MrBallen’s Medical Mysteries - Ep. 18 | Man With the Blue Skin

Episode Date: February 6, 2024

In 1944, nearly a dozen men show up at a hospital in New York. All are violently ill and passing out – and they all have bright blue skin. A medical investigator rushes to figure out what is making them sick… and what is causing their bizarre appearance. See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Hey Prime members, you can binge episodes 49 to 56 right now and ad-free on Amazon Music. Download the app today. The emergency room physician raced to his patient's bedside and jammed a long hollow tube down the unconscious man's throat. He fed the tube down the man's esophagus, down into his stomach. Once it was in place, he attached a large syringe full of water to the tube. He depressed the plunger on the syringe, forcing the water down the tube and into the man's stomach. Then, the doctor slowly retracted the plunger on the syringe, creating suction. Fluid immediately

emptied out of the man's stomach and back into the syringe. The doctor dumped that fluid into a bucket beside the bed and then repeated that process over and over again until he was certain that every ounce of food had been emptied from the man's stomach. The doctor hoped that along with the liquid and bile came whatever poison had made this old man sick in the first place. The poison that caused this man to collapse on the sidewalk, gasping for air as his skin turned a bright sky blue. A pitch to an audience of potential customers. If the audience liked the product, a kiss from in front of our panel of experts, Gwyneth Paltrow, Anthony Anderson,

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You can listen to Kill List and more Exhibit C true crime shows like Morbid early and ad-free right now by joining Wondery Plus. 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 liked today's story, please offer to stain the Follow Button's brand new hardwood floors, and then once they say yes, please help me with that. Just go ahead and rub coffee grounds and

different colors of paint and grass and mud all over the bare wood and then leave. This episode is called The Man with the Blue Skin. blue skin. Just before 8 a.m. on the morning of September 25th, 1944, a police officer patrolled Day Street in Lower Manhattan in New York City. He passed the usual morning bustle, factory workers leaving the subway, telephone operators on their way to the nearby telephone and telegraph building, a food truck unloading vegetables at a dingy corner market, and someone begging for change outside an abandoned warehouse. Then, the officer noticed what looked like a heap of clothing just lying on the sidewalk ahead of him.

The officer sighed and shook his head. He hated litter and took a lot of pride in keeping his streets clean. So, the officer approached this pile of clothes, looking for a trash can to dump it in. But as he got closer, the officer realized this pile of clothes was actually an elderly man in a shabby overcoat. He was doubled over and clutching his stomach. The officer felt annoyed as the smell of stale alcohol and body odor rose from the old man's coat. He figured this man was just drunk after a long night out. So, the officer bent down and shook the man's shoulder, asking if he was okay. Then, without warning, the old man turned over and vomited onto the sidewalk.

The officer jumped back to avoid getting puke on his shoes. This old man was clearly very drunk and so could not be left on the streets alone. The officer had no choice but to arrest him for public intoxication. But as the officer reached for his handcuffs, he stopped because he noticed something very odd about this old man. His nose, lips, ears, and fingers were all as blue as the sky above. It was so strange that it took a moment for the officer to register what he was even seeing. Then, between this guy's blue skin, the glazed over look on his face, and the vomit on the sidewalk, it clicked. This was not public intoxication. This was a medical emergency. So, the officer ran to a payphone and called dispatch

and requested an ambulance. Luckily, there was an emergency room close by at Beekman Downtown Hospital. The hospital was only six blocks away, so an ambulance arrived in just a matter of minutes. The officer helped one of the emergency responders hoist the old man off the sidewalk and onto a stretcher, and then they loaded him into the back of the ambulance. The officer took a step back as the ambulance driver closed the door and then sped away. After the ambulance had disappeared around the corner and the police officer had resumed his beat, he thought to himself, in all his years on the force, that might have been the strangest thing he'd ever come across.

A few minutes later, an attending physician named Dr. Francis Stevens ran outside of Beekman Downtown Hospital. He'd been notified about the incoming patient with the sky-blue skin, and now he was rushing to meet the ambulance, pulling up out in front. Dr. Stevens helped the ambulance driver pull out a stretcher, and then using it, they carried the old man inside. The driver explained that although the old man had been awake when he was loaded into the ambulance, he had lost consciousness during the short drive to the hospital.

