Dr. Scott Laney

Dr. A. Scott Laney

Q: This is Sam Robson, here with Dr. Scott Laney. Today is Wednesday, I believe, December 20th, 2017. I'm here in Scott's office at the NIOSH [National Institute for Occupational Safety and Health] headquarters at CDC's [United States Centers for Disease Control and Prevention] offices in Morgantown, West Virginia. I get to talk with Scott today about his part in the Ebola response--he spent time in both Liberia and Sierra Leone, I think, but primarily Liberia--for the CDC Ebola Response Oral History Project of the David J. Sencer CDC Museum. The first thing I'll ask Scott is, would you mind saying "my name is," and then pronouncing your full name for me?

LANEY: My name is Scott Laney.

Q: What is your current occupation?

LANEY: Currently, I work at the National Institute for Occupational Safety and Health here in Morgantown, and my job is primarily to look at the respiratory health of coal miners, so I primarily work on black-lung-related issues.

Q: If you were to tell someone in just a few sentences, very briefly, what your role was in the Ebola response, what would you say?

LANEY: Briefly, yeah, that's a very difficult question because I actually was there for over seven months and had a number of different responsibilities. Initially, I was a field responder and was outside of the capital, sort of on my own out in the field, but as time went on I began to get more responsibility for the response, all the way up to being the response leader towards the end. So, actively involved throughout the entire outbreak situation. A lot of different roles and responsibilities.

Q: Can you tell me when and where you were born?

LANEY: I was born in Manhattan, Kansas, on Valentine's Day 1974, and so I'm 00:02:00always happy to say that I was born in Manhattan. [laughter]

Q: A bustling metropolis!

LANEY: That's right.

Q: In the middle of Kansas. Is that where you were raised?

LANEY: I grew up in eastern Colorado, so the part that nobody goes to. It's the Kansas-Oklahoma-sort-of-Texas border down there in the [Great] Plains, and I grew up there until my senior year of high school when I moved to Durango, Colorado, which is in the Four Corners region, sort of like moving from hell to heaven. [laughter]

Q: Did you feel like that when you were growing up? Did you feel like, I'm out in the middle of nowhere?

LANEY: I think that in our community, largely we all did. The attitude was, I can't wait until I get old enough to get the hell out of here. There are 00:03:00relatively few people who stayed behind, and the people who could get out were the ones who did. Still, that's I think the case in some of these more rural communities, and certainly the case there.

Q: Who raised you?

LANEY: My mom and dad. And the community, to some extent. It was a really small community. I think there were like eight hundred people in the entire county, and so it was an incredibly rural and isolated population of people. Everybody knows everybody's business and everybody sort of looked out for everybody. It's a way to grow up, and paradoxically, when I was growing up at the time, I said if I can get out of this place, I will never, ever come back to a place like 00:04:00this. I left and tried city life and things, and decided that when I was going to have a family and raise my kids, I was going to move to a very similar place. So now I'm here in Central Appalachia, raising my kids in a very small community out in the mountains. That's the way it works, I guess. [laughter]

Q: Can you tell me a bit about your parents, like what they did?

LANEY: My dad was a small-town preacher. He was the preacher of a Christian church in Eads, Colorado. My mom worked at the bank, the only bank in town. That's sort of how things went when I was a kid. Lived in the parsonage next to the church. It was right across from the school, so could walk to school every day. Small town living.

Q: What kinds of things were you interested in?

LANEY: I was interested in the sorts of things that got me beat up quite a bit. 00:05:00Musical theater and literature and things that most of the farm kids had no truck for, as they would say. [laughs] Yeah, that's the kind of stuff I was interested in. We for a long period of time didn't have television, and so I didn't have the opportunity to sit around watching TV programs like most of my cohort, and even today a lot of the cultural touchstones for my cohort, I really don't have any awareness of. I can't talk about Star Wars or any of the movies or essential things that made up what pop culture existed at the time. It's interesting.

Q: What was your pop culture like? What were you reading?

