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Arthur Roeder had not become the head of the United States Radium Corporation without being an astute and wily businessman. He was an expert negotiator, skilled in manipulating situations to his advantage. It was always wise, he considered, to keep your friends close—but one should always keep one’s enemies closer.

On April 2, 1925, he invited Frederick Hoffman to the Orange plant.

The statistician, in fact, visited two or three times, noting in particular the lack of warning signs about lip-pointing. And perhaps Roeder observed his notes, or maybe what happened next was simply part of the ongoing safety precautions the president had instructed Viedt to put in place. For on Hoffman’s final visit, on Good Friday 1925, Roeder called his attention to new notices in the studio which commanded employees not to put the brushes in their mouths. Hoffman approved: “They had impressed me,” he later said, “with improved conditions.”1

Roeder knew what he was doing. With relations between the two men cordial, he pressed home his advantage. “I wish that I could persuade you,” Roeder wrote Hoffman, “to defer publishing a paper on the subject of ‘radium necrosis.’”2 He wanted Hoffman, he said, to have the “opportunity to thoroughly investigate the subject.”3

Hoffman responded genially: “I wish to express to you my sincere appreciation of the courtesy extended to me during my visit and of my own sympathy for the trying position in which you find yourself.”4 However, Roeder was too late. “I find on looking over my file that an abstract of [my paper] was furnished to the [American Medical] Association some time ago for inclusion in the Handbook which has gone to the printer… The paper is now out of my hands.”5 Hoffman added that he had agreed to supply the Bureau of Labor Statistics—the government agency led by Ethelbert Stewart—with a copy of his report.

One can only imagine Roeder’s reaction to that news—although he had smoothly tried to allay the concerns of the bureau as well. When Swen Kjaer had interviewed Roeder that spring about Marguerite Carlough, Roeder told him frankly that he “thought that the ailment was not due to any cause in the factory; in fact, was probably an attempt to palm off something on [the firm].”6

At least the Carlough girl had given him an excuse to put off John Roach. When Roach had heard that the report supplied by the firm was a whitewash, he had immediately requested a full copy of the study. But Roeder had replied that, because of the Carlough suit, “The matter has been placed in the hands of our New Jersey attorneys, Lindabury, Depue & Faulks, and I am consequently referring your request to Mr. Stryker of that firm.”7 He said the same in response to Drinker’s plea for him to publish the full study: “In view of the [legal] situation, I have taken no action in regard to submitting your paper for publication; we are not issuing any reports now except on advice of counsel.”8

Now, however, the situation started to spiral out of Roeder’s hands. Drinker began to lose patience with the president’s continued stalling and wrote directly to Roach to find out exactly what the company had said of his study. Roach duly sent him Viedt’s letter of June 18, 1924—and Drinker was stunned to find that, just as Hamilton had told his wife, the company had lied. “We have [both] been deceived,” he declared to Roach, “in our dealings with the United States Radium Corporation.”9 He was so shocked by the firm’s behavior that he arranged a face-to-face meeting with Roeder in New York to confront him.

Roeder was still trying to calm the troubled waters. When Drinker told him sharply that he “felt the conduct of his firm in this affair had not been very creditable,”10 Roeder “assured [him] that their desire had been quite the reverse and he would at once see to it that [Roach] received a complete copy of the original report.”11 Though somewhat reassured, Drinker was not wholly placated. He therefore made a deal with the company president. As long as Roeder kept his word, Drinker promised him, “I will do nothing about publication.”12

It was a good deal for Roeder: the game was now up with Roach, after all, and the lack of wider publication meant that the litigating Marguerite Carlough would have no access to the expert report that directly linked her illness with her employment. Yet it was also an ultimatum—and the powerful Arthur Roeder was not the sort to kowtow to pressure from those he had employed.

In fact, he did not seem at all perturbed by the doctor’s attempted negotiations; he simply passed on Drinker’s demands to Stryker, the company lawyer. Roeder was paying Stryker good money; he would trust him to deal with these latest developments. In the meantime, Roeder had an ace up his sleeve. Drinker, he thought, wasn’t the only expert in town.

Enter Dr. Frederick Flinn.

Dr. Flinn specialized in industrial hygiene, just like Drinker. He was the assistant professor of physiology at the Institute of Public Health at Columbia University; previously, he had been a director for a handful of mining companies. He was a serious man in his late forties with thinning hair and wire-framed glasses. Within a day or so of being asked to undertake research into the harmful effects of radioactive paint, he had met with Roeder, who agreed to furnish money for his study.

This was not Flinn’s first interaction with USRC; he had been involved with the firm the previous year, part of its defense against a lawsuit for damages regarding the fumes from the Orange factory, about which residents were still complaining. The company was also likely familiar with Flinn’s work with the Ethyl Corporation in early 1925, when the doctor had been hired to find evidence that leaded gas was safe.

Flinn began work the next morning with a tour of the Orange plant—but his remit did not end there. Through the contacts of USRC, Flinn gained access to the dial-painters of other firms, including the Waterbury Clock Company, giving them physical check-ups. To begin with, Flinn said, “I made my first examinations without any cost to the companies.”13 But, later, he was paid by the firms employing the girls.

