It's 1957. Dr. Herbert Needleman is on his way to see a three-year-old patient at the Children's Hospital of Philadelphia.
Needleman is a young doctor, about six feet tall, with brown eyes and dark hair. This is the first case of lead poisoning he's ever seen.
When he shows up, the girl is not in good shape. Her eyelids are drooping. Her pulse is slow. She's not making a sound.
"This girl was lethargic and almost comatose," says Lydia Denworth, who wrote a book about Needleman and lead poisoning called Toxic Truth. (Needleman has Alzheimer's disease and was unable to interview for this story.)
Needleman prescribes the girl a medicine that gets rid of the lead in her blood. Over the next couple days, she starts to feel better, and Needleman thinks he has fixed her problem.
He talks to the girl's mother, saying, basically: your daughter is okay, but she was probably poisoned by lead paint or dust at home, and you can't go back there.
"And the mother just looked at him and said, 'Well where am I supposed to go'?" Denworth says. "She didn't have any money. She was a single mother. And suddenly Needleman says it's like the scales fell from his eyes."
As a doctor, Needleman couldn't go home with this family and remove the lead from their apartment. This girl was probably going to end up back in the emergency room again.
For Needleman, this patient marked the beginning of a lifelong crusade. He would later go on to make a huge discovery that changed the way we think about the dangers of lead. And surprisingly enough, in 2016, a lot of doctors are in the same position he was that day: there's not much they can actually do for patients who come in with lead in their blood.
A long history
In the 1950s, when Needleman was a new doctor, lead was everywhere: in paint, pipes, gasoline, and toys. People had been using lead since the time of the Romans.
Doctors knew lead was poisonous at high levels, but they thought that was primarily a problem for industrial workers who were around the metal all the time. That perception began to change as both adults and children came into their doctors' offices with the same symptoms as metal workers and painters.
Still, a lot of doctors weren't testing kids for lead, because many of the symptoms of acute lead poisoning — like vomiting, fatigue, and seizures — looked like other diseases, Denworth says.
As an experiment, Dr. Needleman's hospital started testing all kids for lead. The doctors began to see that lead poisoning was more widespread than anyone had imagined, she says.
After this, Needleman became obsessed with lead. Sometimes he thought about it on his commute to the hospital from his home in West Philadelphia.
"He describes riding along in the trolley and looking at all the faces of the kids who were in the apartment buildings and houses and playing on the street and beginning to wonder just how many of those children were lead poisoned," Denworth says.