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Blue Collar Doctor Tracks Ground Zero Workers

ROBIN FINN / NY Times 31jan03

HIGH-PROFILE healers don't opt to practice occupational medicine: it's a blue collar science, dominated by asbestos and asthma and lead poisoning. Only a fellow fixated on being a doctor since he was 6 but captivated in the 60's by the effect one's station in life has on one's health would willingly veer off the beaten path — a surgery internship at Bellevue and a psychiatry residency at St. Luke's — into this branch of medicine.

So it's no stunner that Dr. Stephen M. Levin, director since 1987 of the Mount Sinai Irving J. Selikoff Center for Occupational and Environmental Medicine and co-director of an unprecedented $12 million health screening for ground zero workers, turns out to be a scruffy-beneath-the-surface character. Attention embarrasses him. He would rather have his tired brown eyes in a research book, or be with a patient. But the trade center tragedy has put his expertise in the spotlight.

"Sometimes history behaves like that," he will say when he's finally been located inside his claustrophobic office at 10 East 101st Street. "Events occur and suddenly you find yourself and your organization swept up in something you never dreamed you'd be involved in."

This week, Dr. Levin and his team held a news conference alongside benefactors like Senator Hillary Rodham Clinton and Representative Carolyn B. Maloney to announce the daunting preliminary results of their screenings, which began last July and will continue until June. So far, more than 3,500 people have been seen; a survey of 250 examinations revealed three-fourths of the patients still had respiratory problems 10 months after the attack, half had lung-related complaints, and half were experiencing psychological trauma warranting further review.

As for late-onset cancers, time will tell: "I'm not saying we'll see a huge wave of cancers in 20 years, but I know the rate won't be zero," he warns. "The point is not to count statistics, but to plug the people who need it into care, and to detect the diseases as early as possible when we still might have a shot of curing them." Of the 70 patients Dr. Levin has personally taken on since Sept. 11, 2001, no one has made a complete recovery.

Mount Sinai's program can screen 9,000 workers before funds run out; it is estimated that some 35,000 workers and volunteers spent time at ground zero or adjacent to it. The doctor finds it scandalous that most worked without protective gear; he calls it a public health outrage. In public. On network television, before the City Council, the State Assembly, a Senate subcommittee. And we thought he was on the shy side.

No, Dr. Levin, 61, has plenty to say about this. The trick is finding him. Hint: he is the only doctor in the place wearing a navy tie with tiny salamanders poised atop a bed of flames, symbol of the asbestos workers union. You can't buy that tie at Bloomingdale's. Other hint: he is the only doctor whose office décor consists of a sign from a United Brotherhood of Carpenters and Joiners of America convention (his father was a cabinetmaker), and a smoky photo of the trade center ruins snapped by an ironworker (he began monitoring ironworkers at the Manhattan Bridge for lead exposure a decade ago).

Dr. Levin works in an unmarked office behind a closed door whose tiny window has been blocked over; once found, he proves sociable. But busy. His phone and pager take turns bleating, and he seems inclined to take each call. It's how he is. He was screened himself for this line of work 24 years ago by his late mentor, Dr. Selikoff, who never let the demands of research, or policy, get in the way of patient care; he takes pains to do the same.

BUT he is irked that the program has received no assurance of continuance past June. He believes the workers' health should be tracked and treated much the way the government provides health care for nuclear arms workers exposed to radiation during the cold war. He says $160 million is a reasonable amount to cover two decades of treatment.

"The issue has become something of a political battle," he says. "It's a public health mistake and a lost opportunity to do the right thing if government fails them. I just hope the clinical consequences aren't too severe."

Dr. Levin grew up in Philadelphia. His mother worked in a hospital, and his father had dropped out of eighth grade to support his own mother and siblings as a carpenter. Dr. Levin was a science fanatic early on: "I was one of those kids who looks under rocks and takes the radio apart and fixes a bird's injured wing."

He got a full scholarship to Wesleyan University and received his M.D. from the New York University School of Medicine in 1967. He remains nostalgic for four years spent in general practice in Pottstown, Pa., a factory town, in the 70's. He did "everything but deliver babies," and charged his patients what they could afford: $2 a visit for factory workers, $7 for management. He returned to New York to be closer to a son from his first marriage, and in 1979 he obtained the final spot in Dr. Selikoff's then-new occupational medicine program at Mount Sinai.

Now a widower, he moved 18 years ago from the Bronx to Dumont, N.J., with his wife and their three children. He chose Dumont, he says, because "it's a blue collar town. I didn't want my kids to grow up in some suburb surrounded by other doctors' children. I wanted them to have the same kind of life experiences I had. I thought it was important."

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