Document ZmGo8Yw3vjGypJjprv9253QJ

A pril 7, 1954 Dr. Robert C. Page Standard O il Company (N. J . ) 30 R ockefeller P laza New York City 20 . D ear Bob: I return to the subject of our con versation on the night of the 29th in ord er to m ake a few com m ents and to ask fo r som e additional inform ation. A fter leaving you I talked to G eorge G ehrm ann, and having given the m atter som e carefu l thought sin ce, I am prepared to d isc u ss the entire subject with the m em b ers of the m edical staff of Ethyl C orporation w hose w ork w ill be affected, and to recom m end a p olicy and procedure for accom plishing the d e s ir e d r e s u lt s . B e fo r e d oin g so I'd lik e to b e s u r e o f th e s c o p e of th e problem , so far aa you and your group are concerned, sin ce this m atter has fa ir ly broad, sig n ifica n ce, and I want to deal w ith it e ffe ctiv ely and fa ir ly . I p resu m e from what you have said that D r. Wade is concerned about the m atter. I sh all w ish to deal with him and with any others w hose p osition and attitude are sim ila r , but,I w ish, for the sake of future d irect p rofession al r e la tio n sh ip s, to be qu ite su r e what th e ir w ish e s a r e . M y a s s o c ia te s w ill w ish to d e a l with, the lo c a l r e fin e r y p h y sic ia n s d ir e c tly , and to e s ta b lis h m utually sa tisfa cto ry proced ures and relation sh ip s, th ese to be clea r ly defined in advance betw een them and th eir m edical d irecto rs, to such extent a s D r . Wade a n d /o r o th er m e d ic a l d ir e c to r s m a y d e s ir e . In a g e n e r a l w ay, I s h a ll k e e p D r . G ehrm ann and M s a s s o c ia t e s in fo r m e d a s to what we a re doing, and from a p r o fessio n a l (and p erson al) view point th ere w ill be no lack of cou rtesy betw een ou rselv es and the Du Pont m ed ical group, but there are sev e r a l v ery good reasons why I do not w ish to arrange th ese m utters through a joint d iscu ssio n with them and you and your a sso c ia te s. I cannot se t up any blanket p olicy for this m atter at p resen t, and the p recise nature of our procedure w ill have to depend on the joint judgm ent of our 3taff, w hose acquaintance with the lo ca l and general situation is b etter than m in e. H ow ever, I do w ish to a ssu re you that we are prepared to develop procedures that w ill m eet the fu ll approval of the m edical d irecto rs and lo ca l physicians . of the J e rse y com panies and oth ers a s w ell. I have b eliev ed in the clo sest'a n d b est p rofession al relationships that could be achieved am ong physician s gen erally, both in and out of industry, a ll of m y life , and we sh all not fa il to fu lfill our 0004735 D r. R obert C. P age - (2) - A p ril 7, 1954 resp on sib ilities for such cou rtesy and cooperation. I have a lso believed in the acceptance of resp o n sib ility for the health and sa fety of p eople, to the extent that this was p roperly entrusted to p h y sicia n s. The two s e ts of r e s p o n s ib ilitie s a r e n ot o ften in c o n flic t, and I cannot b e lie v e th at th e y n eed be in con flict as betw een your m ed ica l a sso c ia te s and m in e. M ay I say, in the above con n ection and in explanation of m y v igorou s and som ewhat d efensive com m ents of la st Monday night, that I w as su rp rised and hocked by your d isclo su re of the depth of feelin g among som e of your people concerning our apparent encroachm ent upon what they b elieve to be th eir proper province. I have never heard a m urm ur of com plaint or c r itic ism from any of th e m ed ica l m en in the p etroleu m industry in rela tio n to our a c tiv itie s, and in view of m y p erso n a l and p ro fessio n a l acquaintance with them , I should not have su sp ected that any such feelin g could have a r ise n without th eir bringing it d irectly to m y attention. Undoubtedly, I have been too preoccup ied with sp e c ific p rob lem s and genax-al p r o fe ssio n a l co n sid era tio n s to reco g n ize dais d ev elo p m en t, but I a m s t ill su r p r ise d not to have had any c o n sc io u sn e ss it it. C le a r ly th e tim e h a s c o m e to r e c o g n iz e th is by a p p r o p r ia te a c t io n ,' and in n il good faith and w illin g n e ss, w e sh a ll'd o so . H ow ever, th is w ill not be autom atic or im m ediate, and there m u st be a corresponding w illin gn ess, on the part cf the physicians in the industry, to recogn ize that the resp o n sib ility which w e have a ssu m ed for tw en ty-eigh t y ears cannot lig h tly be abandoned without our finding effectiv e m eans fo r it3 p artial or convolute assu m p tion by The relationship s of m edical and hygienic rep resen tatives of Sthyl C orporation with the m e d ic a l, h y g ien ic and operating people cf the o il in d u stry have b een too intim ate a m ean s cf exchanging inform ation and of coordinating a ctio n (on such m atters a s tank clean ing, the hygienic asp ects of m anufacturing, tra n s porting end m arketing leaded gasolin e, container p rob lem s, utilization