CHAPTER TWO babies. When the scientists gave fluoride to the baby rats following their birth, the animals had cognitive deficits, and exhibited retarded behavior. There were sex differences, too. Males appeared more sensitive to fluoride in the womb; females were more affected when exposed as weanlings or young adults. The two women told Jack Hein and Harold Hodge about the results. The men ordered them to repeat the experiments, this time on different rats. The team performed still more tests. Mullenix remembers that Harold Hodge kept asking her about the results, even though he was by now very ill. He had gone to his home in Maine but kept in contact by telephone. He asked every day. By 1990 the data were crystal clear. The women had tested more than five hundred rats. "I finally said we have got enough animals here for statistical significance, said Mullenix. There is a problem," she added. The two women talked endlessly about what they had found. Mullenix was a newcomer to fluoride research, but Pamela Den-Besten had spent her career studying the chemical. She suspected that they had made an explosive discovery and that dentists in particular would find the information important. My initial gut reaction was that this is really big, said DenBesten. Although the Forsyth rats had been given fluoride at a higher concentration than people normally drink in their water — an equivalent of 5 parts per million as opposed to 1 part per million — DenBesten also knew that many Americans are routinely exposed to higher levels of fluoride every day. For example, people who drink large amounts of water, such as athletes or laborers in the hot sun; people who consume certain foods or juices with high fluoride levels; children who use fluoride supplements from their dentists; some factory workers, as the result of workplace exposure; or certain sick people, all can end up consuming higher cumulative levels of fluoride. Those levels of consumption begin to approach — or can even surpass, for some groups — the same fluoride levels seen in the Forsyth rats. "If you have someone who has a medical condition, where they have diabetes insipidus where you drink lots of water, or kidney disease — anything that would alter how you process fluoride — then you could climb up to those levels, said DenBesten. She thought that the Forsyth research results would quickly be followed up by FIREWORKS AT FORSYTH 13 a whole series of additional experiments examining, for example, whether fluoride at even lower levels, 1 part per million, produced central-nervous-system effects. "I assumed it would take off on its own, that a lot of people would be very concerned, she added. Jack Hein was excited as well, remembers Mullenix. (Harold Hodge had died before she could get the final results to him.)' Hein said, I want you to go to Washington, Mullenix said. Go to the National Institute of Dental Research and give them a seminar. Tell them what you are finding. Jack Hein knew that if more research on the toxicity of low-dose fluoride was to be done, the government's National Institutes of Health and the U. S. Public Health Service needed to be involved. THE CAMPUS-STYLE GROUNDS of the federal National Institutes of Health (NIH), just north of Washington DC, have the leafy spaciousness of an Ivy League college. White-coated scientists and government bureaucrats in suits and ties stroll the tree-lined walkways that connect laboratories with office buildings. This is the headquarters of the U.S. governments efforts to coordinate health research around the country, with an annual budget of $23.4 billion forked out by US taxpayers. 2 The campus is the home of the different NIH divisions, such as the National Cancer Institute and the National Institute of Dental Research (NIDR), as it was then known. (Today it is known as the National Institute of Dental and Craniofacial Research.) On October to, 1990, Phyllis Mullenix and Jack Hein arrived at the NIH campus to tell senior government scientists and policy makers about her fluoride research. As director of the nation's leading private dental-research institute, Jack Hein was well-known and respected at NIH. He had helped to arrange the Mullenix lecture. Mullenix was no stranger to public-health officials either. One of the Institutes' biggest divisions, the National Cancer Institute, had awarded her a grant that same year totaling over $600,000. The money was for a study to investigate the neurotoxic effects of some of the drugs and therapies used in treating childhood leukemia. Many of those drugs and radiation therapies can slow the leukemia but are so powerful that they often produce central-nervous-system effects and can retard childhood intelligence. The government 14 CHAPTER TWO wanted Mullenix to use her new RAPID computer technology at Forsyth to measure the neurotoxicity of these drugs. To present her fluoride data, Mullenix and Hein had flown from Boston, arriving a little early. Hein met up with some old friends from NIDR, while Mullenix strolled into the main hospital building on the Bethesda campus, killing time before her seminar. In