Black lung expertise with a little sass

Who says speakers of note don't come to Lee County, Virginia?  If someone here in Jonesville had told me that a nationally-known scientist and medical examiner was to be visiting the area I probably would have rolled my eyes at them and said "Really?" too. Nonetheless, last Thursday I had the (free) privilege and entertainment of hearing Dr. Joshua Perper speak locally on the issues of: coal workers' pneumoconiosis (i.e. black lung), typical, medically-recognized symptoms, and necessary medical proof that a coal worker needs in order to collect medical benefits from the afflictions of black lung. Like I said, Dr. Perper is a medical examiner of national esteem, most widely known for his efforts as chief ME in Broward County, Florida for 17 years (1994-2011) and performing the autopsy of former Playboy model and actress Anna Nicole Smith. He's basically Alex Woods of CSI Miami! You see the similarities, right?:

       
Images taken from: http://www.tvrage.com/CSI_Miami/character_guide?character=691
http://articles.sun-sentinel.com/2011-09-07/news/fl-perper-press-conference-20110906_1_zvi-harry-perper-medical-examiners-commission-illegal-pill-sales

Yeah, me neither. In addition to his work at a medical examiner, toxicologist and forensic pathologist, Dr. Perper has done a great deal of research on coal workers pneumoconiosis. His talk was remarkably enlightening, highlighting in some very accessible ways via explanations, pictures, etc. the key components of black lung and why it is so harmful. For example, smokers can immediately begin improving their respiratory health by ceasing to smoke. Not true for coal workers who have been exposed to coal dust due to their labor in the mines; the dust particles that enter their lungs will remain there forever. Thus, years after not working in the mines, an individual will still have those particles floating around in his lungs, causing scratching and scarring of valuable lung tissue.

Another commonly posed question deals with the pollutant particles that millions, even billions of city inhabitants inhale daily as they go about their normal lives. Isn't this dust just as dangerous to the lungs, and why haven't all those individuals also developed black lung like coal workers? Dr. Perper explained that development of black lung does not occur, even if the pollution is from coal waste product substances, because there are distinct kinds of minerals and particles released from the rock when it is extracted in its raw form (within the mine). Thus, coal workers are exposed to a more raw, dangerous form of the coal dust not present in the "refined" pollution of a city. In conclusion, my asthmatic self (and subsequent interest in the respiratory system and other breathing conditions), plus my undying curiosity, plus a part of my undergraduate student self that misses the weekly chance to hear a speaker on any given topic thoroughly enjoyed listening to Dr. Perper's presentation. Unfortunately, it seems that the extensive medical proof necessary to legally and medically establish that a former coal miner has coal workers' pneumoconiosis is nearly impossible to provide with convincing certainty to the proper authorities-- many of whom I assume are in the back pockets of the coal company giants. A combination of breathing capacity tests/studies, lung biopsies, chest scans, proof of working in the mine for an elongated period of time and finally, a certified autopsy by a certified medical examiner are all integral for a coal worker or his widow to receive financial compensation for the condition. It seems like sort of a crazy, sad reality.

The "little sass" that I mention in this post's title came from Dr. Perper himself and his presentation style. His talk was hosted in the newly renovated Lee Theater which opened just a little over a month ago. The first quirkiness emerged within the sound system's set-up. Dr. Perper was initially stationed behind a podium with a microphone but it quickly became evident that: 1) the microphone had not been readjusted for Dr. Perper's height and 2) Dr. Perper did not want to be limited by the confines of that podium to do his speaking. Many muffled words, a few giggles (mine) and strained looks (from cute little coal workers' widows) from the audience, and 4 gentlemen approaching the podium later and Dr. Perper finally emerged to stand in front of the podium, microphone in hand, to continue delivering his talk. The best part though was the antics that surfaced with whomever was controlling Dr. Perper's powerpoint presentation from the balcony. This individual seemed to have trouble not only with paying enough attention to change the slide on Dr. Perper's (very clear) hand cue, but also with the backward versus forward concept of advancing the presentation's slides. At one point of elevating frustration, Dr. Perper commented "It's not a car you know." The audience died with laughter but the tech controller must have been mortified. Let your imagination add here the doctor's unique character standing front and center: a Romanian who escaped Nazi rule during WWII, sought asylum and education in Israel, earning degrees in medicine and law, an immigrant to the United States who studied forensic pathology at Johns Hopkins and worked for the cities of Baltimore, Pittsburgh and Broward County (Fort Lauderdale, Florida). He was the epitome of a strong, straightforward personality-- all business.  I'm still not sure why the technical execution of the presentation was such an issue; how much more simple can advancing slides in a Powerpoint presentation be?

Lesson for the week: never, ever underestimate who might boldly cross the threshold of the Lee Theater. You might be pleasantly surprised.