Monday, November 21, 2011

Honoring Admiral Elmo Zumwalt and Remembering the Service Connected Asbestos-Induced Mesothelioma That Killed Him

[Bath, Maine]  Mesothelioma, as we know, does not respect fame, fortune, fitness, beauty or power.  It has taken down movie stars (Steve McQueen), athletes (Merlin Olsen), artists (Warren Zevon), politicians (Bruce Vento), and warriors, such as Admiral Elmo Zumwalt.

Back in the late 1990s, when I helped launch the first-ever meso medical research  foundation (MARF),  Congressman Bruce Vento had just been diagnosed. Although his plate was full, and understandably he was reluctant to let the asbestos cancer shape his legacy, he agreed to serve on MARF’s board of directors.  Vento was exposed to asbestos while working construction jobs earlier in his career.

About the same time, Admiral Zumwalt, who served as the Chief Naval Officer from 1970 to 1974, was also diagnosed, and soon after he passed away. Admiral Zumwalt was exposed to asbestos while serving his country on Navy ships. His mesothelioma was truly a “war-related disease.”

I was privileged to meet Congressman Vento, but I never met Admiral Zumwalt. We reached out to the Admiral’s children at the time his condition was made public to ask whether they would be interested in by serving on MARF’s Board. Mouzetta Zumwalt-Weathers agreed.

Branding Meso as a War-Related Disease

In the early days, Mouzetta helped MARF shape it’s research and advocacy agenda. This included the effort to re-define mesothelioma as a “service connected disability” for thousands of asbestos-exposed US Navy Veterans. We hoped the “rebranding” would help persuade Congress and the DOD, in particular, to establish an asbestos cancer research program, much in the same way as it did for Agent Orange injured veterans.

In the early 2000s, there was also an effort in Washington, D.C., led by Senator Patty Murray, to ban asbestos.  It was during this mission that I had the honor of meeting retired Lt. Colonel Jim Zumwalt (USMC).  Jim gave a passionate speech on the day the bill to ban asbestos was announced, a speech laced with history, poetry, and the call to duty. 

Jim Zumwalt became my hero of sorts.  Like his father, who was not afraid to shake things up in the pursuit of progress, Jim expressed indignant disbelief that despite knowing about asbestos diseases since the early 1900s, and despite the thousands of warriors and civilians whose lives were cut short by asbestos, the US Government had yet to ban the evil carcinogen.

I'd Share A Fox Hole with this Guy

Jim and Mouzetta Zumwalt
I was at once struck by Jim’s palpable strength, his charismatic leadership and his Homeric honor. I remember thinking at the time that if I was ever thrown into combat I’d like this guy in my fox hole.  Over the ensuing years, we exchanged e-mails and I always looked forward to reading his columns.  Not only is Jim an amazing orator, the former Marine is an author and  journalist who writes muscular and cliché-free columns about some of the unsung yet dire threats facing our national security. 

So a few months ago, when Jim invited me to join his family in the “laying of the keel” ceremony for a new class of destroyers named after his father, I lept at the opportunity. I’m certainly not a student of naval warfare. I don't invest in companies who profit handsomely from the military industrial complex. I don’t hob knob with politicians. And Bath, Maine was 3000 miles from home.  But both Jim and Mouzetta had volunteered their time and energy to help causes that were near and dear to me, so I felt like it was the least that I could do.

Meso: In Search of a Poster Boy

And, on some level, as an asbestos research advocate, I was curious about whether anyone would mention Admiral Zumwalt’s cause of death. It’s one of those telling details I look for.  Every cancer, it seems, has a “poster” boy or girl.  Mesothelioma certainly has its celebrities, but for understandable reasons, few survivors, and even fewer of their heirs, are eager to attach their names to something so hideous as mesothelioma.  Most of us want to be remembered for how we lived, and the things we accomplished, not how we died, or what killed us.

Did I want, in some selfish way, for my hero Jim Zumwalt to mention how his father died? I’m not sure. General Dynamics printed up a very classy glossy brochure about the Admiral Zumwalt. Inside were headshot pictures of the three surviving Zumwalt children and the deceased fourth and oldest son, Elmo Zumwalt III.  Beneath the latter’s photo, the caption read: “A Navy Lieutenant and Vietnam veteran, Elmo died in 1988 as a result of Agent Orange induced cancer.”

There it was, in frank language, the connection between the war, the combatant and the product that took his life. The brochure told us what killed the son, a carcinogenic herbicide used by our forces to defoliate the jungles of Vietnam.  But it didn't mention what killed the father and namesake of the new line of sophisticated destroyers -- asbestos products.

Toxic Words?

I listened with rapt attention to the speeches.  Would anyone mention asbestos?

Jim delivered a fine speech, telling us that in 2000 when President Clinton decided to name a new line of destroyers after Admiral Zumwalt, the decision was met with stiff resistance. But for the valiant advocacy of a few stalwart officers, according to Jim, it never would’ve happened.  Mavericks tend to make enemies.

