Ep. 51 | Culture Clash
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A young doctor carefully maneuvered her way through the crowded hallway of her hospital's emergency room. It was the middle of the night, but the place was jammed with dozens of patients who had all arrived in the past few hours. Gurneys filled the hallway because all the beds in the emergency room were now occupied, and almost every patient the doctor saw was doing the same thing, grabbing at their stomach and moaning in pain.

The doctor stepped aside to make room for a lab technician who was pushing a rattling cart full of urine and stool samples. And that's when the doctor bumped into a man on one of those gurneys in the hallway who she'd actually examined a few hours earlier. And so she hoped he'd be feeling better by now. But when she turned to look at him, she saw the man was still clutching his abdomen and his hospital gown was stained with vomit. And as soon as this man looked up and saw the doctor, he began to shout,

He demanded to see his test results right now. But the doctor explained that everyone at the hospital, all the staff was working as hard as they could, but they were overwhelmed by all these patients. And so everything was delayed and his test results would unfortunately take at least a few more hours.

But at this, the man got totally incensed and he sat up and he actually grabbed a urine sample off the lab tech's cart and threw it at the doctor. And the doctor managed to duck out of the way before it smashed into the wall. And then suddenly security was called to deal with this guy. And the doctor just stepped back and couldn't believe the chaos in front of her. In all her years of practice, she never experienced anything like this.

And so she wondered how much bigger this outbreak was going to get and if it would even ever end. "What time is it?

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That's Amazon.com slash ad-free true crime to catch up on the latest episodes without the ads. From Ballin Studios and Wondery, I'm Mr. Ballin, and this is Mr. Ballin's Medical Mysteries, where every week we will explore a new baffling mystery originating from the one place we all can't escape, our own bodies. If you like today's story, please drive your car in front of the follow button on the highway and then turn on your left blinker, but never turn.

This episode is called Culture Clash. On Sunday, September 9th, 1984, Dave and Sandy Lutkin sat down for lunch with some friends at a pizza place in the small, tight-knit community of The Dalles, Oregon. Dave looked around at the bustling restaurant, and then he looked over at his wife and smiled. They owned the place. It was a franchise of the Shakey's Pizza Parlor chain, and he and his wife were clearly thrilled to see so many people stopping by to eat after Sunday church services.

Business was actually going so well that Dave and Sandy were thinking about opening up another location in nearby Hood River. But it was Dave's day off today, and he didn't want to think about work. Between raising kids and running the restaurant, he didn't get much time to just hang out and catch up with friends. And so Dave turned back to the two friends at the table with he and his wife, and they were a married couple named Dan and Kay. And Dave asked them, you know, how are things going?

Now, Dave knew that Dan was very active in local politics and therefore kind of knew all the latest town gossip. And so really that's what Dave was asking Dan, like, hey, what's going on in town? What have you heard? And so after asking this question, Dave began to eat his macaroni salad as Dan very enthusiastically began to fill them in on what was happening behind the scenes in the Dalles. There was a debate about tearing down an old school that they had attended as kids and

And there were also some plans to renovate a nearby park. But the big news was local officials were still clashing with a religious commune that had recently bought a ranch on the outskirts of town. And the people in this town were complaining that some of these commune members dressed very funny and they smelled weird, like they could be homeless or something. And worse yet, according to the townspeople, this commune had apparently bussed in actual homeless people from around the country and then registered them to vote.

And so as Dan was talking about this, he couldn't help himself and just shook his head and said, you know, what would happen if these weirdos from the commune took over?

As Dave listened, he thought about his own experience with this commune. He actually didn't have any complaints about them. In fact, sometimes a few of them would venture into town and come to Shakey's to eat, which was great for Dave and Sandy. And they never caused any problems and they always paid for their food. So really, Dave had no complaints. And so Dan continued chatting for a bit longer about the commune and about some other topics around town. And then eventually they all finished eating their lunch and they stood up and said their goodbyes and went their separate ways.

Later that day, Dave was standing behind the cash register inside of their restaurant, counting out the day's profits. And as he did that, suddenly a cramp stabbed at his stomach so hard that he had to bend over. He tried to breathe through the spasm, but it only seemed to get worse. And then also he was hit with a wave of nausea.

