Vaccination News Home Page

http://www.nytimes.com/2002/06/12/nyregion/12TOWN.html

The Pill That Treats Not Terror, But Fear

By MATTHEW PURDY

ORKTOWN, N.Y. — The women outside the obstetrician's office were talking about the pill.

"It's reckless not to get it," said one. "It's in my wallet."

Suddenly, the other woman said, it "feels like it's very possible" that the pill might soon be necessary.

The Pill for the Age of Al Qaeda is potassium iodide, known by the chemical formulation KI, which protects against thyroid cancer caused by radioactive iodine.

Whether the terror threat in the vicinity of the Indian Point nuclear power plant is greater than elsewhere is open to debate, and very loud debate at that. But people here now have a leg up on the rest of us who warily wonder what we will do if our neighborhood subway stop or favored Hudson River crossing is Al Qaeda's next target. They have something to take if their nightmare comes true.

Westchester County began distributing the potassium iodide pills last week for use in what officials stressed as "the unlikely event of an emergency at Indian Point." Counteracting radioactivity is one aim. But the pills may have more significance as a kind of duck-and-cover exercise for the war on terrorism — a gesture of control in a big, bad world.

"What some of my colleagues have said is that KI is being used to treat anxiety, not to prevent thyroid cancer," said Joshua Lipsman, the county health commissioner.

Certainly there are circumstances, however remote, in which you would want potassium iodide pills, since a significant release of radiation would increase the risk of thyroid cancer. But the radiation could also cause other diseases for which there are not as reliable antidotes. And in a truly catastrophic attack on Indian Point, those facing only the long-term effects of radiation exposure would probably consider themselves fortunate.

In the current atmosphere, when the remote feels real, why not take the pill if someone is offering it?

Pharmacies in northern Westchester have had a run on the pills. On Saturday, the first day of the county's free potassium iodide program for residents within 10 miles of the plant, more than 2,600 people showed up at the high school parking lot here to get pills — one per resident.

The response even surprised William Primavera, who on Saturday collected hundreds of signatures on petitions to shut down Indian Point. "I don't understand the steady stream of people going into that parking lot," he said. "It was like the last scene in `Field of Dreams.' "

The pills are now another front in everyone's private haggling with fear. I'll go into New York City, but not take the subway. I'll fly, but not in the morning.

"You can get crazy," said Jennifer Grossman, pill-less in the park with her children the other day. "We won't go to the Yankees game, but we will go to the Hudson Valley Renegades in Dutchess County," a minor league baseball team.

Fear is a curious fire; everything seems to stoke it. Warnings from the government. Reassurances from the government. Rampant rumors. Dead silence.

MORE than a few people were shocked when they picked up the phone last week and heard a taped message from Westchester County executive, Andrew Spano, announcing the pill distribution.

"I was like, `Mom, Mom, Mom!' " Jennifer Moreira, 19, said, recalling her reaction. "It wasn't just people in the community being nervous, it was community leaders being nervous. It's like growing up and seeing your parents cry."

Her mother, she said, got to the high school parking lot early on Saturday.

Lee Joffee, whose pharmacy has been inundated with calls from people seeking potassium iodide pills, said that if there were a big release of radiation, pills were not "going to make that much of a difference." But, he said, "if people are sleeping better because they have this pill on the night table, maybe it's worth it."

The distribution program is being run with approval — and free pills — from the Nuclear Regulatory Commission, which is offering pills to communities near power plants around the country. And Dr. Lipsman said that, as a matter of public health, "it's not irresponsible to distribute KI in advance" of an actual radiation release. But the real public health issue is fear. Dr. Lipsman said that this situation reminded him of the early years of AIDS and the first summer of West Nile virus.

That's the beauty of the pill.

"You can't control Al Qaeda, you can't control Afghanistan, you can't control Iraq, you can't control all the planes in the sky, but, by God, you've got your pill," Dr. Lipsman said. "You've got something."

Vaccination News Home Page

ALL INFORMATION, DATA, AND MATERIAL CONTAINED, PRESENTED, OR PROVIDED HERE IS FOR GENERAL INFORMATION PURPOSES ONLY AND IS NOT TO BE CONSTRUED AS REFLECTING THE KNOWLEDGE OR OPINIONS OF THE PUBLISHER, AND IS NOT TO BE CONSTRUED OR INTENDED AS PROVIDING MEDICAL OR LEGAL ADVICE.  THE DECISION WHETHER OR NOT TO VACCINATE IS AN IMPORTANT AND COMPLEX ISSUE AND SHOULD BE MADE BY YOU, AND YOU ALONE, IN CONSULTATION WITH YOUR HEALTH CARE PROVIDER.