Thursday, November 15, 2012
Black Lung - Dr. Donald Rasmussen, a Doctor Devoting his life to defeat Black Lung
Dr. Donald Rasmussen
Dr. Donald Rasmussen, a Doctor Devoting His Life to Defeating Black Lung
Interviewed by Betty Dotson-Lewis
Oral History Interview with Dr. Donald L. Rasmussen
The story of the coal miners' struggle in obtaining black lung benefits as well as the events leading up to Jock Yablonski, his wife and daughter's brutal murder during his bid for President of the United Miners Workers of America.
(Introductory comments by friends and associates)
Sherry Williams, August 6, 2002, Beckley, WV
In 1975 Dr. Rasmussen helped my mother get her black lung. My father died when he was 51 years old. Dr. Rasmussen performed an autopsy and that was instrumental in my mother getting black lung. He has been instrumental in getting hundreds and hundreds of coalminers their black lung. He is not only a number one doctor. He is a number one person.
Cecil Roberts, UMWA (United Miners Workers of America) President - August, 2002
As a champion for human rights, Dr. Donald Rasmussen helped spearhead the fight waged by the United Mine Workers of America and other advocates to compensate victims of black lung and prevent further victimization. As a leading expert on pulmonary disease, he helped change the way that America's medical profession views this disease. Through his extensive research on black lung, he was able to dispel the mythology spewed by operator-hired doctors, who often claimed the disease resulted from smoking instead of coal dust. As an outspoken advocate for justice, he played a key role in shaping laws that provide compensation and benefits for black lung victims, including thousands of UMWA members, in West Virginia and across America.
Alan Derickson, Penn St. Professor and author, Black Lung: Anatomy of a Public Health Disaster
Donald Rasmussen made a singular and extremely important contribution to the historic efforts to compensate victims of black lung and to prevent further victimization. All those who care about this issue and, beyond that, about a human society are deeply in his debt.
Mike Clark. Yellowstone National Park, Heritage Foundation, August, 2002
Please pass on to Dr. Rasmussen my warmest personal regards. I have few heroes left -- perhaps a legacy of growing older in America -- but he is one of my heroes and I admire him enormously. His work remains for me the outstanding example of a medical doctor in Appalachia responding to a region-wide crisis, bringing his medical expertise and moral judgment to bear on the problem, and then helping ordinary people and their union work to solve the problem.
His expertise on black lung and his willingness to help thousands of victims and their families improved the lives of miners throughout the country. All of us who care about coal miners and the coal mining regions of the United States are forever indebted to him for his service, his humanity, and his leadership over the past thirty years.
During my time at Highlander and in the years since, I have often been reminded of his unique role and his leadership in bringing about reforms in the coal industry and in public health for rural people in this country. I remember his willingness to not only help coal miners, but to also educate other industrial workers about hazards in the workplace.
For example, once at a Highlander workshop for textile workers suffering from brown lung, Dr. Rasmussen made the long drive to Highlander and spent a day with about thirty disabled textile workers. At the end of the day, one leader in the group, with tears in her eyes, told me -- "That's the first doctor I've ever met who told us the truth about why we can't breathe and who has helped us figure out what to do about it."
Those workers went on to gain some degree of compensation for their disease in North and South Carolina because of what Dr. Rasmussen taught them that day.
I think this kind of story could be repeated again and again about the good doctor. Please convey to him my complete admiration for his career and my thanks for all he has done for working people in this country.
Sophia, West Virginia
During an oral history interview with a coalminer suffering from black lung, I learned that Dr. Donald Rasmussen was still in the Appalachian area. I wrote a letter to him explaining the purpose of my website and sent him copies of several stories I had collected from coal miners. I asked him for an oral history interview to capture the story of the miners' struggle in obtaining black lung benefits; as well as the events leading up to Jock Yablonski, his wife and daughter's, brutal murder during his bid for President of the United Miners Workers of America.
Two weeks passed, no call, no letter, nothing from Dr. Rasmussen-I was becoming a little skeptical, a little worried I would not get this great story-then one day, I was busy working at my desk in the early afternoon around two p.m. when my phone rang; it was Dr. Rasmussen. We spoke briefly and he agreed to an oral history interview
I was so excited I immediately emailed friends out of the region who are familiar with Dr. Rasmussen's work; Branscome, NYC; Hall, DC; Clark, Montana; Derickson, Penn St. I quickly wrote Ken Hechler a letter. Then, I told everyone in the office, Dr. Rasmussen is giving me an oral history oral. I was the lucky one.
