Ep. 73 | Darkness in Donora
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Hey Prime members, you can binge episodes 73 through 80 right now and ad-free on Amazon Music. Download the app today. On the afternoon of Saturday, October 30th, 1948, a teenage boy wearing an orange and black uniform ran across his high school's football field. He searched the sky for a pass from his quarterback, but a thick layer of fog had rolled in that made it impossible to see. As the boy waved his arms, the ball bounced off his helmet and fell to the ground. But before he could even jog back to his teammates,

The boy heard the school's announcer call his name over the loudspeakers. The announcer sounded urgent and told the boy to report to the sidelines right now. And when he got there, his coach told him he had to head home right away. His mother needed him. So the boy just took off his helmet and ran home through the fog. When he burst through the door, he saw his father lying on the couch with the doctor standing over him. And his mother was standing by, weeping. The doctor told the boy that he was very sorry, but his father had just died. The boy just stood there, stunned.

His father had been fine that morning. He didn't understand what could have happened. However, what this boy did not know was that his father was not the first person in town to die that day, and he would not be the last, because this community was in the middle of a medical disaster that would change the course of American history.

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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. So if you like today's story, please go to a store the follow button is currently shopping at and page them over the intercom to tell them their car is being towed. When they run out to go deal with it, steal their shopping cart. This episode is called Darkness in Donora.

On the morning of Friday, October 29th, 1948, a young woman named Helen Stack woke up inside her modest home in the small town of Donora, Pennsylvania. And as soon as Helen opened her eyes, she started coughing. Her throat had been sore for a few days, but this morning it felt even worse. She thought she might be coming down with a cold, but Helen was not the kind of person to let a minor illness slow her down.

So, she still got out of bed, got dressed, and then drank some coffee and ate breakfast before starting her walk to work. From where her house stood near the top of a hill, Helen could sometimes see the entire town. Donora sat inside of a valley right on the banks of the Monongahela River, surrounded on three sides by 400-foot-tall cliffs. On the fourth side were rolling hills that stretched off into the distance.

That morning, though, Helen couldn't see any of Donora's natural beauty because fog was blocking her view. In fact, low gray clouds had been hanging over the town for the past four days. But that was actually normal because Donora was inside of basically a natural bowl in the earth. The surrounding cliffs and hills blocked the wind, so the fog would accumulate and then get stuck in the valley.

To Helen, this was just part of life in Donora. And while it was sort of frustrating at times, it was easy to ignore, because there were so many other good things about living there. Everybody was friendly, there were plenty of jobs, and there were always fun events going on. As she walked to work, Helen could hardly see across the street. But she could see enough in front of her to say hello to the neighbors who passed her by on her side of the sidewalk, who all knew her by name.

And then at some point, she passed by a street next to a bunch of industrial mills that were also shrouded in fog. And she knew that somewhere in that fog, most of the men in Donora were working. And when she reached McKean Avenue, the main street in town, she could barely make out the workers who were hanging up decorations for that evening's annual Halloween parade. Eventually, Helen came to a stop in front of a tall brownstone building on McKean Avenue. She went inside, walked up to the second floor, and unlocked the door of the doctor's office where she worked.

Helen was the only employee working for the two doctors, Ralph Kohler and Edward Roth. To Helen, these two men seemed pretty similar. Both were in their 40s, they were tall and heavy set, and they both had very kind and patient demeanors. The only obvious difference between them was that Dr. Roth smoked cigars like a chimney, and Dr. Kohler avoided cigars altogether because he had diabetes and a heart condition.

As for Helen, she was a receptionist, a secretary, and a nurse, so she had a lot of responsibilities at the office. And today, like most days, she was the first one to the office. She turned on the lights and opened up the blinds in the waiting room, then began sweeping up the thin layer of soot that had blown in through the air vents and settled on the floor overnight. Like the fog in Donora, the soot was also very annoying, but totally normal to Helen. She knew it came from the mills nearby.

It was just a normal part of living in a factory town inside of a valley. After Helen was all done cleaning up the waiting room, she looked around and smiled. Because she had just enough time to go smoke a cigarette before the doctors came in and patients began to arrive. Helen sat down behind the reception desk and lit her cigarette. She took a long drag, but immediately she noticed it had a strange, bittersweet taste to it. She tried again, and suddenly the tobacco tasted so awful that she doubled over coughing.