the hallway, the scientist started to giggle. On the wall was a colorful posterboard display, recently mounted by NIH officials, titled The Miracle of Fluoride. "I thought how odd," remembered Mullenix. "It's 1990 and they are talking about the miracle of fluoride, and now I'm going to tell them that their fluoride is causing a neurotoxicity that is worse than that induced by some cases of amphetamines or radiation. I'm here to tell them that fluoride is neurotoxic." She read on. Ironically, her trip to Washington fell on the historic fortieth anniversary of the Public Health Service's endorsement of community water fluoridation. Mullenix knew little about fluoride's history. The chemical had long been the great white hope of the NIDR, once promising to vanquish blackened teeth in much the same way that antibiotics had been a magic bullet for doctors in the second half of the twentieth century, beating back disease and infection. Terrible teeth had stalked the developed world since the industrial revolution, when the whole -grain and fiber diet of an earlier agrarian era was often replaced by a poorer urban fare, including increased quantities of refined carbohydrates and sugars.' Cavities are produced when bacteria in the mouth ferment such sugars and carbohydrates, attacking tooth enamel, with the resulting acid penetrating into the tooth's core. Hope of a simple fix for bad teeth arrived in the 1930s, when a Public Health Service dental researcher named Dr. H. Trendley Dean reported finding fewer dental cavities in some parts of the United States, where there is natural fluoride in the water supply. Dean's studies became the scientific underpinning for artificial water fluoridation, which was begun in the 1940s and 1950s. Dean also became the first head of the NIDR. By the 1960s and 1970s, with rates of tooth decay in free fall across the United States, dental officials pointed a proud finger at the fluoride added to water and toothpaste. NIDR officials revered H. Trendley Dean as the father of fluoridation." FIREWORKS AT FORSYTH 15 "It was a major discovery by the Institute, said Jack Hein. But opposition to fluoridation had been intense from the start. The postwar decline in rates of dental decay in developed nations had also occurred in communities where fluoride was not added to drinking water and had begun in some cases before the arrival of fluoride toothpaste.' Widespread use of antibiotics, better nutrition, improved oral hygiene, and increased access to dental care were also cited as reasons. And while medical and scientific resistance to fluoridation had been fierce and well-argued — the grassroots popular opposition was in many ways a precursor of todays environmental movement — Mullenix found the NIH's posterboard account of antifluoridation history to be oddly scornful. "They made a joke about antifluoridationists all being little old ladies in tennis shoes," she said. "That stuck in my mind." Since Deans day laboratory studies have forced a revolution in official thinking about how fluoride works.' While early researchers speculated that swallowed fluoride was incorporated "systemi-cally" into tooth enamel even before the tooth erupted in a child's mouth — making it more resistant to decay — scientists now believe that fluoride acts almost exclusively from outside the tooth, or "topi- cally" (such a "topical" effect has always been the explanation for how fluoride toothpaste functions, too). This new research says that fluoride defends teeth by slowing the harmful "demineralization" of calcium and phosphate from tooth enamel, which can leave teeth vulnerable to cavities. Fluoride also helps to remineralize enamel by laying down fresh crystal layers of calcium and a durable fluoride compound known as fluorapatite. And there is a third "killer" effect, in which the acid produced from fermenting food combines with fluoride, forming hydrogen fluoride (HF). This powerful chemical can then penetrate cell membranes, interfering with enzyme activity, and rendering bad bacteria impotent.' I still believe that fluoride works, says the Canadian dental researcher turned critic of water fluoridation, Dr. Hardy Limeback. It works topically. But these new ideas have not quenched the old debate. Dental officials now argue that water fluoridation produces a lifelong benefit not just for children; by bathing all teeth in water, officials argue, fluoride is continually repairing and protecting tooth enamel in 16 CHAPTER TWO teeth of all ages. Critics worry, however, that if hydrogen fluoride can inhibit bacteria enzymes in the mouth, then swallowing fluoride may unintentionally deliver similar killer blows to necessary bodily enzymes, thus also inhibiting the ones we need.' Phyllis Mullenix, reading the NIH fluoride posters and preparing to give her speech on that fall day in 1990, knew almost nothing of the history of controversy surrounding fluoride. She was about to walk into the lion s den. She was stunned when she entered the lecture hall at the National Institutes of Health. It was packed. There were officials from the Food and Drug Administration. She