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Hey Prime members, you can binge episodes 41 through 48 of Mr. Ballin's Medical Mysteries right now and ad-free on Amazon Music. Download the app today. On a blustery November morning in 2007, a medical investigator from the Minnesota Department of Health inspected the slaughterhouse floor of a pork processing plant.
She was there to investigate a troubling outbreak. Over the past year, multiple employees had suffered severe nerve damage. It was so bad that some of them had even been paralyzed, and so far nobody knew what was causing it.
As the plant's CEO showed the investigator around, she carefully examined every step of the processing line, and she couldn't believe how quickly the dead pigs were broken down into various cuts of meat. The employees barely had time to finish their tasks before a new pig arrived in front of them. But otherwise, the investigator thought that everything else seemed to be clean and orderly. That was until she saw something so horrifying it made her stop in her tracks.
She had never seen something so gruesome, so barbaric, so unsanitary in her whole life. And if her suspicions were right, this was the reason behind the dangerous outbreak.
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From Ballin Studios and Wondery, I'm Mr. Ballin, and this is Mr. Ballin's Medical Mysteries, where every week we will explore a new baffling mystery originating from the one place we all can't escape, our own bodies. If you like today's story, please invite the follow button to join your hacky sack circle. But instead of serving them the hacky sack, just throw them a live tarantula. This episode is called The Mist.
On December 10th, 2006, a slight man in his 20s with thick black hair stood shivering as he worked on the slaughterhouse floor at Quality Pork Processors in Austin, Minnesota. Machinery clanked in the background and the metallic smell of fresh blood and acrid bleach hung in the air.
The man, whose name was Javier, felt the freezing wind blow in from the loading docks and seep through the thin white lab coat he wore over his clothes. But Javier wasn't just cold. His muscles ached. He felt like he might have a fever, and his hands and feet tingled as if they were asleep. He hoped he wasn't coming down with the flu. He stomped his feet and tried to shake the tingling sensation out of his hands, but that didn't help.
Javier's workstation was the last stop on a conveyor line that snaked its way through a large room. On this line, workers systematically carved up each hog carcass into roughly 150 pounds of pork, sausage, bacon, and other cuts of meat. Javier stood shoulder to shoulder at a long table with two other workers. A young woman named Maria was to his right, and on his left was an older man named Carlos. And the three of them, their job was to process the pigs' heads.
All three of them wore rubber boots and safety glasses, and their lab coats were pretty much always stained with blood and gore. Maria and Carlos looked up as Javier kept stomping his feet, but they quickly forgot about him and returned their attention to the work in front of them. A new pig head came down the line about every three seconds, and there really wasn't time to make conversation.
Javier had started this job three months earlier after moving all the way from Oaxaca, Mexico. Someone he knew from his hometown had moved here to Austin, Minnesota first and then sent word back home to Mexico saying there were lots of good jobs here. And so the town of Austin, Minnesota had now filled up with friends and relatives from the same area in Mexico.
Javier and his wife, Ana, had decided to take a risk and follow all these people going to Minnesota. They'd packed up their entire lives and brought their two young kids. The freezing winter was a huge adjustment, and it was hard to be in a place where they didn't speak the same language. But Javier was learning English as quickly as he could, and for now he was lucky that most of his co-workers were Latino as well, so he could speak Spanish at work. And so Javier and Ana were quickly becoming part of a tight-knit Mexican community in Minnesota.
Javier, who loved basketball, had even found a few friends to play pick-up games with on the weekends when it was warm enough outside.
And so all in all, Javier was happy with his new life in Minnesota. He was glad to have his job at the meatpacking plant, even though it was totally physically punishing. Everyone on the processing line did the same thing over and over and over again all day long. Javier knew that many of his coworkers suffered from repetitive motion injuries, such as carpal tunnel syndrome, which causes numbness, tingling, and pain in the hand and forearm.
But on that cold December day, Javier tried not to focus on his aching, tingling limbs. There was a nurse on duty at the plant, but he didn't want to risk being sent home. He didn't have many sick days left, and he really needed the paycheck. His family needed winter clothes, and their expenses were much higher in Austin, Minnesota than they had been back in Mexico. So despite how horrible he felt...