She coughed until she had tears in her eyes, but she wasn't sure if it was from the cigarette, her sore throat, or maybe both. Either way, Helen stubbed out the half-smoked cigarette into her ashtray, and then she heard the door open. She looked up to see Dr. Kohler walking inside, and so she knew her workday was about to begin. A few hours later, at 3 p.m., Dr. Kohler stood in the back of the doctor's office and pulled on his overcoat. Even though it was only mid-afternoon, he already felt exhausted.

His diabetes and his heart condition left him chronically tired, and to deal with it, he kept to a very specific schedule. He went home every day at precisely 3 p.m. so he could lay down and rest before dinner. But right when he was about to leave, he heard quick footsteps coming down the hallway, and Helen rounded the corner. She looked concerned and said an older man had just come in, wheezing and complaining that he couldn't catch his breath.

Dr. Kohler knew he needed to get home for his own sake, but his partner, Dr. Roth, had already gone on a break and he couldn't just turn away a patient who needed help. So he took off his overcoat and told Helen to bring the patient back to an exam room. Moments later, Dr. Kohler met that patient in the exam room and he recognized him as one of his regulars. The man was one of many locals in town who Dr. Kohler treated for asthma, which is a chronic condition that causes a person's airways to swell and make it difficult to breathe.

And so as a result, Dr. Kohler wasn't surprised that this patient was wheezing. Whenever the fog in Donora got really thick, people's asthma tended to flare up. So Dr. Kohler gave his patient the usual asthma treatment for 1948, which was a shot of adrenaline. Adrenaline is a hormone that can help open a person's airway when they're having trouble breathing. Once the adrenaline shot took effect and the man caught his breath again, Dr. Kohler sent him on his way.

Then, the doctor put his overcoat back on and followed that patient out, anxious to go home and get in bed. Thirty minutes later, Helen sat at the reception desk and flicked through the day's mail. Usually, the office got quiet in the afternoons, and then business would pick up again in the evenings. So, she was using the lull to get some administrative work done. Helen pulled out the junk mail from the pile and then got up to throw it away.

But as she was walking towards the trash can, she heard a loud crash from the hallway outside the office, followed by the sound of somebody yelling. Helen's first thought was somebody fell down the stairs. And so she rushed to check if they were okay. And what she saw in the hallway absolutely terrified her. A man she didn't recognize was clinging to the banister and his knuckles were white and his face was turning blue. He was moaning in pain, kicking the wall and screaming, help me, help me, I'm dying.

Helen was so confused and afraid that she just froze. Luckily, another doctor who ran his own private practice across the hall from them soon showed up, and so did the other doctor that Helen worked for, Dr. Roth. While those two doctors began to help the man, Helen heard the sound of her phone ringing at her reception desk.

And so Helen kind of broke out of her trance, ran back inside the office and answered the phone, and immediately she heard the sound of a woman screaming on the other end of the line for help, just like the blue-faced man in the hall had been doing. The woman said her husband couldn't breathe and he needed help right now. Helen got the woman's address and promised that Dr. Roth would be there soon.

However, before Helen could run across the hall and tell Dr. Roth that another patient needed his help, the phone rang again, and then again, and then again. And everyone Helen spoke to said the same thing. They couldn't breathe, they were coughing up blood, their heads hurt, their stomachs were killing them, and they all thought they were going to die. And unfortunately, the town only had a single ambulance, and it was booked solid.

And so one after another, Helen took down these people's names and addresses and added them to the growing list of patients the doctors needed to visit. Helen had no idea what was going on in Donora, but it certainly felt like all hell had broken loose inside of her normally quiet town.

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Get started risk-free at greenlight.com slash Wondery. Two hours later at 6 p.m., Dr. Roth squinted as he very slowly drove down McKean Avenue after an afternoon of house calls. Because of the fog, which now had gotten so bad, he could hardly make out the lines on the road. And so he just gripped the steering wheel tightly and went really slow, keeping an eye out for the brownstone building where he worked. Dr. Roth had never been in a situation like this before.

People all over town were struggling to breathe, regardless of whether they had asthma or not, and Dr. Roth really didn't know why. He figured it must be something in the air, literally. But even with fog this bad, he'd never seen it affect people this much before. By this point in the day, he'd already given so many patients adrenaline injections that he'd run through his entire supply, and he'd barely made a dent in the list of people who still needed help.

And so now he needed to stop by the office and refill his supply of adrenaline before making more house calls. But it was literally too foggy to even find his own address. And so Dr. Roth figured he'd have better luck if he just parked his car and walked. So he carefully pulled to the curb, turned off the engine, and got out. He went to the sidewalk, and when he saw the nearest building to him, he realized he'd actually driven past his office without knowing it.