One of the radium companies he worked for was the Luminite Corporation in Newark, where he now encountered Edna Bolz Hussman, the “Dresden Doll” beauty who had worked at the Orange plant during the war. Since her marriage to Louis in September 1922, Edna had worked for Luminite only intermittently, just to keep some housekeeping money coming in to boost Louis’s wages as a plumber. They didn’t need much though; they had no children. Instead, they shared their home with a small white terrier.

Edna was employed at Luminite one day when Dr. Flinn asked if he could examine her. Although Edna later said that she did “not know directly in whose behalf the examination was had”14 and that it “did not take place at my request,”15 it did, nevertheless, take place. Flinn examined her elegant body carefully and took some blood.

At that time, Edna had slight knee pains, but she was paying them no attention, and it is not known if she mentioned them to him. She had probably heard the rumors about the Carlough lawsuit, however, so it must have come as a huge relief when Flinn gave his verdict following the tests. “[He] told me,” she later said, “that my health was perfect.”16

If only her former colleagues were as fortunate. Katherine Schaub was having a dreadful time. It had been, she later wrote, “a very depressing winter.”17 Her stomach was now troubling her, so much so that she could not retain solid food and had endured an abdominal operation. She felt like she was being passed from pillar to post, dentist to doctor, and no one offered any answers. “Since [my] first visit [to a doctor], it had been nothing but doctors, Doctors, DOCTORS,”18 she wrote in frustration. “To be under the care of a skilled physician and yet not show any sign of improvement was most discouraging.”19 Her illness was affecting her whole life, for though she tried to work, her ailments now made it impossible for her to be engaged in any form of employment.

Grace Fryer, however, was still maintaining her job at the bank. Thanks to Dr. McCaffrey’s attentions, the infection in her jaw seemed to have cleared up, but she was very apprehensive that it might come back. And although her mouth was all right, her back still plagued her. Dr. Humphries’s strapping treatments no longer had any effect; “I have been to every doctor of any note in all New York and New Jersey,”20 she said—but not one of them could determine the cause of her ailments; often, they made things worse. Grace’s chiropractic treatments, in the end, “became so painful that I was compelled to stop taking them.”21

In Orange, Grace’s friend Quinta McDonald was having no better luck. In April 1925, she was finally removed from the constricting plaster cast that had encased her body for nine months. Yet despite the doctors’ best efforts, her condition declined. Now, she could walk only with the greatest difficulty. By the end of the year, her family doctor had been called out ninety times: a bill of some $270 ($3,660).

It was awful timing. She found herself unable to manage the fifteen-minute walk to her sister Albina’s house just at the time when she most wanted to be with her. Highland Avenue sloped sharply down toward the railway station on the way to her sister’s home, and Quinta simply couldn’t get down the hill anymore, even with a stick, let alone back up it. Albina Larice, to the whole family’s delight, was pregnant, after almost four years of trying. It was such good news, and there was little enough of that to go around at the moment.

While the Maggia family at least had a reason to celebrate that spring, just down the road on Main Street, the Carloughs were really struggling. They were still spending money they didn’t have on Marguerite’s care; by May 1925, the medical bills ran to $1,312 (almost $18,000). Sarah Maillefer was distraught by her little sister’s condition. She tried to keep talking to her, soothing words or jokes to lift her spirits, but Marguerite’s hearing was greatly impaired in both ears because of her infected facial bones, and she struggled to hear what Sarah said. The pain was awful: her lower jaw was fractured on the right side of her face and most of her teeth were missing. Her head, essentially, was “extremely rotten”22—with all the putrefaction that implies. But she was alive, still. Her whole head was rotting, but she was still alive.

Her condition was so bad that, at last, it prompted Josephine Smith to quit her job. Nobody could see what had happened to Marguerite and not be moved. Frederick Hoffman and Dr. Knef were still fighting her corner too. Seeing her rapid decline, they now sought aid from a perhaps unlikely source—USRC founder Sabin von Sochocky.

Von Sochocky was no longer part of his company. He had no ties to the corporation and, if anything, may even have felt bitter about the way he had been ousted. Perhaps, too, he felt some responsibility. One of the girls’ allies later wrote of him, “I feel absolutely satisfied that there is no prejudice but every desire to assist in a useful way.”23

And that is what von Sochocky now did. Together with Drs. Hoffman and Knef, the trio admitted Marguerite to St. Mary’s Hospital in Orange to find out what was the matter with her. On admittance, she was anemic and weighed ninety pounds; her pulse was “small, rapid, and irregular.”24 She was hanging on, but barely.

A week or so after she was admitted, which was partly thanks to Hoffman’s intervention, the statistician did the dial-painters his biggest service yet: he read his paper on their problems before the American Medical Association—the first major study to connect the women’s illnesses to their work; the first, that is, to be made public. And his opinion was thus: “The women were slowly poisoned as a result of introducing into the system minute quantities of radioactive substance.”25

That “minute” was important, for the company—all the radium companies—believed dial-painting to be safe because there was such a tiny amount of radium in the paint. But Hoffman had realized that it wasn’t the amount that was the problem, it was the cumulative effect of the women taking the paint into their body day in and day out, dial after dial. The amount of radium in the paint may have been small, but by the time you had been swallowing it every single day for three or four or five years in a row, there was enough there to cause you damage—particularly when, as the Drinkers had already realized, radium was even more potent internally, and headed straight for your bones.

