Libby clinic remains on front line of care

At the Center for Asbestos Related Disease, where new patients still walk through the doors on a weekly basis, fingers crossed for a negative diagnosis, the clinic’s research and medical staff understand with the utmost clarity their mission in Libby is far from over.

A trip to the clinic, commonly referred to as CARD, is a gamble that weighs heavy on most as statistics suggest about half of screenings end with a positive diagnosis for asbestos-related disease.

The intimidating benchmark is one that has remained consistent for the majority of the clinic’s 19 years of existence, regardless of the varying volumes of people who have sought screenings over the course of nearly two decades.

According to Dusti Thompson, outreach specialist for CARD, there are 7,000 patients currently on the clinic’s list, which translates to approximately 180 patients a month.

That number is up from 5,540 patients in 2013, according to one summary report that also relayed at the time, “there is a strong need for ongoing screening services.”

The numbers indicate the obvious ­— the clinic serves an important purpose and will for quite some time to come. How long the clinic will be around, however, is currently undetermined.

That’s because there is a 20- to 50-year latency period associated with the Libby amphibole asbestos-related diseases diagnosed at the clinic, which include mesothelioma, asbestosis and lung cancer.

Some officials with CARD estimate the steady stream of new patients coming to the clinic may only begin to subside in 2030.

“We would love to shut the place down,” said Mike Giesey, president of CARD’s board of directors. “But with that latency period, we still have people walking through the doors all the time. Believe me, we are anxious for the day that CARD is no longer needed.”

The patients are all victims of the W.R. Grace & Co. vermiculite mining operations that lasted for decades as miners unknowingly brought toxic asbestos dust from the nearby mine into their homes, exposing their families to harmful fibers that, when inhaled, latch onto the lungs. The mine’s operations ceased in 1990, a year marker that, because of the disease’s latency period, means people may still be diagnosed with asbestos-related disease possibly into 2040 and beyond.

“When you look at the big picture, we have a ways to go,” Giesey said.

Despite the center having launched in 2000 as part of St. John’s Lutheran Hospital, Giesey said the latency period makes it seem as though the clinic’s work is “only just getting started.”

It’s a daunting thought as other major players in Libby’s asbestos crisis, such as the U.S. Environmental Protection Agency, are wrapping up the tasks they set out to accomplish 20 years ago. The end of the agency’s cleanup and subsequent handoff of the project to state and local governments means almost all EPA employees will be gone by the start of the new year.

But as the agency prepares to depart, the clinic has no intentions of leaving — a sentiment that was expressed in a recent letter to the clinic’s patients.

“The EPA is finished with what they are doing, yes, but CARD isn’t going anywhere. The Libby, Montana community and its residents are still facing a critical environmental and public health crisis caused by the slow motion technological disaster of asbestos exposure,” the letter reads.

AS ONE headline in a Dec. 3, 2000, article by the Daily Inter Lake read, the “clinic is on the front line of health care,” and that’s a reputation Giesey said will stick with the center until their last patient walks through the door.

The clinic first opened after Agency for Toxic Substances and Disease Registry screenings during 2000 and 2001 identified high number of lung abnormalities in patients. Officials said it became apparent that long-term specialty care needed to be established.

The clinic began as a department of St. John’s Lutheran Hospital in 2000. CARD moved to its current location off East Third Street in 2004.

In the early 2000s, Dr. Alan Whitehouse of Spokane came on as a consulting physician to the clinic. Whitehouse, now 82 and retired in Spokane, is largely credited with being the first to research the amphibole asbestos fibers in the 1970s and ’80s after he began noticing patterns in his patients in Spokane who had worked at the mine. He was the first pulmonary doctor in Libby.

Whitehouse was one of the first to recognize the strange latency period and notice that amphibole asbestos-related disease weren’t even common until mine operations had been underway for many years.

“That latency period was one of the oddest discoveries,” Whitehouse said. “When I was so deeply involved in this back in the day, I had figured it wasn’t rearing its ugly head until 10 to 20 years after exposure.”

Whitehouse recalls it took quite some time before anyone believed him and his research. He said everyone “thought he was crazy.”

But one physician who began to listen was Dr. Brad Black, who has been a doctor in Libby since 1977 and is currently in charge of the CARD clinic. Black has been on the front line of care at the CARD clinic since its early days.

Looking back, Whitehouse said he believes his groundbreaking research and work in Libby is a highlight of his career. He said his patients kept him coming back to Libby for years, despite his discoveries initially falling on deaf ears.

For some reason people chose not to believe science and doctors,” Whitehouse said. “But it was something that still needed to be done. When people are hurting it’s our job to help; that’s just what doctors do.”

Reporter Kianna Gardner can be reached at 748-4407 or kgardner@dailyinterlake.com