spotted the head of the National Institute of Dental Research, Dr. Harald Loe, and she noticed men in uniform from the Public Health Service. The lights dimmed. Mullenix told them about the new RAPID computer technology at Forsyth. At first the audience seemed excited. Then she outlined her fluoride experiment. She explained that the central-nervous-system effects seen in the rats resembled the injuries seen when rats were given powerful antileukemia drugs and radiation therapies. The pattern of central-nervous-system effects on the rats from fluoride matched perfectly, she said. The room fell suddenly quiet. She attempted a joke. I said, I may be a little old lady, but I m not wearing tennis shoes, she remembers. Nobody was laughing. In fact, they were really kind of nasty. The big guns from the NIH opened up. Hands shot into the air. They started firing question after question, attacking me with respect to the methodology," remembered Mullenix. She answered their ques tions patiently, and finally, when there were no more hands in the air, she and Jack Hein climbed into a cab and headed for the airport. Jack Hein is reluctant to discuss these long-ago events. It was a messy ending to his career. He retired from Forsyth the following year, in 1991. He agrees that the Mullenix fluoride results were unpopular but adds that data showing fluoride damage to the central nervous system should have been "vigorously" followed up. " That perspective had never been looked at before," he remarks. "It turned out there was something there. Hein believes that getting the NIDR and the government to change their position on fluoride, however, is a difficult task. Many senior public-health officials have devoted their professional careers to promoting fluoride. NIDR really fought hard showing that fluoride was effective, Hein says. FIREWORKS AT FORSYTH 17 "It was a major discovery by the Institute. They did everything they could to promote it. " Hein made a final effort to sound a warning on fluoride. He told Mullenix that he was going to call a meeting of industry officials whose products contained fluoride. Like Mullenix, Hein had spent a career cultivating ties with various large-scale industries. He sent her a note listing the people who are coming for a private Fluoride Toxicity conference that would be held in his Forsyth office. He said, NIDR were being stupid, the industries will respond better, Mullenix recalls. Several months after the Washington seminar, Phyllis Mullenix sat at the table in Jack Hein s office with representatives from three of the worlds most powerful drug companies: Unilever, Colgate-Palmolive, and SmithKline Beecham. Anthony Volpe, Colgate-Palmolive s Worldwide Director of Clinical Dental Research, was there, and so was Sal Mazzanobile, Director of Oral Health Research for Beecham. The senior scientist Joe Kanapka was sent by the big transnational company Unilever. Mullenix outlined her fluoride findings. The men took notes. Suddenly Joe Kanapka of Unilever leaned back in his chair with an exasperated look. "He said, Do you realize what you are saying to us, that our fluoride products are lowering the IQ of children? remembers Mullenix. And I said, Well yes, that is what I am saying to you.'" As they left, the men "slapped me on the back," Mullenix said, telling her, "We will be in touch, we need to pursue this." The next day a note from Jack Hein's office arrived with the tele- phone numbers of the industry men, so that she could follow up. "I did call them," says Mullenix. "And I called. And the weeks went by and the months went by." Eventually Joe Kanapka from Unilever called back, she remembers. "He says, V I gave it to my superiors and they haven t gotten back to me. Contacted recently, Joe Kanapka said that he had visited Forsyth many times" but had no memory of the fluoride conference. When asked if he had once worried that his products might be hurting children's intelligence, he replied, "Oh God, I don't remember any- thing like that, Im sorry. He explained that open-heart surgery had temporarily impaired his memory. I dont remember who Mullenix is," he added. 18 CHAPTER TWO Beechams Sal Mazzanobile remembers the meeting. The fluoride data presented that day were preliminary, he recalled. Mullenix never called him again, he claims, and he therefore presumed her data were inaccurate. I cant see why, if somebody had data like that, they would not follow up with another study in a larger animal model, maybe then go into humans, he said. It could be a major health problem. Did the director of consumer brands at Beecham — makers of several fluoride products — call Mullenix himself or find out if her data were ever published? "I wasn't the person responsible to follow up, if there was a follow-up," Mazzanobile answered. He did not remember who at Beecham, if anybody, might have had responsibility for keeping apprised of the Mullenix research. Procter and Gamble followed up on Mullenix's warning. They flew her out to their Miami Valley laboratories in Cincinnati. Mullenix flew home with a contract and some seed money to begin a study to look at the effects of fluoride on children s intelligence. Shortly afterward, however, "they pulled out and I never heard from them again, recalls Mullenix. In 1995 Mullenix and her team published their data in the scientific journal Neurotoxicology and Teratology. Their paper explained that, while a great deal of research had already been done on fluoride, almost none had looked at fluorides effects on the brain. And while earlier research had suggested that fluoride did not cross the crucial blood brain barrier, thus protecting the central nervous system, Mullenix's findings now revealed that "such impermeability does not apply to chronic exposure situations." 