Philadelphia Reflections

The musings of a physician who has served the community for over six decades

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Philadelphia Physicians
Philadelphia dominated the medical profession so long that it's hard to distinguish between local traditions and national ones. The distinctive feature is that in Philadelphia you must be a real doctor before you become a mere specialist.


Central Pennsylvania
"Alabama in-between," snickered James Carville, "Philadelphia, Pittsburgh, and Alabama in-between."

Three-Mile Island

Three Mile Island

On a mud flat of the Susquehanna River called Three Mile Island, a nuclear energy plant had been built around 1970. The mud flat was in front of the entrance of the Swatara Creek, where Middletown the first town in the County had been laid out in 1732. Later on, the town of Harrisburg became the capital city of Pennsylvania, located a few miles north of the Swatara Creek at what had been called Harris's Ferry, later Harrisburg. For quite a while, Middletown and Hummelstown, also on the Swatara Creek, were the two main towns in the area, but the location of the state capital attracted railroads and steel mills to Harrisburg. One of its main claims to fame was that Confederate General Robert E. Lee was thought to have it as his primary objective for invading the North, frustrated in this goal of course by his defeat at the battle of Gettysburg. Meanwhile, Middletown has declined to a small country town and was therefore originally glad to have the industry of electricity generation located next to it. It's true the huge cooling towers loomed ominously, and huge plumes of evaporated water rose in clouds to be seen for miles. But Middletown slowly took on the look of a refurbished 18th Century town, fancy new restaurants and all, prosperous and waiting to be discovered as a tourist attraction. Maybe in time, it would be the next Williamsburg.

{The China Syndrome}
The China Syndrome

On March 28, 1979, some valve got stuck within Reactor Number Two. The plant had two reactors, each with a spare cooling tower so it looked as though there were four nuclear plants instead of two. Warning lights and whistles went off, and it is easy to imagine a general panic within the operators of the plant, especially since a popular movie, The China Syndrome had just been issued two weeks earlier, depicting an imaginary implosion of a similar nuclear plant with famous movie actresses running around screaming. It took about five days for the plant operators to make a preliminary assessment of the TMI situation, which did not seem as bad as it might have been. It would take six months to reach a final evaluation of just what had gone wrong, and why. In the meantime, almost anyone could say or imagine almost anything; no one could prove they were wrong. The local citizens held a referendum; they wanted all of the facility to be closed, permanently. Secretary of Health Gordon MacLeod wanted a somewhat more reasonable thing, which was large supplies of sodium iodide pills to be distributed to the populace to prevent the radioactive iodine content of escaped gases from being attracted to the thyroid glands of the population, especially children and child-bearing mothers. Unfortunately, he took the unforgivable step of criticizing the state government for not having stock-piled the pills, and the Governor fired him, thus demonstrating strong decisive action in an emergency. The news media were equally at sea because this was big news. When all was finally said and done, there was no evidence that anyone was injured as a result of the accident. More than thirty years later, there is still no sign that anyone was ever hurt.

{Hiroshima Explosion}
Hiroshima Explosion

We might not have been so lucky, of course. When the Russian plant at Chernobyl had a worse accident in 1986, literally thousands of Ukrainians were sickened, and the death rate was appreciable. In Japan, the victims of the Hiroshima explosion were closely followed for many years, and the incidence of cancer of the thyroid among the survivors was truly frightening. However, after more decades elapsed, it was possible to determine that the overall death rate from thyroid cancer was not increased, suggesting these new cancers were not particularly malignant. But in a different set of circumstances, when the Chinese set off their tests of nuclear weapons, it became clear that these tests were followed in a few years by a world-wide epidemic of Hashimoto's Disease of the thyroid. Radioactivity in mushroom clouds is mainly radioactive iodine, with a half-life of seven days. Unfortunately, the clouds sail around the earth, eventually settling into the dirt on the ground. Grass grows there, and cows eat the grass. By this time, the radioactivity is much diminished, but the digestive systems of cows concentrate this weak radioactive iodine, which then gets into milk in a more active form. The kids drink milk and get Hashimoto's disease. Whether they will later get thyroid cancer and die of it remains unknown, but possibly not, in view of the Hiroshima experience. So, amidst a welter of conflicting evidence, it is still possible to say almost anything about nuclear power risks without fear of provable contradiction. It is only safe to repeat that radioactive iodine exposure doesn't do anyone any good.

Unfortunately, thirty years after the accident, we now all understand it would be a good thing to develop energy independence from Middle East sources; but we remain unsure just how unsafe we are willing to become in order to re-adopt nuclear energy. Since the accident at Three Mile Island, our government has made it impossible for a single atomic plant to be built in America. And the politicians are surely right about frightening public opinion on the topic. Just look at pretty little Middletown: it's moving toward becoming a dilapidated ghost town.

Without claiming any expertise in atomic energy production, it is possible to quote others to the effect that the hesitation of the politicians is no longer focused on the danger that a plant will explode. Rather, the real dispute is about the disposal of nuclear waste. No one wants it nearby. The French have built nearly sixty plants in the thirty years we have hesitated; how do the French dispose of nuclear waste? The answer seems to be that waste disposal is not a problem with the French methodology, but a new problem surfaces that the French approach generates a type of waste which is much easier for an undeveloped country to deploy as material for atomic bombs. So, the rumor commonly circulating is that this is really the main practical objection to constructing nuclear energy plants in the French style. As is true for the entire nuclear topic, the rumors outrun the evidence.

Originally published: Wednesday, October 27, 2010; most-recently modified: Thursday, June 06, 2019