And that is what von Sochocky now did. Together with Drs Hoffman and Knef, the trio admitted Marguerite to St Mary’s Hospital in Orange to find out what was the matter with her. On admittance, she was anaemic and weighed 90 pounds (six-and-a-half stone); her pulse was ‘small, rapid and irregular’. She was hanging on, but barely.
A week or so after she was admitted, which was partly thanks to Hoffman’s intervention, the statistician did the dial-painters his biggest service yet: he read his paper on their problems before the American Medical Association – the first major study to connect the women’s illnesses to their work; the first, that is, to be made public. And his opinion was thus: ‘The women were slowly poisoned as a result of introducing into the system minute quantities of radioactive substance.’
That ‘minute’ was important, for the company – all the radium companies – believed dial-painting to be safe because there was such a tiny amount of radium in the paint. But Hoffman had realised that it wasn’t the amount that was the problem, it was the cumulative effect of the women taking the paint into their body day in and day out, dial after dial. The amount of radium in the paint may have been small, but by the time you had been swallowing it every single day for three or four or five years in a row, there was enough there to cause you damage – particularly when, as the Drinkers had already realised, radium was even more potent internally, and headed straight for your bones.
As early as 1914, specialists knew that radium could deposit in bone and cause changes in the blood. The radium clinics researching such effects thought that the radium stimulated the bone marrow to produce extra red blood cells, which was a good thing for the body. In a way, they were right – that was exactly what happened. Ironically, the radium did, at first, boost the health of those it had infiltrated; there were more red blood cells, something that gave an illusion of excellent health.
But it was an illusion only. That stimulation of the bone marrow, by which the red blood cells were produced, soon became over stimulation. The body couldn’t keep up. In the end, Hoffman said, ‘The cumulative effect was disastrous, destroying the red blood cells, causing anaemia and other ailments, including necrosis.’ He concluded emphatically, ‘We are dealing with an entirely new occupational affection demanding the utmost attention,’ and then – perhaps thinking of Marguerite’s lawsuit, which was dragging sluggishly through the legal system – added that the disease should be brought under the workmen’s compensation laws.
Katherine Wiley was, in fact, attempting to do just that through her work with the Consumers League, campaigning to have radium necrosis added to the list of compensable diseases. In the meantime, Marguerite’s only hope for justice was the federal court – but her case was unlikely to be heard before the fall. As Alice Hamilton noted with dismay, ‘Miss Carlough may not live till then.’
Hoffman continued to present his discoveries. He noted that although he had looked for cases of radium poisoning in other studios across the United States, ‘There was none affected outside of this plant.’ Unwittingly, Hoffman now revealed exactly why that was, but he didn’t grasp the relevance of his statement. ‘The most sinister aspect of the affliction,’ he wrote, ‘is that the disease is apparently latent for several years before it manifests its destructive tendencies.’
Several years. The Radium Dial studio in Ottawa had been running for less than three.
Both Hoffman and von Sochocky, whom he’d consulted for his paper, were struck by the lack of other cases. For USRC, it was clear evidence of why the girls’ illnesses could not possibly be occupational. Hoffman and von Sochocky, however, who were convinced that dial-painting was the cause of the girls’ sickness, did what any scientists would do: they looked for a reason. And when von Sochocky gave Hoffman the top-secret paint formula, they believed they had found it. ‘[Von Sochocky] gave me to understand,’ Hoffman later said, ‘that the difference between the paste used in the plant in Orange and the paste used elsewhere was mesothorium.’
Mesothorium – radium-228 – and not radium; at least, not the radium-226 that people used in their tonics and pills. That had to be the answer. And so Hoffman, building on Dr Blum’s work, commented in his paper: ‘It has seemed to me more appropriate to use the term “radium (mesothorium) necrosis”.’
In conclusion, it wasn’t – not exactly – radium that was to blame.
However, when news of Hoffman’s report hit the headlines, the radium industry fought back. Radium was still the wonder element and new products were being launched all the time – one such right there in Orange. A highly radioactive tonic called Radithor, produced by William Bailey of Bailey Radium Laboratories – a client of USRC – had been launched in early 1925. He and others spoke out publicly against the attempts to link radium to the dial-painters’ deaths: ‘It is a pity,’ Bailey said, ‘that the public [are being] turned against this splendid curative agency by unfounded statements.’
But while the radium men were quick to strike back, Hoffman’s paper, although it attracted some publicity, was a rather niche, specialist publication. Not many people subscribed to the Journal of the American Medical Association. And who was Frederick Hoffman anyway? Not a physician, who might really know about these things. Even the women’s allies were aware of his lack of authority. ‘It seems to me unfortunate,’ wrote Alice Hamilton to Wiley, ‘that Dr Hoffman is the man to make this situation public. He does not command the confidence of physicians and the work that he does will not be thorough nor proof against attack.’
What the women needed was a champion. A medical mastermind – someone who could not only command authority, but also, perhaps, find a way of definitively diagnosing their disease. Blum had had his suspicions, Barry too, but neither of them had actually proved that radium was the cause. Most importantly of all, they needed a doctor who wasn’t in the pocket of the company.
Sometimes, the Lord works in mysterious ways. On 21 May 1925, a Newark trolley car was trammelling along its tracks on Market Street when there was a commotion on board. The commuters, making their way home in the evening rush hour, made room for the passenger who had suddenly collapsed to the floor. They called out to give him some air, for the trolley car to stop; a kindly passer-by no doubt bent to mop his brow.
It was all in vain. Only a few minutes after the man had first been stricken, he died. His name was George L. Warren. In life, he had been the county physician for Essex County – a senior medical figure with responsibility for the welfare of all residents within the county’s borders, which included those in Newark as well as Orange: the locations where former dial-painters were now dying unstoppably.
With Warren’s passing, his position became vacant. The role of county physician – what would become the powerfully titled Chief Medical Examiner – was now open. Whoever filled it would make or break the case.
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