9 When the baby rats drank water with added fluoride, the scientists had measured increased fluoride levels in the brain. And more fluoride in the brain was associated with "significant behavioral changes" in the young rats, which resembled "cognitive deficits," the scientists reported. The paper also suggested that when the fluoride was given to pregnant rats, it reached the brain of the fetus, thus producing an effect resembling hyperactivity in the male newborns. The Mullenix research eventually caught the attention of another team of Boston scientists studying central-nervous-system problems. They produced a report in 2000 reviewing whether toxic chemicals had a role in producing what they described as an epidemic FIREWORKS AT FORSYTH 19 of developmental, learning and behavioral disabilities in children. Their report considered the role of fluoride, and focused on the Mullenix research in particular. In Harms Way — Toxic Threats to Child Development by the Greater Boston chapter of Physicians for Social Responsibility described how 12 million children (17 percent) in the United States suffer from one or more learning, developmental, or behavioral disabilities." Attention deficit and hyperactivity disorder (ADHD) affects 3 to 6 percent of all school-children, although recent evidence suggests the prevalence may be much higher, the scientists noted. Not enough is known about fluoride to link it directly to ADHD or other health effects, the report pointed out. Nevertheless, the existing research on fluoride and its central-nervous-system effects were " provocative and of significant public health concern," the team concluded. The Mullenix research surprised one of the authors of the report, Dr. Ted Schettler. He had previously known almost nothing about fluoride. It hadnt been on my radar screen, he said. Most startling was how few studies had been done on fluorides central-ner vous-system effects. Schettler turned up just two other reports, both from China, suggesting that fluoride in water supplies had reduced IQ in some villages. That just strikes me as unbelievable quite frankly," he said. "How this has come to pass is extraordinary. That for forty years we have been putting fluoride into the nations water supplies — and how little we know about [what] its neurological developmental impacts are.... We damn well ought to know more about it than we do." Does Mullenix s work have any relevance to children? Schettler does not know. Comparing animal studies to humans is an uncertain science, he explained. Nor was Schettler familiar with Mullenix's computer testing system. But the toxic characteristics and behavior of other chemicals and metals, such as lead and mercury, concern him. For those pollutants, at least, human sensitivity is much greater than in animal experiments; among humans, it is greater in children than in adults. The impact of other toxic chemicals on the developing brain is often serious and irreversible. So is the Mullenix work worth anything? I don t know the answer to that," Schettler said. "But what I do draw from it is that it is quite plausible from her work and others that fluoride inter- 20 CHAPTER TWO feres with normal brain development, and that we better go out to get the answers to this in human populations. The burden of testing for neurological effects falls on the Public Health Service, which has promoted water fluoridations role in dental health for half a century. Whenever anybody or any organization attempts a public health intervention, there is an obligation to monitor emerging science on the issue — and also continue to monitor impacts in the communities where the intervention is instituted. So that when new data comes along that says, Whoa, this is interesting, here is a health effect that we hadnt thought about,' we better have a look at this to make sure our decision is still a good one, Schettler said. Phyllis Mullenix says that she carried the ball just about as far as she could. Following the seminar at NIH, Harald Loe, the director of the National Institute of Dental Research, had written to Forsyth's director Jack Hein on October 23, 1990, thanking him and Mullenix for their visit and confirming "the potential significance of work in this area." He asked Mullenix to submit additional requests for funding. "NIDR would be pleased to support development of such an innovative methodology which could have broad significance for protecting health," Loe wrote. 