A Trust Betrayed

by Mike Magner

  The cost of the survey would be $1.6 million in fiscal year 1998 and another $190,000 in fiscal year 1999, for a total of $1.79 million, Bashor told Munsell in his letter. He argued that under the Superfund law, the Defense Department was responsible for covering those costs.

  The Pentagon pushed back hard. Elsie Munsell sent back a terse rejection letter saying that “the volatile organic chemicals found in the water supply under investigation came from an off base source, ABC One Hour Cleaners. According to our investigation, this off site source of contamination is a National Priorities Listed Site under the jurisdiction of the EPA. Therefore, in accordance with CERCLA 107(a), it is more appropriate for you to seek funding for the study from the responsible party.”14

  In August 1997, Navy Environmental Health Center epidemiologist Jeffrey Hyman picked apart the ATSDR’s study proposal in a ten-page review. Hyman started out by citing weaknesses in the Woburn studies—the sample sizes were too small, there were other contaminants in the water besides TCE, and there were other risk factors that were not evaluated, such as a father working in an industry with chemical exposures or a mother who used alcohol during pregnancy. “Unfortunately, every problem that existed in Woburn and limited the conclusions . . . exists in at least as severe of a form in the Camp Lejeune population,” he said. Even if the ATSDR managed to contact 83 percent of the 12,000 families with children born at the base—“which seems virtually impossible,” Hyman noted—“this study would have (at best) no more power than the Woburn studies,” he wrote.15

  The Navy’s epidemiologist also argued that PCE, not TCE, was the major contaminant in the Tarawa Terrace water system, while the opposite was true at Woburn. Plus, Hyman said, there would be no way to determine through telephone interviews how much water people drank at Camp Lejeune; moreover, the rapid changes in the population at the base made the control group for the study suspect.

  “In summary, it is very difficult to see how, even if successfully completed, this study could contribute anything to our understanding of the relationship between VOCs and childhood leukemia,” Hyman wrote. The methodology, he said, was “extremely expensive, poorly thought out, has little chance of being successfully completed and providing useful information, and it lacks the detailed information that any competent funding agency would demand before considering it.”

  Hyman recommended small “pilot studies” to determine if there was a problem with childhood leukemia at Camp Lejeune. The names of children born at the base could be checked against cancer registries in states with high military populations, the records of military hospitals could be reviewed, and doctors who worked at Lejeune could be asked for their recollections about childhood cancer cases, he said. “These pilot studies would cost only a small fraction of the cost of the proposed ATSDR study,” Hyman said. And if they showed an excess of leukemia cases among children born at the base, “the Armed Forces Epidemiology Board should be asked to offer their opinion on the feasibility of conducting a large study in this population, given the known problems,” he said.

  The Navy not only refused to provide money for ATSDR studies in 1998 and 1999, but it also refused to help locate residents of Camp Lejeune who gave birth at the base between 1968 and 1985. An official of the Defense Manpower Data Center, which keeps records on past and present military personnel, told the health agency that providing information from its database would violate the federal Privacy Act.16

  Still, the ATSDR pressed forward, issuing a new report in August 1998 that verified its earlier statistics showing a significant association between exposure to contaminated water and adverse pregnancy outcomes, including low birth weights. The report said that birth certificates were studied for the children of 6,117 women who had drunk water tainted with PCE, for 31 women who had been exposed to TCE, and for 5,681 women who had been unexposed. Infants whose mothers had lived in housing with PCE in the water weighed an average of 24 grams (about o.8 ounces) less at birth than those whose mothers had lived in unexposed housing, the report said. And for mothers over age thirty-five and mothers who had previously experienced fetal deaths, the babies weighed an average of 205 grams (7.2 ounces) less. “Because associations in these subgroups were not anticipated, these results should be considered exploratory,” the ATSDR acknowledged. “They are, however, biologically plausible and deserving of followup.”17

