Document 4aNXD1BzgnJx5RVOwqQRZpyRN

Ost ober 9, 1962 Dr. Kieffer Davis Phillips Petroleum Company Bartlesville Oklahoma Dear Kieffer: I enclose herewith a somewhat hastily written (but not hastily considered) memorandum of my interpretation of the case of your Mr. I may not have included every small point that could have been made, but I have presented a fairly complete clinical analysis of the case. I have been influenced somewhat, in tha matter of my recommendations, by the attitude which you expressed as the Medical Director of Phillips Petroleum Company. X tend as you do, to lean toward a kindly and generous disposition of such cases. In this instance your* employee has been misled by a physician who appears generally to be competent, but who knows nothing about lead poisoning (except, of course, that there is such a disease). Your Company is at a disadvantage in dealing with such a situation. However, in my view, you should explain the matter to the man, after dealing with his problem as generously and effectively as possible, and then see to it that a watch (clinical super vision) is maintained of his future course. This case is typical of a fair number that come to my attention of which the prominent feature is that of mishandling at the outset. The only means of heading these off lies in their initial handling by experienced and knowledgeable physicians in industry, who know where and how to obtain the right information promptly. It is important to recognise in this and in many other instances of alleged occupational illness, that the diagnosis is not made by a sleight-of-hand trick in a laboratory, but by the proper use of a laboratory by a physician consultant. Just to save time for both of us, I am sending a bill to cover the cost of this professional service. Sincerely yours, n RAK:ss Robert A. Kehoe, M.D. Enclosure: 4 copies of Memorandum Bill of costs. N 5284 F.iv u m asti S m t e r p r e t &t t m &t i h e Secars ia tb Cas ot . as rapioyoe o ip* P&tral&m Comimny fise m i e o tft a v ftUe b i i a fo M iU e a ita lo ti to & c e littg o f ueop t i ie **t is ft e t ia a ,ia tiuet th siiagnoi a a rn ve s l a t a s i e e r ta ia iy ia c o r r e c t , ile no otfce r w r e *p t d ia gn o s is can b sufe e tatiat d. Wtlt rapoct a ttm diagnosi tlsst m s muI - ttut o lesti itaxicutio - uat a single cUnic&l criterio fer sudi & diagnosi# m & i&ltiiim, 1% a to b*e vsmatoa**> ami traeteti, fcfc&t th tii&g&csie o iead pi#aig ia st# jo ciittlial ground i.., o ttm reccgaitm o* a charaeteristie syntiroea. n anch yntirst&e ha ' b m observed or 4*erhti t thl* CMC. 1 Tmr & was 0 hiatory o signiicant o* occupaiioaal - os* other mprnum to ceti, The opportuni.!* or th* a t e M p U d a o load mi tieeeribeti w trifllng enti ! t ttusnt&tativ .a aegXigible, Tfe lmti*taitting arterial haaoieti b y tisi# sa ave incapatolo o b#ias *la#ete*ti tlircifii th* s&Ut; mpomwtm by inbalatioa, t u hinted *t, m a puraijr theoretical and o o prue*! significane! tac ingestin o leed, bccouae o unelcaniy habita, aight toar* b e m o sos* significane* 4i 4t boti oceurrcd coustaatly, i.., reguiarly, but it m not, aut 0 ausi h ttisstlsseti a* of h l & l y i&prntoaUl* aigmieane. 2. Ib septana and pbyaiesl sigas m v e ccrtaial^ aot cbarscteriatic o lesti peisoniag, bu were vague, uaeoavincmg and lacn*taat. Thcr as no culle suggeativ o 1&4 colie, so suggestive digesti* disturbane#, bat r&ttoer vague ifj o iadigestioa th*t had oceurreti ol usti a ur yara, witaont defintive or cute epsotile carnet. T-tv urolofi! pinture-wa* H^ually uneertain la ita tyi>e, erigi enti N 5284.01 %t I A* o % Ml m ON 2n ta* t m & u iaa ua I 1 I O w o t tt t t% t 1 * Vi 0 i*S * I* * * w i 83 4i a s>n S1 cn ri w c0l VI cu3> S3 H *0 ** 4 *$ 3 ? s 1 -*a*t 4 0 : !s &f \J * ! 