6
Anne Anderson got a call from her friend Carol Gray on the afternoon of September 10, 1979. “Read the newspaper” was all that Carol would say. Anne went out to the front porch and picked up her copy of the Woburn Daily Times. On the front page was a five-column banner headline: LAGOON OF ARSENIC DISCOVERED IN N. WOBURN. It was a pleasant, sunny day in late summer but Anne was oblivious to the world around her. She read the newspaper as if in a trance. “Everything seemed to stop still for me,” she recalled some years later.
The article, by a young reporter named Charles C. Ryan, told of the discovery in north Woburn that past July of a half-buried lagoon, nearly an acre in size and five feet deep, that was contaminated with arsenic, lead, chromium, and traces of other heavy metals. The lagoon had been uncovered by a construction crew working at the site of the old Merrimack Chemical Company, producer of arsenic-based insecticides and tanning chemicals. The crew had also unearthed several pits containing the rotting remains of animal hides, hair, and slaughterhouse wastes, the legacy of Woburn’s tanneries. “Arsenic in small doses,” the article stated, “is suspected as a cancer-causing agent,” and chromium was a known carcinogen that caused tumors of the lungs and nasal passages when inhaled. It was unclear, stated the article, whether these toxic metals had contaminated Wells G and H, situated a mile to the south. But the article did note that the two wells, which had pumped as much as a million gallons of water a day during the fifteen years since their construction, had already been closed “because they were contaminated by trichloroethylene, an industrial solvent that has been found to be carcinogenic.”
When Reverend Young heard about the Daily Times article, he went out at once to buy a copy of the paper. “Suddenly,” he recalled, “everything Anne had been hammering away at seemed plausible, just from one day to the next.” That evening, he decided it was time for him to act. The logical first step, he reasoned, was to find out exactly how many leukemia cases had occurred in the city during the last fifteen years. He had once tried to find this information, but neither the state nor the city kept a record of the incidence of leukemia. Anne had told him of eight cases that she knew of. That did not seem like an excessive amount in a city the size of Woburn. Were there more cases? the minister wondered. How many cases was too many?
The next day he called Anne and told her he had come up with a plan. He would write a letter for publication in the Daily Times asking parents who’d had a child diagnosed with leukemia in the last fifteen years to come to a meeting at Trinity Episcopal. Maybe they wouldn’t discover anything they didn’t already know, the minister told Anne. Maybe no one would show up at the meeting. But it was worth a try, he said, and Anne agreed.
On an evening three weeks later, Reverend Young propped open the door to the church meeting hall and arranged several rows of metal folding chairs on the scuffed linoleum floor. Donna Robbins arrived early to help him. The minister went to the door to greet people as they came in. He recognized several parents from the hospital clinics. By seven-thirty, he counted more than thirty people, mostly couples, standing in small groups, talking with one another. The minister waited a few moments longer, and then he stood and introduced himself. He explained why he’d called the meeting. “We want to find out if there is a problem in Woburn, or if there isn’t,” he said. He passed out copies of a questionnaire that a nurse at Massachusetts General had helped him to prepare, and asked that they be returned to him as quickly as possible.
Toward the end of the meeting, people began asking questions, voicing their worries and suspicions. Some people talked about their children, but not everyone who had come had a leukemic child. A few had family members with different sorts of cancers, one had a cat with leukemia, and others had come simply out of a concern about the local environment. The atmosphere felt loose and friendly. Many people joined in the talk. Anne was not one of them. Throughout the meeting she sat quietly with her husband. She had told Reverend Young that she didn’t want her role in this affair mentioned, and he respected her wishes. She did not like speaking before groups of people, and she also feared that others might ridicule her intuition. “I did not make my opinions known,” she explained some years later at her deposition, “because I was living with paranoia, because I saw myself as a housewife without training.”