Dave knew Sandy was outside in the car waiting for him. And so he pushed through the pain and finished at the register. And then he went to the doors, walked outside, locked up behind him and made his way over to the car. Once he was inside, you know, he told Sandy about this pain he had and he told her he felt nauseous. And he said, I just got to get home.

And so Dave drove as fast as he could back to their house trying to keep the nausea at bay and as soon as they pulled into the driveway, Dave hopped out, ran inside the house, ran into the bathroom, locked it behind him and then he just began vomiting practically non-stop into the toilet. A minute later, Dave heard Sandy knocking furiously at the door and Dave grabbed onto the bathroom sink to kind of pull himself back to his feet and he reached over and unlocked the door.

Dave thought his wife was knocking because she was worried about him. But no, as soon as the door opened, she just rushed past Dave and took his spot at the toilet and began retching into the bowl too. Dave figured they must have caught some sort of stomach bug and just needed to rest. But when he tried to walk to their bedroom, he became so dizzy he almost fell over. So he just sat on the ground waiting for his wife to finish in the bathroom. And as he waited, Dave put a hand to his forehead and felt how hot he was getting.

His body became slick with sweat as chills ran down his body and his stomach began to cramp up again very painfully. And then when Sandy finally emerged, Dave felt nauseous again and so he rushed back inside and began vomiting. And then every time he was done vomiting, he would have these horrible bouts of diarrhea.

And so when Dave came out of the bathroom the second time, he found Sandy lying on the bed. She was pale and there was sweat running down her face and she started saying something to him, but when she spoke, her words were slurred and unsteady. At this point, Dave was really beginning to worry. It seemed like they both might not just have a stomach bug, that this might be something kind of serious and they might need medical attention.

But at the same time, Dave wasn't sure he could even drive them to the hospital with how he was feeling. And so Dave just climbed onto the bed next to his wife and the two of them just laid there for several hours hoping that whatever was going on with them might begin to taper off. But after several hours, Dave was still feeling incredibly weak and horrible. And so at this point, Dave decided they couldn't wait any longer to get help. He knew that he and Sandy were now so dehydrated that he was worried they could pass out or something.

So Dave got out of the bed and stumbled to the kitchen and called a taxi. Ten minutes later, he and Sandy were in that taxi on the way to the emergency room. After a short ride, Dave walked inside of the emergency department with Sandy leaning on his arm for support. To Dave's surprise, the waiting room was already completely packed, and right away he spotted a few people who had eaten at his restaurant earlier that day. And all of them looked pale and sweaty just like he and his wife.

Dave and Sandy limped over to the checking counter and nearly bumped into their friend, Dan, who looked even worse than Dave and Sandy. The trio sat together as they waited, but nobody said anything. They all felt too sick to talk. Eventually, Dave and Sandy were admitted to the hospital and a nurse hooked them up to IV drips to replenish all the fluids they'd lost. Then, the doctor explained that the couple was too sick to go home and they would need to stay overnight for observation, or at least until they figured out what was making them so sick.

And so after Dave and Sandy were set up in their room, a doctor said a nurse would come by soon to collect blood and stool samples shortly. The next morning, the doctor returned to Dave and Sandy's hospital room and told them he had their test results. Dave listened intently as she explained that he and Sandy had salmonella poisoning, a bacterial infection that attacks the intestinal tract. And in fact, the doctor said the majority of the other people who had come in the previous day along with Dave and Sandy, they also had salmonella poisoning.

Now, the doctor said they didn't know where the salmonella had come from, but immediately, Dave had a bad feeling. He didn't dare say it out loud, not even to Sandy, but secretly, he worried the salmonella poisoning had come from their restaurant.

Dave grappled with that horrible thought as he and Sandy were discharged and began to make their way back through the hospital towards the exit. And as they got near the exit, they saw there was still a crowd of patients waiting to be seen, which actually made the waiting room seem even busier than it had been the night before. Dave guided Sandy to the door, feeling very grateful to be getting out of the hospital, but also feeling very guilty that his restaurant might very well be to blame for this outbreak.

