Its advocates and apologists will dispute it, but over the past century, a vast medical literature has exhaustively described the means by which asbestos has killed, according to EPA estimates, 259,000 people in the United States, with another 166,000 deaths anticipated over the next 30 years. Among the proud array of carcinogenic products, natural and fabricated, only tobacco has contributed to a higher death toll. Most of its victims will never know what caused their death, because they are unaware they have been exposed to it, and the lapse between exposure and the onset of illness is typically longer than 10 years. In this way, it maims not like a gun, inflicting harm at the moment of contact, but rather like a land mine, which lies dormant for years.
"There's something about this fiber that's not average," says Dr. Brad Black, the director of Libby's new Center for Asbestos-Related Disease. Black's job is not what he bargained for when he opted to be a small-town doctor in a place served by a 24-bed hospital and fewer than 10 physicians. Since the "asbestos clinic," as everyone in town calls it, opened last year, Black has seen, he estimates, four or five hundred asbestos-diseased patients, including the construction worker whose chest X-ray he has put on display for me.
"See those large patches of white?" Black says, pointing to blocks of washed-out-looking glare that rim the dark crescents of lung. "They wouldn't be there in a healthy lung. It's scarring." Black explains that tremolite asbestos fibers, once inhaled, embed themselves in the lining of the lung – the pleura – like needles, and stay there. The body can't flush them out; medicine can't destroy them; surgery can't cut them out. Surrounding tissue responds to the irritation by calcifying. A healthy pleura is as thick as Saran Wrap; in a person with asbestosis, it may be as thick as an orange peel. Then the lung itself gets covered with calloused tissue; oxygen struggles to find its way into the lung, and carbon dioxide struggles to find its way out. "It's just a progressive scarring," Black explains, "until respiratory or heart failure."
If one were to attempt to devise the perfect suffering, death by asbestosis would come close to fitting the bill. It is slow and incapacitating. It steadily wastes the patient. It brings the patient to the very verge of suffocation and allows him to remain there for months, even years, on end, to reflect on his situation. A typical patient will cough until he vomits. His lungs will fill with fluid. He will feel as if he is swimming in the fluid, drowning.
Just ask Don Kaeding, who survived four years as an artilleryman during the Second World War, but is paying for his 28 months of service on behalf of Zonolite. I find Kaeding yoked by a 50-foot length of tube to a noisy machine in the corner of his living room. The tubing fits snugly in his nostrils, curls over his ears, runs down his shirt, and snakes its way along the wall to a canister that feeds Kaeding his breath. "God damn, but this is an irritating disease," he says apologetically. "I got these cords to drag around, and they're always in everybody's way. My wife's mother tripped on them one night and broke her arm." Kaeding is 78. His skin is ashen, his hair waxy, his lips blue. He's been on supplemental oxygen for five years, like a puppet on a life-giving string, and, as he tells me, "ain't no one volunteers for this."
Kaeding – who filed a personal-injury suit against W.R. Grace, only to have his claim dismissed for exceeding the three-year statute of limitations – is one of a cadre of Libby residents being kept alive by mechanical means. Most of them don't leave the house much, because the effort of slipping into a portable oxygen unit, which weighs down a frail body and which gets unpleasantly frosty, tends to consume as much energy as an oxygen-deprived person can muster on a given day. Nonetheless, I spot shoppers resting their air tanks in their carts at the local grocery store. I see an oxygen-outfitted man wheeling a bicycle around town, stowing his gear as others would their Gatorade. And one of my new circle of asbestos-diseases acquaintances tells me the tale of an old woman in Libby who, not long ago, while hooked up to her air supply, put her head beneath her bedcovers, lit a furtive cigarette, and blew herself straight to the next world.
EXCERPT FROM THE DEPOSITION OF EARL LOVICK,FORMER LIBBY MINE SUPERINTENDENT, OCTOBER 27, 1998
Q: And you knew at least by 1962 that your men were being diseased, correct?
A: Yes, sir.
Q: It wasn't at risk of disease, they were in fact being diseased, correct?
A: Some of them, yes, sir.
Q: And they were in fact dying, correct?
A: Some of them, yes, sir.
Q: You had absolute proof that these men had been diseased up there at the mill by 1966 at the latest? Is that true?
A: Yes, sir, that would be true.
Q: And none of the records you had on that were shared with the men. Is that true?
A: Yes, sir.
Q: And so at this point it wasn't just a matter of men being exposed to something that might injure or kill them, these men were already injured and dying, and they were continuing to be exposed every day, is that true?
A: Yes, sir.
Q: And is it fair to say that since you knew that workers were going home with asbestos dust on them, that they were taking home toxic dust?