Dermatologic Manifestations of Paraneoplastic Syndromes

Over 50? These Problems Can Sneak Up On You

It goes without saying that ageing causes your body organs to age as well. This causes a variety of health issues in elderly life. According to the National Council on Aging, about 92% of the elderly have at least one chronic condition, and nearly 77% have two or more. Here are some of the most prevalent health problems that older adults face.

Outsmart your age: More than nine out of ten older people have a chronic condition, and nearly eight out of ten have more than one. So, you will probably get one sooner or later. There are, however, things you may do to live a healthier life.

High blood pressure: As you age, your blood vessels become less flexible, which strains your circulatory system. Two-thirds of over 60 persons have high blood pressure. Other factors are controllable. Watch your weight, exercise, quit smoking, manage stress, and eat well.

Diabetes: Diabetes is a common incidence as age increases. Diabetes can cause heart disease, renal damage, and blindness. Check your blood sugar with your doctor.

Heart disease: The accumulation of plaque in your arteries is a primary cause of heart disease. It begins in childhood and worsens with age. Heart disease affects roughly 20% of males and 9.7% of women between the ages of 60 and 79.

Obesity: If you weigh far more than is appropriate for your height, you may be termed obese; it's not simply a few extra pounds. At least 20 chronic illnesses have been associated with it, including heart disease, stroke, diabetes, cancer, high blood pressure, and arthritis.

Osteoarthritis: Once, doctors blamed the joint illness on ageing. Genetics and lifestyle may also be factors. Joint injury, lack of exercise, diabetes, and obesity can all contribute.

Osteoporosis: Osteoporosis weakens your bones, which can lead to fractures. A balanced diet rich in calcium and vitamin D (both are required for strong bones) and frequent weight-bearing activity, such as dancing, running, or climbing stairs, can assist.

Chronic obstructive pulmonary disease (COPD): This promotes inflammation and prevents air from entering your lungs. It's a slow-moving condition that can go undetected for years; symptoms generally appear in your 40s or 50s. It can cause difficulty breathing and cause you to cough, wheeze, and spit up mucus. Exercise, a nutritious diet, and staying away from smoking and pollution can all help.

Hearing loss: Nothing indicates "you are getting older" like being asked, "What did you say?"  Loud noise, sickness, and your genes all contribute to hearing loss. Some drugs might also cause hearing difficulties. Consult your doctor if you cannot hear as well as you used to.

Vision problems: The bothersome blurriness you experience while trying to read the small print on labels or menus isn't the only threat to your eyesight as you age. Cataracts (clouding of the eye's lens) and glaucoma (a group of eye disorders that affect the optic nerve) can impair your vision. Regular eye exams should be scheduled with your eye doctor.

Bladder problems: Incontinence, either in terms of not going when you need to or going too frequently, is a common concern as we age. Muscle weakness, nerve damage, tissue thickening, and an enlarged prostate are all potential causes. Reducing coffee intake or avoiding heavy lifting are just two examples of lifestyle adjustments that might be helpful.

Cancer: The greatest cancer risk factor is just becoming older. Although the illness does strike the young, the risk increases dramatically between the ages of 45 and 54. Although you have little say over the passage of time or your genetic makeup, you may influence risk factors like smoking and sun exposure.

Depression: Depression is one of the most frequent mental diseases among adults aged 18 and above. Some individuals get depressed as they age, health difficulties arise, loved ones die or move away, and other life events occur.

Back pain: This is very common as people age. Being overweight, smoking cigarettes, not getting enough exercise, and having preexisting conditions like arthritis or cancer all increase the risk. To keep your bones healthy, it's important to maintain a healthy weight, exercise regularly, and consume enough vitamin D and calcium. In addition, work on your back strength; you will be using it a lot.

Dementia: Alzheimer's disease is a kind of dementia that typically does not manifest itself in people until they are 65 or older. It is not in your power to alter some risk factors, such as your chronological age or family history. However, there is some evidence that a heart-healthy diet and monitoring blood pressure and blood sugar may be beneficial.

Keeping aware of the common health problems your seniors might face helps plan for prevention and stay prepared for any impending health emergency.

An Oil Field, An Explosion, And A Man's Fight For His Life

R ight around noon on Oct. 10, 2019, just outside Pecos, Texas, in the Permian oil patch, Jeff Springman bends down to the desert floor, grabs some dirt, tosses it in the air to see which way the wind is blowing. At this site there are a total of seven tanks, called a tank battery. Three of them hold produced water, an innocent name for the toxic and naturally radioactive wastewater that surges to the surface in oil-and-gas development. Four of them hold oil, which runs the world and is what Springman has come for. He's an oil hauler.