  The agency made plans to begin the survey, using its own funds, at the beginning of 1999. But the launch was delayed, at least in part because of objections raised by the Marine Corps that it should not coincide with the December 1998 release of the movie A Civil Action, which was based on the childhood leukemia case in Woburn, Massachusetts. “Just a thought, with the movie coming out in Dec, can we delay the questionnaires until April/May time frame?” Camp Lejeune’s information officer, Neal Paul, wrote in an e-mail to the Marine Corps public affairs manager in Washington, Kelly Dreyer, on October 23, 1998. The military got its way—the ATSDR survey wasn’t mailed out until October 1999.18

  Dreyer insisted in an e-mail to the ATSDR in April 1999 that the Marine Corps supported the study of childhood diseases at Camp Lejeune, but restrictions in the Privacy Act prevented the release of information. Kathy Skipper of the ATSDR Office of Policy and External Affairs responded to Dreyer with a warning that the agency had received permission from the White House Office of Management and Budget to move ahead with the study whether the Navy cooperated or not. “We very much need to work out a way that this can happen,” Skipper told Dreyer. “With OMB approval a ‘done deal,’ this whole issue could prove very embarrassing and problematic for the Marine Corps if the public perception is that names aren’t provided or needed information isn’t being provided ‘proactively.’ As a former military [public affairs officer] and one married to a retired officer, I feel a strong allegiance to the military community and don’t want this thing to go in this direction.”

  Skipper added, “However, you need to know that full-page ads for the Federal and Navy Times, and other publications are being discussed. I think you and I both know how this would ‘play in Peoria’ not to mention inside the beltway. What can I do to help prevent this scenario from developing?”19

  Not much, apparently. It wasn’t until the fall of 2000, when the ATSDR made plans for a “national media blitz” to try to locate more families who had babies at Camp Lejeune, that the Defense Department agreed to help. The agency had done pretty well on its own, tracking down more than 6,000 families, but it needed twice that many to make it a valid survey. It would not look good for the military to be absent when federal health scientists issued a mass appeal for help locating former Marines.

  Finally, at a press conference on November 1, 2000, Colonel Michael Lehnert, head of the Marine Corps Facilities and Services Division, stood side by side with the ATSDR’s chief of epidemiology and surveillance, Wendy Kaye, inside the Pentagon. Lehnert said he was there to ask the media for help in reaching some 10,000 former residents at Camp Lejeune. “The people we are trying to locate are the parents of children born or conceived while living in base family housing at Camp Lejeune from 1968 through 1985, who may have been exposed to contaminants in the water supply,” he said, adding that the ATSDR was attempting to investigate “possible relationships” between exposure to contaminants and the health of the children.

  “For your background, we began testing the water systems at Camp Lejeune in the early 1980s, in compliance with federal guidelines,” Lehnert said. “The testing indicated we might have a quality concern with the water from both the Tarawa Terrace and the Hadnot Point water distribution systems. When we confirmed the contamination of the water, we took the necessary steps to close the wells and notified the appropriate authorities. News of the situation and what the Corps was doing to guarantee quality water for the residents was carried in the base paper and the local media.”20

  Lehnert added that some had questioned why the Marine Corps had waited until now—late 2000—to try to reach all the p
eople who might have been exposed over the past several decades.

  “That is a valid concern,” he said. “It would be virtually impossible for me or anyone else to go back and analyze the many decisions that were made with regard to this situation since 1985. What I can tell you is that I truly believe that the decisions that were made were based upon the best information science could provide at the time.”21

  8

  SLOW AWAKENING FOR THE VICTIMS

  That’s when I finally realized it wasn’t me.

  —LOUELLA HOLLIDAY, MOTHER OF BABY BORN AT CAMP LEJEUNE IN 1973

  The efforts of the Agency for Toxic Substances and Disease Registry to contact parents brought a grim awakening for some, and the hope of answers for many.