He invited me to come to his home in Sophia, WV on the following Tuesday around 5:30 pm. (same coal camp town where Sen. Robert C. Byrd grew up). I left for Sophia on that Tuesday right after work heading toward Sophia, WV on Robert C. Byrd Drive. At exit 42, the sign said "keep right for Sophia."
I arrived in Sophia, a typical southern Appalachian coal mining town. At the stop light, I turned right instead of left and realized I was lost. Pulled over to the side and waved to a town cop, who immediately came to my rescue. When I asked him for directions to Dr. Rasmussen's home, he just said, "Follow me." It was probably two blocks away. A home for Dr. Rasmussen in the heart of the Southern Appalachian coalfields of West Virginia.
I was greeted warmly by Dr. Rasmussen, his beautiful wife, Carmen, their dog and two of their 6 cats.
How did you get here and become involved in the coal miners' struggles?
Rasmussen -"The Journal of American Medical Association classified ad in October, 1962 read, - "Doctors Needed in Beckley, West Virginia, at the Miners Memorial Hospital"
"I came to look around and never left." - Dr. Donald Rasmussen, Black Lung Specialist, told me.
When did you become an advocate for the coalminers and their families?
Rasmussen -I was merely caring for my patients. It was all in the scope of my job, I never considered the work I did as anything beyond what my job called for in caring for my patient. I never used the term "advocate" to describe myself-just a physician performing my duty. Unfortunately not a lot has changed for the coal miner, maybe some in the areas of safety and health improvements have been made.
Where did you grow up, was it near West Virginia?
Rasmussen -I was born in the southern part of Colorado in a little place called Manassa, just north of the New Mexico state line on the banks of the Conejas River, close to a town called Alamosa, between Trinidad and Durango.
When I was five, my family left there and moved to Ft. Collins where my father went to veterinary school. I attended school in Ft. Collins through the first three grades; when my dad got out of school we moved to Ogden, Utah where my dad's brother had a veterinary practice.
We lived there in Ogden up to my junior year in high school. We moved to Logan, Utah, where I finished high school and pre-med in college. So, I was not born in West Virginia but many miles away.
Where did you complete your education?
Rasmussen -I did my undergraduate work at Utah State University at Logan, Utah. I then went to medical school in Salt Lake City at the University of Utah. I graduated in 1952 I interned at the University of Minnesota and then spent one year at the University of Utah and two years at Letterman General Army Hospital in San Francisco. I had one year of pulmonary residency at Fitzsimmons General Hospital in Colorado.
I was in the Army in 1955 and stayed until 1962. I was in the Army for some of my training at Letterman and Fitzsimmons Army Hospitals. I was in the Army between Korea and Vietnam serving initially at Ft. Ord, California. Then I was assigned to Fitzsimmons as Chief of TB and then Chief of Chest Services at Brookside Hospital at Ft. Sam, Houston, Texas.
When I got out of the army and I was looking for a place to practice medicine, I ran across an ad in JAMA (Journal of American Medical Association),"Doctors needed in Beckley, West Virginia at the Miners Memorial Hospital." They were going to pay my way out and back. I came in October 1962 just to look around and I never left.
I liked what I saw, the facility and the people. I was very much impressed with the medical staff at the Miners Memorial Hospital in Beckley in 1962. They had, for example, a pulmonary specialist. He was Robert Hyatt and he subsequently went to the Mayo Clinic and eventually became the director of the Mayo Clinic's Pulmonary Function.
(Author's note: I spoke with Dr. Hyatt on the phone at his cabin in northern Minnesota after Dr. Rasmussen told me that he had originally practiced at the Miners Memorial Hospital. He has just retired after three decades of work at the Mayo Clinic. I also learned that Dr. Hyatt supervised doctors at Ground Zero; to help diagnose rescue workers suffering from respiratory problems at the site of the September 11 attacks - Dr. Hyatt told me he was leaving Miners Memorial Hospital when Dr. Rasmussen came on board but he did remember him well. Dr. Hyatt said he had visited the area two years ago looking for the little state police headquarters converted to a house he and his family occupied while living in Beckley. He told me that his daughter attended college in Blacksburg, VA. Finally, Dr. Hyatt said that he could never forget the beauty of the region but was appalled by what he saw happening with mountaintop removal.)
Rasmussen -We had a pathologist who was interested in cytopathology. We had a
Cardiologist who had done a lot of work on cardiac rhythm who later was working with George Washington Medical Center. A medical center was dedicated to him. We had others who were excellent, plus the situation was comfortable with the closeness of the staff and the salary was attractive. I also liked the idea of caring for the coal miners. I was impressed. I never regretted coming to the hospital. I was fascinated by the work.