"I need you five feet back," Springman shouts to Greg Fausto, his trainee for the day, then climbs the metal stairs to the catwalk that connects the tanks. At the top, Springman scans for dead birds, an indication hydrogen sulfide or other contaminants may be lurking in the tank, but there are just some dead bugs, normal. 

Because oil is being directed into tank four right now, Springman will have to pull oil from tank three. Now he must do his work, accurately measuring the type and amount of crude oil in the tank is critical in determining profits. But as his right hand grasps the lid of the thief hatch, there's a problem. It won't budge. Sometimes lids get stuck, perhaps because of age. To pop the lid, Springman must depress a latch with his fingers, and this lid, as he recalls it and is later alleged in court, is gummed up right at the latch.

Tank lids are heavy and can be difficult to lift even when they are functioning properly, and this one remains stuck. So Springman uses more force, and presses down on the latch even harder. Still no movement. He uses both hands. At some point, a vague notion enters his mind that something is off-kilter, not right. He presses down hard on the latch one last time and suddenly, it budges, and the tank lid pops open. He's immediately enveloped in a reddish-brown cloud. "It looked like Yellowstone," Fausto says, "and that shit smelled like burnt eggs."

Where does one go, in that moment of free fall? The job, the toil, the endless hours, sleeping in the truck, showering at a gas station, the lonely Raisin Bran breakfasts, the terrible Permian weather, missing his daughter's childhood. And yet there's a job to do, an integrity to uphold and git-r-done. You're feeding the nation its fuel, supplying the power that literally keeps American life moving, even those rallying for the climate and renewables use Springman's oil, have used it. Somewhere, somehow, we owe him something. There is a quietude to the job, a stillness. He gets to be on the road, out in one of the nation's great deserts. He loved predawn in the Permian, when he lowered his ear to the desert floor and listened beside the pipe, he could hear the oil tumbling forward from deep within the earth. We are all born with infinite possibility; you become a man and grow strong, you can break things with your fist or manipulate them with your fingers and build a world. And then, you take one wrong breath, and it all explodes.

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Springman is down. Red droplets fall out of the sky. His gas monitor is going crazy, and he isn't breathing. His eyes roll back in his head, there is blood on his ear. Fausto drags him along the catwalk away from the fuming tank. Springman comes to but cannot taste, cannot smell, and there's a strange coating on the inside of his mouth that he cannot get rid of. "He looked like a zombie," Fausto says.

There is no easy way to say this, but now, five years later, Springman says he is dying, and he believes the oil-field chemicals he was exposed to that day are responsible. 

I HAVE BEEN REPORTING ON oil fields for more than a decade and met my share of sick and dying workers. Guys like Randy Moyer, a Pennsylvania trucker who was drenched in fracking waste. He landed in the emergency room, and later his face and knees would swell up as hot red rashes leapt unpredictably across his body. He had always told me no doctor would take his story seriously, so to expel the toxics from his body, he ate raw garlic and bathed in turmeric. Moyer died in 2022. From what I've seen, oil-field workers sickened by chemical exposures rarely ever have doctors examine them in a manner that determines what's truly wrong. I learned of Jeff Springman via a desperate call from Sharon Wilson, director of Oilfield Witness, a certified optical-gas-imaging thermographer who has spent years documenting the harms Texas' oil-and-gas industry has wrought on the Texas environment and its own workforce. Springman's case was different. 

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Despite America being one of the richest, most prolific, and presumably most advanced oil-and-gas-producing nation, despite oil being one of the planet's wealthiest industries and regularly turning record profits for executives, despite the industry's eternal pronouncements of worker safety, the way a worker like Springman often must go about getting oil from tanks at the wellhead seems like a task out of the Dark Ages. 

"When a worker opens a tank," reads a 2016 government hazard alert on the practice, "the worker's breathing zone can immediately become an acutely toxic mix of concentrated hydrocarbon gases and vapors." The hydrogen sulfide, which interferes with the body's ability to utilize oxygen and reeks of rotten eggs, can — when levels are high enough — put a worker into cardiac arrest within seconds. Hydrocarbon gases like ethane, propane, and butane can displace oxygen and cause asphyxiation, or an explosion. And benzene, a dangerous hydrocarbon vapor, is inhaled into the body, where it goes to the inner bones and can cause blood cancer years later. The sheer force of the gas rushing out can knock a grown man off his feet. These are not small doses — levels of hydrocarbon gases and vapors push dozens of times above what's known as the IDLH level, short for Immediately Dangerous to Life or Health.