Dr. Stevens nodded, guessing that his new patient had likely passed out from shock. He could tell from the man's skin color alone that his heart must not be pumping enough blood through his body, which meant he was at risk of a heart attack. As they transferred the old man from his stretcher to an actual hospital bed, Dr. Stevens saw that nearly half of this man's body had turned blue. Dr. Stevens jumped into action. They only had minutes to supply the old man's body with oxygen and then get his heart to pump it through his bloodstream. Without immediate treatment, this man would die. Dr. Stevens figured that the old man must have ingested something that made him this sick, so he raced to pump the man's stomach until he was sure it was empty. This meant that whatever had made him sick hopefully would not be able to do any more damage. The doctor then strapped an

oxygen mask over the old man's face to increase the oxygen in his blood and then gave him stimulants to help his heart pump more efficiently. After this, there was nothing to do but wait. Dr. Stevens looked at the old man lying unconscious in the bed, his skin still bright blue, and the doctor just hoped they had treated him in time to save his life. Later that morning, Dr. Stevens returned to check on the old man and found him lying in bed, fully awake. His lips and fingertips did have a bluish tinge still, but the effect clearly had dramatically lessened. The man said his name was

William and that he was 82 years old and then after that he began looking around the room with very suspicious eyes and demanded to know what had happened to him. Dr. Stevens told William that he had been suffering from a condition known as cyanosis that results from inadequate oxygen in the bloodstream. Cyanosis is known for causing people's skin to turn blue. It was a rare condition and they weren't sure why William had gotten it. Although Dr. Stevens could assure William that for the time being, the best treatment available was just to rest. This answer did not seem to satisfy William, because his next question was, well, when do I get to go home?

But before Dr. Stevens could answer him, the doors of the emergency room burst open and another unconscious man was carried into the waiting room. Dr. Stevens rushed from William's side to help this new patient. As the man was laid onto a bed, Dr. Stevens stopped and just stared at him with a look of surprise on his face. This new patient was also an old man

dressed in tattered clothes, and as Dr. Stevens bent over him, he noticed that just like William, this old man's lips, nose, and fingers were also bright blue. So Dr. Stevens administered the same treatment he'd just given William, a stomach pump, an oxygen mask, and heart stimulants.

But as he was working on this new patient, Dr. Stevens started to have this sinking feeling in his gut. Two cyanosis cases on the same day? What was that about? He knew that in rare cases, cyanosis was a symptom of carbon monoxide poisoning. He worried that there might be a gas leak in a nearby building, and in a neighborhood as crowded as Lower Manhattan, that could be disastrous. Dr. Stevens was able to stabilize this new patient's condition, but the doctor didn't

have a moment to rest. Almost immediately after the second patient was stable, he heard another ambulance pull up out front and seconds later, three more people were carried in. And from across the room, Dr. Stevens could already see that all three of them were elderly run-down men and they were all bright blue. Now, Beekman Downtown Hospital had a total of five cyanosis patients. Dr. Stevens and his staff worked through the entire morning to save these three new blue patients, and then just before lunch, two more blue men were carried in, and ten minutes later, another two. Dr. Stevens was totally confused. Something in the city had to be making all these men sick, but it just was not

clear what it was. By noon, there were nine ragged elderly men who had blue skin who were laid out in the hospital's beds. Dr. Stevens and his staff ran from bed to bed, administering treatment, until all nine men were totally stabilized and their skin was slowly turning back to its normal color. It was only then that Dr. Stevens had a moment to step back and actually go look at the men's admission papers. These documents revealed that all of the men had been found on sidewalks or in condemned buildings all around the neighborhood. Dr. Stevens didn't know what to make of this, but the fact that the men were coming from different places meant that a

single gas leak probably could not have made them all sick. But if it wasn't gas poisoning, what was making these men turn blue? Dr. Stevens worried it could be some kind of airborne illness or virus. And so even though Dr. Stevens did not really know what was going on, he knew it was now time to report this outbreak to the Department of Health. About an hour later, a field epidemiologist with the New York Department of Health named Dr. Ottavio Pelletieri walked through the doors of Beekman Downtown Hospital. He showed his identification to the receptionist and asked to speak with the physician who was in charge.

Dr. Pelletieri's job was to investigate possible outbreaks of disease. His eyes wandered around the emergency room. Of the nine blue-skinned patients laying in the beds against the wall, only five of them were awake. Dr. Pelletieri focused on William, who was the first patient brought in that morning. William was sitting upright in his bed, his skin still somewhat blue, but he was clearly feeling better. Dr. Pelletieri walked over and introduced himself. He asked William about his morning. The old man coughed into his fist and then thought for a moment.

