By Michael J. Katin, MD
The few who have been consistently reading this column since 1997 may recall that the May and August columns of that year dealt with creating awards for radiation oncology to give our colleagues incentive to enhance their performance. I had considered an annual column regarding this but realize this would provide an irresistible opportunity to suck up to anybody who might do something for me and I abandoned that thought, thinking it preferable for any such aggrandizement to be done more subtly. I still feel tempted at this time of year, now that the Academy of Motion Picture Arts and Sciences has gone through its ritual for the 73rd time, to revive this concept, but will resist in favor of reflecting on the story of *r*n Br*ck*v*ch. (Extra credit..what's the difference between an Academy and a College?)
In fact, I'm still chagrined that there weren't any nominations for "Dude,
Where's My Car?" but since we haven't seen Jesse Jackson and David Boies
pushing for a recount I'll concede the issue. There was a medically-related
spin to "*r*n Br*ck*v*ch" which produced an issue drenched in pathos that
energized and legitimized the main character, and resulted in the awarding
of Best Performance by an Actress for Julia
Roberts' interpretation. For those who have not seen the film, the town
of Hinkley, California, was contaminated with Chromium 3 by PG&E, with numerous
inhabitants developing medical problems which were being disregarded until
the pattern was uncovered and recognition pursued by an untrained legal
aide. She gets the attention of the media and courts and the lawyers and
even some of the townspeople wind up with a huge settlement.
Every day, and sometimes b.i.d., we in radiation oncology wonder whether what we're doing makes a difference, to individual patients, to their families, and to society as a whole. Is it worth it to continue to encourage development and deployment of advanced technology, utilize complicated and time-consuming clinical protocols, and, more importantly, use our precious time to interact with our patients as much as possible? We need to remember the story of *r*n Br*ck*v*ch, who made an impact by being persistent in doing what she thought was right.
And in that case, we probably should overlook that the citizens of Hinkley,
while watching premium channels using their newly-purchased satellite dishes
and sitting in Strato-Loungers eating Godiva chocolates, are probably still
being exposed to multiple contaminants, many of which have probably not
been identified. Since I didn't get to see the film I don't want to make
any errors, but I didn't hear that they were relocated like snail darters
or black-footed ferrets to a new homestead. Am I wrong in assuming that
environmental exposure is still taking place? So maybe we shouldn't be down
on ourselves if we don't always accomplish what we desire, when every patient
isn't cured and every family isn't satisfied that everything worked out
for the best. Maybe that's the lesson we should learn from the people of
Hinkley. They achieved some palliation of their plight, at least in the
short term, and everybody thought that was good enough. And are they worrying
that their children and grandchildren will have the risk of being affected
by these contaminants? They're willing to be patient and just wait to see
And the best news is that since many children from that area are becoming sexually mature by age 5, they'll only have to wait until the end of the decade to find out.
Thanks for the input of Robert Casale, RTT, and Kevin Kearney, without whom this column would have been later and shorter.