls did not extend to call forwarding. Please hold for Dr. Mel. That conversation was brief, primarily used to schedule a visit.

Two days later Mel walked to Woz’ office. Mel’s prior contact with medical personnel primarily involved Navy Corpsmen during WWII’s battle for Okinawa. Beyond inter-service teasing, Marines generally held Corpsmen in high regard causing him to speculate that this new relationship might extend Mel’s fledgling medicinal chemistry interest.

Woz was nervous about soliciting an older professional for a mostly unpaid assignment, perhaps accounting for the interest he showed in Mel’s medicinal plant inquiry. Woz was surprised the mainly unpaid nature of the consultancy did not deter Prof Mel. Mel was similarly pleased to find this Wozniak person was taking his questions seriously. The sole unresolved issue was that

of a contact telephone number. Mel handed Woz his business card, adding his wife could always get in touch.

Brooklyn had lectured through a box of chalk-sticks when Office Lady squeezed into the lecture hall, hand-signing an incoming call.

Brooklyn bonus-ed her with Coke money any time Office Lady could rescue him from the lecture hall. I have Dr. Wozniak from poison control on hold.

As if the twenty-year-old’s had missed anything, Brooklyn loudly re-phonated the Dr. Wozniak feature. Sans an apology, he abandoned them in favor of monopolizing her handset, baritoneing Dr. Brooklyn, as if halfway through a Nobel-meriting synthesis.

Woz initially complimented Brooklyn on unspecified good things he hear about the latter’s industrial experiences. Indicating they should meet in person, Woz invited Brooklyn for afternoon coffee.

Commencing the meeting, Woz pursued the certified industrial feature without clarifying, mainly because he didn’t understand it.

Favoring the first two of the three certified – industrial - hygiene terms, Brooklyn neglected the hygiene element, weirdly expounding on pollution challenges facing Bossier City, Louisiana.

Woz silently listened, mainly reviewing clinical features of poorly-treated thyrotoxicosis, interrupting Brooklyn to confirm the latter was comfortable with sampling air for benzene and analyzing blood specimens for lead.

This back-and-forth continued until Woz seriously over-invested in his chemical knowledge, inquiring if Brooklyn possessed something similar to Star Trek’s Tricorder, taking Brooklyn’s silence as a Tricorder-no.

Brooklyn then asked if Woz had encountered Richard Feynman’s writings, ones that suggested heart surgery would eventually be performed when a patient swallowed a molecular surgeon. Professing tiny surgeon ignorance, both men laughed, realizing neither understood much about the other’s work.

The pharmacy assistant shorty patched an urgent call to Woz’ speaker phone, one originating from the Wabash hospital in rural Missouri. The caller indicated an eighty-year-old suicidal gentleman in Moberly had laced a glass of orange juice with three tablespoons of weed poison. Brooklyn listened as Dr. Wozniak

described a bicarbonate treatment protocol for correction of the poisoned man’s acidosis.

Listening to Woz’ side of the call, Brooklyn became antsy, shortly miming his way toward a departure. Outside of Woz’ office, he was relieved to return to molecules of his choosing, ones removed from Glyphosate cocktailed into orange juice. Mainly, though, Brooklyn reasoned he required a nap.

Only a few days passed before the Brooklyn-Racer duo received a call from poison control requesting industrial hygiene assistance.

The caller shared how someone he referred to Wanda Swearengin had called poison control enough they recognized her by voice.

Wanda’s residence was located in an older Kansas City neighborhood, one called Harlem just east of the downtown airport. The assistant shared that Wanda Swearengin believed vapors from nearby Cook Paint Company were making her ill.

Racer recognized the Cook paint name because it sponsored a semi-pro basketball team, the Painters. The semi-feature applied to athletes who formulated paint ahead of a four o’clock plant whistle, preceding night-only home games. While Kansas City noses could locate Cook Paint, as far as Brooklyn knew its emissions didn’t constitute a health problem Electing to send Racer to the Swearengin residence, Brooklyn outlined the task. Would you ride there to monitor paint chemicals, toluene and xylene? Depending on what you find, we’ll compare results with references from the 1974 Threshold Limit Value list, my TLV booklet.

Reaching the Harlem neighborhood meant crossing the Missouri river, Racer requisitioned the Econoline for the bridge passage.

Stuffing Brooklyn’s TLV booklet into his jersey pocket, he bicycled to K-L-W where Kern provided him with a trip clipboard and two dimes for Paseo bridge tolls.

Studying the case file, Racer noted the address placed her east of the Richards air field. By 1979 converted from commercial to general aviation, its runways accommodated planes powered by aviation fuel (Avgas). He questioned whether Avgas might be a partial reason for Ms. Swearengin’s breathing challenges.

Upon his arrival Racer quickly learned her health conditions were only exceeded by medication entries, multiple prescriptions

from five unacquainted physicians. She joked that her struggles gave rise to crank status, but as she explained, that of a nice lady crank.

While she went inside to quiet a ringing phone, Racer opened a small leather case, Draeger-lettering announcing German origin, shortly notching two detector tubes, one applicable to a common paint chemical, toluene and another reasonably specific for xylene, anticipating color changes proportionate to concentrations. Neither produced a measurable reading.

While disappointed, Wanda resigned herself the fumes weren’t too bad, suggesting a follow-up visit. She then presented oddly Racer with an unused inhaler, noting she had been unsuccessful in coordinating its activation with her breathing cycle Reading aloud to her from an unfolded instructional insert, Racer circled its depiction of a robust young male inhaling while using that model.

Following goodbyes, he retraced his bridge path before returning the Econoline to K-L-W. Wanda shared with her Harlem neighbor news that poison control had sent a doctor to her way. I feel so much better knowing someone cares.

Before stuffing the Heartland center’s response in an envelope, Woz re-read and edited the 4-C consultant section. Restricting himself to fewer than three corrections, he zigged-and-zagged via an IBM Selectric spacebar, wondered if he could spoof Brooklyn about such anon-NASA spacebar. He also corrected a typo, one in which his assistant had listed Brooklyn as C-I-A eligible, overtyping C-I-H as corrected by BWMD. While Dulles’ may have been limited to three-letter abbreviations, he could handle four.