LANEY: As a kid, I read a lot of Stephen King and Dean Koontz sort of stuff, and this was way before the internet came around. Computers didn't exist then, and so we had to rely on the local library and whatever they could bring in, and most of it was either old garbage and encyclopedias, which I would spend time looking through, or the new Stephen King books. Because I was brought up in a sheltered community and in a sheltered home, that was about the raciest thing I could get my hands on and get away with. So I took every opportunity. [laughter]

Q: Academically, did you have subjects that you were attracted to?

LANEY: Not at all. Since we lived in such a rural community, to get public 00:07:00teachers to come was very challenging, and so often there would be classes that didn't have teachers. The ones that did come were early out of their career, so it would be their first job. We went to school four days a week because we had this agricultural community and kids had to work on the farms, and there wasn't a high priority in the same sort of federal and state standards for education that exist now. It's sort of hard to imagine that that existed, but the reality is that I graduated from high school with no education whatsoever. I never had a mathematics class, I never had a reasonable science class. The highest math I had was business math, which at the time was learning how to do some basic accounting, balancing your checkbook, that sort of life skills stuff. The notion 00:08:00that chemistry or physics could be taught in high school was completely foreign. It didn't exist as a concept to us in that school, and there was no expectation that we would use any of that because this was a farming community and you would take over Grandpap's farm and that sort of stuff. As far as being educationally driven, it wasn't a thing, and even the idea of college for most of us at Eads was not even--it wasn't something that existed. It wasn't even something that we would think to attempt because it wasn't across our radar. That's a long answer to your question about being academically-minded. But, no, not in any sort of traditional sense.

Q: You said it was your senior year that you moved to Durango?

LANEY: That's right.

Q: What prompted that?

LANEY: My dad took a new church in Durango. I don't totally understand the entire history and the motivation and thoughts behind all of that, but that's how we wound up in Durango. It's interesting from an academic perspective because when I went there, this is a much more affluent community that is very college-preparatory-minded and driven, and they didn't know what to do with me when I showed up my senior year. I didn't have a transcript that had any value whatsoever. I couldn't be put in any sort of classes, and so when I went to Durango, I took jazz band, I took concert band, I took three different theater classes and an English course, and that's the only thing that I could really be placed into because there was no way that--I didn't have any of the 00:10:00foundational, even junior high education to be able to take any high school classes. [laughs] They let me get away with it, and I graduated from high school from Durango having a whole bunch of theater courses. It was great. I absolutely flourished there and enjoyed my life so much more. But then after high school, I was sort of a listless ship for a while. I had to grow up and sort of figure out life.

Q: What happened?

LANEY: I graduated high school and went to work for the local wood mill, and I became incredibly disenfranchised because I was just dissatisfied in general with that being my life. I went to the local Denny's and was hanging out 00:11:00drinking coffee, and a couple of hippies came in and sat at my table and we started talking and said, let's just get out of here and go do something. I sold everything of any sort of value I had. I had a really nice bicycle and a car and some mountain gear, and sold all of that, bought a one-way ticket to London, and started hitchhiking around for about four or five months and wound up in Scotland sleeping in the hills with the sheep. I think that was really the beginning of transforming my worldview about what was and wasn't possible. I continued on that path for a while. I'd come back and work at the mill for six months and save up my money, and then I'd go fly off to Australia and sleep on the beach for four months, and then I'd come back.

Of course, that starts to get long in the tooth, too. You have no home, you have 00:12:00no--and so I decided that it was time to really make a swing. I had a friend of mine who had a sort of similar situation. From Durango, he went to college and then dropped out and was feeling sort of sorry for himself, just like I was, and we decided that we were just going to go off to New York City and try our hand at doing cattle calls for a Broadway or any sort of off-Broadway shows because we were both heavily into theater. We did this sort of cross-country trek to New York and wound up stopping in Syracuse, and stayed there for a year and a half or something. Didn't even make it to New York City. [laughter]

During that time, I somehow fell into taking an EMT [emergency medical technician] course and started working on an ambulance in Syracuse, and I started dropping these bodies off to the emergency room and meeting these 00:13:00emergency room doctors and thought, there's nothing special about you. I think that I'm probably as smart or smarter than you are, so there's nothing particularly special--I could do that. I could do what you're doing. So when I had that self confidence that I could be an emergency room doctor, it was like, how do I get there? And the way is you go to college and you take pre-medicine and then you go to medical school. I sort of understood that, and that's what I decided I was going to do. I didn't do that, [laughter] but that was the plan.