He said at first it was just an ordinary day. He'd woken up in a nearby rooming house called the Globe Hotel, which was a crumbling, dingy building filled with as many twin beds as possible. After waking up, William said that he wandered down to breakfast at the Eclipse Cafeteria, where low-income people could get a hot meal very cheap. He ate some oatmeal and drank some coffee and then started back to his boarding house. And when he reached the sidewalk right outside of the Globe Hotel, he suddenly started feeling these stabbing pains inside of his stomach. Then he fell to the ground and the next thing he knew,

he was in this hospital bed. Just as Dr. Pelletieri was about to open his mouth to ask William some follow-up questions, the cyanosis patient in the next bed over piped up and said that he also had eaten at the Eclipse cafeteria that morning. Dr. Pelletieri raised his eyebrows. He stepped away from William's bed and asked the five conscious patients if they'd also eaten at Eclipse that morning. And all of them nodded yes, they had. Dr. Pelletieri now knew where to start his investigation. Something obviously was wrong at the Eclipse cafeteria. The question was whether there was a carbon monoxide leak there or if something else in the restaurant had made these men sick. It could be food poisoning, though Dr. Pelletieri thought this was unlikely since the symptoms of food poisoning usually take at least 12 hours to

manifest, and these men had passed out from pain and shock within just minutes of leaving the Eclipse cafeteria. Dr. Pelletieri then thought of something else that could have caused this quick and sudden illness. He took another sweeping look at the five conscious men in front of him and told them he had one more question. He promised they would not be in trouble, but he just had to know whether any of them had used a drug such as heroin that morning. There was a pause as the men stared back at him, but then all of them shook their heads no, and then told Dr. Pelletieri that they were actually drinkers, not drug users. They were all so serious that Dr. Pelletieri immediately believed them.

Just then, a nurse walked up behind Dr. Pelletieri and tapped him on the shoulder. She pointed across the room to Dr. Stevens, the ER doctor, who was striding toward him. Dr. Pelletieri gave Dr. Stevens a nod and met him halfway across the room, extending a handshake. After the men shook hands, Dr. Pelletieri explained that he would need blood samples from all nine patients. They'd be sent to the city toxicologist for overnight testing. Dr. Stevens nodded and agreed to help. For the next 10 minutes, the two of them moved from patient to patient, collecting small vials of blood and labeling them carefully. By the time they were done, all but one of the

cyanosis patients were awake. The only one who remained asleep was a man named John Marshall. He was laid out in the bed closest to the wall, fully unconscious, skin still pale blue. Dr. Pelletieri looked John up and down before labeling his blood and placing it in a small box with the other samples. It was clear to Dr. Pelletieri that whatever had made these men sick, John must have gotten the worst of it. Dr. Pelletieri grabbed his briefcase full of samples and then left the emergency room. He dropped the samples at his office for testing and then head straight to the Eclipse cafeteria. If he could figure out what had happened, there might still be time to save John's life.

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But the lights were on inside, so the doctor knocked on the dingy glass door. When there was no answer, he knocked again, announcing himself loudly as a member of the health department. Finally, he saw someone inside pop out of the kitchen and hurry across the dining room. The man was dressed in a well-tailored trench coat and wore a suit. He unlocked the front door and opened it for Dr. Pelletieri and then introduced himself as Mr. Weinberg and said he was from the New York Bureau of Food and Drugs. He explained to Dr. Pelletieri that a secretary from the New York Department of Health had already called his office. Now that a restaurant was potentially responsible for the cyanosis outbreak, his department needed to be involved. Dr. Pelletieri felt grateful for the unexpected help, and so he stepped inside of the Eclipse cafeteria, and right away he was hit with

this horrible smell. It was like an algae-filled aquarium. Dr. Pelletieri thought there must be so much mold lurking behind all the filthy and cracked tile walls. This place was so overdue for a proper cleaning that an inch of black grit clung to every corner of the floor. Dr. Pelletieri looked around the rest of the room and he saw fruit flies climbing the walls. There were 17 rickety tables that filled the dining room, each with its own sticky bottle of ketchup and salt and pepper shakers. Weinberg told Dr. Pelletieri that he had not found a gas leak anywhere inside, but he'd already sighted the cafeteria with 15 separate health code violations. The kitchen was even more disgusting than the dining room. A thick layer of grease clung to every surface,

bags of rotting garbage sat beneath the kitchen sinks, Dr. Pelletieri picked up a fork lying on the counter and a thick layer of starch coated the fork prongs. To him, everything inside of this cafe was a potential contaminant. It was only then that Dr. Pelletieri noticed the cook and the restaurant owner standing beside the oven. Dr. Pelletieri was even more surprised to find that both men looked genuinely upset, maybe even afraid. Dr. Pelletieri was even more surprised to find that both men looked genuinely upset, maybe even afraid. Dr. Pelletieri felt relieved. Usually, restaurant owners were combative when the health department showed up, but he guessed that these men were going to be cooperative.