And so Dr. Roth doubled back towards the brownstone, threw open the door, and began running up the stairs. However, after only a few steps, he had to stop because he ran out of breath, and then he began to cough. His chest felt tight like somebody was squeezing the air out of him. He managed to make it back to his office, but immediately when he got there, he doubled over in the entryway and coughed until tears were streaming down his face. Dr. Roth felt like he was choking. He started to panic and looked around for help.

But, his secretary, Helen, had left for dinner, and his colleague, Dr. Kohler, who had left to go take a nap, was still at home. Dr. Roth realized he was all alone in his office. He held onto a desk and tried to steady himself, but he kept hacking until he felt nauseous. He managed to make it to the bathroom before he actually vomited. And then after that, he stumbled to the bathroom sink and splashed cold water on his face. His heart was racing and his whole body felt weak.

But he knew he couldn't just stand there, because he still felt faint. So he rushed towards the back room, where drugs were stored, and grabbed a vial of adrenaline and a clean syringe. With his hands shaking, Dr. Roth filled the syringe, poked the needle through his pant leg into his thigh, and injected himself with adrenaline. And after that, he just collapsed into his office chair. After a few moments, Dr. Roth took a big, deep breath. He sat there for several minutes, relishing how good it felt to breathe again.

And as he slowly calmed back down, Dr. Roth tried to figure out what had just happened to him. Just like the patients he'd been visiting all day, he'd had what seemed like a sudden, very severe asthma attack. But why? He felt sure that something in the air, in the fog, was causing people all over town, including him, to nearly suffocate. But what? Fog was normal in Donora. So what was different about it this time?

As he was thinking it over, Dr. Roth opened up a drawer in his desk and out of pure habit, he grabbed a cigar. Without thinking, he struck a match with the cigar and took a puff. And immediately he launched into another uncontrollable coughing fit. Meanwhile, Helen was on her way back to work after her dinner break. She walked through the fog and passed a crowd of people gathered on McKean Avenue. There were adults and kids all dressed up in festive costumes.

Helen knew they were all waiting for the annual Halloween parade to begin, but she couldn't think about candy and costumes right now. She was too preoccupied with getting back to work and making sure her patients were okay. She soon made it to the brownstone and went upstairs to the doctor's office. And right when she opened the door, she heard the phone ring. But before she could answer it, she heard something else. There was a groaning sound coming from the back hallway.

It made the hair on the back of Helen's neck stand up, because Dr. Kohler and Dr. Roth were supposed to be at home on their dinner breaks. Helen should have been alone at the office. She followed the groaning sound back to Dr. Roth's private office, and she opened the door to find one of her bosses slumped in his chair. His face was bright red and drenched in sweat, he was wheezing, and his eyes were huge and terrified.

But somehow, Dr. Roth spoke and he told Helen he was okay. He just needed to catch his breath. Helen did not believe him, but she could still hear the phone ringing and Dr. Roth told her to just go answer it. And so perhaps against her better judgment, she turned and left and when she got back into the waiting room to answer the phone, she now saw there were a few patients that had come inside. She gestured to let them know she'd be with them in a second and then she answered the phone. But this time, Helen didn't hear a patient begging for help.

She heard her other boss, Dr. Kohler, and his voice sounded strained. He said that ever since he had left the office earlier that afternoon, he'd been struggling to breathe too, and he said he didn't know when he'd be able to come back to work. Helen said okay, but it really was not okay, because as she stood there holding the phone to her ear, the office door swung open and more coughing, wheezing patients tumbled inside. Helen felt so confused and helpless.

Half the town was outside enjoying the Halloween parade, totally oblivious to what was happening. Meanwhile, the phone wouldn't stop ringing and patients were flooding into the doctor's office one after another. And the doctors, Dr. Kohler and Dr. Roth, were both deathly ill, and no one actually knew what was causing any of this. Helen felt like she had no choice but to close the office, because there was nothing Dr. Kohler or Dr. Roth could do for anybody.

So she hung up the phone and turned around and told the patients gathered in the waiting room that she was very sorry, but they would have to leave and go to a different doctor's office for help. About seven hours later, a man named Rudolf Schwerha was lying in bed with his wife. They were both fast asleep until the sound of the phone ringing jolted them awake. Rudolf rolled over, looked at the clock on his bedside table, and sighed. It was 2 a.m., which meant the call could not be good news.

And that was because Rudolph was both a mortician and the county coroner. He lived right above the funeral home that he owned and operated, and he only got calls in the middle of the night if somebody had died. Rudolph picked up the phone and said hello. And sure enough, the woman on the other end, a dispatcher at the local sheriff's office, said a 70-year-old man had passed away about half an hour earlier. She said he'd suddenly developed severe respiratory symptoms and stopped breathing.

