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Born a Texan, but traveled the US extensively.  Now staying on the East coast.

Thursday, June 26, 2014

Building a Reputation

The first health director had used the information that came to him from the lab to further his own ideas, the new health director relied on the information and the results of our test to make policy, at least most of the time.
My skills with databases were becoming very strong and I ended building databases for at least three other department and there was evening work because of it.
I also used our own database to understand what was happening with well water, what were issue, what were not issues.  The new health director had me go to the American Public Health Associations (APHA) annual meeting in New York and present.  I also went to the annual American Association for the Advancement of Sciences (AAAS) in Washington DC to present the same information.
Both presentations were well received and I began to be contacted nationally regarding the information.
Unlike a private company, any information I garnered was already public information and I was open about sharing it, to the surprise of many.
The more testing I performed in the lab, I began to realize that I did not really care what the outcome was, I was not invested in the result.
The more testing we did, the more people noticed and I was featured in the local paper, along with pictures several times in the papers.  When people would compliment me on making the paper, i would make light of it saying that it was so beach goers could have a face to throw darts at when the beaches were closed.
This created a reputation for me and people would come in with problem samples.  Some times they came in with a specific thought in their mind and some times they were correct, often times their was something else.
With each person, each sample, I tried to learn something.  I did not know everything and would read and listen to anything  that I could, then I would test to see if it were true.
A fun example would address mineral build up in dishwashers, I had heard that Tang was an effective cure for the problem.  Intuitively, I understood that the citric acid in Tang, would dissolve minerals, so I devised an experiment, drying calcium carbonate in a glass breaker.  I added a teaspoon of the orange powder and it dissolved the minerals in warm water.  Not content with the lab experiment, I went to the home of friends who had very hard water and added the powder to a regular run of the dishwasher, not only did it clean the dishwasher, the dishes were also sparkling for the first time in years.  Doing the "what if" thing was working nicely for me and I passed on the info.
The Environmental Health division was changing and more person from that department were looking for help with problems they were finding.
They began to ask for my help in designing the surveys.
One particular survey challenged someone with money and influence and used tracer dyes.  I had to prepare the entire procedure because everyone was sure it would be challenged.  The orders coming from the results of the test were challenged and then appealed at the state level.  Our orders stood.  My results stood.
I now had the respect of the state.
At this point the lab workers were paid significantly less than the Environmental Health personnel with a "RS" behind there names.  I thought that if I were ever to challenge that structure, I needed a "RS" or Registered Sanitarian certification.
I took the test, without studying, finished first in the group taking the test and received the highest score that had been.
More insects came to the lab for identification, some so strange, they would baffle even the experts at the State agricultural Experiment Station.
We used them a great deal, even using them for bizarre, experimental methods to help identify unknown items that were brought to the lab and now they knew us on a first name basis.
Several nearby (and some not so nearby) health departments sought our, okay in reality, it was my help in testing recreational beach water. There were several non-profit environmental agencies looking at the Long Island Sound and they began asking for help with some of the water quality questions they had.  Knowledge with them was a one way street, I gave and they kept, but here I met an environmental activist, but realist, who volunteered at one of them.  Art Glowka and I would become good friends and he would share what ever information he could, but he was best at asking questions and I was best trying to find answers for him.  This was a symbiotic relationship.
Lyme disease began making news and we were sending the ticks to the Agricultural Experiment Station (Ag Station) for testing.  While one of the environmental health persons did the bulk of the work, we took it over after only a few years and it became a lab function.  The Ag Station appreciated our screening of things that were not ticks and our reputation increased.
Of course working in lab, we wore protective clothing, that is white lab coats.  It was obvious for persons coming into the lab that there was a great deal of medical work going on.  The white lab coat generated an unusual response from the general public, they thought we were doctors.  This was understandable for we did much clinical testing for the health department programs and for the medical community in Stamford.  Sometimes even our secretary had people open up to her on the phone concerning medical issues because we were the health department lab, but as we became known as a tick testing center, people would come in and ask any one of us if such and such was a tick bite and an article of clothing would be removed.  While for a short time one of the technicians was an MD waiting for his internship, we mostly had to calmly and carefully explain that we were not doctors and they needed to put what ever they took off, back on.
While this was a bit humorous to us, we all took the time we had advising the public very seriously, they trusted us and with Lyme disease and other issues this was very serious.
We tried to follow the Centers for Disease Control's guidelines and we told the persons coming into the lab for advice exactly what was recommended.  This brought me into some conflict with the lab director since he felt I was giving out medical advice and challenging doctors who were not treating people who had obvious symptoms, including the bull's eye rash, but rather waiting for a blood test that was at best unreliable.  I had no problem with it, but both us agreed that there were real reasons for "chronic Lyme" that went beyond an infection.
I wanted an educational seminar to educate doctors, but that was not going to happen.
Rabies crossed the Hudson river and began killing the large, urban raccoon and skunk population.  Again, we were the primary source of current information for the public, doctors and veterinarians and our reputation grew.  The reduction of the raccoon population by 95% actually affected the water quality at the beaches, improving it because the storm drain system was where they lived. 
I wrote more informational papers.
Outside of the lab, I volunteered for a non profit organization, setting up a lab that could test for chlorophyll.  All I asked was that the data collected be shared and it was.
New organisms were being recommended as the indicators of polluted recreational water by the US EPA.  In previous years, I was looking for this new indicator organism (enterococcus) along with the previous one (fecal coliforms), well because.  I continued, trying to link old information with the new, but then I noticed something interesting.  Using fecal coliforms, I was never able to predict when they would be elevated.  Part of the reason is that in warm water, they would grow if there was algae around.  Now fecal coliforms and even E. coli  are  defined as being from warm blood mammals, but they exist just fine in a normal environment without any source.  In fact they live just fine in soil so not all of then affect health.  The enterococcus was a pathogen and more the levels would increase in the bathing waters after a heavy rain and then disappear after a day.  I did not know why the organisms seemed to dissipate after 24 hours, but with a lot of testing, the evidence was there. 
The health director embraced this and made it policy. 
I wrote a presentation which reached the ears of the State of Connecticut policy makers, who passed to on the US Environmental Protection agency, who passed it on to the US Geological Survey agency.

For Connecticut, the recommendation was for all coastal towns to find ways to enact this concept of preemptive closure based on the Stamford model.
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