Reverend Young waited for the questionnaires to be sent back. Several weeks after the meeting he and Anne met in his office at the church. They had information on twelve cases. That still did not seem to Young like a particularly large number over a fifteen-year period, but he did not mention this thought to Anne. He had purchased a street map of the city. Anne read aloud the address of each case, and the minister marked it on the map. Of the twelve cases, eight were located in east Woburn, and six of those were clustered in the Pine Street neighborhood, where perhaps two hundred families lived. Young thought the distribution looked highly unusual, especially when plotted on the map. He told Anne he’d call Dr. Truman the next morning and make an appointment to show him the map. He asked Anne if she wanted to come with him, but she told the minister he should go alone.
When Reverend Young arrived at the hospital some days later, he found the doctor in his office, about to eat lunch. Truman offered to share his meal, but the minister declined. He began telling Truman about the October 4 meeting. Truman listened politely. Young unfolded the map and placed it on Truman’s desk.
“Here,” explained the minister, finger to the map, “is east Woburn, and here is Anne Anderson’s house. And this is the Zonas’, and right next door are the Nagles. Here are the Kanes, and the Toomeys. Over here are the Carlsons; Donna Robbins, and Barbas, Ryan, Veno …”
Truman abandoned his lunch and looked intently at the map. “This is very interesting,” he murmured as if he were talking to himself.
“We’ve identified twelve cases altogether,” continued the minister. “There may be more. The problem is, I don’t know if twelve is unusual for a fifteen-year period.”
“This is a very striking cluster,” said Truman. “There’s no doubt about that.”
Truman told Young that he knew a doctor at the Centers for Disease Control in Atlanta who had investigated other leukemia clusters. “I think the next step is for me to call him,” Truman said, and he reached for the telephone.
The man whom John Truman called at the Centers for Disease Control was Dr. Clark Heath. He was the world’s foremost expert in leukemia clusters. It was a distinction that Heath himself might not have valued highly, since he was no longer sure that such a thing as a leukemia cluster existed.
Heath had first encountered what seemed to be a cluster in the spring of 1961, as a young doctor in his second year at the CDC. He’d been sent to the town of Niles, Illinois, a Chicago suburb, after a pediatrician there had reported the deaths of four young girls from leukemia within three months. In Niles, Heath methodically combed through death certificates and discovered four additional cases, three girls and one boy. The eight victims had lived within a single parish of Niles, an area slightly more than a square mile in size. All but one of the victims had attended the parish parochial school or had siblings who did, and the one who did not, a ten-year-old girl, had lived within a block of the school. Heath also discovered three adult leukemia cases in the parish. Two of those adults had children at the school. All the cases had been diagnosed within the last three years.
Heath was a young man then. He began to hope that he might discover in Niles the cause of childhood leukemia. He and a colleague from the University of Chicago studied each leukemia case in great detail, scrutinizing medical records, examining samples of bone marrow and blood, testing the blood of family members, monitoring the levels of background radiation in the homes of the victims and at the parish school and church. They found no evidence of any hereditary factor. Heath felt almost certain that some infectious agent, probably a virus, had caused the disease. Researchers had identified leukemia viruses in animals—in mice and birds—and it seemed re
asonable to suspect that such a virus also existed in humans. Moreover, leukemia occurred most frequently in children under six years of age, a time when they were most prone to infectious diseases. In Niles, Heath discovered that a “rheumatic-like illness” had circulated among children at the same general time as the onset of leukemia, and this, he thought, suggested “some infectious process.” But he could not link it with any certitude to the leukemias. After a year of work he was no closer to knowing what had caused the outbreak in Niles than on the day he’d arrived. Back then, he did not doubt that he’d seen a genuine leukemia cluster. In a report published in the American Journal of Medicine in 1963, Heath wrote: “The cluster of eight cases of leukemia among children in Niles cannot reasonably be attributed to the effects of random distribution. These cases constitute a clearly defined micro-epidemic.”
