The Great Tenderloin Radiation Survey
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The Great Tenderloin Radiation Survey

By Dr. Zoomie

Over a decade ago, the extremity dosimeter for a nuclear pharmacist in San Francisco indicated he was receiving high finger doses during his work.  His supervisor, the pharmacy owner (and a nuclear pharmacist himself) suggested various methods of controlling dose, but the worker still ended up exceeding the dose limit of 50 rem to the fingers.  Which required a report to the state regulators and corrective actions, of which my presence was one – the pharmacy RSO (the owner and my sole student) was required to undergo remedial training in radiation safety, concentrating on medical radiation safety. 

The state regulators approved my curriculum and off I flew to San Francisco.  The training was actually fun – I don’t get to do much one-on-one training, and the student was quite enjoyable to talk with.  Around lunchtime on a Sunday (the training took place over two weekends due to the student’s work schedule), we got a phone call that the isotope delivery vehicle had been broken into and a 2 mCi capsule of I-131 had been stolen.  This particular driver had to make a delivery early Monday morning to a hospital about 200 km away; since he didn’t want to have to drive to the pharmacy in the early morning, he decided to keep the dose in the trunk of his car from Friday evening until the delivery on Sunday.  Unfortunately, the driver’s car was broken into in the wee hours of Saturday morning, and the box with the I-131 capsule was stolen.  We found out about it Saturday afternoon, when the driver noticed the broken car window.

When the call came in, we checked the regulations and confirmed that the loss of anything more than 1 mCi had to be immediately reported to the State of California.  We made the phone call, then a second phone call to file a police report, then went to the scene to see what we could find.

The driver lived in San Francisco’s “Tenderloin District”, a not-very-reputable part of town with a lot of crime and drug use.  As we pulled up, we saw a syringe stuck in a pile of feces – we didn’t try to find out what species – a lot of empty vodka, whiskey, and beer bottles, and the requisite number of street people hanging around.  The driver had been talking with some of them – one claimed to have heard the car break-in the previous night, and they had found some of the packaging (including the top of the lead shield).  We wandered down the alley while waiting for the police to show up, trying to stay out of the light rain.

The cop looked sort of dubious about the whole thing.  He couldn’t believe he was being asked to take a report for something that was only worth $100, and he couldn’t believe that someone was actually stupid enough to park a car in that particular alley, which experienced robberies almost every night.  On the other hand, when we told him that a small amount of radioactivity was involved, he didn’t seem at all concerned; he just told us that, if it was a capsule, the thief probably swallowed it immediately, wondering what it might do and hoping to get high. At one point the cop asked what they should be looking for. “For the next couple of weeks, someone who sets off your radiation pagers.” Then I thought about the effects of having one’s thyroid destroyed and added “After that, someone who’s really lethargic.” The cop gave me a long-suffering look over the top of his sunglasses. “This is the Tenderloin District, man – everyone here looks lethargic.”

We reported this back to the regulators, then drove back to the client’s office to pick up a radiation detector (we had decided to leave the meters at first to try to avoid upsetting anyone).  Then, microR meter in hand, we returned to the scene.

I got the impression that the people living and hanging out in this area didn’t have much novelty in their lives.  When we pulled up, they came over to the car immediately and filled us in on what they had been doing (not much) and what they had found out (even less).  Then they asked if there was a reward for finding the capsule, and one of the men asked if we could spare $5 for the “work” he’d already done.  As I started down the street with the meter, one man asked what we were looking for.  “A package with some medicine in it – one capsule.”  “Only one?  What about 15?”  This made me wonder if he’d stolen 15 capsules earlier in the day.  Then they noticed my meter.  “What’s that for?”  I really didn’t want the San Francisco street people talking about lost radioactivity.  I briefly considered telling them we were actually looking for a lost alien spaceship, then just told them it would help us find the chemicals in the medicine that had been lost, and that we were trying to find it for the cancer patient it was intended for. They seemed happy with this and we managed to start a survey.

Although we spent a half hour going over the most likely escape routes, I never got a peep on the meter – we had some puzzled looks, but these seemed to mostly come from tourists who seemed fairly lost, and the puzzlement probably had little to do with seeing a guy carrying a radiation meter down the street, being tailed by a man in a black Mercedes sedan.  And, considering that earlier that day we’d seen a man dressed as a banana, a topless woman with stars painted on her breasts, and a trio of men in matching striped shorts and shirts, I was probably among the more normal-looking people on the street that day.

Needless to say, there was no iodine to be found amidst the strip clubs, vodka bottles, and syringes, so we headed back to the lab to make up a new dose of I-131.  I suggested that it might be a good idea to change the delivery procedure to require that all isotope be delivered on the same day it was compounded, and the driver (who was studying philosophy at the University of California at San Francisco) looked suitably chagrined.  Dose calculations show that, if the thief did take the capsule, he or she will receive a dose of about 3000 rem to the thyroid, which is significant.  But, lacking a way to survey everyone in this area, the thief could not be found.  Other scenarios (dropping the capsule in the park, spilling it on the street, dropping it into the sewer) give almost no dose at all, so the general public had nothing to worry about.  And, given the rains that came down off and on all day, any spilled iodine probably ended up in the storm sewers and wouldn’t expose anyone.

I can’t say that this incident had a happy ending, but neither was it a bad ending.  Somewhere, a thief got a highly dosed thyroid, but that was self-inflicted.  My student had some work to do in revising procedures, talking with his regulators, and re-training his drivers.  And I got to spend a wonderful afternoon in the San Francisco rain, surveying the Tenderloin District among the prostitutes, tourists, and drug users.

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