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It was a unanimous appointment. The board congratulated the new county physician with firm handshakes and much approving nodding of heads.

Dr. Harrison Martland, please step up.

Martland had already shown an interest in the dial-painters’ cases, having met briefly some of Barry’s patients. Although, not being able to determine the cause of the problem, he had by his own admission “lost interest,”1 the cases had remained on his mind. Reportedly, when Hazel Kuser died, he had endeavored to arrange an autopsy to determine the cause of death, but Theo had been so attentive in making the final arrangements for his beloved wife that her body had been buried before Martland could contact the proper authorities.

Martland had perhaps also been hampered by territorial politics. Previously he’d had authority to investigate issues in Newark alone; since the plant and many of the victims had been located in Orange, it wasn’t necessarily the done thing for him to examine the matter further. Now, however, with the broader remit given him by his new role, he had the power to get to the bottom of it.

Martland was a man of extraordinary talents, who had studied at the College of Physicians and Surgeons in New York; he ran his own laboratory at the Newark City Hospital, where he was chief pathologist. Though he had a wife and two children, he was in many ways married to the job—he made “no difference between weekdays and Sundays”2 and worked late most nights. He was forty-one years old, a “heavy but distinguished-looking”3 man with jowls. His hair, which was light brown and graying at the temples, lay flat on his scalp; he wore circular spectacles. He was the kind of man who worked in his shirtsleeves, “sans tie,”4 a colorful personality who drove open-top automobiles and “did his exercises to the loud phonograph music of Scots bagpipes”5 every morning. Everyone called him Mart or Marty, never Harrison and certainly never Harry. As chance would have it, he was also a Sherlock Holmes enthusiast.

The Case of the Radium Girls was a mystery to challenge even the greatest of medical detectives.

Martland took his new responsibilities seriously. As he himself said, “One of the main functions of a medical examiner is to prevent wastage of human life in industry.”6 The cynical would say, however, that this proclamation had absolutely nothing to do with why he took an interest in the radium cases at that moment. The cynical would say there was only one reason a high-profile specialist finally took up the cause.

On June 7, 1925, the first male employee of the United States Radium Corporation died.

“The first case that was called to my attention,” Martland later remarked, “was a Dr. Leman.”7

The chief chemist of USRC, he who had “scoffed”8 at the Drinkers when they’d expressed concern about the blackened lesions on his hands the year before, was dead. He died aged thirty-six of pernicious anemia, after an illness of only a few weeks. His death had occurred much too rapidly for a normal case of anemia, so Martland was called in to conduct an autopsy.

He suspected radium poisoning, but the chemical analyses he carried out on Leman’s body failed to show any sign of the element; specialist testing would clearly be required. Martland, as Knef and Hoffman had done a short time before, now turned to Sabin von Sochocky, an authority on radium, for assistance. And he asked someone else for help too. Where could he possibly find the best-qualified radium expert in town? Surely the United States Radium Corporation knew a little bit about it?

Together, Martland, von Sochocky, and USRC’s Howard Barker tested Leman’s tissues and bones in the radium-factory laboratory. In exchange for its help, USRC asked Martland to promise that he would keep his conclusions secret.

The tests were a success. The doctors reduced Leman’s bones to ashes, then tested the ash with an instrument called an electrometer. In so doing, they made medical history in measuring radioactivity in a human body for the first time. In so doing, they determined that Leman had died from radium poisoning; his remains were saturated with radioactivity.

As Martland and von Sochocky worked together, von Sochocky asked the medical examiner to help the dial-painters; Knef made a similar appeal. And so, only a day or so after Leman had died, Martland found himself in St. Mary’s Hospital, meeting a brave young woman called Marguerite Carlough.

She lay weakly in her hospital bed, her shockingly pale face surrounded by limp dark hair. At this time, “her palate had so eroded that it opened into her nasal passages.”9 Also visiting Marguerite was her sister Sarah Maillefer.

Sarah was no longer quite as matronly in figure as she had once been; she’d been losing weight for the past year or so. It was the worry, she thought. Worry for Marguerite, who was so badly ill; worry for her daughter, who was now fourteen years old. Like most mothers, she rarely worried about herself.

A week ago, she’d noticed that she’d started to bruise easily. And it was more than that, if she was honest with herself: large black-and-blue spots had broken out all over her body. She’d come to see Marguerite anyway, not wanting to miss the visit, limping up the stairs with her walking cane, even though she felt very weak. Her teeth were aching, too, but you had to put things into perspective: look at her sister; she was far worse off. Even when her gums started to bleed, Sarah thought only of her sister, who was so close to death.

As Martland met the Carlough girls, he observed that although Marguerite was more ill than Sarah, Sarah was also not well. When he asked her, she confessed that the black-and-blue spots were causing her intense pain.

Martland ran tests and found Sarah to be very anemic. He told her the results, spoke with her about her jaw trouble. And then Sarah, perhaps finally worried over what it might mean, “went bad quite rapidly”10 and had to be admitted to the hospital. But at least she wasn’t alone. She and Marguerite shared a hospital room: two sisters together, facing whatever might lie ahead.

The hospital doctors examined Sarah closely, concerned at her decline. Her face was swollen on the left side, her glands hot and tender. She was running a temperature of 102.2 degrees—increasing up to 105.8 degrees in the evenings—and by now had marked lesions in her mouth. She was, it appeared, “profoundly toxic.”11

Martland wanted to test the two women to see if radium was the cause of their illnesses—but the only tests he knew, those he had conducted with von Sochocky and Barker, required burning bone to ash. You couldn’t very well do that with living patients.