10 "I was very excited about that," said Mullenix. "I took their suggestions in the letter. [However] every one of them ended up in a dead end.' Mullenix now believes that the 1990 letter was a cruel ruse — to cover up the fact that the NIH had no interest in learning about fluoride's potential central-nervous-system effects. "What they put in writing they had no intentions [of funding]. It took years to figure that out," she says. Dr. Antonio Noronha, an NIH scientific -review adviser familiar with Dr. Mullenix's grant request, says a scientific peer-review group rejected her proposal. He terms her claim of institutional bias against fluoride central-nervous-system research "farfetched." He adds, We strive very hard at NIH to make sure politics does not enter the picture.'" But fourteen years after Mullenix s Washington seminar the NIH still has not funded any examination of fluoride's central-nervous-system effects and, according to one senior official, does not currently regard fluoride and central-nervous-system effects as a FIREWORKS AT FORSYTH 21 research priority. No, it certainly isnt, said Annette Kirshner, a neurotoxicology specialist with the National Institute of Environmental Health Studies (NIEHS). Dr. Kirshner confirmed that although our mission is to look into the effects of toxins [and] adverse environmental exposures on human health, she could recall no grants being given to study the central-nervous-system effects of fluoride. "We'd had one or two grants in the past on sodium fluoride, but in my time they've not been neuro grants, and I've been at this institute about thirteen and a half years." Does NIEHS have plans to conduct such research? "We do not and I doubt if the other Institutes intend to," said Dr. Kirshner by e-mail. Nor do the governments dental experts plan on studying fluorides central-nervous-system effects any time soon. In an e-mail sent to me on July 19, 2002, Dr. Robert H. Selwitz of the same agency wrote that he was "not aware of any follow-up studies" nor were the potential CNS effects of fluoride "a topic of primary focus" for government grant givers. Dr. Selwitz is the Senior Dental Epidemiologist and Director of the Residency Program in Dental Public Health, National Institute of Dental and Craniofacial Research, NIH. At first he appeared to suggest that the Mullenix study had little relevance for human beings, telling me that her rats were "fed fluoride at levels as high as 175 times the concentration found in fluoridated drinking water. But his statement was subtly misleading. Rats and humans have very different metabolisms, and in laboratory experiments these differences must be compensated for. The critical measurement in studying effects on the central nervous system is not how much fluoride is given to the laboratory animals but how much of the chemical, after they drink it, subsequently appears in the animals blood. The amount of fluoride in the blood of the Mullenix rats — a measurement known as the blood serum level — had been the equivalent of what would appear in the blood of a human drinking about 5 parts per million of fluoride in water. This, of course, is just five times the level the government suggests is optimal for fluoridated water- 1 ppm. I asked Dr. Selwitz, therefore, if it was fair to portray the Mullenix rats as having drunk 175 times the amount of fluoride that citizens normally consume from fluoridated water. 22 CHAPTER TWO Wasn't the "blood serum" measurement and comparison more relevant? Wasn't his statement, inadvertently at least, misleading? Dr. Selwitz, who had just been ready to dispense medical arguments and implied reassurances as to why Mullenix's research was not relevant to human beings, now explained that he could not answer my question. "The questions you are asking in your recent e-mail message involve the field of fluoride physiology," wrote the senior dental epidemiologist at NIDCR. "This subject is not my area of expertise." FAR FROM USHERING in new opportunities for scientific research, Mullenixs fluoride studies appear to have spelled the death knell for her once-promising academic career. When Jack Hein retired from Forsyth on June 30, 1991, the date marked the beginning of a very different work environment for Phyllis Mullenix. She gave a seminar at Forsyth on February 20, 1992, outlining what she had discovered and explaining that she hoped to publish a major paper about fluoride toxicity with Pamela DenBesten. "That's when my troubles started," said Mullenix. Pam DenBesten had been worried about the Boston seminar. Senior researchers at Forsyth, such as Paul DePaola, had published favorable research on fluoride since the 196os. The seminar was " ugly," says Mullenix. DenBesten describes the scientists' response as "angry" and "sarcastic." "She was risking their reputation with NIH," DenBesten explains. Karen Snapp remembers "hostile" questioning of Mullenix by the audience. "They looked upon Phylliss research as a threat. The dental business in this country is focused on fluoride. They felt that funding would dry up. We are supposed to be