When I came, I had no knowledge about coal miners' lung disease, black lung. I did not come for that but I began to see a lot of miners who had trouble with their lungs and breathing. I became more interested and began to study the cases. They had definite shortness of breath. Even the X-rays did not show very much.
Breathing studies might not show much either but we had seen a lot of different types of lung disease at Fitzsimmons. The patient may not show shortness of breath until they exercised. Normally these people would show a drop in oxygen in the blood.
I was able to persuade the hospital to get a gas analyzer and I guess the first coal miner that we exercised and drew blood from showed the same kind of abnormalities we had seen in unusual lung disease cases in hospitals where I trained in Denver and San Antonio.
For example, here was a guy, a coal miner, who complained of shortness of breath. His breathing test was normal, but through the exercise studies we were able to determine a respiratory problem. We found a fair number of those with shortness of breath with abnormalities and function and that was very interesting. I did not come here to do lung disease, but this really got me interested. I was fascinated by these cases.
Later, I quit my job with the Miners Hospital and spent two years in the public health services. I was doing the same type of studies though, and I traveled throughout the Appalachian coalfields supervising two field teams evaluating Appalachian coalminers. I was able to continue to do the exercise studies while I was in the public health field.
To date we have evaluated approximately 50,000 coalminers for black lung disease. About forty percent of those who have come to us show some evidence of the disease. We continue to find the same abnormalities, as well as miners with COPD.
What I began to do after public health service-was to write reports for some of these men for social security disability and others who were filing workers compensation claims as a result of respiratory problems. I actually spent a lot of time being cross examined as an expert witness. I would go to Charleston and testify and be cross-examined.
Also, I have served as an expert witness before federal judges in Washington, DC or in many cases the attending physician in cases relating to Black Lung claims such as the appeal case of Mildred Clovis, widow of Everett Clovis vs. FMC Mining Equipment Division, Decision issued, December 22, 2000). These cases usually involve the awarding of a miner or his widow benefits and then the coal operator tries to take those benefits away. These cases are heard by Federal Appeals Judges.
Then in 1968 Dr. Hawey Wells, a pathologist in the public health service, who was working at Johnstown, PA., (had been working in Washington, D.C. with Congress) invited me and three coal miners to come to Washington and testify before the Judicial Subcommittee. l never thought that Subcommittee or the Bill they were talking about had any authority over the coalminers and lung disease. There were so many injuries and fatalities at that time in the mines due to inadequate health and safety measures.
I suppose that was the first time I did any advocacy work, trying to explain to congressman the problems miners had. The next year the miners had their annual convention in Denver, the fall of '68. Those miners came back from that convention with a strong determination to change laws. Dr. Lorin Kerr, who had been concerned about coal miners' lung disease for many years, gave a talk at the convention. That was the spark that really got it going. They began to organize for changes in the workers compensation laws and an election was coming up.
The miners wanted the House and Senate to talk to Dr. I. E. Buff who had been talking about lung disease for some time as it related to the coal industry. He was drawing a lot of attention to the problems. There was also a group of local union presidents that came to my office and asked me to speak to and for the miners in the workers compensation cases and they begin to invite me, Buff and Wells to their organization meetings.
After that we were known as a circus; Buff and Wells were great entertainers. I was shocked at what Buff would do. He would thunder out, "Y'all got black lung and y'all gonna die!"
It was an interesting act to try to follow. Wells was the one who had gotten the dry inflated lung tissue from Dr. Lorin Kerr and he would crunch this stuff up and let it fall to the floor and say, "That is what is happening to your brothers' lungs."
Buff would come with an oxygen tank and mask and a white hat and black hat. He would tell the miners about the legislators, "They wear their black hat when they talk to coal operators. He would wear the oxygen tank and oxygen mask and roar this when talking to miners, "This is what you will end up wearing." That was quite an experience.
In November 1968 the mine at Mannington blew up. This focused the whole county on the mine issue. It was obvious they needed laws to address safety and health of the coal miners nationwide. Legislation was needed for workers compensation to become more fair for the miners.
They kept that up at rallies and really what they did over Christmas and New Years in 1968 and 69 at Cabin Creek, they organized the Black Lung Association. A large percentage of the miners in the state belonged to the organization.
They hired a lawyer. The first President of the Black Lung Association was Charles Brooks, a black miner, who began working in the mines in 1941. He mortgaged his home to get a down payment for a lawyer. Paul Kauffman was the lawyer; Paul had been a West Virginia state senator in 1968. He ran for governor and lost. I campaigned for Paul. That was the first time I had done anything like that. His son is Circuit Judge in Charleston, Todd Kauffman. Paul basically wrote the provisions for the Black Lung Association. (Paul, his wife and another son were killed by a drunk driver in the '80s).