Javier remained in his place between Maria and Carlos at the end of the processing line. He turned his attention to the work in front of him and finished his shift before heading home. The next day, Javier woke up in his apartment, shivering under his blanket. Before he even opened his eyes, he realized that he still felt achy and his hands were still very tingly, and it was an odd sensation in his hands, almost like his hands belonged to someone else.
As Javier pulled the blanket closer to his body, he immediately felt that same feverish chill that he'd had the previous day at the plant. Javier desperately just wanted to go back to sleep, but he knew he couldn't. He had to go to work. Javier finally opened his eyes and tried to swing his legs towards the edge of the bed, but nothing happened. His legs remained still,
He tried to tense the muscles but felt no response. With his heart racing, he sat up and grabbed at his thighs with his hands, and to Javier's horror, they just felt like dead weight. No matter what he did, he couldn't get his legs to move. Javier frantically yelled out that he couldn't feel his legs. His wife, Anna, rushed inside with a look of deep concern on her face. Cold sweat started dripping from Javier's brow as the realization of his situation sunk in. He told Anna that he needed to go to the hospital right now.
The couple didn't have a car, so Anna called a taxi, and then she and their kids literally carried Javier from his bed to the cab. Javier did his best to keep a brave face on for his family, but when he looked over at his wife, he could tell how scared she was. When Javier and Anna arrived at the Austin Medical Center, which was just a few miles from their apartment, medical technicians lifted Javier onto a gurney and wheeled him into an exam room.
A few minutes later, a doctor entered the room, followed by an interpreter, who greeted Javier in Spanish and said her name was Carol. For the next few minutes, the doctor and Javier discussed his symptoms as Carol translated their statements. Finally, the doctor said something to Carol, and then the doctor left the room. Javier could hear him making a phone call from his office across the hallway.
Carol leaned into Javier and explained that the doctor suspected that Javier had nerve damage, but he didn't know what had caused it and the Austin Medical Center was not really equipped to treat it. The doctor had recommended that Javier be transferred to the Mayo Clinic, a larger medical center about 50 miles away in Rochester, Minnesota. He was making those arrangements now. Javier looked over at Anna as she squeezed his hand. He didn't want to go so far away from her and the kids, but he needed to get better so he could go back to work.
Javier looked back at Carol and nodded. He would go to the Mayo Clinic. Two weeks later, Javier lay in a hospital bed at the Mayo Clinic, looking out the window at the falling snow. It was Christmas Day, and Javier wished he could be home celebrating with his family. He had spent the past two weeks having countless blood tests, being rolled in and out of MRI machines, and feeling needle pokes at his veins. But he didn't feel much better, and he still couldn't move his legs.
The doctors explained that his spinal cord was severely inflamed, which was causing his symptoms. However, the doctors said that they still had no idea why except that it had to do with Javier's own immune system. For some reason, it was attacking his own nerves instead of helping to keep him healthy. A nurse walked into the room and checked Javier's IV drip.
Javier was being treated with steroids, which are powerful chemicals that reduce swelling in the human body. His doctors had promised Javier that steroids would bring some relief to his spinal cord, although they probably would not completely cure his mysterious ailment. Javier winced as he remembered the doctor who told him that he might spend the rest of his life in a wheelchair.
The thought of that filled Javier with dread. If he couldn't walk, then he would not be able to keep working at the meat processing plant. He would have no way to make a living for Anna and the kids, and he would become dead weight to his whole family. Javier thought that he and Anna had come too far and worked too hard to give up now. And so he looked down at his tingling legs, and with all his might, he tried to move them, and just then he saw he could wiggle his toes. Just a little. Wasn't much, but it was a start.
Javier decided he would do everything he could to try to get back on his feet. As Javier was struggling to recover, Carol Hidalgo, the translator at the Austin Medical Center, walked into a small exam room with a doctor to help out a new patient. It was early in the spring of 2007, about four months after Javier had first been hospitalized, and Carol was always extremely busy.
