Preface
At 10 o'clock on
Sunday morning July 2, 1995, sitting comfortably in my study
preparing to do some work on a biostatistics assignment, a sharp
metallic, acidic taste suddenly emerged on my tongue and on
the roof of my mouth. It was a sensation I had never felt before.
Within less than six months I would be diagnosed with a toxicant
induced chemical sensitivity disorder and my 52 year old life
would be dramatically changed in ways I would never have guessed.
I would find it virtually impossible to be in any of the carpeted
rooms at the college where I am a professor (and almost all
the college rooms were carpeted), my marriage would end, I would
have to find a chemically safer place to live, I would be unable
to get into my vehicle without becoming sick, I could not go
out to restaurants, theaters, and many stores because they made
me ill, I would not be able to go to church because of the chemicals
in artificial fragrances that people wore, and I would sometimes
find it almost impossible to be around even my own grown children
because of a hypersensitivity to some of the chemicals in their
homes and on their clothing.
Before this diagnosis
I had been an almost perfectly healthy man in his prime years,
who exercised and ran at least two miles every day (sometimes
five miles or more), who had virtually no medical complaints,
who loved his work teaching philosophy and who was considered
quite good at it, who loved his family deeply, who enjoyed several
hobbies, who was completing the writing of two books, and whose
life was generally rather good.
In fact, at the age
of 51, I had decided that I wanted to go back to graduate school
and earn another postgraduate degree, this time a master's in
public health (MPH). My degrees in philosophy had been earned
25 years earlier, and I was now eagerly anticipating the challenge
of taking on an entirely new enterprise to complement my teaching
and writing. In addition to teaching regular philosophy courses,
I had been teaching courses in medical ethics and HIV/AIDS for
approximately ten years and was enjoying it. It seemed like
a good idea to earn a degree in public health, and it also seemed
like it would be great fun. I applied to the University of Washington
School of Public Health and was accepted.
Classes for the MPH
started in mid-June 1995, just two weeks before the metallic
taste began. I was enjoying the classes thoroughly, although
they were challenging, and I liked my classmates a lot. I was
relishing the experience of being a student again, and having
fun working with peers to understand new concepts and to complete
challenging homework assignments.
That Sunday morning,
July 2, my wife was gone for a few days of traveling with friends,
and I was cherishing the peace. I had just settled in, with
a mug of hot coffee in one hand, my feet up on the desk, and
a heavy textbook in my lap, to do some homework for the biostatistics
and epidemiology courses we were all working through that summer.
The unusual metallic
taste was sharp enough to be not only distinctive, but also
immensely distracting. It was difficult to concentrate on the
biostatistics assignment without wondering about what was going
on in my body that would cause such an odd taste. "I wonder
if it's the coffee," I thought. "Something foul about
this particular cup." So I went out to the kitchen and
made another mug, adding just the right amount of creamer and
my usual two tablets of NutraSweet.'
After several hours
of personal observation and experimentation, I discovered that
the taste did not seem to be related to the coffee at all. Nor
could I make it go away even when I went outside and sat on
the front porch. It seemed to come and go on its own whim, regardless
of where I was or what I was doing.
The next day in epidemiology
class, I asked a few MD friends if they knew what might cause
a metallic taste like that. Had I changed my diet lately, they
asked. I had not. Was I on any medications? No. Well, it's probably
nothing, they said. Wait for a few days, and it will probably
go away on its own.
Unfortunately the
taste did not go away. I could not make it go away. I was also,
I now noticed, often feeling dizzy in the mornings after taking
a shower. Sinuses and nasal passages were closing up during
the shower, and just being in our bedroom for any length of
time made my nasal passages close up so severely that I literally
could not breathe through my nose at all.
During the next weeks,
as the taste continued to come and go, I noticed a variety of
other symptoms, particularly while in the classroom building
where the MPH classes were being held; symptoms such as slight
nausea, mental confusion, difficulty concentrating, an odd raspiness
in my voice that sometimes led to coughing and choking, and
occasionally sudden great fatigue. I eventually made an appointment
with my regular family physician. She also seemed puzzled, though
not terribly concerned. She ordered some routine blood work
and, when the results came back a week later, all the tests
seemed to be within normal limits. I eventually saw another
physician in my HMO who specialized in occupational medicine
and she too declared that nothing was discernibly wrong.
Over the next weeks
I explored a variety of different hypotheses to explain what
was happening to my body, one of which was that I had perhaps
developed some kind of allergy. Allergy tests all proved negative,
however. I eventually visited a physician who specializes in
environmental medicine. After taking a thorough medical history,
doing an examination of recent blood work, asking about what
symptoms I generally experienced in relation to various exposures,
and recommending more lab tests, he eventually diagnosed me
with multiple chemical sensitivity (MCS), probably developed
as a result of chemical injury.
As a diagnosis, MCS
is considered somewhat controversial among conventional medical
practitioners. However, since these physicians as a rule have
received no medical training in low dose toxicant induced pathologies,
either while in medical school or in postgraduate education,
it is not surprising that they would find the diagnosis to be
outside the limits of their expertise.
This, as societies
will soon realize, is a significant weakness in medical training
that sorely needs to be remedied. As the number of people suffering
from toxicant induced pathologies continues to grow with each
passing year, and as their impact on society begins to take
an increasingly serious toll, it will become more and more important
that our physicians be trained to recognize and treat such conditions.
This book examines
some of the ethical issues associated with the increasing emergence
of low dose toxicant induced illnesses.
I have written two
other books on ethical issues in public health, but this one
is different. In each of those I took great pains to argue both
sides of the relevant issues, to explain the thinking on both
sides, and to show the legitimate tensions between the two opposing
positions.
This book is different
from those in that it takes a clear position and argues for
it. The position taken is this: today's public policy regarding
the manufacture, marketing and use of toxics is inadequate.
It fails to adequately protect the health of the world's citizens.
Significant changes need to be made, and in Chapter Three I
recommend several.
I am entirely aware
that there is another side to this question: namely, that position
represented by the chemical manufacturing corporations and by
the recent crop of optimists who claim that today's environmental
policies are entirely adequate to protect the environment and
public health. I believe their position to be mistaken, and
much of this book explains why.
The book is arranged
(after the Introduction) in four chapters which have a logical
progression. It argues that, given certain facts, about toxicant
induced illnesses (Chapter One, Data), and given certain ethical
principles (Chapter Two, Principles), some definite changes
will need to be made (Chapter Three, Modest Proposals), despite
some serious obstacles and challenges (Chapter Four, Brick Walls).
The recommended changes are momentous, and the challenges heroic.
But, as we will soon see, they must be faced if we hope to avoid
some very serious threats to our physical health, to our mental
capacities, and to the future well-being of our children, our
grandchildren, and the generations to come.
Environmentally
Induced Illnesses:
Ethics, Risk Assessment and Human Rights
Thomas Kerns
McFarland & Company, Inc., Publishers
ISBN: 0-7864-0827-8
304pp $39.95
2001
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