It was von Sochocky who came up with the answer. If the women were radioactive, all they had to do was devise some tests to prove it. These tests, which would be honed and largely invented by Martland and von Sochocky, were created specifically to test the dial-painters’ bodies. No physician had ever attempted to test living patients in this way before. Later, Martland would discover that a specialist had done something similar before him, but in June 1925, with the clock running down on Marguerite Carlough, he innovated the tests knowing nothing of the other scientist’s work. He was, indeed, a man of extraordinary talents.

The pair devised two methods: the gamma-ray test, which involved sitting the patient before an electroscope to read the gamma radiation coming from the skeleton; and the expired-air method, whereby the patient blew through a series of bottles into an electroscope so that the amount of radon could be measured. This latter was born from the idea that, as radium decayed into the gas radon, if radium was present in the girls’ jawbones, the toxic gas might be exhaled as they breathed out.

The doctors took their equipment to the hospital to try on Marguerite. But, when they got there, it was Sarah Maillefer they decided to test first.

Being in the hospital had not helped her. Despite being given a blood transfusion on June 14, Sarah had become so ill she’d had to be removed from the room she shared with her sister. When Marguerite asked where she was, the nurses told her Sarah had been “removed to receive special treatments.”12

That was true, in a way. The tests Sarah was about to have were special, for she was the first dial-painter ever to be tested for the presence of radium. The first who would prove whether or not all that conjecture was correct.

This was the moment of truth.

In a hospital room in St. Mary’s, Martland and von Sochocky set up the equipment. They first tested Sarah’s body. As she lay weakly on the bed, Martland held the electrometer eighteen inches above her chest, to test her bones. A “normal leak” would be 10 subdivisions in 60 minutes: Sarah’s body was leaking 14 subdivisions in the same time. Radium.

Next, they tested her breath; the normal result they were looking for was 5 subdivisions in 30 minutes. This test wasn’t as easy as simply holding the measuring device over Sarah’s prone body, though. This test, she had to help with.

It was very hard for her to do, because she was so unwell. “The patient was in a dying, almost moribund condition,”13 remembered Martland. Sarah found it difficult to breathe properly. “She couldn’t for five minutes’ time.”14

Sarah was a fighter. It’s not clear if she knew what the tests were for; whether she had the capacity at that stage even to know what was going on around her. But when Martland asked her to breathe into his machine, she tried so very, very hard for him. In…out… In…out. She kept it going, even as her pulse raced and her gums bled and her gammy leg ached and ached. In…out… In…out. Sarah Maillefer breathed. She lay back on the pillows, exhausted, spent, and the doctors checked the results.

The subdivisions were 15.4. With every breath she gave, the radium was there, carried on the very air, slipping out through her painful mouth, passing by her aching teeth, moving like a whisper across her tongue. Radium.

Sarah Maillefer was a fighter. But there are some fights that you cannot win. The doctors left her in the hospital that day, on June 16, 1925. They didn’t see as her septic condition increased; as new bruises bloomed on her body, blood vessels bursting under her skin. Her mouth would not stop bleeding; pus oozed from her gums. Her bad leg was a constant source of pain. Everything was a constant source of pain. She couldn’t take it anymore; she became “delirious”15 and lost her mind.

But it didn’t take too long, not after that. In the early hours of June 18, only a week after she’d been admitted to hospital, Sarah Maillefer died.

The same day, Martland conducted an autopsy; the results would take some weeks to come back. He was bound by no promises of secrecy this time. He spoke to the media on the day Sarah died as they gathered to hear of this latest death. “I have nothing more than my suspicions now,” he told them. “We are going to take the bones and some of the organs of Mrs. Maillefer’s body, reduce them to ashes and make extensive laboratory tests with the most delicate instruments available for radioactive substances.”16 And then he continued, probably striking fear into the hearts of Sarah’s former employers: “This poisoning, if my suspicions are correct, is so insidious, and sometimes takes so long to manifest itself, that I think it possible it has been going on for some time throughout the country without being discovered.”17 That time was now at an end, although Martland wasn’t rushing into anything: “We have nothing more definite than a theory at present,” he said. “I will not make the statement that commercial ‘radium poisoning’ exists until we can prove it.”18 But, the implication was, once he could…

The press were all over it; Sarah’s death even made the front page of the New York Times. Yet while the whole world knew of her passing, there was someone who didn’t.

Her little sister, Marguerite. She hadn’t seen Sarah since June 15, the night she’d been taken from their shared room. She’d inquired several times as to how her sister was. Even though Marguerite had seen Sarah decline, she must have had hope. Sarah had always been the strong one once Marguerite had sickened, and she had only been seriously ill for a few days.

The nurses put her off when she asked after her big sister. But on June 18, when the papers were filled with the news of Sarah’s death, Marguerite had innocently asked to see a newspaper.

“No,” the nurses said, wanting to spare her.19

“Why?” asked Marguerite.20 Of course Marguerite Carlough would ask why.

And so the nurses told her of her sister’s death. “She is said to have borne the news bravely—and expressed regret that she could not be present at the funeral.”21 She was far too ill to go.

It was Sarah’s father, Stephen, who told the authorities of his daughter’s death; who arranged her funeral; who looked after her teenage daughter, Marguerite. It was he who watched her coffin being lowered into the ground at Laurel Grove Cemetery, shortly after 2:00 p.m. on Saturday, June 20.

Sarah may have been thirty-five, but it was his little girl who’d gone.