This area had a lot of Spanish-speaking residents, so she was constantly translating for the hospital's medical staff. It was tiring work, but Carol enjoyed it. She felt like she was a problem solver. The latest patient was a tired-looking man in his 40s who worked at the Quality Pork Processor's plant with Javier. The man, whose name was Carlos, the man who stood next to Javier on the processing line, rubbed his legs as he explained that he'd been feeling weak and experiencing tingling in his limbs for over a month now.
Carol listened carefully and relayed his symptoms to the doctor. Carlos said that his right hip and thigh were throbbing and it was as if the soles of his feet were on fire. At first, he thought he was just tired from standing all day long, but now he was having trouble walking. Carlos said that he barely had the energy to do his job, but he desperately needed the money. His family's trailer home had burned down in the winter and he was putting in extra hours to try to afford the rent on their new home.
Carol's heart broke for him. She saw a lot of patients like Carlos. They worked so hard in order to make a better life for their families, but it was often at their body's expense. Their bodies often broke down as a result of the grueling work. She translated his story for the doctor, who nodded and told Carol to let Carlos know she was going to examine his legs. And when she was done, she shook her head and said that she'd need to run more tests.
Carlos' muscles seemed fine, and so the doctor suspected that his problems were actually a nerve issue. As the doctor was speaking, Carol frowned. Something about this sounded familiar, but she couldn't exactly place what it was. And anyways, she saw so many patients every single day that it really wasn't that surprising that people's symptoms kind of bleeded together and sounded similar. So Carol jotted down some notes, and then she shook Carlos' hand and told him she hoped that he would feel better soon.
Carol followed the doctor out of the room. Austin Medical Center was very crowded that day, and Carol had another patient that she needed to help. In May of 2007, so about five months after Javier first got sick, Javier proudly walked back through the Quality Pork Processor's plant doors with a huge smile on his face. For months, his family had survived on their tiny savings and the charity of friends and neighbors.
His doctors still didn't know what had made him sick, but the steroid treatments had reduced the inflammation in his spinal cord. And with intense and very painful physical therapy, Javier had slowly learned to walk again, even though he did still need a cane for balance. But his doctors thought he was well enough to work again, and the plant had cleared him to come back.
Javier yelled greetings to his co-workers, Maria and Carlos, over the very noisy machinery. And right away Javier noticed that they both looked very tired and were moving so stiffly. But there really wasn't time to talk. It was time to get back to work. Javier was the happiest he'd been since that horrible day in December when he first got sick.
But despite the progress he had made, Javier still was not fully healed. While he had regained control of his legs, he had not regained control of his bladder. So he had to wear a catheter, a tube that collected his urine in a bag. The bag was taped to his leg under his pants so it wouldn't be noticeable to anyone. Javier took a deep breath, stepped up to his old place in the assembly line, and got back to work.
Three weeks later, Javier sat on a bench outside the factory during his lunch break, resting in the sun. Since he had come back to work, the pain in his legs had returned. He knew his body wasn't as strong as it used to be and he hoped it was just part of the healing process. As Javier tried to relax, Maria, the woman who worked with him on the processing line, walked over and eased down next to him. She groaned and rubbed her legs. She told Javier she had a knot in her calf that just wouldn't go away and her arms were feeling so heavy.
Maria's eyes filled with tears as she told Javier that her arms were so sore she could barely hold up the spoon to feed her baby daughter when she was at home. She said their colleague, Carlos, was struggling too, but he was trying to work through the pain.
Suddenly, a whistle blew, which meant the lunch break was over. Javier watched as Maria slowly stood up and stretched, and then Javier tried to get up too, but suddenly his legs gave out from under him. He tried to stand up again, but his legs just wouldn't move. Javier told Maria to please go get help. He needed a doctor immediately.
Three months later, in September of 2007, Carol, the translator at Austin Medical Center, was in the emergency room helping a young woman named Maria, the same Maria who worked next to Javier at the QPP processing plant.