Later that day, Oregon State epidemiologist Dr. Lawrence Foster picked up the ringing phone on his desk. An epidemiologist is someone who investigates patterns and causes of disease and injury. Dr. Foster was a quiet man with a gentle demeanor who operated extremely well under pressure, responding to emergencies with science and logic. He actually loved the intense work of being an epidemiologist and listened closely as an official on the phone outlined a new breaking case.

In the past 24 hours, nearly 20 patients had arrived all at once at a small hospital near the Dalles, Oregon. All of them had been diagnosed with salmonella poisoning, and almost all of them had eaten at a local pizza place right before getting salmonella poisoning. Dr. Foster thanked the official for calling with the update and said he would get right on it.

After hanging up the phone, Dr. Foster did not think this was some crazy crisis. Instead, he thought this was a pretty straightforward case of food poisoning. And so now his job was to locate the source of the salmonella bacteria and eliminate it. So he grabbed his car keys and headed for the door. He knew where to start looking. About an hour later, Dr. Foster pulled up to Shakey's Pizza Parlor in the Dalles. It looked like an old-school pizza joint with a large hand-painted sign and Adirondack chairs out front.

The restaurant was closed for the day, but the doctor had picked up the keys from Dave Lutkins, one of the owners, on the way over. After opening the door, Dr. Foster stepped inside and slipped on a pair of latex gloves. The first step to pinpointing the exact source of the salmonella outbreak was to gather food samples and then take them back to the lab to be tested. And so that's what Dr. Foster was here to do, get those samples.

And then while the food testing was underway, members of Dr. Foster's team would interview the restaurant's employees, while others would talk to the patients at the hospital who had fallen ill. And so Dr. Foster began walking around the empty restaurant, stopping periodically to look closer at table surfaces and kitchen equipment and whatever else he could see. And then eventually he walked over to the large walk-in refrigerator...

And when he poked his head inside, he saw there were rows of plastic containers holding the restaurant's salad bar offerings. Fresh veggies, several kinds of lettuce, garnishes and dressings. And right away, Dr. Foster felt like this very likely could be where the salmonella came from. He knew from experience that the raw ingredients on an open-air salad bar were a very common source of food poisoning.

And so Dr. Foster worked his way through the walk-in fridge, carefully plucking out samples of each food item using sanitized tweezers and placing them all in the small plastic containers that he'd brought along. By the time he left the restaurant, Dr. Foster was certain the samples he had taken would crack the case in no time. Later that week, Dave Lutkin sat in a corner booth at Shakey's, dejectedly staring out the window. He and Sandy had been sick for days, but he was feeling better and the delirium had finally gone away.

However, coming back to his senses was no picnic. Even though he had deep cleaned and reopened his restaurant and had shut down his salad bar just in case, word was all over the news that their restaurant, Shakey's, had very likely caused the big salmonella outbreak. And so as a result, Dave and his wife had not seen a single customer all day, or all week for that matter. Dave let out a sigh as he thought about all the money they were losing.

But even worse than that, 13 of his employees were still sick, and dozens of his regular customers had fallen ill and were still dealing with symptoms. Suddenly, the ring of a telephone pulled Dave away from his negative, spiraling thoughts, and so he rushed to the counter, hopeful whoever was calling was a customer maybe looking to place a takeout order.

And so he brought the receiver to his ear, and the second it was against his ear, he quickly had to pull it away. Because on the other line was a man who'd gotten sick after eating at Shakey's, and he was screaming at Dave through the phone, threatening to sue him. And so Dave just sat there listening as this guy accused him of feeding his customers dirty produce. Dave had gotten dozens of calls just like that one, and he was starting to worry that they would never end.

Once the yelling man had said his piece and hung up, Dave walked back to the booth, shoulders slumped. Then he turned back to the window and went back to scanning the streets for customers he knew would never come.

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What you'll wear on that third date. Download the Instacart app today to get free delivery on your first three orders while supplies last. Minimum $10 per order. Additional terms apply. A week later, Dr. Foster sat in his office with his head in his hands. He'd been so sure that this outbreak of food poisoning was due to contaminated ingredients at Shakey's Pizza that he really hadn't even considered if that wasn't it. It just seemed so likely.

