Lead Poisoning, a Heart Transplant and Now a Lot of Questions

Ebony Thomas-Smith is fighting for her life — again.
Ebony Thomas-Smith is fighting for her life — again. COURTESY EBONY SMITH-THOMAS

This story was produced in partnership with the Pulitzer Center.

Ebony Smith-Thomas likes to celebrate anniversaries.

In August, she held what might be described as a festival on Facebook as she counted down the days to the first anniversary of her heart transplant. On the big day, she treated her hundreds of fans and followers to a YouTube video set to music and with a mashup of favorite images she collected during the weeks she spent in the hospital.

On the day we last Zoomed with each other, Smith-Thomas had been sharing images on Facebook from a rather more grim anniversary. It was the day — just weeks after the transplant — that she underwent a second open-heart surgery to address a blood clot. Still, she marked it in an upbeat way with a selfie in which she signaled victory with two fingers and wore a mask saying, "EBONY IS A SURVIVOR."

Smith-Thomas marks these occasions in part because she was often unconscious or only semiconscious back then. Now that she is clear headed, she wants to remember what happened. But the anniversaries also give her a chance to inspire other people who share her plight and "to thank the ones who were praying for me, encouraging me and showing me love."

There are other anniversaries in her life to mark as well, but they are hazier — and the support system perhaps not as strong. There was that day in mid-September, in 1985, when physicians at Cardinal Glennon Children's Hospital diagnosed Smith-Thomas with lead poisoning. Her mother, Debbie Thomas-Smith, remembers a physician telling her that her toddler likely would be impaired for the rest of her life.

A hospital record that Debbie saved indicates the physicians had worked at flushing the lead from Ebony's body. The record also indicates that a "social service consult was obtained to look into the source of lead."

The source, according to Debbie, was paint chips that Ebony had eaten while the family had been residing in student housing at Saint Louis University.

In the immediate aftermath of her daughter's diagnosis, Debbie remembers asking the university to eliminate the lead contamination in her apartment and to provide support for her daughter's care. She said officials never responded in a meaningful way. She contacted an attorney about the issue, but said he quickly lost interest.

Despite the dire prognosis, Ebony Smith-Thomas, now 38, recovered and did quite well for the next three decades of her life.

By her early 30s, she had managed to earn a bachelor's degree and dual master's degrees in business management and information systems. She would go on to serve for nearly fourteen years with the nation's largest operator of campus bookstores, while also raising two sons, Clayton, 5, and Khamari, 16, and parenting two beloved nieces, Mykinzi, 21, and Mareah, 23, through their adolescence.

And then, five years ago, Smith-Thomas found herself at death's door with an illness called peripartum cardiomyopathy. And she began to wonder ...

Did the lead poisoning from her childhood have anything to do with her current condition? Does Saint Louis University bear some responsibility to help her, now that she can no longer work and must rely on government benefit programs to maintain her health and support her children? Did the "social service consult" lead to any mitigation efforts at the student residence? Did anyone else ingest paint chips in the student housing? If so, what were their outcomes?

Environmental racism

Whatever the answer to these questions might be, it's easy to connect Smith-Thomas' childhood experience to what many public-health practitioners and social-justice advocates have identified as environmental racism.

Civil rights leader Benjamin Chavis is credited with introducing the concept in the 1980s, describing it as "racial discrimination in the enforcement of regulations and laws, the deliberate targeting of communities of color for toxic waste facilities, the official sanctioning of the life-threatening presence of poisons and pollutants in our communities ... ."

Smith-Thomas would qualify in the "presence of poisons" category. She was one of thousands of St. Louis children afflicted with lead poisoning because of their exposure either to lead-based paint or tap water running through lead pipes — or because they lived in a neighborhood with airborne contaminants.

Smith-Thomas' malady — as her mother Debbie Thomas-Smith later determined — came from eating paint chips from a windowsill located in what was once the Coronado Hotel. Thomas-Smith had caught her daughter peeling the chips from the sill. She couldn't know if perhaps she had done it before. It was only after some time, when her child began crying and complaining that her fingers hurt, that Thomas-Smith sought medical attention for such an unusual symptom.

SLU's role in the lead-poisoning crisis

Ebony Smith-Thomas' lead-poisoning diagnosis came in the mid-1980s as St. Louis was struggling with a plague of lead poisoning falling most heavily on families of color in the city's most vulnerable neighborhoods.

Almost every year since the 1950s, public-health officials were able to document at least one case of a child dying from lead poisoning, with hundreds more identified as having severely high levels of lead in their blood that affected their cognitive abilities and their behavior. Mass screening programs began in the 1970s, and advocacy groups organized protests to pressure regional leaders to do more.

Notably, the Saint Louis University School of Medicine organized a Get Out the Lead conference in 1971, and by 1972 the city had established a lead-poisoning evaluation center. Around that time, the city introduced stricter lead-abatement statutes. More funding and staffing would follow in the 1980s.

In the early 2000s, city officials would proudly say that they were making significant inroads against lead poisoning. But not long after that, the city's public-health department underwent budget cuts. The city would have many fewer people to address compliance with lead-poisoning mitigation. Still, there was some good news. Older buildings with lead issues either were getting demolished or repainted with non-toxic paint. Manufacturers were getting the lead out of their products.

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