  Mike Gros had joined the Navy for one reason—he needed help paying for medical school. Little did he know when he made the decision in the early 1970s that it would doom him to a lifetime of medical trauma.1

  Growing up in San Antonio, Texas, in the 1950s and 1960s, Gros knew he wanted to become a doctor, possibly a psychiatrist, but he was good with his hands so he ultimately decided he should do something involving surgery. His family was not wealthy, so he worked his way through Trinity University in his hometown, living with his parents to save on room and board. He then signed up for a health professions scholarship in which the Navy would pay for medical school on a one-for-one basis—for each year of school, the student would owe a year of active duty.

  While earning his MD at Baylor College of Medicine in Houston, Gros met his future wife, Janie, then a part-time secretary in the psychiatry department at Methodist Hospital. They were married the week after he graduated from Baylor and spent their honeymoon driving through Virginia to the Naval Medical Center in Portsmouth, where he would do his internship and residency in the obstetrics and gynecology department.

  When it came time to pick a duty station in 1980, Gros, who had a one-year-old son by that time, decided to ask for a family-friendly location on the mainland, thinking this preferable to one of the overseas bases, where security and safety issues always lurked in the background. He also knew some of the Ob/Gyn staff at the Camp Lejeune hospital from his time in Portsmouth, so he put the North Carolina base at the top of his Navy “dream sheet.” His request was granted, and he and his wife and son, Andy, moved to the base in July 1980.

  Life seemed good in the comfortable officers’ quarters on Hospital Point, overlooking a marina in the New River. At no time, Gros said, did he or his wife suspect that anything was wrong with the water provided by the Hadnot Point treatment plant, even though tests conducted the year they arrived showed a heavy presence of solvents in wells serving that water system. “There were no taste or smell abnormalities,” he said later. “That’s the sinister side to this—a million people would never know they were drinking contaminated water.” Gros had an especially high exposure level. As a hospital physician, he was scrubbing his hands in hot water from Hadnot Point many times each day. Studies show that solvents like TCE evaporate rapidly in hot water, and those who breathe the steam get a dose of chemicals five times more potent than if they drank it, Gros said.

  In July 1983, after three years at Lejeune, the Gros family—now with two young boys—moved off the base to Chapel Hill, North Carolina, where Mike started a hospital fellowship at the invitation of a doctor there who had trained some of the residents at Camp Lejeune. But it wasn’t long before he and Janie were headed back to Texas, where they always knew they would settle down. Mike set up his own Ob/Gyn practice in the Cy-Fair area of Houston, with Janie as his office manager, and eventually he joined with three other obstetricians in a partnership that lasted twenty years, he said. “It made life enjoyable not to be on call all the time,” he said.

  In 1997, Gros decided he was overdue for a checkup. “I felt fine but hadn’t done one in a long time, so I went in for full blood work and a urine test.” The results were startling. His white blood cell count showed a deficiency of the granular lymphocytes that gobble up bacteria and too many of the kind of lymphocytes that aren’t needed as much. “I was flipped,” Gros said. “I repeated the test in a month and found the same thing.” Gros took his slides to a pathologist, who looked them over and immediately suggested a visit to an oncologist—it appeared to be a form of leukemia. A doctor at Baylor confirmed the worst: Gros most likely had B-cell chronic leukemia.

  “He gave me all the stats, and said there was no chemotherapy for it,” Gros said. “He basically gave me a fifteen-year life span. It was hard to digest. A transplant would have been an option, if we had a bone-marrow donor.”

  Devastated, Gros shared the diagnosis with his family, and none of them could believe what they were hearing. There was no history of cancer in their family, and Gros himself seemed as healthy as ever. About a week later, Gros sought some respite on the golf course. But during the round he got a call from the Baylor doctor, who apologized for a mistake in reading his slides. “It turned out it was not B-cell, it was T-cell, and it’s worse,” Gros said. “You die soon. It could be tomorrow.”

  Gros and his wife sought a consultation at the Mayo Clinic, where they met with an oncologist who confirmed the diagnosis of T-cell leukemia. The only possible treatment, the doctor said, would be a bone marrow transplant. Gros then decided that since he had one of the best cancer hospitals in the world in his own backyard—the MD Anderson Cancer Center at the University of Texas in Houston—he should go there. The head of the cancer center’s Department of Stem Cell Transplantation and Cellular Biology, Dr. Richard Champlin, who had volunteered to assist victims of the Chernobyl nuclear disaster in Ukraine in 1986, was considered one of the best in his field.