saying that fluoride is good for you, whereas somebody is saying maybe it is not good for you. ... In their own little minds, they were worried about that." The following day Forsyth's associate director, Don Hay, approached Mullenix. "He said, 'You are going against what the dentists and everybody have been publishing for fifty years, that this is safe and effective. You must be wrong,'" Mullenix recalled. "He told me, You are jeopardizing the financial support of this entire institution. If you publish these studies, NIDR is not going to fund any more research at Forsyth. FIREWORKS AT FORSYTH 23 Karen Snapp also remembers Don Hay as opposing publication of the paper. "He didn't believe the science. He didn't believe the results — and he did not think the paper should go out." Both Snapp and Mullenix were concerned that somehow Don Hay would prevent the paper from being published. "I think we were even laughing about it, saying I think in America we have something called freedom of the press, freedom of speech?" Snapp recalls. Don Hay calls allegations that he considered suppressing the Mullenix research "false." He told Salon.com: "My concern was that Dr. Mullenix, who had no published record in fluoride research, was reaching conclusions that seemed to differ from a large body of research reported over the last fifty years. We had no knowledge of the acceptance of her paper prior to the time she left [Forsyth] ." Editor Donald E. Hutchings of Neurotoxicology and Teratology, where the Mullenix paper was published, says that there was no effort to censor or pressure him in any way. Her study was first "peer -reviewed" by other scientists, revised, and then accepted. "Was I called and told that 'If you publish this we are going to review your income taxes, [or] send you a picture of J. Edgar Hoover in a dress?' No," he said. Hutchings was a little bemused, however, to get such a critical paper on fluoride from a Forsyth researcher. He knew that Forsyth had long been a leading supporter of a role for fluoride in dentistry. "It almost strikes me like you are working in a distillery and you are doing work studying fetal alcohol syndrome. That is not work that they are going to be eager to be sponsoring. I didn't care — it wasn't my career. I thought it was really courageous of her to be doing that." On May 18,1994 — Just days after the paper had been accepted — Forsyth fired Mullenix. The termination letter merely stated that her contract would not be renewed. There was no mention of fluoride. A new regime was now installed at the Center. The toxicology department was closed, and a new Board of Overseers had been established, with the mission "to advise the Director in matters dealing with industrial relationships." 14 Mullenix describes the final couple of months at Forsyth as the lowest ebb in her career. The big grant from the National Cancer Institute had dried up and her laboratory conditions were horrible, she said. "The roof leaked, they destroyed the equipment, they 24 CHAPTER TWO destroyed the animals. That was the lowest point, right before I physi cally moved out in July 1994. Nobody would even talk to me. Her mother remembers Phyllis calling frequently that summer. She was very upset about it, said Olive Mullenix. At first she wondered if her daughter had done something wrong. Phyllis explained that her fluoride research had been unpopular. There was no use to get angry, said Olive Mullenix. She was honest about what she found and they didn't like it." Stata Norton got calls too from her former student. Norton was not surprised at the hostile response from Forsyth. She knew that clean data can attract dirty politics. There are situations in which people don't want data challenged, they don't want arguments," said Norton. The implications of Mullenix s work have been buried, according to her former colleague, the scientist Karen Snapp. Is it fair to say that we don't know the answer to the central-nervous-system effects of the fluoride we currently ingest? I think that Phyllis got just the tip of the iceberg. There needs to be more work in that area, Snapp said. Jack Hein wishes that he had approached things differently. He knew that the scientific landscape of the last fifty years was littered with the bodies of a lot of people who, like Phyllis Mullenix, got tangled up in the fluoride controversy. His team should have tested other dental materials before tackling fluoride, said Hein. It would have been better if we had done mercury and then fluoride," he said. Less controversial. It would have made no difference, believes Mullenix. Nor does she believe another scientist would have been treated differently. She had stellar academic credentials, powerful industry contacts, and hard scientific data about a common chemical. "That is the sad part of it," she said. "I thought I had the people back then. I thought you could reason one scientist to another. I don't know that there is anything I could have done differently, without just burying the information." Mullenix no longer works as a research scientist. Since her fluoride discovery at Forsyth