But now he knew he was incorrect. That had not been the source. Because he'd just gotten word that there were an additional 20 cases of salmonella poisoning from people who ate at two other restaurants in town. So Shakey's could not be the only source of the bacteria that was making these people sick. Dr. Foster was confident in his abilities, but he also knew when to admit that he had been wrong. And he definitely underestimated the severity of this salmonella outbreak.

It was way bigger than just Shakey's. In fact, he was receiving daily calls from the Dalles emergency room begging him for updates as the number of Salmonella cases surged towards 100. And so far, Dr. Foster didn't have any answers. And so he stood up from his chair and began pacing around his office. He couldn't just sit around and wait all day. With all the new cases popping up, maybe his team just needed to expand their investigation.

30 minutes later, Dr. Foster, along with his team, sat around a large table in the conference room. He did his best to stay calm and collected, but truthfully, he was starting to feel nervous. He told his team that all they knew for sure right now was that all these people who got sick had gotten sick after eating at three different restaurants all in the Dalles. And then after saying that, he opened up the floor to discussion. He basically wanted people to come up with more ideas about where the salmonella outbreak could be coming from.

And so after going back and forth for a few minutes, kind of rehashing the same details everybody knew, one scientist who'd been quiet during the entire discussion so far suddenly spoke up. He wondered if maybe the salmonella could have somehow entered the town's water supply. If the bacteria was in the water supply, then it kind of made sense that it was now being found in multiple locations.

Dr. Foster considered the alarming implications of this possibility. If the salmonella was coming from the water supply, there was no telling how much bigger this outbreak would get. Dr. Foster told the scientists to gather his things. They were going to go to the Dalles to check their water. The next day, Dr. Michael Skeels leaned over a lab bench in his laboratory at the Oregon State Public Health Lab near Portland.

Like his colleague, Dr. Foster, Dr. Skeels had been working around the clock to try to figure out the source of the salmonella outbreak in the Dales, examining dozens of samples every day. Dr. Skeels adjusted his tortoise shell glasses on the bridge of his nose, willing his tired eyes to stay open as he screened yet another petri dish with bacteria grown from a lettuce sample. Unsurprisingly, it seemed to be teeming with salmonella bacteria. But there was something odd about all the bacteria they kept finding.

There were 2,500 different strains of salmonella that Dr. Skills knew of, but they kept finding the exact same very rare strain over and over again. Dr. Skills reasoned that this meant that all of the salmonella had almost certainly come from one source, but he had no idea what the source could be. Dr. Skills knew one thing for sure though, it was not the water supply. His staff had tested the public water samples Dr. Foster's team had collected and they had found no bacteria in the water. It was totally clean.

So, the investigation was sort of back to square one. Dr. Skeels sighed as he lifted his head from the lab bench and looked around the room at his exhausted colleagues hunched over their work. He desperately needed more coffee, or even better, a nap. But that wasn't going to happen anytime soon. Because not only was their investigation stalled, the public health crisis in the Dalles was only getting worse. Over the past few days, the number of restaurants involved in salmonella poisonings had increased.

Salmonella had now been found in 10 restaurants. And so now a second wave of infections was engulfing the town. And this time it was much bigger than the first. Dozens more people were sick and more and more people were arriving at the hospital every hour.

The scale of this second outbreak was overwhelming the town. Emergency rooms were struggling to manage the new patients, and all of the hospital beds were full, and patients were sleeping in the hallways. And so, of course, the people who were getting sick were lashing out at the only people they could, the doctors and nurses, who were doing their best, but they were having a really hard time keeping up. It was just complete chaos.

Dr. Skeels was struggling to keep up too. He was doing his best to manage all of the lab testing while also trying to figure out why this new outbreak was happening. It seemed like the salmonella was showing up everywhere and yet still coming from nowhere. The bacteria kept being found where they expected it to be, mostly in salad bar vegetables like lettuce and cucumbers, but also they found it in items that are rarely contaminated with salmonella, such as salad dressings and coffee creamers.

and they still had no idea how so many different foods could be contaminated. It wasn't the water supply, so where was this bacteria coming from? Dr. Skeels waved his tired staff over to him in the middle of the lab, and as they walked over, he took in their bloodshot eyes and their stained lab coats, and he knew he looked just as bad as they did. Dr. Skeels took his glasses off and rubbed his eyes.