Carol couldn't believe that Maria was sitting in a wheelchair. Just a few months earlier, she'd seen the young mother for another exam and she seemed fine. Now, Maria could hardly stand up and needed help to get on the exam table, and when she tried to sign an authorization form, she couldn't even hold the pen. Maria said that it felt like her right arm had fallen asleep and her feet were completely numb and tingling.
A doctor came into the room and performed an examination. He tested Maria's reflexes and then arranged for additional blood tests. Then he had Carol tell Maria that he did have a diagnosis. Maria had a condition called neuropathy, which is a general term for nerve damage. It explained her weakness, numbness, and pain. He didn't know what was causing it, but he was still prescribing her steroids. After the doctor left, Carol, the translator, could see that Maria seemed unsure what to do.
In a quiet voice, Maria told Carol that she was scared. A lot of her colleagues were getting sick too. One of them had even lost movement of his legs twice. Carol gave her a hug and promised her that the doctors would find an answer. Then she helped Maria back into her wheelchair and wheeled her to the elevator. After Maria left, Carol returned to the treatment area deep in thought. Carol liked to write while she puzzled things out in her head. She sat in a chair and took out her notebook and a pen and she watched people rush by in the hallway.
She realized that she had translated for several patients over the past few months who all had very similar symptoms. There was Maria, who just a few months ago was walking but now could barely move. And then there was Carlos, whose feet felt like they were burning. And then there was Javier, whose legs had stopped working altogether. She scribbled down the first thing that they had in common. They had all been diagnosed with a type of neuropathy. And so Carol wondered if maybe something else connected these patients.
Carroll knew that each of these patients had different doctors and nurses, and these doctors and nurses rarely talked about their patients to each other. As a translator, Carroll might be the only person in the clinic who knew that these patients had been diagnosed with the same problems. Just then, Carroll spotted the chair of General Medicine, Dr. Richard Schindler, walk by in the hallway. Carroll knew he valued the opinions of everyone on his staff. He always found the time to talk.
Carol ran after him and asked if he had a moment to chat. He nodded and said that he did. Then Carol took a breath and she asked him, "What causes neuropathy?" Carol had heard the diagnosis before, but she'd never quite understood it. He smiled at her and said that one of the most common causes of neuropathy was diabetes.
Carol shook her head. She knew that Javier didn't have diabetes, and neither did Carlos or Maria. Dr. Schindler then told her that neuropathy can also result from traumatic injuries, exposure to toxins, and from infections. Dr. Schindler asked Carol why she was interested, and she told him that she'd translated for at least three patients who were all diagnosed with neuropathy.
Carol was almost certain they all worked at the same pork processing plant. She thought there might be more she had forgotten about, but she needed his help to get a better understanding of their diagnosis. Dr. Schindler's expression grew thoughtful, and he told Carol to please find him later and he would help her try to figure it out. And so, later that afternoon, Carol and Dr. Schindler sat down together and went over the files of every patient that had been diagnosed with neuropathy in the past year.
Carroll could see Dr. Schindler's face grow anxious as they sifted through the names and charts. By the end of the day, he and Carroll had identified six different cases of neuropathy that all seemed to be linked. Not only did they all work at Quality Port processors, but they all worked in the same area of the processing line.
Dr. Schindler thanked Carol for paying such close attention to the patients, and Carol told him that all she wanted was to figure out what was making them sick. She saw firsthand how much their jobs meant to them and their families. Carol just hoped that there was still time to help them before they became permanently paralyzed or worse. Mr. Balling Collection is sponsored by BetterHelp.
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The next morning, after going through the patient files, Dr. Schindler picked up the phone to call the pork processing plant. He reached the factory's nurse and introduced himself and then explained the situation. He said several workers from her plant who were suffering from neuropathy had come to his clinic to be treated and so now he needed to know if maybe other people who worked at this plant had maybe come to her with the same symptoms.
He could hear the nurse pause for a moment, and then she said that she did remember some workers coming to her with tingling and soreness in their limbs, and she gave Dr. Schindler their names. He added them to the list of patients that he and Carol had already identified, making a total of more than 11 workers from this plant who all had similar symptoms. Dr. Schindler thanked the nurse for her help, and then they hung up.