Deaths are harrowing. Trent Vigus, 30, found in the fetal position beside an oil tank in eastern Montana. Blaine Otto, dead on a catwalk with his eyes open. Gregory Claxton, an Iraq War veteran and father of a three-year-old boy, "died so suddenly" at an oil tank in Montague County, Texas — on Valentine's Day 2015 — that the Texas Tribune reported his body was found standing up. Just how many workers die in this manner is unknown. The National Institute for Occupational Safety & Health (NIOSH) has tried to track manual-gauging deaths, and its figures indicate about two workers die a year. But the agency, part of the CDC, doesn't know how many people there are like Springman, who don't die immediately, but slowly and painfully rot away. "This is information that we do not have," says Stephanie Stevens, a National Institute for Occupational Safety & Health spokesperson. 

There are other factors keeping reported deaths down. Investigative journalist Mike Soraghan has revealed local medical examiners and coroners often link manual-gauging deaths to heart attacks, blaming genes or lifestyle choices and not the oil field. In one instance, Soraghan reported, "oil and gas chemicals could have gone undetected" in a postmortem analysis, "because the test was done for recreational drug use ['glue sniffing' or 'huffing'] rather than exposure to industrial chemicals."

The government knows opening tanks can kill. NIOSH has put out a video to explain the problem and issued a report telling health care professionals treating oil-and-gas workers and medical examiners investigating their deaths to pay closer attention to toxic emissions. And NIOSH and OSHA have laid out simple fixes to save lives, like monitoring tanks' fluid levels with remote devices so workers never have to open a tank, installing a sampling port or tap near the base of the tank, or using tank-pressure gauges that would convey to workers when a tank was overpressured and poised to blast toxic gas and vapors in their face. In fact, the American Petroleum Institute has known for more than 70 years that benzene exposures can harm workers — a 1948 report from its department of safety found benzene exposure may impact the central nervous system, heart, "the blood-forming system," and bone marrow, and can lead to a swift death or have effects that linger. But across a good portion of the oil patch, workers continue to open tanks of deadly gases directly into their faces. Diamondback Energy has not replied to a detailed list of questions on the matter.

"The tragic truth," one Texas law firm, Williams Attorneys, which operates across the Permian, stated on its website, "most oil worker deaths involving toxic gas exposure during transfers and tank gauging are caused by the actions of oil and gas companies who are willing to risk workers' lives to save a dollar." 

SPRINGMAN MET LENDY ONLINE IN 2015, and their first date was at Capital Pizza, in Lubbock, Texas. Their daughter, Olivia, was born on a March day in 2016. Springman spent much of her childhood working as a freelance oil hauler. Like tens of thousands in this roving workforce, he hauled oil by day, and spent nights in his truck. Either jammed in among other rigs at one of dozens of busy Permian truck stops, or the lonelier setting of a highway pull-off — some desolate clearing scraped from the desert brush. 

It was fast food and microwave meals; if he was lucky, a truck-stop shower and cell service to call home. The curse of the oil field for a worker with family elsewhere — Lubbock is a seven-hour round trip drive from the heart of the Permian — is living on the marginal salary of an oil hauler in today's economy: To make the many tens of thousands of dollars a year needed to support them, you must spend as much time as possible away from them. Still, Springman participated when he could and happily watched his baby daughter grow into a little girl, with her own thoughts and preferences. Olivia's favorite color is pink; her favorite animal, llamas.

The oil tank hatch Springman was trying to open at the time of the accident.

In September 2019, Springman signed a contract with an oil-supply company called Pilot and moved into the type of drab worker housing standard in the oil field known as a man camp that Pilot operated in Monahans, Texas, a city surrounded by heat and sand, and 177 miles from Olivia and Lendy. If you've never heard of Pilot, take a road trip through the hot American night. Among the endless ribbon of highways, the company's big, glowing gas stations emerge from the darkness like lit-up spaceships. Open 24 hours, they have rows of restrooms and diesel fuel and a supermarket of energy drinks, chips, and ham sandwiches. 

