Document zdKarwqjyDmQmvyYyGnw7jpZn

Ju ly 20, 1956 D r. B. B. Reeve M edical D irector Stan d ard O il Com pan y (In dian a) 910 Sou th M ic h iga n A v e n u e Ch icago 80, Illin ois D ear Doctpr Reeve: We ar e en tirely w illin g to h elp you out by an aly sin g sam p le s of blood and u rin e obtain ed by su itab le m ean s from an y reason ab le n um ber of you r com pan y's em ployees un der your su p ervision . I hope that m y letter to M r. H alley w as not r e gar d e d by h im a s a p e r so n al c r it ic ism , fo r I h ave gr e at r e sp e c t fo r h is kn ow ledge an d ju d gm en t. In stead it w as in ten ded to h ead off, so fa r a s we ar e in volved, a su rvey m ade u n der n on -m ed ical au sp ice s, the r e su lt s of w h ich m igh t be h an dled, o r , a s we h ave seen frequ en tly , m ish an d led , so a s n o t ;o h av e th e u se fu ln e ss th at th ey sh o u ld . So lon g a3 th e r e su lt s a r e r e p o r t e d to a p h y sician (or h i3 d ir e c t r e p r e se n t a t iv e ) an d d e alt w ith a s m e d ical d a t a , I h ave no ob ject ion to th e p r o c e d u r e . H ow ever, in ou r p r e v io u s e x p e r i en ce, th e p r o ced u r e h as n ot been ap p lied p r o p e r ly , in lay h an d s, an d we h ave h ad enough e m b ar r assin g in ciden ts to d em on str ate th e n eed fo r st r ic t m ed ical h an dlin g. F o r exam p le, th e fin din g of evid en ce of e x c e ssiv e ab so r p tio n of lead , w ith in ce r t ain sp e cifie d lim it s, m ean s th at a m an sh ou ld be r em oved p rom p tly from all exp osu re fo r a p eriod determ in ed by the r e su lt s of fu rth er an aly sis. Attem pts m ade by laym en to explain th is situ ation to a m an an d to provide fo r h is t r a n sfe r to oth er w or k h aveled to m isu n d er st an d in g r e se n t m e n t , union gr ie v an ce s an d oth er d iffic u lt ie s, a ll of w h ich can be atten d ed to w ith out an y tr ou b le by a p r o p e r ly in for m ed p h y sician . It i s , in sh o r t , fr o m e v e r y asp e c t , a m ed ical problem and a m ed ical resp on sib ility both organ ization ally and le ga lly , an d it can n ot be h an dled o th e r w ise sa t isfa c t o r ily o r w ith p r o p r ie t y . Th is an d a se r ie s of oth er p rob lem s a r ise w h en ever one r e so r t s to th ese an aly tical p ro ced u res fo r the p u r p o ses of in d u strial h ygien e, and th erefore I in sist upon t h e ir b ein g h an d led st r ic t ly a s m e d ic a l d at a if w e h ave an y sh a r e in them . F o r p r a c t ic a i p u r p o se s, if you can a r r a n ge to h ave th e sa m p le s co lle ct e d in o u r c o n ia liijiers b y th e m e a n s w e p r e sc r i b e ,a n d i f y o u h an d le t h e fin d in gs t h r o u gh you r o ffice w ith p r o p e r ly in st r u ct e d p e r so n s at th e v ar io u s r e fin e r ie s who a r e r e sp o n sib le to you, w e w ill ce r t ain ly n ot "sh u t th e d o o r " on you r e ffo r t s. Th e co st of o u r an aly sis is a un it co st fo r th e se r v ic e w h ich the Lab o r at o r y p ro- N 6270 D r . B . R e e v e (2) - Ju ly 20, 1956 i .. . v id e s in th at con n ection . It is a s low a s it is fo r th e r e aso n th at w e h an dle a la r g e voliim e of su ch an aly se s fo r o u se lv e s an d o t h e r s. It in clu d es no sp e cial ch ar ge fo r con su ltation se r v ic e s a s su ch , but it d oes in clu de, o r is in ten ded to in clu de, its sh ar e of a ll of the overh ead expen se o f th e con duct of th e w ork, in cludin g^ o f c o u r se , se c r e t a r ia l se r v ic e an d som eth in g