Q: So what did you do?

LANEY: Well, in the meantime when I was in Syracuse, I met my now wife. We drove around the United States looking for undergraduate colleges for me to attend. I decided I wanted to go to school somewhere, and we'd just drive around to 00:14:00various places. We went out to Washington State and thought that might be a good fit, and wound up back in Central New York, and I went to school at the State University of New York. The reason was because I thought it was a really cool town, and my estimation at the time was that college is college in the United States. That's largely true. This was a cool town, a cool place to live. I started at SUNY Fredonia, and they let me in off the basis of not having a reasonable high school transcript, not having any sort of SAT or ACT scores, because I didn't take those exams, and not having gone to school for the last four or five years, just whacking around the world not having a job. I was not a 00:15:00strong college candidate, and they let me in. I started school there for undergrad [undergraduate school] and what became immediately apparent was that I had no basic academic underpinning to achieve any sort of success. I had to take all of the introductory courses for non-majors for the major that I was pursuing. I think one of the hardest college courses that I've ever taken throughout my entire college portfolio was probably college algebra. Learning algebra as a twenty-three-year-old person who had never been exposed to any sort of basic mathematics at all. I think probably part of the reason that I excelled so much in math, as it turned out, was that I didn't have any of the baggage that's brought with how you teach a twelve-year-old mathematics. When you bring 00:16:00more of a formulated adult mind to these esoteric concepts, I think it was helpful for me to be able to do what I did in college.

Q: What does a twelve-year-old bring to math that holds him back?

LANEY: I think that--imagination and worldview. The way that math is taught in primary school is through solving puzzles. Memorize this series of events and then bring them to use on this particular problem. That really structural approach to, this is how you solve this problem. Busting out of that is very difficult later on. That's my opinion. I don't know, I think there's probably a 00:17:00whole variety of different opinions about how you learn mathematics and when is the best time and when do revelations come to you in that field. We see that probably most of the best scientific and mathematical discoveries occur somewhere between the age of nineteen and twenty-five, and then that period is just a window that is tight and shut off and you don't see field medalists who are fifty years old creating new mathematical discoveries and things. Historically, that's the way that it's been. I don't purport to be a mathematical genius by any stretch of the imagination, but it's certainly helped get me from there to here, and out of the notion of patient interactions and clinical management in medicine, which is what I had thought that I wanted to 00:18:00do. When the world of math became part of my existence and worldview, I knew that that's what I wanted to pursue because I had put myself in the biology track and the pre-medicine track and I wanted to help people. When I found out that epidemiology was a thing, which I'd never heard of before probably my sophomore year in undergrad college at the age of twenty-five, I was like, no, that sounds exactly like what would be perfect for me to do. Once I realized that, I left the college I was at because I knew that I wouldn't have any exposure to public health or to epidemiology. Went to a larger university that had a community health and epidemiology program, said I want to work for CDC and I will do whatever it takes to get there. Walked in to my new school at the 00:19:00University of Missouri and said, I want to work for you people in epidemiology, and this is what my career goals are. They put me to work, and it was great. Once I decided this is what I wanted to do, I knew it was going to be an eight-year, ten-year affair to get there, but I had that goal in mind and pursued it fully all the way.

Q: Do you remember how it was that you learned about epidemiology?

LANEY: Yeah. I had a parasitology professor at Fredonia who pulled me aside one day and said, "I know that you're doing this pre-medicine stuff, but you don't want to be a doctor. You want to do epidemiology." He told me about EIS [Epidemic Intelligence Service], and once I learned about EIS, I said, that sounds like the coolest thing I've ever heard of, that's what I want to do, and by God I will. Once I wound up in graduate school, I decided that I didn't need 00:20:00EIS, and I wasn't going to do that. As a sort of lark, I said I should at least apply to make this circle complete. Once I got accepted, I said, this pays a whole lot better than an NIH [National Institutes of Health] post-doc [post-doctoral fellowship], so I think I'll do it.

