Louisville Medicine Volume 66, Issue 9 | Page 27

IN REMEMBRANCE In Remembrance JOHN CREECH JR, MD October 1922 – August 2018 DR. JOHN CREECH JR.’S REMARKABLE CURIOSITY Dr. John Creech was a work-a-day general surgeon at St. Anthony’s Hospital after his training at the UofL School of Medicine and in our residency under Dr. Rudolph Noer. He then did a fellowship at MD Anderson and settled into general surgical practice and what was a fairly routine job as plant doctor for B.F. Goodrich, which was then located on the Standiford Field campus. Because the UofL family unit practice had begun to do clinical work with inpatients as St. Anthony in the early 1970s, we were occasionally asked to see patients for them there. That is where I got to know John a little better than you typically do when you change clothes besides someone once a week in a surgical locker room. I was surprised and delighted when he called me in early 1974 and said he wanted to talk to me about an unusual set of circumstanc- es at his “plant doctor” job. There was a past history of employees there and elsewhere with digital tenderness and resorption of the distal joints on radiograph of the hand (acroosteolysis), possibly due to vinyl chloride. In essence, what John had done, working with Dr. Laszlo Makk who was then Chief of Pathology at St. Anthony, was to recognize a cluster of seven patients from the B.F. Goodrich factory who had the very rare lesion called angiosarcoma of the liver. Industrial toxicity was not even a social subject at that point in time, but Dr. Creech had recognized an unusual clustering of patients in one single building at the plant. To make a very long story much shorter, more work was done to get monitoring practices arranged. Carlo Tamburro, MD, who was a well-respected hepatologist from New Jersey, was recruited to UofL faculty and the Brown Cancer Center to continue a productive study of these patients and the environmental and industrial implications thereof. Like everyone else at the time, I learned the significance of vinyl chloride and the potential carcinogenicity thereof. As I recall, the company joined in, at the behest of its medical officer Maurice Johnson, MD, with a vigorous search for causes and mechanisms and was helpful in patient care and illnesses as a whole, which followed. This is quite a different approach from that shown by other companies, lost in a fog of tolerable ppm (parts per million). 1 This whole thing came to light because of Dr. Creech’s remarkable curiosity. His contribution became an important milestone in the historical industry of the Occupational Health and Safety Adminis- tration. OHSA must work continuously at making work places safer and less toxic to the workers, and in Louisville, Dr. John Creech’s discernment and initiative sparked this endeavor. He deserves all the credit for the imagination and insight, aided by Dr. Makk’s es- sential pathologic workup and interpretation, for recognizing this mini-epidemic. Their efforts sparked a nationwide search for ways to severely limit exposure to this commonly used gas. This serves as a constant reminder that there are many ways doctors can contribute to society and this is a most unusual one, but one that most appreciated by all concerned. - Hiram Polk Jr., MD Those interested in details should and background should see Deceit and Denial: The Deadly Politics of Industrial Pollution by Gerald Markowitz and David Rosner, pages 174-193. Univ. of California Press / Milbank Memorial Fund; October 7, 2002 1 Jan 1975 issue Annals of the New York Academy of Sciences ( Heath, Falk, and Creech) 2 Dr. Creech was a GLMS member for 62 years. FEBRUARY 2019 25