He told the group that the outbreak was getting way too big for this small staff. If they were going to find the source of this mass poisoning and prevent new cases, they needed help. It was now time for the federal government to step in, which meant they needed to contact the Centers for Disease Control, or CDC for short. His very tired team nodded in agreement, and so Dr. Skills turned and headed to his office to make the call. A few days later, Dr. Skills could barely contain his shock as he combed through the CDC's research.

The CDC had put its enormous resources to good use, interviewing hundreds of patients as well as their families and friends. They spoke to 325 food handlers who had all worked at the 10 restaurants. They measured salad bar temperatures and investigated food handling practices. They even visited a few farms to inspect the milk and vegetables that these restaurants had used.

And they discovered that people who had food that was delivered from these 10 restaurants did not get sick, but the people who actually physically ate inside of those 10 restaurants did get sick. They also discovered that while the blue cheese salad dressing at one of these salad bars was teeming with salmonella, well, the powdered mix that makes that salad dressing contained no salmonella.

To Dr. Skeels, these were very revealing discoveries because it meant that the food in these 10 restaurants was safe when it left the kitchen, like for a takeout order, but then somehow once it was in the dining areas inside of these restaurants, it became contaminated. But it was hard for Dr. Skeels to even come up with an idea of how that could happen.

He wondered, for example, how the powdered salad dressing mix could be clean while it was in storage and then suddenly turn poisonous when the staff prepared it for the salad bar. It just didn't make sense. But then Dr. Skeels had an alarming thought. What if someone was putting the salmonella in the dressing after it was prepared? Or putting the salmonella in the food once it was inside of the dining hall? I mean, if this was done by a person, then it all made sense.

Dr. Skills realized that he was imagining a possibility that seemed too far-fetched to be true. You know, did someone purposely grow toxic bacteria and then for some reason choose to release it into the community? The name for that was bioterrorism. But the question was, if it really was bioterrorism, which again was very far-fetched, who would want to do that?

About a week later, Dr. Skeels sat in the conference room at the Oregon State Public Health Department, along with some of his senior scientists, to hear the latest update from the CDC officials. One of the CDC representatives began with the good news. The salmonella outbreak had finally died down sort of on its own. Thankfully, no one had died, and there hadn't been any new cases for a week. But then Dr. Skeels heard the bad news.

They still did not know what or who had caused the two waves of salmonella cases that sickened an incredible 700 people. But the more they'd learned about these outbreaks, the more everyone seemed to agree with Dr. Skeels. The whole fiasco did seem like a deliberate attack. They just couldn't prove it. The CDC said they were going to continue their investigation, but it seemed like for now the crisis was over.

Dr. Skeels was relieved to return to his usual work, but he felt haunted by the fact that he hadn't solved this mystery. A year later, on October 2nd, 1985, Dr. Skeels pulled his car to the side of a country road outside of the Dalles. His team was already there waiting for him.

As he approached the group, Dr. Skeels felt the nerves and anticipation bubbling up all around him. But public health officials were not the only ones on the side of this lonely road. They were surrounded by federal agents carrying semi-automatic weapons and wearing bulletproof vests. This was a raid by federal agents, and Dr. Skeels felt very out of place.

Now, this job, being a part of this raid, could not be more different than Dr. Skeel's usual stream of research and meetings, but he reminded himself that they needed him. If this raid was going to be a success, he needed to stay calm and focused and do his job. And so the leadership in charge of the raid finished running through the plan a few more times, and then everybody returned to their respective vehicles.

Dr. Skeels drove behind the rest of the 50-person group as they entered through the gates of the 64,000-acre ranch that was the home of the Rajneeshi Religious Commune. Dr. Skeels headed straight for one unassuming building, search warrant in hand. He was accompanied by a germ warfare expert from Washington, D.C. The instant they stepped inside of that building, Dr. Skeels could not believe what he saw. It was a state-of-the-art medical laboratory that this commune was clearly running.