of leaded fu els fo r various purposes by m ilita ry person n el and civilian s in various parts of the w orld) in relation to in d u strial and public sa fety to be allow ed to s u ffe r undue a tten u a tio n . If th is w e r e to o c c u r , th e b e n e fits o f th e lo n g - t e r m in vestigation s w hich have b een ca rried out in the K ettering L aboratory would la rg ely bo lo st. (Incidentally, I have n ever been able to find the tim e to m ake the r e su lts cf th ese in v estig a tio n s availab le in m ed ica l and h ygien ic lite r a tu r e . H ie m ost im portant m atters have been published, and the effective procedures have been applied in the p r a c tic e s of the in d u stry, but the docum entation is sadly d eficien t. I have been working toward a com p reh en sive m onograph on the su b ject, in w hich p ro b lem s, m ethods and r esu lts would be se t down adequately but the currents of p rofession al activity in the general field s of p rofession al training, r ese a rc h and p ra ctice in occupational m ed icin e have been too strong for m e and have taken so m uch of m y tim e and en ergy that this job has been h eld in a b ey a n ce. It m u st be done b efo re lo n g , and th e r e fo r e you can u n derstan d, I am su re, why I am ready and anxious to relinquish any job or resp on sib ility w hich I can put in oth er hands. 0004736 D r. Hobart C. P age - (3) - A p ril 7, 1954 A s i v isu a lize the p resen t situation, it w ill be fe a sib le and d esira b le fo r m em bers of the staff of S th yl C orporation to d eleg a te the conduct of the physic u exam ination of m ixing plant person nel to p h ysician s of the o il com -oaiiies when and w here the fa c ilitie s for so doing a re sa tisfa cto ry and when ana w h ere an agreeable and m utually b en eficial relationship of p rofession al mention can be achieved lo c a lly and a ls o at h ig h er le v e ls in the n sd ica l rpa'ii- itio n s c o n c e r n e d . Ju st w h at sh o u ld b e th e r e la tio n s h ip s and d u tie s o f ,.;e a - .-ociated n o n -m e d ic a l p e r s o n n e l, i. e . S th y l C o r p o r a tio n 's in d u s tr ia l ly p ie n ists (s a fe ty e n g in e e r s b y p r e s e n t t it le ) and o il co m p a n y in d u s tr ia l iy'Cionisfcs, is not e n tir e ly c le a r to m e a t the m o m en t, but s in c e th e s e a r e un der lhe general direction of the m ed ica l p erso n n el of both S th y l C orporation and the "orsey affiliates, this should create no v ery serio u s or insurm ountable problem e -resn oot to th e s e c o m p a n ie s . A fte r th e s e m a tte r s h a v e b e e n w o rk ed ou t, or:.-o.-.ox^uonm ents can be considered as they see m to be required. th is has turned cut to be an unduly long le tte r , but Xhave fe lt it n e c e s s a r y to explore the auoject rather ca refu lly , sin ce n eith er you and your a s so c ia te s nor car: yvrtify a h u r r ie d aban donm en t o r an ill- c o n s id e r e d m o d ific a tio n o f a ..n o d ica l and h y g ie n ic p r o g r a m w h ich , a p p lie d to a h ig h ly h a z a r d o u s in d u s tr ia l - ....i n, .w c e v o lv e d out cf e x p e r ie n c e , w h ile a c h ie v in g c o m p le te and u n in te r --r.ce:. f.u ccesr fo r m o re than a q u arter of a cen tu ry . Xam not ev en s lig h tly in te r e s te d in it,3 unrK.-.iified co n tin u a n ce a s a m a tte r o f p r e c e d e n t, but l a m ioepiy cor.corned that it sh all not suffer the attenuation that follow s inevitab ly when a coo-m uch subdivided resp o n sib ility becom es no cu e's resp on sib ility. 1 have lived too long and too c lo se ly in the m id st of a va riety of hazardous industrial operations not to recognize this as the p rim ary problem in th ese h a z a r d o u s t r a d e s . ,\rifch n o ta b le (and in c r e a s in g n u m b e r s of) e x c e p t io n s , th e industrial physician does not take with sufficien t ser io u sn e ss h is resp o n sib ility for the safety of p erson s who w ork in jobs that involve leth al and in sid iou s ixuzards. He a ccep ts a form u la, not of h is own m aking, fo r the routine of h is day's work, and he does not keep actively a live in h is co n scio u sn ess the vital Im portance of knowing, in the effectiv e tech n ical sen se of to x ico lo g y and physiology, the sign ifican ce of what m en do and the p r e cise conditions under w hich they ao it. He is m uch too sm ug in h is conventional idea of h is com p e ten ce, and is content to turn th ese m a tters ov er to "industrial h y g ien ists, " vaen in fa ct he is the only one who is , or in the nature of th ese m a tters can b e, the ind ustrial h y g ien ist equipped w ith p h y sio lo g ica l to o ls and co n cep ts. If I io not tr u st th is situ a tio n fa r , it is b e c a u s e m y e x p e r ie n c e h a s not p e r m itte d m e to do so , and th erefore I shall m ove gradually and on the b a sis of the eviden ce of achievem en t of the d esired end, in th is situation. \7ith b e st reg a r d s, Sincerely yours. Robert A. Kehoe, M. D. ef