a decade ago, she has received no funding or research grants. "I liked studying rats," she said. "I probably would have continued working with the animals my entire life. Now, she added, I dont think I will ever get to work in a laboratory again. FIREWORKS AT FORSYTH Jack Hein and Pamela DenBesten knew about fluorides bizarre undertow, one that could pull and snatch at even the most established scientist, and they were able to swim free from the Forsyth shipwreck But Mullenix was dragged down by a tide that no one warned her about. "I didnt understand the depth, she said. And to me, in my training, you pay no attention to that. The data are the data and you report them and you publish and you go from there. Mullenix is disappointed at the response of her fellow scientists. Jack Hein walked off into the sunset of retirement. Most of her former colleagues were reluctant to support her call for more research on fluoride, she said. Instead of saying maybe scientifically we should take another look, everybody took cover, they all dove into the bushes and wouldn't have anything to do with me." Olive Mullenix did not raise her daughter that way. You cant just walk away from something like this, Phyllis Mullenix said. I mean, they had to find out that thalidomide was wrong and change. Why should fluoride be any different? "A Spooky Feeling" ONE HOT JULY evening in 1995 the phone rang. Dr. Phyllis Mulle-nix was in her office, upstairs in her Andover, Massachusetts, home. Scientific papers were strewn on the floor. She had been depressed. Her firing from Forsyth the previous summer had hit the family hard. Her daughters were applying to college ; she and her husband, Rick, were quarreling about money. She lifted the receiver. A big bass voice boomed an apology from New York City for calling so late. Mullenix did not recognize the speaker. She settled back into her favorite white leather armchair. Joel Griffiths explained that he was a medical writer in Manhattan. He had a request. Would Mullenix look at some old documents he had discovered in a U.S. government archive? The papers were from the files of the Medical Section of the Manhattan Project, the once supersecret scientific organization that had built the worlds first atomic bomb. Mullenix rolled her eyes. It was late. Rick, now an air traffic controller, was trying to sleep in the next room. The atom bomb, Mul-lenix thought! What on earth did that have to do with fluoride? 26 CHAPTER TWO Mullenixs own patience was growing thin. Since her research had become public, she had been bombarded with phone calls and letters from antifluoride activists. Some of the callers had been battling water fluoridation since the 1950s. Late-night radio talk shows were especially hungry to speak with the Harvard scientist who thought that fluoride was dangerous. They called her at three or four in the morning from across the country and overseas. Usually "there was no thank you note, and you never heard from them again," Mullenix said. The New York reporter dropped a bombshell. Dr. Harold Hodge, Mullenixs old laboratory colleague, was described in the documents as the Manhattan Projects chief medical expert on fluoride, Griffiths told her. Workers and families living near atomic-bomb factories during the war had been poisoned by fluoride, according to the documents, and Harold Hodge had investigated. Mullenix felt a sudden "spooky" feeling. She shifted in her chair. Harold Hodge was now dead, but as the journalist continued, Mullenix cast her mind back to the days in her Forsyth laboratory with the kind old gentleman, the grandfatherly figure who had some-times played with her children. "All he did was ask questions," she told Griffiths. "He would sit there and he would nod his head, and he would say, You don't say, you don't say. Once, Mullenix recalled, as Hodge watched her experiments, he had briefly mentioned working for the Manhattan Project. But he had never said that fluoride had anything to do with nuclear weapons — or that he had once measured the toxic effects of fluoride on atomic-bomb workers. Yes, Mullenix told the journalist, she wanted to see the documents. Some days later a colleague of Griffiths s arrived at the Mullenix home. Clifford Honicker handed her a thick folder of documents. Honicker was part of a small group of researchers and reporters who had unearthed many of the ghoulish medical secrets of the Manhat tan Project and the Atomic Energy Commission. Those secrets had included details about scores of shocking cold-war human radiation experiments on hospital patients, prisoners, pregnant women, and retarded children. For years the media had ignored the information about human experimentation that Honicker and others were discovering. Finally, FIREWORKS AT FORSYTH 27 in 1995, an investigative journalist named Eileen Welsome had won a Pulitzer Prize for revealing how atomic-bomb-program doctors had injected plutonium into hospital patients in Tennessee and New York. She uncovered the names of the long-ago victims. Harold Hodge had planned and supervised many of those experiments, the documents