Warren McGraw who was a West Virginia House of Delegates member at the time, also, wrote a model and was very instrumental in the passing of what the Black Lung Association wanted.
At any rate, The Black Lung Association lobbied in the state capitol. They had representatives from all over the state. The miners had some of the lung tissue from Dr. Lorin Kerr and they carried it around in a coffin with a sign "Black Lung Kills." Basically, they polled every member of the House and Senate. They were complimented by some of the most conservative news media because they were said to have not even overturned an ash tray.
They were orderly; this subsequently culminated in some big rallies held all over the state. Eventually, in Charleston they had the combined House and Senate Judicial hearings in which three groups participated.
The United Mine Workers President, Tony Boyle, opposed the legislation. He even sent a delegate from Washington, D.C. in an attempt to dissuade the Black Lung Association in going on with their proposal. Kaufman put a stop to that by debating an attorney they had chosen.
When the hearings started, The Black Lung Association had some of us testify on their behalf. The coal operators had experts to testify. The group The United Miners Workers had selected included the renowned radiologist, Dr. Eugene Prendergrass. They looked at the lung disease X-rays from Phil Jetrow Gough from Great Britain who had done the pioneer work on coal workers lung disease. Leon Cander at one time had been Governor Scranton's Chief of Lung Disease in Pennsylvania. At that time he was professor of medicine and physiology in San Antonio.
The testimonies of these three were 100% in favor of what the members of the Black Lung Association proposed. Afterward they rebroadcast the hearing. That night Leon came to the hotel and he was saying, "We won!" "We won!" "We won!"
At any rate, we all felt so happy and satisfied by that hearing. Guess what? They claimed the transcript had been lost and they came out with a new proposal that was worse than what the miners had been living under.
Kauffman and McGraw started scrambling to get something but that was not quick enough. The miners started walking out all over the state. They agreed to adopt some of the provisions the Black Lung Association wanted. The most significant was the "Presumption Clause" which said that if someone had worked ten years or more in the mines subjected to dust exposure, you didn't need X-rays.
They keep trying to bend that all the time. That has helped a good many miners by having that "Presumption Clause" in there. It has been valuable to coal miners. When Governor Moore signed that bill the miners went back to work.
July 30, 2002 - second interview, Sophia, West Virginia: This interview took place after Quecreek, Pennsylvania, mine disaster which occurred on July 25, 2002 resulting in miners trapped underground.
We talked about the Quecreek rescue and Dr. Rasmussen told me he was not surprised the miners were still alive. I asked him about the rumors of inadequate mapping as the possible fault for the cutting in of the abandoned adjacent mine. He told me in many cases the mapping is fine - sometimes coal operators instruct the miners to go beyond the lines on the map.
Dr. Rasmussen told me the following stories about miners he knew.
One story was about a miner who was involved in a mining accident, both legs were cut off - at that time there was no workmen's compensation or unemployment and he had to support his family, he made a cart with wheels, rolled himself into the mines and continued to shovel coal.
We talked about the role of the coal operator and the concept of "Paternalism" brought about by coal camp life with the coal operator controlling the life of the miner and his family; I was disturbed by this revealing statement - "Yes, they depended on the coal operator for everything-in many cases the miners were treated no better than slaves." I remember a story, he said, "A miner living in a coal-camp, his sister died. She lived in another town. He needed a cash advance to go to her funeral. The coal company required he report all his assets, everything he owned; when the coal company officials found out he had a cook stove in his house not purchased at the company story, they denied the salary advance and the brother was unable to attend the funeral."
His wife Carmen came into the kitchen where we were working and she told me she came from a family of coal miners. She said that her grandfather worked in the coalmines, underground. He was in a mining accident and got both his legs cut off. She said that her grandparents never wanted her father to work in the mines.
What kept you involved in this movement?
The thing that motivated me-I could see the injustice done to coal miners in the workers' compensation arena because some of the miners I had may not have had enough X-rays to satisfy people in those positions who had a say; so those miners were denied Black Lung benefits. We had a big fight on hand. We knew, based on studies from Britain, we could cut down on lung disease by cutting down on the dust the miners were exposed to in the mines. This has been known for hundred of years. So the proposition has been made repeatedly over the years to take measures to cut down on the dust in the mines.
I wanted to get laws passed for the miners, but I never voluntarily pushed myself out. I was invited to come and testify before the Congressional Committee in D.C. I did not voluntarily push myself out and I never considered myself an advocate; I only did the work I knew was correct. I saw the miners who needed help; I never felt I was leading a charge. I just told of my own experiences and went on from that position. Everything I did and said was from the laboratory and that is basically the same thing that happens now on a daily basis. I do stick up for miners who have impairment and so I back up the same thing I say. So basically, that is what I do. That is part of my normal duty-to take care of my patients in whatever capacity needed.
