When radiation misfires…literally

The New York Times has a rather chilling account of how radiation overdose in the treatment of some cancer patients caused deadly side effects leading to death. The entire sobering article deserves to be read. In one case a man’s tongue was going to be selectively irradiated; instead his whole face received a blast of radiation that led to a horrible, slow death. His story makes for very painful reading. In another case, misguided radiation beams literally cut out a hole in a woman’s chest that gradually killed her.

And all this mainly because of computer errors that were not detected by human beings, errors that caused the radiation to be overdosed or misdirected. Seems like one of those classic “technology is a double-edged sword” kind of scenarios with the whole system just becoming too complex for human understanding. In one instance, a wedge in a linear accelerator delivering the radiation was supposed to focus the beam in the “in” position. But the computer that used Varian software- the same software that I used in grad school for operating the NMR spectrometer built by the same company- made a mistake and instead pivoted the wedge to the “out” position, removing the radiation shielding. The mistake was not detected 27 times, leading to acute radiation overdoses in the wrong parts of the body. In the case of the man whose tongue was supposed to be treated, an error in the software failed to save the critical settings for the accelerator which would have focused the radiation to the right parts.

The statistics unearthed by the Times are startling. From 2001 to 2009, more than 600 cases of improper radiation treatment were reported. Out of those, 255 were related to an overdose, while 284 were related to the wrong parts of the body being exposed to radiation. Even in its idealized form radiation has side-effects, so one would assume that doctors and technicians would be deathly serious about operating these protocols. These statistics were collected for New York State, which is apparently supposed to have some of the strictest radiation standards in the country.

What is even more shocking is the lack of transparency due to “privacy laws”. Names of the culprits have been withheld, and some of them seem to have been let off the hook with a simple reprimand. Some doctors who have participated in the treatments refused to talk to the journalists. There also does not seem to be a single agency responsible for these radiation safeguards. On top of it all there seem to be scant ways for patients to pick beforehand which hospital they would like to receive radiation treatment in, since records of mistakes are not available to the public. The whole shebang sounds appalling.

Now I understand that 600 cases in 8 years is probably peanuts compared to the total number of cases in which radiation has worked successfully. Nonetheless, the factors responsible for the lapses and the horrendous consequences deserve scrutiny (seriously, death due to “computer error” sounds like something out of a bad science fiction horror movie). For something as serious as radiation treatment for cancer, one would assume that the same kinds of safeguards, fail-safe mechanisms and backup checks would be in place as are used in nuclear reactor safety. Yet it seems that shoddy training, computer error, and lack of accountability are dealing out death and enormous physical and psychological suffering to patients and their families.

EXPELLED! NO NUANCE ALLOWED

I was reminded of the title of Ben Stein’s ludicrous new movie on creationism when I came across BBC’s recalling the Three Mile Island which took place on this day in 1979. The reporting makes it clear how reporters sweetly shy away from any subtleties or scientific nuance, which unfortunately turn out to be details that matter. I do understand that almost everyone was more ignorant or fearful of anything in nuclear in 1979 and to be fair the BBC does note later that nobody died from the accident, but what strikes me is how they used the blanket-word “radiation” so many times in the article without in any way qualifying what it means. This is quite similar to the irrational gut reaction many people have when they hear the word. To recapitulate:

1. “Radiation” bathes us from head to toe throughout our life. Background radiation is hundreds of times more than any radiation accrued from living near a nuclear reaction. It’s even more than radiation possibly escaped from a nuclear reaction in an accident if the reactor has a containment structure.

2. There is no proof that low-level “radiation” causes cancer; in fact there is proof that it may be generally good for life. Plus, almost everybody who reports such studies fails to consider the relative risks from “radiation” compared to other causes. As the well-known scientist James Lovelock notes in his The Revenge of Gaia (2006), it is misleading to say that 40,000 extra people will die earlier because of some radiation. The question is, how much earlier? As he says, if people are going to die on an average a week earlier because of some radiation, compare that to hundreds of thousands that would die instantaneously if the giant dam they live next to bursts open? How many people die years earlier because of heart disease? How many lives are prematurely cut short because of road accidents? Yet we pristinely accept these risks in daily life. People have no problem living near dams on the Yangtze when the risk they pose is much higher than that from “radiation”.

3. And of course, the simple scientific error of not noting what the radiation consists of is commonplace. Every college kid knows that radiation can consist of many different particles- alphas, betas, gammas, neutrons- that each have a vastly different effect on living tissue. Plus, the isotope that emits the radiation is crucial; uranium is vastly preferable to strontium. But strontium has a smaller half life….and so on.

In case of TMI, it was immensely bad timing since the accident was preceded by the scare-mongering movie The China Syndrome starring Jane Fonda, a well-known irrational anti-nuclear spokesman. In it, the reactor core is feared to be melting away through the earth to China, a preposterous scenario even by fictional Hollywood standards. (although some of the Amazon reviewers don’t seem to get this) The point is, it is pure fear-mongering to kick around words like “radiation” and “radioactive steam”. Sadly, the scenario has not changed too much, and I doubt if most people will do a much more responsible job of reporting such an accident if it happens today. I feel miffed in thinking that a similar accident today will essentially impact the public’s perception of nuclear energy almost the same as TMI. I do hope I am wrong. But then, the media has a proven track record of not caring about subtlety and nuance when reporting on science (or many other things for that matter). Unfortunately, they are the “respectable” sources who reach the most people and who most people rely on for their daily dose of “reality”.