showed. President Bill Clinton ordered an investigation. His energy secretary, Hazel O'Leary, began a new policy of openness. And Honicker and others had gained access to newly declassified cold- war documents — including much of the new information on fluoride. That night, after Honicker left, Mullenix settled in her chair and began to read. Her face drained as she read one memo in particular. The fifty-year-old document mentioned Harold Hodge — and dis- cussed fluorides effects on the brain and central nervous system. It was the same work she had done at the Forsyth Dental Center. "I went white. I was outraged," said Mullenix. "I was hollering and pacing the floor. He wrote this memo saying that he knew fluoride would affect the central nervous system!" The central-nervous-system memo — stamped "secret" — is addressed to the head of the Manhattan Projects Medical Section, Colonel Stafford Warren, and dated April 29, 1944 It is a request to conduct animal experiments to measure the central-nervous-system effects of fluoride. Dr. Harold Hodge wrote the research proposal. "Clinical evidence suggests that uranium hexafluoride may have a rather marked central nervous system effect. ... It seems most likely that the F [code for fluoride] component rather than the T [code for uranium] is the causative factor," states the memo. 15 A light flashed on for Mullenix. At the time, in 1996, she was still sending grant requests to the National Institutes of Health in Washington, DC, asking to continue her studies on fluoride's central-nervous-system effects. A panel of NIH scientists had turned down the application, flatly telling her, "Fluoride does not have central nervous system effects." Mullenix realized the absurdity of what she had been doing. Harold Hodge and the government had sus- pected fluorides toxic effects on the human central nervous system for half a century. She read on. The 1944 memo explained why research on fluorid e's central-nervous-system effects was vital to the United States' 28 CHAPTER Two war effort. Since work with these compounds is essential, it will be necessary to know in advance what mental effects may occur after exposure. . . . This is important not only to protect a given individual, but also to prevent a confused workman from injuring others by improperly performing his duties. All of a sudden it dawned on me, said Mullenix. Harold Hodge, back in the 1940s, had asked the military to do a study that I had done at Forsyth.... Hodge knew this fifty years ago. Why didnt he tell me what he was interested in? Why didnt he say to me, This stuff, I know, is a neurotoxin?'" All he did was ask questions, and he would sit there and he would nod his head and he would say, You dont say, you dont say. He never once said, I know it is a neuro-toxin, I know it causes confusion, lassitude, and drowsiness. Today Mullenix calls Harold Hodge a monster for his human-radiation experiments. In retrospect she compares sharing a laboratory with him with being in a movie theater, sharing popcorn with the Boston Strangler. Had the two Rochester alumni — Jack Hein and Harold Hodge — manipulated the toxicologist to perform the fluoride studies that Hodge had proposed fifty years earlier, she wondered. Did they let Mullenix take the fall when her experiments proved what Hodge had already suspected? At first, Mullenix had shown no interest in studying fluoride, she remembered. It seems strange that a neuro-toxicology person was brought into a dental institution to look at fluoride, Mullenix said. I felt that I had really been lied to, or led along," she added, "used like a little puppet." Mullenix called up Jack Hein. He denied knowing anything about Harold Hodges long-ago Manhattan Project fears that fluoride was a neurotoxin, she said. And instead, he offered to pass the explosive information on to the government, telling Mullenix, Shouldnt you tell the NIDR — do you want me to help you take it to the NIDR? (Hein may have known far more than he told Mullenix, however. In a 1997 interview with the United Kingdoms Channel Four television, he disclosed that one of the primary concerns of Manhattan Project toxicologists had been fluorides effects on the central nervous system.)" The next day Dr. Mullenix called the head of the National Institute of Dental Research, Dr. Harold Slavkin. She hoped the nations top FIREWORKS AT FORSYTH 29 dental officer would be concerned about the wartime memo. Instead, she remembers, He got very nasty about it. He basically pushed me off, like I was some kind of a crackpot. She thought that NIDR would be interested in the memos, that the institute would want to read them. But he treated her as if she were some kind of a whacko, she recalls. She put the telephone down and a terrible truth dawned on her. The public guardians at the National Institutes of Health, like Harold Hodge, also had a double identity. It seemed they, too, were keepers of cold war national-security secrets — bureaucratic sentries at the portcullis of the nuclear-industrial state. Opposite Sides of the Atlantic
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