Wednesday, July 2, 2014

Changes

At the end of July in 1986 after six and one half years of being there, the health director died suddenly.  Dr. Gofstein was brilliant, speaking 6 dialects of Chinese just so he could communicate with the owners of Chinese restaurants about food safety.  He was the one who applied for the grants and on his desk were incomplete applications for a large number of them.  He did not share much with any one; he did most of the work that directed the path the health department took.  He had taken findings from our lab, most of it my own work and initiated a lawsuit against the privately owned water company in Stamford to force them to put ultra fine filters on the water coming out of the reservoir.  His budget proposals were always an honest assessment of the health department's needs.  The governing boards did not believe him because everyone padded the budgets.
He had a temper, but was just.  He had more compassion for the people of Stamford than I think anyone realized.  He was a tough man and now he was gone.
For a time, the director of Environmental Health took over as interim director.
I did not like her personally, but she supported the lab in very, very strong ways.
The interim director gave us the one computer in the health department and I immediately began using it to generate lab reports.  This did not save the data in a way that could be used, but money came from the forensic account and my very rusty skills with computers came to life.
Though the first machine was an Apple, the next were PC's and again with moneys from the forensic account we purchased a DOS based database.
This was extremely important to me because as we were analyzing more samples from the general public, I was seeing a pattern.  To quantify that pattern would take more computational skill than my little programmable Texas Instrument calculator could give me.
We were able to hire a clerk/typist, previously we had to type everything by hand or write it on a form.  The clerk was hired using the forensic money and she was very, very good.  She and I became life long friends.
A new mayor, who wanted to consolidate all the separated pieces of city government into one new building had to be convinced that the lab should be moved.  The interim director did that.
We moved into a new laboratory on the eighth floor of this new government center.  The lab was spacious, but the building was not designed to have a lab with smells and odors.  There was no ventilation.
A new director came and there were new challenges and opportunities.

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 departments and there was evening work because of it.
I also used our own database to understand what was happening with well water, what were issues, 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 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 it 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, and 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 persons 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.
Somewhere in this series of events, I became disliked by the one IT person the city employed for I used my skills and built a LAN system in the lab, connecting all three of our computers and I did this before anyone else was "networked" and with out the IT person's help.  Later, before the one person was replaced by a dozen, he refused to allow the lab into the city network.  The others who replaced him had no such issues and treated me as a power user with a lot of latitude.
Some times doing what was right, got me into trouble.  I tried to do hat was right anyway.
At this point the lab workers were paid significantly less than the Environmental Health personnel with a "RS" behind their 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 whatever 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 were algae in the water, and there always were.  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, which passed it on to the US Geological Survey agency.
For Connecticut, the state recommended all coastal towns to find ways to enact the concept of preemptive closure based on the Stamford model.

On the Top

My reputation was growing, things were happening and it seemed as if I was being pulled in all directions, but unknown samples would come to the lab and all the curiosity that I had would be applied.  Taking something apart to find out what it might mean was at my core.
Such it was when white Styrofoam like material washed up at the beaches.  There was no information on what they might be, but when they showed up, the bacteria levels in the water would increase dramatically.
Viewing them microscopically, they look like something made of a melted wax; they had a briny sewage type odor so I took them apart.  First checking for bacteria, I found all the indicator organisms for sewage in large quantities. I used one of the machines purchased for forensic analysis and found it to be an oleic acid or a kind of cooking oil.  We reported this as sewage grease and these dirty white Styrofoam-like objects became known as "floatables", something the health director would use when talking about a beach closure.  He was laughed at professionally when he would present the issue at conferences.  I brought a sample to a conference of State and Federal officials with my findings and no one laughed any more.
A reported sewage spill had me working with a person from one of the non-profit environmental groups who had been very involved in water quality and sewage in her own country.  She taught me a great deal about organisms which would eat the bacteria from sewage and were, in her country and much of the rest of the world, true indicators of sewage contamination.  For me, I had found a reason that the bacteria that was present after a heavy rain, vanished in 24 hours.  It was eaten.
As my reputation grew, people from other states, would bring me water to test, then two persons, who lived in Stamford, but had connections in other countries, brought me water for bacterial testing.  We had strict guidelines on how to bring the water; it had to be kept cold, almost freezing, it had to be brought to the lab within 24 hours of collection and it could not be brought in on a Friday, because the test took 24 hours to complete.  One sample came from Greece, the other from Antigua, both met our guidelines and were tested, but it felt strange to be so trusted, I was honored.
I became certified by the Drug Enforcement Administration as a forensic chemist during this busy time and even testified in court once or twice, my boss testified most of the time.
With so much going on in what was my area of expertise, the lab was becoming busier in other areas where I also became involved in. 
The first was screening for blood lead and while we had been screening using several indirect methods, now we were collecting blood for lead testing directly.  We could not analyze them in our lab so they were sent to the state.  Elevated levels in the screening using a finger stick were followed with venous samples and those still elevated were followed up by a housing inspector checking for lead where the child lived and were followed by the lab until things either improved or became worse, in which case they were sent to the hospital.  One lab technician performed most of this.  We began to go out into the neighborhoods and do mass screening and at the peak of our screening, we tested over 5000 children.  Where did I fit in?  I learned to perform finger sticks and went out with the other lab person collecting blood; I created a database so we could track children and the multiple places they lived and results of their blood tests.  It was difficult, but rewarding work and the other lab person impressed me with her commitment to help children.
As the health department became more active with the lead issue, the number of elevated lead levels dropped significantly from a high of almost 25% of children tested having elevated leads to less than 0.05% in five years.  I presented this at a national environmental conference, but more importantly, we were having a tremendous impact on children's lives.
The person who did most of the clinical testing retired and a series of other persons came and left, not because they did not like the job, but because they were on the track to become medical doctors and we were just a short stop along the way.
Data, data and more data with all of this information, I became very aware that it was very easy to manipulate it to ones own ideas, if one started with an agenda.  So I became very suspicious of any claim by any organization that claimed they had found evidence for their own cause.  I found this with the studies concerning Long Island Sound and hypoxia (low dissolved oxygen in the water), while the EPA and other private environmental groups were proclaiming nitrogen as the great evil, creating algae blooms which in turn created hypoxia, I could not find the evidence in the samples brought to me and worse, I saw contradictions in the data presented by the US EPA claiming to support such things.  There was a joke that used statistics to prove speaking English caused heart disease.  While this was a joke, it showed just how manipulative statistics could be.

My curiosity needed to approach everything I tested with an open mind and that brought me to first conflict I had with the health director.

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