As early as 1914, specialists knew that radium could deposit in bone and cause changes in the blood. The radium clinics researching such effects thought that the radium stimulated the bone marrow to produce extra red blood cells, which was a good thing for the body. In a way, they were right—that was exactly what happened. Ironically, the radium did, at first, boost the health of those it had infiltrated; there were more red blood cells, something that gave an illusion of excellent health.

But it was an illusion only. That stimulation of the bone marrow, by which the red blood cells were produced, soon became overstimulation. The body couldn’t keep up. In the end, Hoffman said, “The cumulative effect was disastrous, destroying the red blood cells, causing anemia and other ailments, including necrosis.”26 He concluded emphatically, “We are dealing with an entirely new occupational affection demanding the utmost attention,”27 and then—perhaps thinking of Marguerite’s lawsuit, which was dragging sluggishly through the legal system—added that the disease should be brought under the workmen’s compensation laws.

Katherine Wiley was, in fact, attempting to do just that through her work with the Consumers League, campaigning to have radium necrosis added to the list of compensable diseases. In the meantime, Marguerite’s only hope for justice was the federal court—but her case was unlikely to be heard before the fall. As Alice Hamilton noted with dismay, “Miss Carlough may not live till then.”28

Hoffman continued to present his discoveries. He noted that although he had looked for cases of radium poisoning in other studios across the United States, “There was none affected outside of this plant.”29 Unwittingly, Hoffman now revealed exactly why that was, but he didn’t grasp the relevance of his statement. “The most sinister aspect of the affliction,” he wrote, “is that the disease is apparently latent for several years before it manifests its destructive tendencies.”30

Several years. The Radium Dial studio in Ottawa had been running for less than three.

Both Hoffman and von Sochocky, whom he’d consulted for his paper, were struck by the lack of other cases. For USRC, it was clear evidence of why the girls’ illnesses could not possibly be occupational. Hoffman and von Sochocky, however, who were convinced that dial-painting was the cause of the girls’ sickness, did what any scientists would do: they looked for a reason. And when von Sochocky gave Hoffman the top-secret paint formula, they believed they had found it. “[Von Sochocky] gave me to understand,” Hoffman later said, “that the difference between the paste used in the plant in Orange and the paste used elsewhere was mesothorium.”31

Mesothorium—radium-228—and not radium; at least, not the radium-226 that people used in their tonics and pills. That had to be the answer. And so Hoffman, building on Dr. Blum’s work, commented in his paper: “It has seemed to me more appropriate to use the term ‘radium (mesothorium) necrosis.’”32

In conclusion, it wasn’t—not exactly—radium that was to blame.

However, when news of Hoffman’s report hit the headlines, the radium industry fought back. Radium was still the wonder element, and new products were being launched all the time—one such right there in Orange. A highly radioactive tonic called Radithor, produced by William Bailey of Bailey Radium Laboratories—a client of USRC—had been launched in early 1925. He and others spoke out publicly against the attempts to link radium to the dial-painters’ deaths: “It is a pity,” Bailey said, “that the public [are being] turned against this splendid curative agency by unfounded statements.”33

But while the radium men were quick to strike back, Hoffman’s paper, although it attracted some publicity, was a rather niche, specialist publication. Not many people subscribed to the Journal of the American Medical Association. And who was Frederick Hoffman anyway? Not a physician, who might really know about these things. Even the women’s allies were aware of his lack of authority. “It seems to me unfortunate,” wrote Alice Hamilton to Wiley, “that Dr. Hoffman is the man to make this situation public. He does not command the confidence of physicians and the work that he does will not be thorough nor proof against attack.”34

What the women needed was a champion. A medical mastermind—someone who could not only command authority, but also, perhaps, find a way of definitively diagnosing their disease. Blum had had his suspicions, Barry too, but neither of them had actually proved that radium was the cause. Most importantly of all, they needed a doctor who wasn’t in the pocket of the company.

Sometimes, the Lord works in mysterious ways. On May 21, 1925, a Newark trolley car was trammeling along its tracks on Market Street when there was a commotion on board. The commuters, making their way home in the evening rush hour, made room for the passenger who had suddenly collapsed to the floor. They called out to give him some air, for the trolley car to stop; a kindly passer-by no doubt bent to mop his brow.

It was all in vain. Only a few minutes after the man had first been stricken, he died. His name was George L. Warren. In life, he had been the county physician for Essex County—a senior medical figure with responsibility for the welfare of all residents within the county’s borders, which included those in Newark as well as Orange: the locations where former dial-painters were now dying unstoppably.

With Warren’s passing, his position became vacant. The role of county physician—what would become the powerfully titled Chief Medical Examiner—was now open. Whoever filled it would make or break the case.