Clearly, there was something wrong at this pork processing plant, but the doctor didn't know what it was. He wondered if maybe workers were reacting to a vaccination, or maybe they had an infectious illness, or they'd been exposed to neurotoxic chemicals. He didn't know, but there was something there. Something was going on at this plant. Dr. Schindler realized that this could quickly turn into a huge medical investigation, one beyond the scope of just a small regional facility like the Austin, Minnesota Medical Center.
And so the doctor sent out an email to Mayo Clinic, a much bigger clinic, which was where Javier had been treated. It was one of the best medical facilities in the state, and if anyone could help with this investigation that was about to start, it was them. Doctors at the Mayo Clinic quickly brought all 11 affected workers into their clinic one by one to test them for a long list of diseases and disorders.
But all of the tests proved to be negative. Dr. Schindler reviewed the results with a growing sense of frustration. Within just a few months, these once healthy workers now had to use wheelchairs or had lost sensation in their arms, legs, or hands. It couldn't be a simple muscular disorder like carpal tunnel syndrome or any other repetitive stress injury. It wasn't a reaction to a vaccination, cancer, or a virus. It also was not a bacteria or a parasite.
There had to be something happening at the pork processing plant, but no one at the Austin, Minnesota Medical Center or the Mayo Clinic could figure it out. Dr. Schindler realized that if he was going to get to the bottom of why people who worked at this plant were getting so sick, he would need more help. It was time to call the Minnesota Department of Health.
On November 28, 2007, around two months after Carol, the interpreter, realized that something at the plant was making all these people sick, Dr. Ruth Linfield, the Minnesota state epidemiologist, pulled her car into Quality Pork Processing's parking lot. At the same time, several other cars drove into the lot and parked right next to her.
Dr. Linfield was there to lead an inspection of the meat processing line. She'd brought with her a delegation of three animal health experts, a medical detective, an infection control specialist, and a toxicologist. Whatever was causing the workers at this plant to get sick, Dr. Linfield and her team were confident they would figure out what it was.
The company's CEO, a man named Kelly Wadding, along with the head of HR and the company nurse, stepped forward to greet their visitors and lead them into the factory. Dr. Linfield stepped into the entry with the rest of the team, and she pulled protective gear over her dark gray business suit: plastic gloves, booties, masks, and plastic gowns. Then she followed the CEO, Kelly Wadding, out onto the factory floor, and the inspection began.
First, the investigators were escorted through the entry room, where enormous pigs weighing about 250 pounds were stunned and then slaughtered. After the pigs were slaughtered, their blood was drained and their carcasses were thoroughly cleaned. From the entry room, the group moved into the section called the "warm room" where the carcasses were hung by their rear legs and butchered into different parts.
As the investigators followed the path of the pig carcasses around the warm room, Dr. Linfield and her team observed the tasks being performed at each workstation. Each worker made a particular cut in the hog carcass, some used machinery, and others used large knives. It was messy and repetitive, but so far, Dr. Linfield hadn't seen anything that could cause an outbreak of disease.
Finally, at a section near the end of the line, the group came to a large table. About 35 workers were gathered there, removing the last bit of meat from the hog using a specialized device. A pink mist hung over the table. Dr. Linfield stopped walking and looked down at her plastic white gown. She could see all these tiny pink particles settling on her arms, chest, and shoulders. Then she looked back at the assembly line and was horrified by what she was seeing.
And within minutes, the company's CEO, Kelly Wadding, had shut the entire plant down. Dr. Linfield was looking at what Quality Port processors called the head table, where workers literally took apart the pig's head piece by piece. They cut out the snout, the ears, tongues, cheeks, and jaws of each hog using knives, chisels, and automatic cutting tools.
But the part of the process that horrified Dr. Linfield was the very last step, when workers removed the pig's brain. Like the rest of the pig's body, its brain is a marketable product. People in some parts of the world will use pig brain to thicken their stir-fry, while other people scramble pig brain in with eggs. But because the plant processed the pig so rapidly, the plant needed an efficient, easy way to extract the brains from the pig's skulls.