Mouzetta first thanked the thousands of Bath Iron Works shipyard workers who have been diligently building the revolutionary ship.  She then read a letter from President Bill Clinton, who praised the Admiral for championing the civil liberties of all sailors, regardless of their sex, race or creed.

And Ann Zumwalt stepped up to the podium and playfully announced that Daddy always loved her best, adding a welcomed dose of warmth and humor to the solemn affair on such a frigid day.   She said hello to her Mom and Dad up above, who “had the best seats in the house.”   And, with a dramatic flair, she fittingly put her Dad in a long line of intrepid sailors going back to Odysseus: strong leaders who identified with the hardscrabble, bloody knuckled sea dogs. He was, she said, a "sailor's sailor."

To say that I was moved and amazed by the Zumwalt children is a massive understatement. Their Dad was a giant. It was not a day to grieve. Instead it was a day to celebrate and give thanks to all the many friends and shipmates who remained loyal to their Dad when the bullets flew, as they inevitably did around a man who wasn’t afraid to go toe to toe with stupid traditions.

Neither the children, nor any of three other dignitaries who spoke at the ceremony mentioned asbestos or mesothelioma.  I searched the internet the next day and of the 20 or more articles that covered the “laying of the keel” ceremony, not one mentioned what killed Admiral Zumwalt.

Getting it Right

Does this upset me? I’d like to say it doesn’t, as my family and I were honored to be able to witness an important milestone in our nation’s naval history. I met Jim after the ceremony and sincerely congratulated him and his sisters for their moving tribute.  I didn't dwell on the "elephant in the room" omission – it was their story, and their ship, and their father, and their moment, not mine.

And, yet, now I admit to feeling a bit uneasy. Admiral Zumwalt was known for telling it like it was. When it was highly unpopular, he took a stand to open up the US Navy to African Americans and to women.  He cared about the living conditions of the sailors.  He cared about boosting morale. He identified with the sailors and their welfare was important to him. He struck me as the kind of leader who would want to get it right.

Ten years ago I went to Washington DC for a tribute to Congressman Vento, who at the time was being treated for mesothelioma.  President Clinton spoke, as did one of the greatest raconteurs of our time, Garrison Keillor.  Nobody uttered the word “asbestos” or “mesothelioma,” like the words themselves were toxic.

A few years later Keillor wrote a book and in the book he mentioned meeting Congressman Vento who, he wrote, at the time was being treated for “lung cancer.”  Mesothelioma is not lung cancer.  I wasn't trying to be picky or pedantic.  It wasn’t an “inside baseball” or “gotcha” thing but I felt compelled to write to Keillor.  I explained to him that it was “mesothelioma” not “lung cancer” which had stricken the Congressman.  The distinction was important, I wrote, because mesothelioma was an orphan, “industrial” disease that nobody wanted to talk about, let alone try to treat or cure.

Garrison Keillor wrote me back, which I thought was honorable in itself. He wrote words to the effect that he lamented his error,  and that from what he knew of the man, Bruce would’ve wanted him “to get it right."

What Would the Admiral Want?

The Zumwalts have given much to our country.  The admiral and his oldest son were both casualties of war-related injuries.  Both Jim and Mouzetta have donated their valuable time and energy in the campaign to ban asbestos and fund meso research. I can see why on a chilly day in the short amount of time allotted they chose not to mention what took their Dad’s life. It's a special honor to have a new class of ships named after your Dad. 

And yet, I guess I’m disappointed that nobody, at any time, in any medium, including the media who photographed, filmed and covered the event, attempted to “get it right. “  

Roger Worthington with his wife Ann
and daughter Vivian
Crusading for mesothelioma research is an exhausting and thankless mission.  I’ll end this account by noting that over a decade since mesothelioma  took the lives of great Americans like Congressman Vento and Admiral Zumwalt, we still don’t have a bona fide federally funded asbestos cancer research and treatment program.  And, unforgivably, asbestos has not  been banned. Progress is slow going.  Hope can hold out only so long against the corrosive rust of frustration.

Congress has budgeted around $10 billion for the three Zumwalt destroyers. $10 billion with a "B." Thanks in large part to the advocacy of Admiral Zumwalt, whose own son was dying from cancer caused by chemical exposures, the DOD created a program to help Vietnam Vets suffering from Agent Orange induced cancers. 

The history books will remember Admiral Zumwalt as a "sailor's sailor" who dragged the Navy "kicking and screaming" into the 20th Century. My guess, and this is only a guess, as I never met the man, is that the Admiral would’ve been pleased to allocate a slice of that $10 billion budget to fund a federal program to help treat his fellow sailors who were put in harms way by asbestos. He would've wanted to be remembered for making things right.

R. Worthington

To read more about the laying of the keel of the prototype of the Zumwalt class DDG-1000 guided missile destroyers, see below.

General Dynamics Bath Iron Works Moves 4,000-ton Section of Destroyer "Zumwalt" (DDG 1000). Oct. 27, 2011  Click here

Ceremony at BIW marks a milestone for Zumwalt. Nov. 18, 2011  Click here

General Dynamics Bath Iron Works Lays Keel of DDG 1000, First Zumwalt-class Destroyer. Nov. 18, 2011  Click here

Milestone marked in Maine on stealthy destroyer. Nov. 18, 2011  Click here

Monday, November 14, 2011

Dr. Cameron to Asbestos Defendants: Do the Right Thing, Fund Research, Help Us Clean up Your Mess

[Las Vegas, NV] Sometimes you just gotta throw it out there, even though the cards are totally stacked against you.