Q: Did you finish your undergrad at Missouri, or did you finish that up at SUNY?

LANEY: I finished at Missouri. It's pretty interesting because my wife, Tammy, was looking at graduate schools and got accepted to Cornell [University], and so I applied to transfer to Cornell, and we were literally packing up our stuff in a moving van to move to Ithaca and the government called Tammy and said, you know what, we'll pay for all of your education, and not only that, we will guarantee you a job with the National Wildlife Refuge if you do your research with us, with our professor at Mizzou [Missouri]. We literally took the van, 00:21:00instead of going to Ithaca, we went to Columbia, and I had to walk into the admissions office and say, I know you don't know me, but I need to go to school here next week, and they let me in. [laughter]

Q: When it came to epidemiology for you in undergrad, was most of it like--was that the major that you had as an undergrad?

LANEY: I was a biology major in the pre-med track. I don't know how I got turned on to statistics, but I was taking the math that was required of the pre-med track, and it was like pre-calculus and then calc [calculus] 1 and 2, I think 00:22:00was the requirement for the undergraduate degree. Obviously, I had to start with general math and algebra, and took pre-calculus, and then calc 1 and 2, and absolutely became fascinated with that. It overwhelmed any of my interest in biology. By my sophomore year, I was so sick of memorizing garbage. I said, I like the statistics business where I can figure things out and I don't really have to memorize this stuff anymore. So I skated by with the like minimum amount of hours required to get the biology major and just an inordinate amount of statistics that I took, and wound up getting a minor in that, and probably had enough to double major as it turned out.

Q: What happened from there?

LANEY: From there, what happened was I knew I wanted to go to CDC, and the way 00:23:00that you get there is to go to graduate school. I knew I had to go to graduate school, and Emory [University] was right across the street from the CDC, so I set my eyes on going to graduate school at Emory. When I went to Emory, even before school started, I walked over to CDC and sort of banged on the door, when you could do that back in the day--this was when you could drive down Clifton [Road] and walk in the front door. I basically gave them the same spiel I gave to the community health department at Mizzou, which is, I will mop the floors or wash your car, do whatever it takes, I want to work here. I suppose with that sort of enthusiasm--I'm not really sure how it worked out that they found someone who would sponsor my education and allow me to do my graduate research at CDC. I was a project coordinator for an HIV [human immunodeficiency virus] cohort at CDC before even school started, and then I used that as my master's thesis.

Q: As a master's of public health [degree]?

LANEY: That was an MPH from Emory, yeah. Through the course of that work with CDC, I became very involved with basically the last bit of epidemiology related to human herpes virus A, which causes Kaposi's sarcoma, which is a cancer in AIDS [acquired immune deficiency syndrome] patients, and went to meetings and gave talks about that and met the people who were in the field. Actually met the folks who had discovered that virus, and I decided that I would do my PhD in their lab [laboratory]. I went to them and said, "You have to let me come do my work with you," and they said no, of course. Then I said, "I'm not going to 00:25:00leave here until I get a PhD out of your lab," and so they relented. [laughter]

Q: That seems like a good theme. [laughter] Who were they?

LANEY: Pat [Patrick S.] Moore and Yuan Chang, and right now they're still at the University of Pittsburgh. They discovered the virus at Columbia [University] in New York, and then were wooed to Pittsburgh with large sums of money and a number of laboratory resources that they still utilize and do interesting work.

Q: Did you move up to Pittsburgh then?

LANEY: Yeah. I went to Pittsburgh and did my PhD in two and a half years, and then wound up back at CDC with EIS. After my PhD, I applied to EIS and wound up taking the state position in Vermont.

Q: You did your PhD in two and a half years?

LANEY: Yeah.

Q: How did you do that?