Not all travel-stop companies also haul oil, but Pilot does; and its man camp, located behind the Monahans High School football stadium, was little more than a box with a bed, kitchen, and bathroom. Still, it provided a formal roof over Springman's head, with a nicer shower than a truck stop and a stove to prepare the fajitas, spaghetti, and chicken salads that sustained him in what was to be his final job in the oil patch.

WHEN I WENT TO MEET SPRINGMAN for the first time at a restaurant in Denton, Texas, in mid-April 2023, I was expecting the sort of rough-cut worker that has come to symbolize the industry's bravado: strong, arrogant, tattooed, fearless. 

We met on a Tuesday evening, and the following morning he was to have a bone-marrow biopsy at the University of Texas Southwestern Medical Center. Doctors would drill into his pelvis and take a sample, which could possibly reveal what was killing him. Actual evidence. But he was so sick there was a chance he might not survive the procedure. So I had booked a flight to Dallas and arranged to meet him at the Rusty Taco.

I walked through the restaurant twice and still couldn't find him. There is a standard background level of paranoia in meeting a mysterious source — is it a setup? Are they real? Turns out, he was. And I had passed him without noticing because he didn't fit my stereotype. He was a low-key, casually dressed man sitting with his wife, Lendy, and their seven-year-old daughter, Olivia, who was busy playing an educational video game and wore a pink shirt decorated with the planet Saturn and a light bulb that read: "We can go anywhere our imagination takes us."

I joined them at the dinner table, and we spoke. Springman was 52, and he was born in Bakersfield, California, an oil town. His grandfather worked in oil, as a tool pusher, and traveled to Libya and Iraq. His uncle Jerry also worked in oil and received a terrible injury. "Something got caught," Springman says, "and his leg got ripped off." 

He goes on to tell me about his own injury. "I have no stomach lining," he says, speaking across the table over his family's dinner. "I have lesions on my liver. I have diverticulitis in my colon, a gastrointestinal bleed that feels like my guts are oozing and has turned my stool black. My kidneys are damaged, I have an enlarged prostate, my lymph nodes are all jacked out. My legs are covered in little fluid-filled lumps, and they hurt. My tongue has deep cracks in it, my taste is shot, I have a blood clot in my lung, and another blood clot behind my right knee." The biggest issue, he continues, is that "my heart is so weak it has problems pumping blood, and I have an ulcer in my aorta. When that thing pops, I'm gone, they can't fix it."

"Can't do it, can't do it," says Olivia, without looking up from her device. I'm surprised she's paying attention, but, of course, kids are always paying attention.

"A little while ago, my heart hit a couple bumps, and I turned so many colors it was ridiculous," Springman says. "My skin turned dark gray, then yellow — and today I was Neapolitan."

Lendy, he adds, being a registered nurse, has helped him in many ways, including, knowing all these different tricks to get your heart back in rhythm.

"Like what?" I ask, expecting some complex procedure. But it was really quite simple — they were driving to the hospital, Springman's heart was racing, and Lendy thwacked him hard on the chest.

The other big concern beside his heart are his lungs. Recently, in performing a doctor's test to determine lung capacity, Springman took a deep breath and crumpled into a coughing spasm — test failed.

He needs heart surgery, Lendy says, but because his heart and lungs are so weak, the anesthesia could actually kill him. "Or," Springman says, "damage my brain and make me a vegetable."

And this means his bone-marrow biopsy has to be done without anesthesia. Because of the poor condition of his liver and kidneys, and stomach bleeding, he can't even take Advil or Tylenol. Someone orders tacos, and they call out the order. Other families sit and eat. And the hot humid Texas night rolls on.

"I am a walking miracle," Springman says. "Usually, a guy in my position doesn't last long. The industry relies on people to die."

THE MORNING OF THE ACCIDENT, Springman was up at five, grabbed his gear, already prepped from the night before, and was out the door and into his pickup, driving to the Pilot truck yard in Pecos and arriving there around 6 a.M. About a dozen drivers crammed into a small modular office building for the morning safety meeting. The yard supervisor informed drivers a new trainee — Fausto — needed to ride with someone. Springman volunteered. 