They came up with a unique method to get the brain out, which only a few other factories in the world had even tried. Under the company's unusual process, the brain removal workers were required to blast pressurized air into a hole in the pig's skull. And then the brain poured out of that same hole the air went in, now a gooey pink substance that kind of resembled Pepto Bismol or a lumpy strawberry milkshake.
and workers were blasting pig brains at an incredible speed, liquefying about 22 brains every minute. It was a gruesome process to be sure, but what caught Dr. Linfield's attention was something else. It was the pink mist that hovered around the whole head table and then lightly coated the rest of the room thanks to the air currents from the fan above them.
That pink mist was created by tiny particles of pig brain. The air gun that workers used to liquefy the brain was so strong that some of the brain became vaporized and basically floated up into the air.
None of the workers wore any kind of breathing protection such as respirators or face masks, so everyone in the room, but especially those who worked at the head table and even more so the actual brain removal workers, were inhaling particles from 1,350 aerosolized pig brains every hour. Javier was a brain removal worker, and Carlos and Maria worked very close to his station. In fact, almost all the workers who got sick were stationed right near the brain removal machine.
Dr. Linfield's team discovered that all of these workers were suffering from a brand new disease, which was given the name progressive inflammatory neuropathy.
As a result of their massive exposure to aerosolized pig brain matter, their immune systems were constantly creating antibodies to neutralize the foreign proteins. But because these animal cells were very similar to human cells, the antibodies ended up attacking their own nerve cells as well, and over time, the disease could do enough damage to leave victims confined to a wheelchair.
Kelly Wadding, the port processing CEO, shut off the air gun as soon as Dr. Linfield pointed out all the pig brain particles floating in the air all around his employees. And then the CEO had that air gun hauled out of the factory on a trolley, never to return. And once that air gun was gone and the factory resumed work, the workers at the head table stopped getting sick. Javier would return to work a second time, but his body was so damaged that he could not actually handle the physical demands of the job.
Javier's current state of health, the condition of his family, and his location are unknown. The same can be said for his co-workers, Maria and Carlos. As for the plant, they continue to process pork, slaughtering about 19,000 hogs every day. From Ballin Studios and Wondery, this is Mr. Ballin's Medical Mysteries, hosted by me, Mr. Ballin.
A quick note about our stories: we use aliases sometimes because we don't know the names of the real people in the story. And also, in most cases, we can't know exactly what was said, but everything is based on a lot of research. And a reminder: the content in this episode is not intended to be a substitute for professional medical advice, diagnosis, or treatment.
This episode was written by Nora Battelle. Our editor is Heather Dundas. Sound design is by Ryan Batesta. Coordinating producer is Sophia Martins. Our senior producer is Alex Benidon. Our associate producers and researchers are Sarah Vytak and Tasia Palaconda. Fact-checking was done by Bennett Logan.
For Ballin Studios, our Head of Production is Zach Levitt. Script Editing is by Scott Allen and Evan Allen. Our Coordinating Producer is Matub Zare. Executive Producers are myself, Mr. Ballin, and Nick Witters. For Wondery, our Head of Sound is Marcelino Villapando. Senior Producers are Loredana Palavoda and Dave Schilling. Senior Managing Producer is Ryan Lohr. Our Executive Producers are Aaron O'Flaherty and Marshall Louis for Wondery.
Hey, it's Guy Raz here, host of How I Built This, a podcast that gives you a front row seat to how some of the best known companies in the world were built.
In a new weekly series we've launched called Advice Line, I'm joined by some legendary founders and together we talk to entrepreneurs in every industry to help tackle their roadblocks in real time. Everybody buys on feeling, Guy, like everybody. So if you don't give them the feeling that they're looking for, they're not going to buy. A lot of times founders will go outside of themselves to build a story and you can't replicate heart.
You know, I think we all have a little bit of imposter syndrome, which isn't the worst thing in the world because it doesn't allow you to get overconfident and think that you're invincible. Check out the advice line by following How I Built This on the Wondery app or wherever you get your podcasts. You can listen to How I Built This early and ad-free right now on Wondery+.