Dr. Skeels walked around inspecting the various experiments and documents that were strewn about. At some point, he found a copy of the Anarchist Cookbook open to a certain page just laying out on the table. A chill ran down the doctor's spine as he flipped through the instructions on how to make homemade explosives and illegal drugs. Nearby, there was another book that focused on military biological warfare. The literature was fascinating and horrifying, but it was not what he was looking for.

Dr. Skeels continued walking through the lab, making his way to a back corner where he found a large walk-in freezer. His eyes went wide as he took in the rows of rare chemicals and bacteria perched along the walls inside of glass vials. He walked to the back of the freezer and he leaned in close to see the contents. And his breath caught in his throat as he read the label closest to him. It said Salmonella. Dr. Skeels carefully removed the glass vials and placed them in his bag for evidence.

The answer to the poisoning of an entire town was right in front of him. Lab tests would prove that the salmonella samples Dr. Skills collected inside of that lab were an exact match for the strain that was found in the Dalles a year earlier. The Rajneeshis had deliberately planted the salmonella at Shakey's Pizza Parlor and other restaurants in town, hoping to sicken as many people as possible.

The Rajneeshis preached that they were leading the way to a new era of free love at their commune. However, they kept on getting into fights with the Wasco County Commission that regulated what they could and could not do at their commune. So the Rajneeshis had decided to just go ahead and take over the commission by installing their own candidates. The Rajneeshi leaders reasoned that if most local residents were too sick to vote, then their candidates could easily win.

They used the months before the November vote for a bizarre kind of dress rehearsal. Initially, commune members had put salmonella in spray bottles and doused doors and other public places in the Dalles, but no one had gotten sick. So, in early September, they tried spraying salad bars in 10 local restaurants. For good measure, they also sprayed other items like the salad dressings and coffee creamers. And this attack did exactly what the commune leaders hoped for. Hundreds of people got sick.

But amazingly, this was really only the start of the Rajneeshe's plot to win this election. They were going to poison people's food with salmonella, but also they did intend to poison the Dalles water supply with salmonella, and one of their members did get access to the water supply,

But for some unknown reason, the plan failed. And so no one got sick from the water and therefore not enough people got sick. And so enough people turned out to vote. And so the cult's candidates lost the election despite having bust in all those extra homeless people to vote for them. It just wasn't enough. And so after this raid, the Rajneeshi's leader, Bhagwan Sri Rajneesh, and his deputy, Ma Anand Shila, were both arrested. There was not enough evidence to prove Bhagwan was behind the attack.

Instead, it seemed like Sheila had sort of acted on her own, and so she was tried and found guilty for the Salmonella attack and eventually served 29 months in prison before being deported to West Germany. As for the commune compound, it was shut down and the land was sold. Despite being vindicated, Dave and Sandy Lutkin's business, the pizza parlor, never recovered, and so they had to close it down.

However, out of this, they were able to start a catering business instead, where they had much more control over who had access to their food. To this day, the Rajneeshi salad bar poisoning remains the single largest bioterrorism attack in United States history.

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From Ballin Studios and Wondery, this is Mr. Ballin's Medical Mysteries, hosted by me, Mr. Ballin. A quick note about our stories. We do sometimes use aliases because we don't know the names of the real people involved. And also, in most cases, we can't know exactly what was said in these stories, but everything is based on research. And also 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 Natalie Przyszowski. Our editor is Heather Dundas. Sound design is by Matthew Cilelli. Our managing producer is Sophia Martins, and our coordinating producer is Taylor Sniffen. Our senior producer is Alex Benidon. Our associate producers and researchers are Sarah Bytack and Tasia Palaconda. Fact-checking was done by Sheila Patterson.

For Wondery, our Head of Sound is Marcelino Villapando. Senior Producers are Laura Donna Palavoda and Dave Schilling. Senior Managing Producer is Ryan Lohr. Our Executive Producers are Aaron O'Flaherty and Marshall Louis for Wondery.

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