By 8:30 a.M., Springman says, he selected his vehicle for the day, a Mack truck towing an approximately 200-barrel-capacity liquid tanker trailer built by a Texas company called Dragon Products. The color was silver, with Pilot in red. Springman wore the standard oil-field work uniform: shirts and pants called FRs, because they're made of a flame-resistant fabric — Pilot's are red and blue — steel-toe boots, hard hat, safety glasses, and ear plugs. "We're good to go," Springman told Fausto, and the truck's pre-trip program spit out the well site, or lease, where the men would draw their first load of oil: "Binldey 37 1H." According to the lawsuit, Springman was told by Pilot dispatch that the lease was "a green lease producing no emissions." Meaning no dangerous hydrogen-sulfide emissions. Springman had never heard of the Binldey lease, though another driver explained to him the general location, and around 9 a.M., he says, he and Fausto rolled out of the yard. But they couldn't find the lease and spent around two hours looking, more time wasted, missing out on making money. Turns out, there was an error in the pre-trip program: It was Binkley, not Binldey. The actual lease was near an old rock plant, off U.S. Highway 285. Springman navigated the oil tanker down the dirt driveway and pulled beside the row of oil tanks around noon. 

Diamondback Energy has not responded to my questions about its operating practices, including my question about whether or not Binkley 37-1H was appropriately labeled for the gases it contained. (In court, Diamondback denied it was mislabeled.) In 2021, Springman filed a lawsuit against Diamondback and Pilot in state court in Texas, and the case was later moved to federal court. When asked his opinion on what caused Springman's injuries, pulmonologist Kenneth Nugent states, "exposure to toxic hydrocarbon gas." 

In separate testimony, Jerome Spear, an industrial hygienist, opined that "Mr. Springman's hydrocarbon vapor exposure incident" would not have occurred had proper industry and government protocols been followed by Diamondback. Spear reminded the court that NIOSH and OSHA have issued recommendations to the petroleum industry on ways to sample oil tanks without opening the thief hatch on top. "Had the industry recommendations for procedures and equipment retrofitting been followed by Diamondback E&P, LLC on the Binkley lease prior to Oct. 10, 2019," Spear stated, "then Mr. Springman's hydrocarbon vapor exposure incident in question would not, in my opinion, have occurred."

Springman sits with his young daughter, Olivia. Lee Mary Manning

Meanwhile, in legal documents filed in federal court in May 2023, Diamondback conceded that "under certain conditions" substances in crude oil storage tanks "have been known to be toxic." The filing continues: "Defendant Diamondback denies that as a result of its conduct, plaintiff Jeff Springman sustained any physical injuries, that Mr. Springman's injuries are terminal, and that Mr. Springman is currently under hospice care." 

But Springman holds them responsible. As he claims in his lawsuit, he'd already been forsaken by the company before he even approached the tank that day. For one, the "Hazard Alert" put out by OSHA and NIOSH, lists oil tanks having a pressure gauge as one factor that may decrease worker exposure — as this would enable workers to know when a tank was overpressured. A second safety measure is intended to vent excess pressure, and thereby contaminants and deadly gases, into a separate tank. But Binkley 37-1H, according to the lawsuit, provided no indication that within tank three lurked a deadly torrent of gases. In its own legal filings, the company states, "Defendant Diamondback is without knowledge or information sufficient to form a belief as to the truth of the allegations."

In 2019, Bloomberg reported that Diamondback was among companies operating in the Permian whose wells had become "increasingly gassy," an issue that was "undercutting profits." This too stings Springman, because, he believes, it means the company knew there was an issue of excess natural gas in its oil wells, and all the other toxic gases and vapors that go with it. And as he points out to me: "If they can spend $20 million in buying up smaller companies and stock buybacks, why can't they afford $20 to put up a metal sign warning people of toxic gas dangers? How hard is it to put up a sign?"

Every Texas oil-and-gas operator also needs to submit to state regulators an air-emissions report that contains the levels of various toxic gases, including hydrogen sulfide, generated at a particular lease. For Binkley 37-1H, however, Diamondback had used data not from that location, but a lease the company operated about 15 miles to the east called the Neal Lethco 16-1H. Diamondback does not concede that there were toxic gases at Binkley 37-1H; Springman says otherwise. Had the proper lease's emissions been appropriately noted, it's possible Binkley may have been deemed a yellow or red lease rather than a green one, and Springman would have approached the tank with different safety gear and expectations. When asked why Diamondback was able to submit another well's air emissions in this manner, the Texas Commission on Environmental Quality says the two wells tapped the same geologic formation with "the same basic characteristics" and the practice was "acceptable." 