I don't know exactly how the miners began their progress toward getting Black Lung Legislation; maybe it was through the directions from Ken Hechler or John Kline. John Kline was one of the original VISTA (Volunteers in Service to America) workers which began in 1964. John Kline had worked for years helping people. He finally decided to go to law school and had recently graduated and I heard has begun his own law practice.
Craig Robinson, (you have to talk to Craig Robinson-get his story for your project) he actually had been working with poor people and many were displaced miners and disenfranized miners who were members of the UMWA (United Mine Workers of America) whose benefits had been illegally and improperly withheld He was interested in the Black Lung legislation. He met with miners who should have been retired and receiving benefits; but because of the lack of legislation, they were denied. They talked about what should be in the bill for coal miners. He worked along with Rick Banks. They even began formulating a Bill. They enlisted the help of Delegate Warren McGraw. (You need to interview Warren McGraw, he is now Chief Justice) He worked very hard in getting the Act of 1969 with changes in West Virginia Workers Compensation Law.
The Black Lung Association hired Paul Kaufman, an attorney, to write a model bill and to get it introduced; he consulted with those of us involved in the Black Lung Association. Paul knew the ropes on how to get bills introduced into the legislation because he was a former senator himself; so he knew the mechanism.
Well, I guess it was "politics" because it was funny that the bill was delayed and the two groups that Craig had been working with joined together and so they put forth the bill. Craig Robinson and John Kline were principal guys in that work in getting that important Bill passed. They were also strong advocates for the Federal Mine Health and Safety Act.
Craig along with Dr. Daniel Doyle built that up, that clinic as one of the most effective, strong clinics in operation. Craig knew everything about that place. He knew everything, all the records, who was to be paid; they were always trying to improve the image of the place. He is sorta like my boss now. He is doing the same thing at my clinic-trying to salvage it, to keep it from going under financially. Craig can do it, if anyone can.
John Cline stayed around here and worked at various community service jobs. He became a great advocate lobbying for coal miners in their attempts for federal benefits and worked out of New River Clinic for a long time.
What about your clinic, what is going on, can it be saved?
What became the Southern West Virginia Clinic in 1964 was founded when UMWA Welfare and Retirement Fund sold the clinics and hospitals they funded in West Virginia, Virginia and Kentucky to a non-profit group Regional Health Care.
When that happened, most of the doctors who had been here formed the clinic. There was not adequate space at the hospital so in 1967 they built this building. Some of the original doctors are still there at the clinic - Yates and Maiola, they are still here and they came here before I did in 1962.
What were the other guys like, Buff and Wells, did you get along and what has happened to them?
Wells is alive and living in Martinsburg, West Virginia. Buff is dead. We were like a group. I had known Wells since 1964 when he came as a doctor for the public health service. He grew up here. His father was a professor at Concord College. Wells is the kind of guy you can get into a real fight with and the next day everything is fine. He is a likeable guy. You should talk with Wells. He did some of the early pathology work in this country along with Lorin Kerr.
Were you ever in danger or were you threatened?
There were some times when a few threats were made but that was primarily during the United Mine Workers election in 1969. Following the election and actually two weeks after the election, Hechler called me up and said, "I miss those rallies. Yes, let's have another rally, a post rally."
We organized a post rally at Sophia High School, near Beckley, WV. Quite a big crowd of people came. Hechler came a little late and a car with three passengers was parked in the path between the sidewalk and the high school front door. Ken walked over to the car. It was those men who later murdered Yablonski. They had Ken on their list to murder, and they had been following him all the time. It is amazing. The sad part is they didn't have to pay hardly any money to get those guys to do this.
I was with Yablonski at every rally he had between Fairmont, West Virginia and Pikeville, Kentucky, At every single rally. I would do it again. Yablonski, I thought and still do think he would have done things differently. He would have made a strong Union president. He would have picked the union up. If only Yablonski had not been murdered. Two districts in Eastern Kentucky, one in Virginia and several in West Virginia and Ohio and Pennsylvania-that is where the Yablonskis lived-in a nice place in southwest Pennsylvania, that is where they were killed. murdered in their own home in 1969.
It didn't take long for the law enforcement to arrest the murderers because they had been casing the place and had people writing down the license plate numbers of people coming through the area. I think it was only the next day, and that made us more determined than ever to form the Miners for Democracy.
The Girl From Stretchneck Holler, Inside Appalachia