5 8 $ I if I * tf ta 3# Ii1 ^1 1 ldi I 1 e 3 1 I i * & ** lys e d * f& ttesm py o f IcAt po is o n in g fey tu ,Us in is trtlo n o '0*t wntvm *0*S SOJEJ 6* `t? I M * ) D **1 3t v%tvx%matxaa m% mx% s3?tf& it? *m v t n tur? 9 o o f$ m n iiiiifis m e t; ttm ue "d le te in g '' by th e o r a l a a ia ts tra ti i t i e te lafctag as^nt liiseciiu3**Cieiuvs Vrn&t. 5ES5IZ* T&e foi* s.oi?i uiaea*4.eii toite i t i feate* os t t e diafsao aia le s p o is o aiag I n t t e c i i s i ft l set p h y s lo lo g lc ! v t m m &nt . i t da a i* tewvsr dipos@ i t t e p r a c tie a l ^ b l. i presentad fcy tte 'oilawiug gateas 1. <flagosls of leas! poiaooiog te* t oem ate, ate M I * t i lia nat* &s e s w t s o fe s u te ta a tla te * i t im a -asAttmr o mocara. 2, i? tetes* plausible o* convnola^ alagaos! tes oeo ;sM . T$m taafcMag m d s u te ta a tla tio a f tito o o m e t dlagooai t i l jpq u * t o t t c r lt a t e ! tav te i$ *tio & mi t i ( te te ra ia a tio a o l t i aatete &* ce a rs e a i t b i * ssaa* 411, I t 4a improbable t t e t i t te ru it artel i t i h igs ly protefel t t e t i t t i l de ve lo p iu r t t e r or ctrntnm a * ty^ ai r perb&p* lowty pragreaslag 4 i8 fe ili*y . fM # Z m t a 1 1 usan* feut a te r o s t e a ily 411 ana* te tit te tev leaI po4 ssiiags i 11 lte n te ? * and te * tte rclo re * e arno t fe e s p e ciad t retsatrer te lo t e p olm m m g and thua overeo b is lila o s . . 3. It 4 protebiy isagossiM* te thi* tissss, certuinly, to &pxo'm tte original tenga*. caly ti can te vxpect to clarify s te a gn o te te las a . tecoiaewaxlfttio t t e te * ateo i t h i * cs e * i* t t e 'aape e t o t liara i a dj m s sspioy ( t t e l a rvin) o, i fe i lli p a **trlw Co rpo ratio n b ta roaolvo tt ecoaost. iesues in th tapiast posslbl sanner* m to unnerte&e ta m p la y tai $tui ia a p ro d u ctivo jt , f h i i ca be done % a p re ae n tatio o o th fa c t e , itl&ju t to s fte g t&e var ia o e ospttta&tioa a tim .bitsiB t t a t t n e 1 vente wxS ia e ta l**v* sit 4fe tajo s *ili.e feo imp&l m> do abt s to tii* d iagn o s is Sueft. * D is p o s itio n o f ttso p re s e a! ls s u e U i awtke i t p o e s ib le a / lo w fina / a ta ra eore o UM# oo# M U a g i v i a s b i s laojs o t re co ve ry amt reiisefe 1i t &ti oa * , I f tM e re eau im rslviafe a A s e r t a and c o a tiy p re ce e n t, ifc i*oui4 fee co a te tad to ttw* u lt Xm t * ad* {der p re s s e t cireusarttaa , uat i a rle w Mt thm perpoae and p*M ls o 4U llU p a **trol*u Ganpa&y 1 r e ia tio a t o i i * aspioye, a g e a tle r prooeare e eeee to ia d lc a te d . Ijmstoucfe . ttse &mu o o e e u p atio aal le n paie e ai&g fcn fee . 4* r a ls o , 41 se e e s it k e ly tot s i o i i a r c&ee U fee pre ae n te . I t wauld fee Uvisafe l , tiwreioroji i i s & a o f ilin e a s e co urs feieh fte r t i p&tt&Xbittty i a th e ju d gae at o f iM ilip m e dical a t a / i, bat aaapl o b is ad an u ri e be o btalitad Xor m i y s i * t a , ene 8 *at tte be liaadie d ene am Uyaed i a auca a aan ae r, ander tim re a p o a s ifcilty o tb a4ii Oj>arteatf tu a t na doabt e s t e a te rta in o i t re ape o t to tfee s ig a lle a tie * o fce o ccupatlo a&l e xpoaure io e *d , I i llk e i y t at* at** II lap s o o feisse, tfe ie Situ a tio n w i l l hm a n a tu ral deatn i i t fe# aae e rtain e ti tb a t no a ip a JUica n t ty o o cm tjsato sal e xpe aar to te&d e ^ ia t. . \] Hubert a * le fco # , a , . m re e te r . Frost. ?a# So lte r a s lab rato ry in tbe I)ep&rt<mt o '^ c m i i v Me dicine at in d u s tr ia l He alt* Co l le * o Ife icin e , Ua iv e ra ity o Cim s in n s ti. THE KETTERING LABORATORY COLLEGE OF MEDICINE EDEN AND BETHESDA AVENUES CINCINNATI 19, <1110 October 9, 1962 TO: i hi H i p s Petroleum Company Bartlesville Oklahoma Attention: Dr. Kieffer Davis. FOR: Report and intei retation of the case of Mr. I by Dr. Robert A. Kehoe. .$50,00 N 5284.02