If they had something to do with these nine men getting sick, it seemed very much like it was an accident. Dr. Pelletieri wanted to speak with the line cook first. He asked the man if he did anything different than usual when he cooked breakfast that morning. The line cook shook his head and said no. He had made the usual breakfast of oatmeal, rolls, and coffee, nothing different than every other morning. Dr. Pelletieri then followed the cook to the pantry, taking note of the type of dry cereal the cook had used to make six gallons of oatmeal. Then the cook led Dr. Pelletieri to the giant of dry cereal the cook had used to make six gallons of oatmeal. Then the cook led Dr. Pelletieri to the giant metal stock pot that he had used to both cook the oatmeal and then serve the oatmeal, enough to serve 125 people that morning. The cook rattled

off the recipe. Five pounds of that dry cereal, four gallons of city tap water, and a handful of salt. The cook gestured to a gallon can of salt sitting on the stove and then he pointed to a series of canisters sitting on a shelf just above the stove. The cook explained they stored the salt there in bulk, then just refilled the salt can on the stove as needed. Dr. Pelletieri said he wanted to take samples from everything the men had cooked with that morning. Then the doctor grabbed a stepstool to reach the canisters labeled table salt above the oven. And when he was up there and was eye level with these canisters,

he noticed there was a different canister hidden amongst them, one that did not have a label. Dr. Pelletieri lifted that can off the shelf and looked inside, and to him, it just looked like table salt. But just to be sure, Dr. Pelletieri climbed down from the

stepladder and then showed this unlabeled can of white crystals to the cook and said, what is this? The cook explained that this can contains something known as saltpeter, which was a preservative he used to make corned beef and pastrami. The cook said he did not use the saltpeter to make oatmeal. For that, he used regular table salt. Dr. Pelletieri nodded, but just in case, he took a small sample of the saltpeter with him. For a moment, Dr. Pelletieri wondered if maybe there had been some kind of a mix-up and the cook had used saltpeter instead of table salt. But even if that had been the case, that would not have been what made all nine of those men sick. Saltpeter was not toxic. Once Dr. Pelletieri had a bag full of

all the samples he needed, he left the Eclipse cafeteria, hoping he would never have to return. Then he headed for the health department chemist's office. He needed the samples tested for poison overnight, along with the blood samples that he'd dropped off earlier. Dr. Pelletieri really wanted to get back to the hospital to check in on the nine patients. But first, he had to make sure that this cyanosis outbreak was contained and that he was aware of every single cyanosis patient being treated right now in the city. He spent the next several hours visiting every cheap rooming house in the neighborhood, as well as all the nearby hospitals, until he was certain that the only cyanosis victims that were being dealt with right now were the nine at the Beekman Downtown Hospital.

When Dr. Pelletieri finally returned to the Beekman Downtown Hospital, it was well after midnight. And when he got there, a nurse greeted him and told him that since he had left the hospital that afternoon, two more elderly men had arrived with cyanosis, so blue skin. That brought the official count up to 11. Most of them were awake now and back to their normal coloring, but the sickest patient, John Marshall, still lay unconscious in his bed by the wall and his situation seemed to only be getting worse.

Dr. Pelletieri frowned and then thanked the nurse for the update. Then he headed back out the door toward his office to write his initial report summarizing his investigation for his boss, Dr. Morris Greenberg, the city's chief epidemiologist. The next morning, Dr. Pelletieri had to go back to the Eclipse cafeteria even though he really didn't want to. He was exhausted having stayed up most of the night writing his report for his boss, but to continue his investigation, he would need to speak with more members of the kitchen staff. When he got there, the cafeteria was still closed

because of the health department citations, but the busboys and cashiers were waiting for Dr. Pelletieri inside the dining room. He chatted with each of them, following them around the cafeteria as they pantomimed their work days. It didn't take long for Dr. Pelletieri to conclude that their actions had not contributed to the cyanosis cases in any significant way. But as Dr. Pelletieri packed up his belongings and got ready to leave, the cook from the day before appeared in the dining room with a fearful look on his face. He admitted to Dr. Pelletieri that he'd been up all night worrying that maybe, just maybe, he did accidentally season the oatmeal with saltpeter, not table salt, and if so, he was incredibly sorry. Dr. Pelletieri clapped the man's shoulder and thanked him for the honesty, but assured him not to worry. Since saltpeter is edible, it would not have hurt anyone if he had made that mix-up. The cook visibly

