In the classic film “Casablanca,” Capt. Renault (played by Claude Rains) asks self-described saloonkeeper Humphrey Bogart, “What in heaven’s name brought you to Casablanca?” Bogart’s answer is, “My health. I came here for the waters.” The Captain looks puzzled. “The waters? What waters? We’re in the desert.” Bogart shrugs. “I was misinformed.”
Each year as many as 98,000 Americans die because of medical errors by trained health care professionals. Surprisingly, this number is greater than the numbers who die every year from highway accidents, breast cancer or AIDS. No one will ever know how many die because of errors by nonprofessionals, including well intentioned but uninformed bureaucrats.
Following scant public discussion about options or effects on humans or pets, Croton residents are discovering that the composition of their water may soon be altered with additives. But what if the assurances of product safety offered to the mayor and trustees by additive proponents turn out to be wrong? Given the failure to investigate potential dangers and alternative courses of action, a reasonable person might ask: Which of you who are about to vote on the upcoming resolution is satisfied that the issues have all been thoroughly explored?
Let me stipulate that I believe Mayor Schmidt and the four trustees who will be voting Monday evening are sincere in their desire to do what is right. But what if they are wrong in accepting the assurances of the people who are trying to sell this additive program to the village? Other communities have taken the same advice, they argue. Should that alone sway Croton’s decision? New York City’s water is drawn from the Catskills, but it is so pure the state does not require it to be filtered. Neither does Croton’s water require filtration. The city does not add zinc orthophosphate to its water.
Mayor Schmidt is a licensed health professional. As a Doctor of Chiropractic, he is required to have detailed knowledge of human anatomy and particularly of the skeletal and nervous systems. I cannot imagine him making a diagnosis based on evidence as sketchy and anecdotal as that offered in support of this additive proposal. The four trustees include a steamfitter, a former IBM employee, a railroad executive, and a housewife-author and mother of four young children. None has any specialized knowledge in the areas of water chemistry or health. Will their consciences be clear if they vote to move ahead in the face of skimpy, incomplete research?
Let’s examine what’s at stake: Croton’s water is free of lead and copper as it comes from the village’s wells. It picks up neither substance in its passage through village pipes. To solve a problem of rusty water caused by faulty system design, and to counter whatever lead and copper it may pick up in some older homes, a contractor proposes to inject additives into Croton’s water supply at the well head.
Lead and copper in a household’s water pose no health threat when it’s used for flushing a toilet, bathing, showering, doing the laundry or watering the lawn. Whether washing the kitchen floor, the dog, the family car or one’s hair, trace amounts of these metals do no harm. So, why not remove potentially harmful substances like these with a filter at the point where water for drinking and cooking are drawn—the kitchen sink?
Without testing, how can we know whether lead and copper are even present in any household’s water supply? From a scientific point of view, the first action should be to test each household’s water for these substances. Testing would provide a useful statistic about current hazards, if any, and a base level for the future. The health of Croton’s residents should be more important than the lifespan of its water pipes. Why are we talking about additives even before the levels of lead and copper contamination are known? Without these data, why should residents be forced to consume a chemical added to village water principally for the benefit of the village’s obsolete water system? In a very real sense, the proposed solution can best be described as overkill.
A similar situation exists now in the food chain, one that is coming back to haunt us. Cows, pigs and poultry are routinely given synthetic hormones. This causes them to put on weight more rapidly and enables them to be brought to market sooner, thus increasing profits. Medical science now sees evidence that these substances are having an undesirable effect on humans who regularly ingest hormone-laden meat. Consequently, many now buy beef, pork and chicken free of foreign substances or become vegetarians. Will the additives to our water have a similar cumulative effect?
If additives should be injected into Croton’s water, what can residents do to avoid drinking it—other than buying bottled water or moving elsewhere? And what will the mayor and trustees say to residents who may suffer undesirable effects from the additives? Perhaps something like, “Sorry, folks, we failed you. We simply did not do our homework.”
For an example of a bureaucratic health snafu on a grand scale, allow me to turn back the pages of history to a cold February day in 1976 at Fort Dix, N.J. A soldier undergoing basic training there went on sick call. He told an Army doctor that he felt tired, weak and run-down. The next day he was dead. Four fellow recruits were also hospitalized with the same symptoms. Two weeks later, public health officials in Washington made a guarded announcement that swine flu had caused his death.
Recalling that in 1918 a swine flu pandemic had killed millions around the world, the government panicked. To head off a major catastrophe, health officials urged that the country’s entire population be vaccinated against the disease. Convinced of the threat, President Gerald Ford authorized a crash program to create enough vaccine, 200 million doses, to vaccinate every person in the United States in time for the next flu season.
Hampered by bureaucratic errors and miscalculations, the massive vaccine program got off to a late start. Instead of the expected two doses of vaccine from each egg, the yield was only one. Manufacturers scurried to increase production. Even more disturbing, an important antibody needed in the vaccine failed to result from the manufacturing process. With the entire program in disarray, the government abruptly abandoned it after only 24 percent of the population had been vaccinated. Swine flu never made an appearance—but the usual Hong Kong strain of influenza did emerge and could not be countered because the vaccine to combat it had been mixed with the swine flu vaccine. It marked a fitting finish to a veritable comedy of errors.
Only it wasn’t the end, and it wasn’t funny. Although administered to less than a quarter of the population, the swine flu vaccine triggered about 500 cases of Guillain-Barré Syndrome. A rare paralytic disease similar to polio, GBS has a 5% fatality rate caused by secondary pneumonia. It turned out that more people died from the vaccine than died from swine flu itself. The government accepted liability for the botched program and spent millions settling negligence suits. History fails to record whether the health professionals responsible for the vaccine fiasco ever acknowledged that their blunders had caused the illness or death of these victims.
Verily, those who cannot learn from the lessons of history are doomed to repeat them.
— Robert Scott