  Champlin and Dr. Michael Keating, a well-known specialist in leukemia, took on the case together. First they tried treating Gros with two types of drugs: interferon, which has side effects such as extreme drowsiness, and psoralen, which has a one-year regimen that involves the use of ultraviolet radiation. Neither of these drugs worked, however, and Gros was out of options. Champlin and Keating told Gros they needed to monitor his condition closely and would let him know when the time came for a bone marrow transplant.

  Two years into the waiting period, in November 1999, Gros was working in his office when his secretary said someone from the CDC in Atlanta wanted to talk to him. Gros assumed he was being contacted about some emerging threat to public health. In a way, he was right, but it was a threat that had emerged years ago, when Gros was stationed at Camp Lejeune from 1980 to 1983.

  The caller said the Agency for Toxic Substances and Disease Registry had recently discovered that some of the drinking water at the military base was poisoned during the time he was there. Gros said he knew immediately why he was ill. But rather than ask him about his health, the ATSDR representative started asking questions about his youngest son, Tom, who had been conceived and born at Camp Lejeune. Gros said that Tom was fine, thank you, “but let me tell you about me!” The response was that there was no indication that adults had been affected by the water contamination. “Are you serious?” Gros said he replied.

  It didn’t take long for Gros to confirm his suspicion that his leukemia was very likely caused by poisoned water at the Marine Corps base. The ATSDR’s Public Health Assessment, published in 1997—the year Gros had been diagnosed—stated that people there were exposed to volatile organic compounds including TCE and PCE, possibly for as long as thirty years before the contaminated wells were shut down in 1985. Scores of studies available online linked both chemicals to cancer, including leukemia, with an incubation time of about ten years between exposure and effects. For Gros, it was twelve years. “It’s well proven now,” he said more than fifteen years after his diagnosis.

  The doctor was grateful, at least, that neither of his boys or his wife appeared to have been harmed even though they had been exposed to the same pollution. “Each person has different genetic coding and some are affected, others not,” Gros said. “Some are resistant, some
not.”

  In the spring of 2002, Gros was advised that he needed to prepare for a bone marrow transplant. His son Tom turned out to be almost a perfect match, and he agreed to take a break from his studies at Texas A&M University to be his father’s donor. The procedure, in which marrow from both of Tom’s hip bones was transplanted into his father, was done in May 2002. Mike Gros was fifty years old and praying for a new lease on life.

  Around the same time that Gros was battling leukemia in Texas, three daughters of Joan and Eddie Lewis, who had lived at Camp Lejeune as babies or toddlers in the late 1960s, were having serious and unusual health problems, too. Now adults in North Carolina, the sisters had spent the years from 1966 to 1970 in three different homes in the Tarawa Terrace area while Eddie was doing two tours of duty in Vietnam. Those years were marked by frequent visits to the clinic for respiratory issues among the girls, but nothing as serious as what they would experience several decades later. One would have a baseball-sized uterine tumor discovered as she was delivering a baby girl; another underwent emergency surgery to remove more than a dozen noncancerous tumors from her uterus; and another would have half her lung removed because of a rare illness. And their younger brother, who had been born with two vertebrae fused together a year after his mother left Camp Lejeune, had been living for years with chronic back pain and headaches. In 2000—three years after the ATSDR report was completed—Joan Lewis read a newspaper article about the water contamination at Camp Lejeune extending over several decades, including the years her family lived there. She went online and requested information from the ATSDR, only to find when the packet arrived that every one of her children had experienced one or two of the symptoms listed as possible effects from the contaminants. Now convinced there was a connection between the water at Camp Lejeune and her family’s array of health problems, Joan Lewis filed a claim for compensation with the Marine Corps in 2001. In 2013, she was still waiting for a response.2