relaxed, and Dr. Pelletieri smiled and wished him a good afternoon. Within an hour, Dr. Pelletieri made it back to the Department of Health to find a note on his desk from his supervisor, Dr. Greenberg. The test results from all the Eclipse Cafeteria food samples had come back, and Greenberg. The test results from all the Eclipse cafeteria food samples had come back, and Greenberg wanted to see Dr. Pelletieri immediately. Dr. Greenberg was sitting at his desk looking over the results when Dr. Pelletieri showed up and knocked on his doorframe. Greenberg looked up for a moment and waved Dr. Pelletieri in. And then once Dr. Pelletieri took a seat, Greenberg handed him a copy of the results. And as Dr. Pelletieri took a seat, Greenberg handed him a copy of the results. And as Dr. Pelletieri read the findings, his eyes went wide.

The cook had, in fact, accidentally refilled the gallon can of salt on his stove with saltpeter instead of table salt. But that was not the issue. The problem was that both the table salt and the saltpeter contained measurable levels of sodium nitrite, a meat preservative that can be poisonous if not handled carefully. Dr. Pelletieri knew that sodium nitrite wasn't dangerous in small doses, but large quantities of it could be deadly. For a moment, Dr. Pelletieri wondered how sodium nitrite could have gotten into the kitchen in the first place. It was more common at processing plants where meats like salami, hot dogs, and bacon were cured.

And then Dr. Pelletieri remembered that because the nation was in the middle of World War II, the government had approved the use of limited concentrations of sodium nitrite in restaurants to make foods last longer. The sodium nitrite had to be used in very low concentrations that would preserve the meat, but allow any poisonous elements to burn off during the cooking process. But there was a big problem with the way the Eclipse Cafeteria was using their sodium nitrite. The cooks were not just using it to preserve meat. They were also using it to season the morning oatmeal. And this was a critical mistake because oatmeal is not cooked nearly as long as meat is.

During the longer meat cooking process, the toxins in sodium nitrite evaporate. But with oatmeal, they don't evaporate and so when the cooks served it to the men, the toxins were definitely still in the oatmeal. And if that was not enough poison, the 11 men who were hospitalized had apparently gotten a whole lot more sodium nitrite straight from the salt shaker on their tables. Lab tests showed that one of the shakers at the eclipse contained excess sodium nitrite, easily enough to sicken someone. Dr. Pelletieri put the lab results down and smiled. He finally had his answer. He would tell the restaurant about the mix-up right away, and as for the 11 blue men at the hospital, they were unlikely to suffer any long-term health problems from what had happened to them. Dr. Pelletieri thanked Dr. Greenberg, then got up to go spread the good news.

That evening, Dr. Pelletieri stopped by the Beekman downtown emergency room on his way home. When he arrived, he learned that 10 of the 11 blue men had been released with a clean bill of health. When he called Dr. Greenberg to let him know, Greenberg said it was nothing short of a miracle. All of the survivors were self-proclaimed alcoholics and alcoholics often crave salt.

He was sure that all of them added salt liberally to their food, unwittingly putting their lives in danger. Dr. Pelletieri agreed, and he wanted to tell these men how lucky they were, but the survivors had been discharged and had all returned to their transient lives out on the streets. He knew he would likely never find them again. Still, they were part of a special group, survivors of being poisoned with sodium nitrite, an event so rare there were only 10 other cases of it ever in recorded history. But that was no help for the 11th Blue Man, John Marshall. His health had been so bad prior to consuming this sodium nitrite that he had died earlier that evening.

Dr. Pelletieri's throat felt tight when he heard that news. He'd conducted his investigation as quickly as possible, but it still was not fast enough to save everyone. To be continued... 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 Aaron Lan. Our editor is Heather Dundas.

Sound design is by Matthew Cilelli. 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 Sheila Patterson. For Ballin Studios, our head of production is Zach Leavitt.

Script editing is by Scott Allen and Evan Allen. Our coordinating producer is Matub Zare. Executive producers is by Scott Allen and Evan Allen. Our coordinating producer is Metub Zare. Executive producers are myself, Mr. Ballin, and Nick Witters. For Wondery, our head of sound is Marcelino Villapondo. Senior producers are Laura Donna Pallavoda and Dave Schilling. Senior managing producer is Ryan Lohr. Our executive producers are Aaron O'Flaherty and Marshall Louis for Wondery. your area. Your phone buzzes and you look down to find this alert. What do you do next? Maybe you're at the grocery store, or maybe you're with your secret lover, or maybe you're robbing a bank. Based on the real-life false alarm that terrified Hawaii in 2018, Incoming, a brand new fiction

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