Over the years, other leukemia clusters began to surface. Heath went to the small town of Orange, Texas, to investigate three cases that had occurred within nine months. From Douglas, Georgia, came a report of a “leukemia house,” where three residents and a regular visitor had, within ten years, contracted the disease. In Rutherford, New Jersey, six children, four of whom had attended the same elementary school, were diagnosed with leukemia. From Almond, New York, a rural village with a population of two thousand, came reports of four leukemias in less than a year. In all of these places, as in Niles, investigators failed to find a cause, or even a significant lead.
Two decades had now passed since Heath had gone to Niles. He knew more, and was certain of less. “Results have suggested little if any tendency for cases to come in clusters beyond what chance would predict,” he wrote in 1982 in the textbook Cancer Epidemiology and Prevention. Others in the field agreed with this position. Some epidemiologists at the CDC, for example, explained apparent leukemia clusters by analogy to the “Texas sharpshooter” effect: a man shoots at the side of a barn and then proceeds to draw targets around the holes. He makes every shot into a bull’s-eye. If an epidemiologist were to draw a circle around, say, the greater Boston area, he would find an incidence of leukemia comparable with the rest of the United States. Draw a circle around Woburn and he’d find a worrisome elevation. Draw a circle around the Pine Street neighborhood and he’d find an alarming cluster. Was it a real cluster? Or was he just drawing bull’s-eyes where he found bullet holes?
Despite Heath’s doubts about clusters, he still felt it was “highly likely” that infectious agents played a role in the cause of childhood leukemia. But any such agent, he thought, would have to be a pathogen of low potency, one that was widespread but affected only a very few susceptible individuals. And he no longer had much faith that epidemiological investigations would yield any answers to childhood leukemia. The available techniques were too crude and the disease too rare to establish any firm connection between cause and effect.
Nevertheless, when John Truman called him, Heath was duty-bound to investigate. He arranged to send an epidemiologist to Boston to meet with Truman and to collect the records of leukemic children from other Boston area hospitals.
7
Reverend Young left John Truman’s office more certain than ever that there was an epidemic of leukemia in east Woburn. And then events began to converge. Charles Ryan, the Daily Times reporter who had written about the arsenic lagoon, had just completed a story concerning a study of cancer mortality by the state’s department of public health. In Woburn, deaths from all cancers had increased by 17 percent during a five-year period in the mid-1970s. The incidence of leukemia in particular, and to a lesser extent kidney cancers, was alarming. “Even though cancer seems to be on the increase in Woburn,” wrote Ryan, “there is no way of knowing if that increase is due to the toxic wastes found in north Woburn.”
After reading this story, Reverend Young immediately called Charles Ryan at the Daily Times and told him about the leukemia cluster he and Anne had discovered. Ryan’s second story appeared on December 12, 1979, on the front page of the paper under the headline CHILD LEUKEMIA ANSWERS SOUGHT.
The mayor, unhappy with the publicity the city had received about the arsenic lagoon in north Woburn, was even less happy with Reverend Young’s activities. “For anyone with little or no authority to give the impression that there is a major health crisis within the confines of the city, without factual evidence to back up their statements, is totally irresponsible,” announced the mayor at a city council meeting. Reverend Young heard that the mayor, in private conversation, was furious about the “panic” and “hysteria” created by reports of high cancer rates. The chamber of commerce warned publicly about declining property values and other serious economic effects. “Businesses may decide not to expand, or even to move out of the area,” one speaker told the chamber. “Industrial land may not be sold because of the problem. Property values may be down.” The chamber’s vice-president foresaw “an exodus of business” and said, “We’ve got to try to head that off.”
That December the Centers for Disease Control formally requested permission from the city to launch an investigation into the possible leukemia cluster. With help from the Massachusetts Department of Health, an epidemiologist from Atlanta began designing a study for Woburn. Trained researchers from the department of health would be sent to the homes of the twelve families with leukemic children and conduct in-depth interviews on a wide range of subjects. The researchers would also interview twenty-four other Woburn families that had been selected as controls, matched by age and sex with the leukemic families. The study, said the experts, would take a year to complete.
