Dan Fagin’s book about the prevalence of childhood cancer in a New Jersey town may have won a 2014 Pulitzer Prize, but it was Twitter that landed him on the pages of a recent New York Times Sunday Book Review.
“I believe I just won a Pulitzer Prize,” Fagin tweeted, moments after the April 14 announcement that his Toms River: A Story of Science and Salvation had been given the award for general nonfiction. And then, after a few minutes more: “Well, this is something.” The paper quoted both messages in its April 27 edition, causing Fagin to quip, “I finally made the Book Review!” (Toms River had previously received its own glowing appraisal—in the Times’ Health section.)
Weeks later, the wry tweets hadn’t stopped (May 28, on the occasion of the Pulitzer ceremony: “Note to self: Do not spill anything on tie”) and Fagin still tends toward stunned understatement when discussing the aftermath of what he refers to, shyly, as “this Pulitzer thing.”
Claiming you never expected to win is the polite thing to do, but when Fagin says it one tends to believe him. It was his wife, Alison Frankel—a fellow journalist who’d been eagerly scanning the Pulitzer website for the names of her colleagues at Reuters—who delivered the news, he says. “She was like, ‘Dan, Dan, you won!’ It was quite an amazing shock,” Fagin recalls. Both were working from their home offices on Long Island. It had slipped Fagin’s mind that the prizes were being announced that day. “And then the phone started ringing.”
First there was champagne with Frankel, followed by a celebratory dinner out with friends, and then a string of parties, including one with students and colleagues from NYU’s Arthur L. Carter Institute’s Science, Health and Environmental Reporting Program, or SHERP, which Fagin directs. “People who you haven’t heard from in many years resurface just to congratulate you or to say hello,” he says.
In Fagin’s case, this pinnacle of achievement will always be linked to the dark story of corporate greed and government neglect that he spent seven years unraveling. He shares the victory with the remarkable characters from his book—the dozens of real-life scientists, journalists, public officials, and parents of dying children engaged in a decades-long struggle to establish a link between a cluster of rare cancers in Toms River, N.J., and the poisons that had contaminated the drinking water and air there. “They quite rightly think of this as their book too,” he says.
Toms River is a quiet seaside town about 55 miles east of Philadelphia that, during a manufacturing boom in the 1950s, ’60s, and ’70s, large chemical companies used as a dumping ground for toxic industrial waste. By the early 1980s, a network of families, doctors, and nurses had begun to trace an alarming trend of childhood cancers (often of the brain and central nervous system) in the area—but it would be years before local and federal officials were persuaded to invest in a five-year, $10 million study to determine what, beyond genetics and bad luck, might have made the children sick. Toms River offers not just the 60-year history of rampant pollution in the town, but also a tribute to the tenacious advocates whose efforts ultimately caught the attention of reporters like Fagin (who spent the 1990s reporting for Newsday on breast cancer on Long Island) and catapulted a local epidemiological drama to national prominence.
Among the heroes of the story are activists like the indefatigable Linda Gillick, who led other Toms River families to demand a governmental investigation into the environmental causes of cancers like that of her son, Michael, who was diagnosed with neuroblastoma in infancy. (Michael, born in 1979, was given only a 50-50 chance to live to his first birthday; he beat the odds and survived to join the fight alongside his mother—but not without suffering a litany of ailments including tumors that cost him the use of his left eye and ear and shifted the placement of his internal organs.)
The numerous villains make up strands in a tangled web. First there was a chemical company that arrived in town in 1952, opening up a dye-making plant that pumped Technicolor smoke into the air and flushed billions of gallons of gunk into the Toms River (and later, via pipeline, into the Atlantic Ocean at the Jersey Shore). The air inside the factory was so noxious it melted the nylon stockings off of secretaries’ legs. Then there’s the garbage hauler who buried leaky drums of toxic sludge from yet another chemical company in an old egg farm owned by Holocaust survivors—and the various municipal authorities who thwarted inquiries into the safety of the drinking water to in the effort to save face and stem losses in tourism and real estate revenue.
The grieving families’ quest for the truth generates plenty of pathos and suspense in the story, of course. But it’s Fagin’s fascinating digressions—a history of dye-making, a look at cancer at the molecular level, and, most important, a thorough primer on environmental epidemiology, the science of interpreting patterns of illness—that make the book much more than a sad yarn about one sleepy town. At its heart, Toms River is an exploration of the tension between the primal human desire to understand what causes horrifying conditions like cancer and the difficulty of determining scientifically a causal link between any single environmental factor and a cluster of disease in a particular area. It is, improbably enough, a riveting drama about statistics.
“When you look in a small place for a relatively rare disease, you can have a huge amount of random variation,” Fagin says, “and it’s very hard to find the signal in that noise.” In the book he recounts the extremely expensive and time-consuming efforts of various epidemiologists working in Toms River, culminating with two New Jersey health department case-control studies that ultimately found a connection between tap water consumption and leukemia in children under the age of 5. Along the way he offers thorough, readable explanations of many of the concepts central to biostatistics—margin of error, confidence intervals—that too often send non-scientists reeling.
Such writing, Fagin says, is the “raison d’être” for SHERP, where students are trained to bring scientific narratives to life with both passion and precision. “I really hate it when people say that just because something is complex, or doesn’t deliver certainty, it’s not worth the trouble,” Fagin says, referring to the common misconception that empirical findings based in probability cannot be trusted—a thorn in the side of not just the Toms River activists but today’s scientists working on multifaceted problems like climate change as well. “That’s bunk as far as I’m concerned. One of the things that I wanted to demonstrate with this book is that for 400 years, we’ve been doing a really good job at acting on epidemiological information, even though it’s not certain, and taking proactive, sensible steps to reduce health risks. We act on incomplete information all the time.”
The Toms River story concludes with a triumph tempered by exhaustion—and some important lessons for the future. Justice for the victims came in the form of $40 million doled out by the chemical companies to 69 affected families in 2001—one of the largest such settlements in history, but a deflating conclusion to an emotionally and financially draining battle that had begun 30 years earlier. None of the companies admitted liability. Also troubling is Fagin’s conclusion that the chief legacy of Toms River “has been to solidify governmental opposition to conducting any more Toms River-style investigations.” And worse, because only governments have “unimpeded access to cancer registry information,” he writes, “if public agencies do not investigate clusters, then no one will.”
So are we all just left to patrol our own communities for various health risks? “Sure, I would do that,” Fagin says. “But I also don’t think that these issues are best resolved on the individual level. What we really need are smart environmental regulations robustly enforced by agencies that are well-staffed—none of which we have now.”
Toms River can be read, on one level, as a how-to manual for collective action; it’s a chronicle of how many different people—experts and ordinary citizens working in different fields and sometimes in different decades—each played a part in addressing a shared problem. “I’m excited that people are reading this and learning from the story,” Fagin says of the new wave of attention the book has received since the Pulitzer (Amazon sold all the copies it had in stock within an hour after the prize was announced). “That’s all that any author could ever want.”
But an added delight has been giving the people in the book a chance “to see where their part of the saga fits in the big picture.” One event he hosted at the Carter Journalism Institute brought together figures like Don Bennett, a seasoned local newspaper reporter who brought attention to the Toms River story early on, and the lawyers who negotiated the settlement years later.
“It’s been fun for me just to introduce people,” Fagin explains, “and say, ‘Chapter 4, meet Chapter 11.’”