fo r ad m in istr ativ e c o st . Th is is in lin e w ith e v e r y o th er ch ar ge fo r an y k in d o f se r v ic e r e n d e r e d by the Lab o r at o r y . It is p rob ab le th at it d oes n ot c a r r y it s fu ll w eigh t o f over h ead exp en se, sin ce it h as n ot been ch an ged fo r a n u m b er of y e a r s, but it is clo se en ough so a s n ot to be a bu rden on th e oth er ty p es o f w ork don e by th e Lab o r at o r y . We n e v e r p e r fo r m p u r e ly an a ly t ic a l se r v ic e s fo r an yon e, e xce p t o c c a sio n a lly a s a sp e cial fav o r fo r som e colleagu e o r fo r som e in d u strial organ ization th at n eeds ju st th at an d on ly th at an d h as no fa c ilit ie s fo r doin g it . A ll of th e an aly t ical w ork don e on le ad (an d on c e r t ain o th er m e t a ls) fo r d iagn o s tic p u r p o se s o r fo r p u r p o se s o f in d u st r ial h ygien e in th e La b o r a t o r y , go e s th rou gh m y lian as. C om p ar ab le w ork in solvin g oth er m a t e r ia ls fo r sim ila r p u r p o se s is h an dled by one of the p h ysician s on th e st aff, sin ce th is is a m ed ical lab o r ato r y in a*m e d ic a l c o lle g e in a m e d ic a l c e n t e r w it h in w h ich w e m a in t a in c o m p le t e p r o fe ssio n al r esp o n sib ility . Th is d oes n ot m ean th at the m em b er s of ou r tech n ico lo gical n on -m ed ical st aff a r e not fu lly r e sp e cte d apd calle d upon rior th eir sp e cial know ledges an d sk ill, n or d o e s it m e an t h at th ey do n ot c a r r y th e fu ll w eigh t of th eir p r o p e r r e sp o n sib ilit ie s. It d oes m ean th at an y r e sp o n sib ilit y w h ich th ey assu m e in m ed ical m at te r s is d elegated to th em u n der th e d ir e ct guidan ce o r su p e r v isio n of p h y sic ian s. Th is, I m ay sa y , is w h at w e t each a s th e p r o p e r p r in cip le in in d u st r ial m e d ical o r gan izatio n en d fu n ction , an d it is w h at w e p r a c t ic e . In doin g th is we a r e n ot con cer n ed to m ain tain th e p r e st ig e o f th e p h y sician in h is o r gan izatio n o r in h is ge n e r al p e r fo r m an ce . We a r e in ten t, h ow ever, on seein g to it th at the w orkm an in in d u stry is t r e at e d a s a p er so n o r a patien t sh ou ld be in c ir c u m st a n c e s in w h ich h is p r o b le m of h ealth an d w e lfar e is, p r o p er ly sp eak in g, a m ed ical p rob lem . I th ird; yob, w ou ld b e w ise to h ave th e c o n t a in e r s se n t to y o u r o ffic e fo r d ist r ib u tion to y ou r people at th e r e sp e ct iv e r e fin e r ie s. A lter n ativ ely th ey can go to people w h om you d e sign at e at t h e se p la c e s. Sin ce blood h as to be d raw n , so m e p r o p e r p e r so n sh ou ld do th is an d a ll of th e oth er w ork in cid en tal to th e collection o f th e sa m p le s. Th e r e p o r t s sh ou ld go to you on ly, o r to p h y sician s on ly, t o ge t h e r w ith su ch ad v ice a s w e can p r o v id e . . I h ave gon e to som e len gth to con vey m y poin t o f view on th is m at t e r . I h ave b een w orkin g in a clo se r e lat io n sh ip w ith qu ite a n u m b er of th e le ad t r a d e s fo r a lon g tim e. I m ay not h ave seen everyth in g, but p rob ab ly alm o st everyth in g, an d m y p r e se n t attitu de i s th e r e su lt o f su ch e xp e r ie n ce . We in m ed icin e h ave e xcellen t t o o ls fo r h an dlin g th e le ad p r o b lem in in d u st r y w ith co m p letely s a t i s fyin g r e su lt s. H ow ever, in th e co llectiv e se n se , w e ar e n ot m akin g p r o p e r u se