Reverend Young worried that those in authority would try to minimize or even suppress the results of the investigation. On Sunday mornings, from the pulpit at Trinity Episcopal, he began to speak about environmental contamination in Woburn and the high incidence of leukemia. He seized every opportunity to speak in public on the issue, and granted interviews to any reporter who asked. To a New York Times reporter, he said, “I set out to prove [Anne] wrong, that cancer and leukemia don’t run in neighborhoods, but she was right.” When Senator Edward Kennedy’s office invited both him and Anne to testify in Washington before the Senate Committee on Public Works and the Environment, he immediately accepted. Anne told the minister she would not go. She had to take care of Jimmy. Young insisted. “You must do this for Jimmy,” he told her.
So Anne went. She spoke only briefly, but her words became the headline in The Boston Globe’s story the next day. “We fear for our children, and we fear for their children,” she said. “The neighborhood lives in fear.”
8
Donna Robbins got a visit from two researchers working on the CDC investigation one evening in July 1980, seven months after John Truman’s call to Clark Heath. The researchers asked Donna about the medical histories of everyone in the family, how often they had been exposed to X rays, how many pregnancies and miscarriages she’d had. They asked about her and her ex-husband’s jobs, their ethnic and religious backgrounds, their church and community activities, their eating habits, hobbies, and household pets. Did she keep a garden? Had she or her sons ever fished or waded in Woburn lakes and streams? Had she ever smoked cigarettes? Painted her apartment? Used hair spray or hair dye? Traveled outside Woburn? The entire process took nearly two hours. Donna answered as best she could. After the researchers left, she realized that they had never asked her about the tap water.
A few weeks later, Donna got a call from the Woburn lawyer who had handled her divorce, the same lawyer who’d referred her to Reed & Mulligan about Robbie’s hip operation. The lawyer said he’d been following events in the newspaper. He asked Donna if she’d thought about a lawsuit, perhaps against the city. Donna said the idea had not occurred to her. “Well,” said the lawyer, “you might call Joe Mulligan and see what he thinks.”
Donna raised the subject with Reverend Young the next day. The idea intrigued the minister. He thought a lawyer might help them get some answers. He told Donna he’d be happy to meet with Mulligan
and explain the circumstances in Woburn.
Donna called Joe Mulligan. The lawyer expressed interest in meeting with Young and seeing if there was indeed a case. Although nothing had yet come of the case concerning Robbie’s hip, Donna still had faith in Mulligan. He had always treated her kindly. He still assured her periodically that Robbie’s case was developing, and she believed him.
The following week Mulligan drove out to Woburn in his white Cadillac, and Donna greeted him at the back door of the church. She escorted him through the hallway cluttered with the Trinity Thrift Shop’s wares, the piles of old clothes, the chipped dishware and battered toys. Bruce Young’s small, dark office was almost as cluttered as the hallway, and Mulligan seemed to fill all the space.
Reverend Young unfolded the map with the leukemia cases and showed it to Mulligan. He explained how he and Anne had put the map together, told him about his visit to Truman’s office, and described the way the city officials had reacted. “The odds of a cluster like this occurring by chance,” the minister told Mulligan, “are on the order of a hundred to one.”
Mulligan seemed impressed. Twelve children with leukemia—eight of them within a half-mile radius, six of them living almost next door to each other—and contaminated drinking water. It was, in legal terms, as Mulligan later said, “almost res ipsa loquitur”—the thing speaks for itself. There was, however, Mulligan pointed out, one significant problem: Who was to blame for the TCE in the wells? Reverend Young replied that the Environmental Protection Agency had just begun an investigation. Once the agency completed its report, they’d know the source. Mulligan suggested that he meet with the families. Reverend Young agreed to make the arrangements. And Mulligan departed, carrying a file of newspaper clippings that the minister had collected.
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