LANEY: Because I had so much statistics behind me, when I started at Emory, that was a substantial portion of coursework for a degree in public health. I didn't have to take any of the statistics, any of the biostatistics that is foundational for epidemiology. I sort of quizzed out of all that and took more advanced-level courses. By the time I got to Pittsburgh, there was really nothing on offer for me to take, and so there were virtually no coursework requirements for me to do at Pittsburgh. I started directly into research, and because I wasn't searching for a PI [principal investigator] or a lab to go to, I knew exactly what I wanted to do, it was expedited. I got lucky, too. Very 00:27:00early on, someone reported some nonsense in the New England Journal of Medicine that was very easy for us to refute, and so that was like in the first month of me starting at Pittsburgh. Had a paper that was published, and it was sort of a spicy topic and got a lot of attention, and that really greased the skids for everything else that came after. So yeah, it was quick.

Q: What EIS class were you in?

LANEY: 2006. A hundred years ago. [laughter]

Q: Oh-six to oh-eight is what it would have been. Gotcha. Can you tell me about that?

LANEY: Yeah, it's interesting. Being at a state I think is particularly interesting, and the state officer's experience is different than folks who are 00:28:00stationed at Atlanta. I have lifelong friendships that have developed out of that with some of the other state-based officers. Did a lot of work with avian influenza, but what really cut my bones there was that my background is infectious disease epidemiology and molecular virology, and being stationed at a health department, you don't get exposed to that so much. Vermont, which is one of the whitest and richest states, the things that came across my desk were almost all occupational and environmental-health-related issues. There was a sick building that I investigated in Vermont that got NIOSH attention and involved and they started to recruit me here. It wouldn't have even been on my 00:29:00radar to come to this place except for that experience. I wasn't sure that I was interested whatsoever in occupational health, but I didn't want to go to Atlanta and I didn't want to go to Bethesda. I really wanted to be in a place that was in the country and outside. We bought an old farmhouse in the mountains of West Virginia, steadily been trying to pour our lifesavings into that, I guess. [laughter]

Q: So by this time, you had come around to thinking, actually, maybe the city life is not exactly what I want, maybe moving back to something that was similar in some ways to--

LANEY: Yeah, it's funny how that works. Absolutely. Finally, for me, it's the place I really feel at home. I really feel like this is the place. I didn't know 00:30:00that I would care for the job that much, but I did know that I would like the lifestyle, and I figured that the worst-case scenario is I would spin out here and then I could just go do academia either at Pittsburgh or West Virginia University. There were options. But I came here and absolutely have fallen in love with the work and have fallen in love with the lifestyle and the place, and the people here are particularly passionate about the work we do and who our customers are. We care deeply about the US workforce, and I like that attitude. It's nice to come to work every day with people who are passionate about the work that they do, and it makes me passionate, too.

Q: Can you tell me about just starting out here?

LANEY: Sure. I came, and they said, you're going to be working on black lung 00:31:00disease. I had no idea what that was. I hadn't really worked in respiratory health very much beyond influenza, and I really didn't know what I was doing, but one of the things I've learned over the years--and I think EIS was particularly helpful with--was not to be at all intimidated by my own ignorance. [laughter] I feel like if you can learn what needs to be learned, that's the important thing. I sort of threw myself into it, and the learning curve for what we do here is very high, and it's kind of hard for us to recruit EIS officers in fact because it's not something that people study in school. It really is specialized learning that very few people give much consideration to. It took 00:32:00some effort to get up to speed, but it's been nice to be here.

Q: What kinds of things were you getting up to speed in? What are these things that people don't study enough?

LANEY: There's this sort of arcane system. The International [Labour] Organization, which is part of the World Health Organization, has come up with a way to classify pneumoconiosis, which is black lung disease, for surveillance purposes. It is a very arcane system of X-ray reading. You really have to understand that to even have a basis to begin with. It's a completely different language, and it's a completely different set of skills that you would normally 00:33:00not be exposed to. It turns out to be very important, but there are very few people who get involved with this sort of stuff. I think that that's true of a variety of places across CDC, but I think that you see that people are able to move from division to division and mix and match a little bit easier in Atlanta than they are to come into a situation like this because it really does take a different kind of commitment.

Q: Who were some people here who you were initially working with, that you spent the most time with?

