CARD Clinic

The Center for Asbestos Related Disease provides positive ways of living for its patients

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Helen McMillan Zak, Larry Hill and Mike Noble are just three out of 2,300 patients who pay regular visits to the Center for Asbestos Related Disease in Libby.

On the wall inside the clinic’s lobby, bright red pushpins dot a map of the United States. The majority cluster around Libby, but the little dots spread across the map, leaving their mark on numerous states.

Each represents the address of one of the clinic’s patients.

The patients come to the small clinic for regular screenings from Drs. Alan Whitehouse or Brad Black, and to take advantage of the staff’s extensive knowledge of asbestos related disease and how to live with it. Whitehouse, a pulmonologist, has “seen Libby patients for nearly 20 years,” either in his Spokane, Wash., private practice or at the CARD clinic. Black, medical director for the clinic, has lived and practiced in Libby since 1977, and was key in its development.

The clinic, a nonprofit, receives the majority of its funding from patients who pay fees for services, but also generates revenue through partnerships from research projects with other institutions, and from any grants or appropriations they are able to secure. They are currently working to create a foundation that will raise funds for the clinic. W.R. Grace does not provide any funding.

Many patients like Hill, Zak, and Noble are part of research studies to gain more knowledge about the disease and its mysteries. During a routine lung function test, patients step into a large plastic cylinder and sit down. Even though its walls are translucent, the chamber feels slightly claustrophobic. A bubbly therapist explains in detail how to breathe to obtain accurate results from an attached computer that spits out related data.

She hands patients a rubber clamp to place over their nostrils, making them resemble synchronized swimmers without the pool. She shuts the door to the cylinder and instructs the patient to seal their lips around a plastic tube. The patient inhales almost to bursting, and holds the air until the therapist says “Blow!” The trapped air is forced out as fast as possible until the therapist motions to quit.

Multiple variations of the test are run, each repeated about three times. The whole process is lengthy – about an hour or so. It can feel exhausting. Some patients with severe disease barely manage the tests. But they continue to return to monitor any changes in their lung capacity and function. Many patients also voluntarily participate in disease research, hoping they can help future patients.

The clinic doesn’t merely screen for disease. It also helps patients “continue to live well despite having to deal with asbestos health issues” by providing disease education and counseling services. It aims to help patients retain a positive frame of mind.

Though the clinic has only been in existence since 2000, asbestos related disease has been around for years. In 1977, Black moved to Libby to start a practice with his internist partner, Dr. Richard Irons.

It wasn’t long before Irons began noticing signs of asbestos disease in his patients and showed Black, but their medical training had told them they “shouldn’t be seeing this disease anymore – there were adequate controls to protect workers,” Black says.

Unfazed, Irons went to W.R. Grace headquarters in 1978 to try to get them to cooperate and set up a more aggressive screening program to make sure workers weren’t still undergoing excessive asbestos exposure and to make sure their family members weren’t being affected by take-home dust, Black says. However, W.R. Grace was not interested in the proposition.

When a Seattle Post Intelligencer story about Libby’s asbestos exposure broke in 1999 it became very clear there were many people in the community who were affected by asbestos who had simply lived in Libby and didn’t work at the mine.

Today, Black is in a unique situation where for years he’s known many of the people he sees as patients, and subsequently better understands how the disease impacts their lives and health.

“You could not get that in another setting,” he says. “Nobody would understand the depth of the lung disease here unless you were here to watch these people over time and know them well and know what it’s done to their lives.”

He fondly recalls walking to the local butcher shop in town where Larry Hill used to work. The two became friends and would often fish the high lakes together. They haven’t gone in a while.

It’s not easy for Black to see his friends and patients deteriorate.

“That’s the hardest part,” he says, looking down at a pile of chest X-rays.

Despite the damage W.R. Grace has done to these people’s health, Black believes most affected people would be better able to cope if Grace acknowledged its actions and apologized for them.

“It’s the arrogance of just walking away from something like this [that] is hard for people to understand, in our country, the United States of America,” he says. “It’s something you’d expect in a Third World country, but not in our country.”

He would like to see W.R. Grace’s medical plan take care of sick people instead of denying them services such as coverage for medication and oxygen costs. However, Black, as well as many others, realize they may never see any significant aid from Grace, and know they have to move on anyway.

“[They should] just provide health insurance for those who get sick and take care of them,” Black says. “It’s the least you would think they would want to do.”

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