Rudolph did not ask any follow-up questions because it was 2 a.m. and he wasn't really thinking straight and also because he was totally unaware of the mysterious illness currently plaguing Donora. He just asked the woman for the address and then said he would send his hearse, pick up the man's remains. Rudolph then called his hearse driver and explained the situation and the driver said he was on it and would bring the remains back to the funeral home soon.

Rudolph hung up and while his wife went back to sleep, he laid there awake in bed and listened for the sound of the hearse pulling into his driveway. He figured the driver would show up within minutes because the address was only two blocks away. But half an hour passed by before Rudolph finally heard a car's engine rumbling outside. Rudolph was about to get up to go greet the driver but as soon as he threw back the covers, his phone rang again. And again, it's the middle of the night and so these calls are not good news.

Rudolph noticed his wife had just woken up and she sat up next to him, looking confused. Rudolph picked up the phone and said hello, and he was surprised to hear that another person had passed away. And like the first, they'd suddenly developed severe breathing problems and then just died. Two deaths within an hour of each other was unusual in a town as small as Donora, and it was even more strange for two people to just suddenly stop breathing.

Rudolph didn't know what was going on, but now he felt uneasy, and he decided he should go with his driver to the next address. So Rudolph told his wife he'd be back soon, then he got dressed and hurried outside. A few minutes later, Rudolph rode in the passenger seat while his hearse driver inched down the street. It had taken the driver so long to get to the funeral home because the fog outside had somehow gotten even worse. It was like a solid gray wall.

As the driver slowly inched forward, Rudolph stared intently out the windshield, desperately trying to somehow see through the fog. They were headed to a neighborhood on the opposite side of the Monongahela River, and to get there, they would have to drive across a very thin road right next to a cliff, and so Rudolph, naturally, was very concerned that they might accidentally drive right off of it. So, when they neared the cliff, Rudolph told the driver to stop, and said he wanted to drive, but he would still need the driver's help.

While Rudolph got behind the wheel of the hearse, the driver got outside and stood in front of the car. Then he used a flashlight to guide Rudolph through the fog and make sure the car didn't slip off the side of the cliff. And so Rudolph gripped the steering wheel with white knuckles and did his best to drive as carefully as he could. He knew they would only need to cover a very short distance, but every inch on that cliff felt like torture. Finally, after what seemed like an eternity, they made it past the cliff and into the neighborhood.

They picked up the deceased person's body and then turned right back around and did the same process of slowly driving past the cliff. And then finally, once they were on the other side, they headed back to the funeral home. And by the time they finally got back there, it was almost sunrise. And Rudolph's wife at this point was wide awake standing by the front door. And the totally overwhelmed look on her face made Rudolph's stomach drop. He didn't need to ask her what was wrong.

He could tell by the bags under her eyes that she must have been up all night answering phone calls intended for him, meaning more people must have died. So as soon as Rudolph and the driver had moved the second body into the funeral home, they got back in the car to go pick up another, and then another, and another. By 10 a.m., there were nine bodies waiting in the morgue, and the phone kept on ringing. Four hours later, at 2 p.m. on that Saturday afternoon,

A man named August Shambone pulled into the driveway of a stately home in Donora. August was the town mayor, but he'd recently been away on business. So when he walked inside, he immediately went to the pile of messages his family had written down for him while he was gone. And as he worked his way down the stack of paper, his face went pale.

Like many people in Donora, August had had no idea that a mystery illness was suffocating people to death all over town until he saw all these panicked messages from residents, doctors, and morticians begging him for help. August realized he had a very serious emergency on his hands. Donora didn't have a single hospital, and several of the town's doctors were too sick themselves to work, so people who fell ill literally didn't have anywhere to turn.

Meanwhile, bodies were piling up. Between Rudolph's funeral home and the others in town, the death toll was now at 11 people. And based on the calls he'd received, August estimated that hundreds, maybe even thousands more people were sick. August spent the rest of the day doing whatever he could to help. He worked with local nurses to create emergency medical stations. He called in doctors from out of town to come help. He had extra oxygen and inhalers shipped into Donora. He even called the state health department for backup.

But at the same time, August didn't make any emergency announcements. But in fairness, he didn't really have a way to. Donora didn't have a local TV or radio news station, and the newspaper was only published on weekdays. And since this disaster had happened on a weekend, the only way for news to travel was by word of mouth. So while half the town did their best to deal with this mysterious outbreak, the other half was blissfully unaware, carrying on business as usual.