LANEY: When I first started, I was the youngest person here, and I think some of it has to do with the general government cohort effect of aging and retirement that we're seeing now. But I came in and Mike [Michael D.] Attfield was here and 00:34:00[E.] Lee Petsonk was here. Basically, all of the senior management has retired since I've been here. I've been here almost ten years now I guess, and so now I'm the old person. It's really been an interesting transition to go from the bottom to the most experienced old man here in such a short period of time. I think that that's probably happening across the entire federal workforce. It's been an interesting transition. All the people that I worked with are not here anymore.

Q: Was there something that especially caught your interest, that you became passionate about, when it came to, like, black lung the first few years?

LANEY: I think some of the political aspect of it. I've never had so vociferous 00:35:00a pushback against the work that I've done or anything that I've tried to accomplish as much as the work that I've done here because you're talking about big money interests, big energy. Everything that we do has implications related to your electric bill. The constituency against the types of work that we do and try to uncover here is very, very intense, and that's incredibly interesting to me, and that sort of political struggle all the time is something that fires me up. The worst thing you can do to me is to say no, or I shouldn't be doing something. It's like candy. [laughs]

Q: The was a point--I got to come over last night and we had dinner with Satish [K. Pillai] and Athalia [S. Christie] and David [J. Blackley] was there. Didn't 00:36:00make dinner, actually. But you mentioned something about how somebody at one point almost put, like, a bomb in your mailbox because they were so upset about the kind of work that you do. Is that something that happened?

LANEY: Yeah, that is something that happened. My fence out at my place has been shot up by people driving by. It's serious business. When we make recommendations that cost potentially millions of dollars, there's a tremendous pushback. There's a long history of this in black lung in particular. There have been people killed over this thing. A lot of that has normalized in more recent years, but yeah, that stuff is real.

Q: Do you remember what triggered those particular incidents?

LANEY: Yeah. The mailbox situation happened the day after a paper of mine was 00:37:00published. It seems a little arcane to talk about this, this r-type opacity paper. Basically, we identified a specific type of lung abnormality that hadn't previously been identified in coal miners, which was going to potentially cause a whole bunch of new liability for the industry. So some toady tried to send a message that--

Q: That we don't want to learn about this thing.

LANEY: Yeah. No, there have been a number of instances. There's a National Academy of Sciences study that's going on right now that I gave testimony to, and I sent Tammy and the kids away for the week because I knew it was going to 00:38:00be particularly controversial. In fact, it was. The national media picked up on it and did some reporting. That's what makes life interesting. [laughter]

Q: Has it been difficult not just with the people higher up in the hierarchy in the mining companies, but also with people who seek employment, like as miners?

LANEY: Yeah, it's really paradoxical, but we have absolutely no friends. It's not just the industry. We're trying to protect the workers, and the workers don't want our protection, they want jobs. The reality is, with the way that the coal industry is going, there's fewer and fewer jobs. The people in central Appalachia want those jobs, and they don't want anything that is going to smack 00:39:00of government interference or regulatory issues related to mining that could impact their employ. Despite our best efforts to make sure that people can go to work and not be diseased, these are the same people who want us to go away. So yeah, it's everybody. We don't have any friends. [laughter]

Q: Looking to what you did later in West Africa, that kind of intense response work, was there anything that you had done previous to that that was at all comparable?

LANEY: Beyond--I mean, no. The answer is just no. That was such a unique and intense experience. Beyond just travel and dealing with personal interactions 00:40:00with people that you don't know, trying to size up a situation immediately and make fast and furious friends and that kind of stuff, those soft skills are what was the most useful thing. But no, absolutely not. There was nothing that ever came close to that. It in many ways fundamentally changed my life as a result of being that intensely exposed to that situation.

Q: This might be a good part to pause and pick up in the group discussion. Can I just start by asking how you got involved initially?

LANEY: Yeah.

Q: Was there anything else about your pre-Ebola life or career that you think, actually, that's relevant for when we talk about Ebola?

LANEY: No, I don't think so, and if it is, these guys will be more than happy to point it out. [laughter]

Q: Thank you so much, Scott.

LANEY: You bet.

END