Re: Re[2]: NIH Incident

[BFLOOD@SLAC.Stanford.EDU (Bob Flood)]

Since I am not an MD, I haven't seen the term 'brain disease' used to
describe the collection of symptoms we seem to agree are anxiety related,
but I see how that term is medically correct. My point, however, was
intended to be that the news reports (I have read many of the them) convey
the basic events of the incident and quotes from the victim claiming these
symptoms arising from her radiation exposure. An uneducated public is
hearing that radiation causes sleeplessness, loss of appetite, etc. Some (in
casual conversations) have doubted the symptoms, but I see no reason for
that. It is reasonable to understand how fear of radiation, so common in
this country, can lead a pregnant woman to heightened anxiety for herself
and her child. It is also reasonable to understand how the fear may have
been caused by strong reaction of management and health physics staff to the
incident, where that strong reaction was to the fact that the incident
occurred and its associated loss of program control, but may have been
perceived by her as their reaction to severe health consequences. I offer
these as scenarios because I have seen them happen.

Also, I must reiterate my point about the victim's perspective as a woman.
As a male, I will never expereince this perspective and can only speculate
about it. But, in my opinion, the fact of her pregnancy must bear directly
on her response to a threat to her health and also a threat to her unborn
child's health. The strength of the that reaction is something I cannot
judge, but it is entirely possible that the symptoms may not have occured at
all or may have been substantially less severe if she was not pregnant, not
because of any biological effect of pregnancy, but due to the absence of
immediate fear for a child's health.

As an aside, how unfortunate would it be the press to obtain and publish a
medically correct opinion that the woman suffers from a brain disorder (the
collection of symptoms we've been discussing)? This country has an
embarassing history of failing to understand or accept people with
brain/emotional/mental disorders, and tends to lump them all into the same
definition (shame on us).


>If you can not sleep, you can not eat, you can not think the things you
>want to think or need to think in order to adapt and function, i.e., if you
>suddenly can no longer live the kind of mental life you ordinarily do and
>want to, then you have signs and symptoms of a brain disorder.  Period.
>It does not matter whether there is a "good" reason or not.  It does not
>matter if there has been a real trauma that would produce distress in any
>healthy person.  When the distress takes on a life of its own that prevents
>you from living yours, i.e., keeps you from coping effectively with the
>distressor, it is appropriately classified as a disease state. The
>individual in distress becomes deserving of treatment.  And people taking a
>history from the distressed individual need to corroborate the facts they
>are told by the victim of the disease.
>
>Again, the original request was for facts that have been independently
>verified by emotionally uninvolved investigators, as opposed to relying on
>the testimony of a tearful person on TV with obvious manifestations of
>brain dysfunction.  No specific diagnosis was ever suggested.  My free
>advice would be to refrain from making a specific diagnosis unless you are
>getting paid at least $300 an hour for it, but, my advice might in this
>regard may also be worth what you paid for it.
>
>The interest in the case is not purely purrulent.  The victim is not
>actually the issue at all.  The policies that will be elaborated as a
>result are the problem.  The regulations that the TV reporter implied are
>needed to prevent an incident like this from occuring in the future were
>horrifying.  Those I would almost be willing to diagnose as "hysterical" if
>it were not for the archaism and political incorrectness of the label.
>
>Mozley
>
>
>>     The symptoms are consistent with "panic" or anxiety attacks. I am not
>>     sure whether they can be construed to be "brain disease." They are
>>     manifested in a person who has suffered trauma or extreme
>>     psychological stress. I am also not sure whether a person who is
>>     stressed out can be diagnosed as having "brain disease." We all suffer
>>     some form of stress that is manifested in many different ways. This
>>     person is stressed out for very good reason. Whether or not the
>>     radiation exposure has the potential to affect her fetus is not the
>>     important issue here. The important factor is that she "believes and
>>     perceives " that to be the case and is understandably very stressed
>>     out. I would suppose her husband might feel the same, and may even
>>     demonstrate the same traits as she does. I would not consider him to
>>     have a "brain disease" either.
>>
>>     Sandy Perle
>>     Supervisor Health Physics
>>     Florida Power and Light Company
>>
>>     (407) 694-4219  office
>>     (407) 694-3706  fax
>>
>>     sandy_perle@email.fpl.com
>>
>>
>>______________________________ Reply Separator
>>_________________________________
>>Subject: Re: NIH Incident
>>Author:  radsafe@romulus.ehs.uiuc.edu at Internet-Mail
>>Date:    10/13/95 8:29 AM
>>
>>
>>The doctor does not have to be suffering from a case of venereal disease to
>>diagnose and treat it.  The issue has not been why pathological anxiety and
>>other symptoms of brain dysfunction were so palpable on the headline news
>>(CNN).  The questions in this forum have been related to how much of the
>>story this person has told have been verified.  If there were other
>>questions to be asked regarding the affected individual, they would most
>>appropriately address what to do about the brain dysfunction.  The surgeon
>>does not ask why the bullet is in the chest.  It is only important which
>>operation will be performed to deal with it.  Similarly, this person states
>>she can not sleep, has no appetite, is weepy all the time, can't
>>concentrate, can't stop obsessing over the incident, etc.  These are not
>>problems unique to womanhood.  This is a constellation of symptoms
>>manifesting brain disease, pure and (not so) simple.
>>
>>Mozley
>>
>>
>>>I have been reading with interest the comments about the contamination
>>>victim's anxiety. Let me point out that, while we may regard the quantity of
>>>P-32 and its dose implications as medically insignificant and see the
>>>'deliberate' nature of the incident and the loss of control of regulated
>>>material as the salient features, none of us males in the discussion will
>>>ever have any idea what it is like to be pregnant, let alone pregnant and
>>>exposed to a potentially harmful substance, and are, therefore, uniquely
>>>unqualified to judge whether she should be fearful in this situation. (It is
>>>my personal obeservation that the majority of comments have been from male
>>>Radsafers.) It is not difficult to understand how Dr. Ma might find reason
>>>to be anxious about her health and that of her unborn child, even though our
>>>profession's best estimate is that no observable harm should be expected.
>>>The fact that she is an educated woman doesn't mean that her education
>>>included health physics; she may have received most of education about
>>>radiation from the same place as the rest of America: a popular press
>>>educated in science by Beekman's World. Alternatively, her education may be
>>>sufficient to understand how little we know about internal dosimetry for the
>>>fetus. While we may see her fear as unnecessary, her fear is still very real
>>>to her.
>>>
>>>It has been my experience that internal exposure incidents in the workplace
>>>generally involve small amounts of radioactive material and inconsequential
>>>doses, but the unusual nature of the contamination event triggers a strong
>>>response from management and the radiation protection staff. The victim
>>>usually doesn't understand that the staff's reaction is to the unusual
>>>incident, not the magnitude of the doses involved. Thus, the HP staff
>>>reaction can inadvertently create the anxiety in the victim concerning dose
>>>that we see as unwarranted. My question is: has the hoopla (NIH
>>>investigation, all the bioassay, NRC investigation, FBI investigation, press
>>>attention) created a sense of alarm that didn't need to exist? How can we
>>>deal effectively with investigating the events of the incident without
>>>upsetting the participants in the incident?
>>>
>>>Bob Flood
>>>Unless otherwise noted, all opinions are mine alone.
>>>(415) 926-3793
>>>bflood@slac.stanford.edu
>
>
>
Bob Flood
Unless otherwise noted, all opinions are mine alone.
(415) 926-3793
bflood@slac.stanford.edu