The local high school even went ahead with their scheduled football game, even though their players literally couldn't see more than a few feet across the field. But finally, after what felt like one of the longest days of his life, August felt like he needed to call a town meeting. Everybody needed to know what was going on. However, he couldn't get everybody from the city council and the board of health together until the following morning.

And so first thing the next morning, which was Sunday, October 31st, August made his way through the thick gray fog to a government building downtown. There, he met with a bunch of community leaders to discuss what was going on. And they all agreed that the fog must have something to do with it. But there were a lot of questions that nobody could answer, like what made this fog different? And why was it making some people sick and even killing some people while others seemed totally unaffected by it?

They couldn't make sense of it, let alone figure out how to stop it. Then, at some point during their conversation, August began to hear rain pattering down on the roof. He looked out the window and saw the drizzle turn into a full-on downpour, and he watched in amazement as the rain seemed to wash the fog away. The thick, gray clouds that had hung over Donora for nearly a week disappeared in minutes, and with it, the mysterious illness disappeared too.

Just like that, the phones at Denora's doctor's offices stopped ringing. It would take years for public health researchers to understand what had happened during that October week in Denora, Pennsylvania. And that's because there was essentially a large-scale misinformation campaign to hide the truth. However, eventually, the truth came out.

The so-called "fog" that blanketed Donora that week was not actually normal Donora fog. It was smog from Donora's many industrial mills. These mills manufactured steel, zinc, and sulfuric acid, and as part of that process, they pumped dangerous chemical byproducts directly into the air. Normally, the smog would float up towards the sky and dissipate quickly.

But during October 1948, Dinora was hit by a very rare weather event called a temperature inversion, which in short, kept these dangerous chemicals down at street level for days. It worked like this: Usually, air is warmest near the surface of the Earth and gets colder as it goes upward towards the sky. But during a temperature inversion, this gets flipped around.

Warm air moves into the space above cold air and traps the heavier cold air underneath it. And when this happened in Denora, which was situated inside a natural bowl in the earth, the warm air was almost like putting a lid on top of that bowl. And so the deadly chemical byproducts from the mills were trapped, turning the air in Denora into a concentrated poison. But because fog was so normal in the valley, most people didn't think anything of it.

Plus, throughout that very consequential week and for years afterwards, the owners of the mills insisted they were not to blame, putting out a blizzard of misleading information to defend themselves. They claimed the weather was the problem, not the chemical byproducts. And many locals believed this, because they didn't want the mills to shut down. Two-thirds of the men in Donora worked there, and the majority of families in town depended on that income.

All told, at least 70 people died as a result of what became known as the "Denora Smog," and over 4,000 people were sickened. Experts said that X-rays of survivors' lungs looked like victims of chemical warfare. The Denora Smog incident was the worst air pollution disaster in United States history, but it also sparked a national conversation about air pollution and the need for better industrial safety regulations.

Two years later, in 1950, the U.S. held its first ever National Air Pollution Conference. After that, progress was slow but steady. The nation's first major air pollution law was passed in 1963, and the Environmental Protection Agency was formed in 1970. As of today, all of Donora's industrial mills have been shut down.

There's now a museum in that town that commemorates those who lost their lives during Donora smog and proudly displays the slogan, Clean Air Started Here.

Hey, Prime members, you can listen to new episodes of Mr. Ballin's Medical Mysteries early and ad-free on Amazon Music. Download the app today. And also, Wondery Plus subscribers can listen to Mr. Ballin's Medical Mysteries ad-free. Join Wondery Plus today. Before you go, tell us about yourself by completing a short survey at listenersurvey.com.

From Ballin Studios and Wondery, this is Mr. Ballin's Medical Mysteries, hosted by me, Mr. Ballin. A quick note about our stories. They are all inspired by true events, but we do sometimes use pseudonyms to protect the people involved, and also some details are fictionalized for dramatic purposes. 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 Karis Allen Pash Cooper. Our editor is Heather Dundas. Sound design is by Ryan Patesta. Our senior managing producer is Nick Ryan. And our coordinating producer is Taylor Sniffen. Our senior producer is Alex Benidon.

Thank you.

Script editing by Scott Allen and Evan Allen. Our coordinating producer is Samantha Collins. Production support by Avery Siegel. Executive producers are myself, Mr. Ballin, and also Nick Witters. For Wondery, our head of sound is Marcelino Villapando. Senior producers are Laura Donna Palavoda and Dave Schilling. Senior managing producer is Ryan Moore. Our executive producers are Aaron O'Flaherty and Marshall Louis for Wondery. Wondery.

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