Asbestos litigation has raged on for about 50 years.  The asbestos companies have spent billions to defend and settle lawsuits.  Hundreds of millions have been spent on concocting junk science to prove that asbestos is as benign as mother’s milk.  But nary a penny has been invested in finding a cure.

On the medical front, nobody can say with a straight face that in the last 30 years there have been any significant advances in extending the life of mesothelioma patients. Yes, we can talk all day about multi-modal therapies, whether EPP is rational or not,or whether there’s any proven benefit of pursuing chemotherapy versus doing nothing at all.

We’re the richest nation on Earth. Some may argue that when it comes to matters of science, engineering, medicine and even justice we’re the smartest nation on Earth.

But the fact remains that when it comes to extending the survival of mesothelioma patients, we’re barely out of the Dark Ages.  It’s not for a lack of money – the asbestos industry, the government, the drug companies, and the insurance companies over the years have had access to trillions of dollars.

And it’s not for the lack of plausible ideas despite the lack of actual public and private funding of research to treat meso patients, there have always been reasonable theories to convert meso from an always fatal cancer to a treatable chronic disease.

What’s lacking? Simple. There’s been a lack of will. A failure to take ownership of the problem, a denial of the problem, and a refusal to truly marshal the resources to solve it. 

It was against this historical backdrop of pessimism, nihilism, and willful indifference, in a place where reasonable men and women eagerly sojourn to test their luck against impossible odds, that a little bit of history was made.

The Defense Research Institute,  the self proclaimed “voice of the corporate defense bar,” to its credit, invited a doctor who treats meso patients to come talk to the nation’s top defense lawyers about ways to extend the survival of meso patients.

The doctor? Dr. Robert Cameron, a thoracic surgeon renown for putting the interests of his patients above any other financial or academic or ego driven agenda. If you’ve read any of this website you know that when it comes to making choices about treatment options we regard Dr. Cameron as the cool calm voice of reason in a stormy sea of hype, bad science and balderdash.

To that esteemed audience, an audience to which it can reasonably be asked – why would you care about extending the life of patients who are seeking big damages against your corporatate clients? --  Dr. Cameron let it all hang out. Nothing slick. Nothing pre-packaged.  Nothing designed to make you feel good.

His message was simple:  we haven’t advanced much on the medical front, but we do have promising ideas to tame this tumor.  The government has never funded research proportionate to its incidence, impact or responsibility, and corporate America has even done less.  Dr. Cameron was excited – I repeat, he said he was “excited” about several potential therapies  but at the same time ‘frustrated’ that despite their promise he’s never been able to put them to work on account there’s been no money to fund them. 

And these promising research projects don't carry Hoover Dam sized price tags.  Dr. Cameron said that research and trials for the IL-4 toxin, cryotherapy (which he’s already using successfully to freeze out tumors that recur post surgery) and stromal cell manipulation could be underwritten for about $2-3 million each, a drop in the bucket when you consider the size of the NCI cancer budget ($5 billion a year) and the wealth of the corporate defendants (hundreds of billions).

Obviously Dr. Cameron was pitching to a tough crowd.  The asbestos defendants have paid out billions in settlements. About 40 companies have filed chapter 11.  The only asbestos company to ever fund medical research, Owens Corning, filed Chapter 11. Another, WR Grace, pledged to fund research but alas also sought bankruptcy protection. Dr.Cameron could hardly point to any empirical evidence that funding research to clean up the asbestos mess was a sure fire way to drive up a company’s stock price.

So why would an asbestos defendant want to contribute to medical research? Dr. Cameron offered an analogy. In medicine, mistakes are common place. Sponges get left in the human body.  An organ gets nicked. A vessel gets cut.  Accidents happen. But doctors don't always get sued when they make a mistake.  Instead, the doctors who fess up immediately, who speak directly to their patients about what went wrong and why, and own up to their error, usually don’t get sued, because their patients still trust them. It’s the doctors who try to cover up their mistake that get called onto the carpet. It’s usually not the negligence, it's the attempt to cover it up, that gets folks in trouble.

Dr. Cameron humbly admitted that he was not a testifying expert and he did not pretend to know if there were any ramifications regarding liability.  But, he suggested, virtue is its own reward.  Money invested in converting meso from a fatal to a treatable disease would not only engender public goodwill, but it could also perhaps limit damages, as successful patients could die from what all of us hope to die from – old age.

Did it work? Were the lions tamed? Will corporate America step up? When Dr. Cameron finished his earnest speech, going down in history as the first treating doctor to ever ask the asbestos defense (an audience he described as “the top 1% of America’s brain power”) for their help in coming up with funding strategies, the moderator thanked the good doctor for his passion but, on the question of will they or wont they, said: “Never gonna happen.”