Pilot, meanwhile, merged in 2001 with the petroleum company Marathon to form Pilot Travel Centers, linked with Flying J in 2010 to form Pilot Flying J, then was acquired in full earlier this year by Berkshire Hathaway, a massive multinational corporation headquartered in Omaha, Nebraska, run by financial titan Warren Buffet, who rambles on each year about how his secretary pays a higher tax rate than he does. Buffet also owns a natural-gas-pipeline network, a liquid-natural-gas export terminal, and now, through the acquisition of Pilot, which doesn't just operate truck stops but sends trucks out to gather the oil, he owns workers like Springman, too. Pilot has argued in court that Springman "reviewed and signed a number of documents related to his employment, including" one that requires him to go through arbitration for work injuries, thereby invalidating his lawsuit.

Neither Berkshire Hathaway nor Pilot has replied to questions for this story, including questions about the treatment of workers. The Texas Commission on Environmental Quality says it has "not documented violations" related to Springman's case. The Railroad Commission of Texas, the state's oil-and-gas regulator, says it does "not have jurisdiction" and to contact OSHA. I do, and its deputy regional director of public affairs says, "We have searched our records and cannot find anything on Diamondback Energy or Pilot." 

"They didn't do shit for Jeff, they left him hanging," Fausto says. "It's all about the money, it's not about the safety," he says. "They're more worried about their equipment than their human employees."

NEAR THE BEGINNING OF LAST SUMMER, Springman informs me of the results of his bone-marrow biopsy: "We have found some interesting stuff in my bone marrow that is no bueno." What they have found is myelofibrosis, which can lead eventually to a type of blood and bone-marrow cancer called myelogenous leukemia. Both Springman's blood and his bone marrow, where blood cells are formed, have been permanently damaged, with evidence of exposure to benzene and other toxic emissions. "I have to have an iron infusion every three weeks," he tells me. "The problem is, when I get the infusions, it damages my heart, so my choices are go without the iron and within 90 days I will be bedridden, or take the iron and eventually have a heart attack and die. Either way, I'm done. There is no good outcome for me."

Meanwhile, the Permian continues to pump out crude at a record pace. "For all of the focus on an energy transition, the American oil industry is booming, extracting more crude than ever from the shale rock that runs beneath the ground in West Texas," reads a July New York Times article. Among the top beneficiaries of this boom are ExxonMobil and Diamondback, whose "stocks … are at or near record levels." It is a rush on energy that is not just completely removed from the environmental harms posed by the industry, but also the human harms.

And what, I ask Springman, was it like to have a bone-marrow biopsy performed without anesthesia?

"I laid down on the table and they drilled right through my back," he says. "I felt it go through the tissue and hit the bone, and I was screaming and screaming with my face in a pillow."

When Springman and I spoke last December, his condition had rapidly deteriorated.

"I am in so much pain right now I can barely stand," he says. "Getting up out of a chair is hell. My bones. My heart. I'm telling you it hurts so bad, I feel every beat. Every single time I swallow food or drink it feels like salt being rubbed in a wound. I am having problems keeping water down. I can't rest. I've had a constant headache for three months. It's so hard, Justin. I'm not going to make it to September. I am probably going to die in this apartment. That's Lendy's biggest fear, finding my body — it's no way to live."

During our conversation, he is audibly writhing in pain, and it seems to come in waves. There will be a good sentence, and I feel as if he may be perking up, then a bad sentence. "I'm terminal," Springman finally says. "They killed me."

It is hard to know the exact words to say. I want to ask simple things: How is Lendy doing? How is Olivia? What does it feel like to know you may die before your daughter's next birthday? Are you composing a list of life lessons for her? What's your final message to your family, the world? But none of this seems appropriate. In fact, nothing seems appropriate. 

I reconnect with Sharon Wilson, director of Oilfield Witness and the person who initially led me to Springman's story. Knowing workers like Springman have been contaminated like this when fixing the problem can be so easy has shattered her nerves, too. 

"When I see a worker getting ready to open up a tank I feel compelled to park on the side of the road, and I cry," Wilson tells me. "It actually makes me weep to watch them perform this, and I feel helpless, like, I could watch a man die. Should I go and try to pull him out of the plume, what do I do? What do I do?

"I have commented on this practice endlessly at hearings and listening sessions with industry and government officials, and yet they do nothing," she continues. "Lives don't mean anything to the oil-and-gas industry. They know they are killing these men, they are dispensable. They are like a tool: When they are broken, they just throw it away."

Earlier this year, Springman's case against Diamondback was settled in a confidential settlement. The remainder of the case against Pilot Travel Centers has been moved to arbitration, which is still pending and is likely to be heard in the early fall. But as Springman points out to me, there are bigger things on the line, namely, his life. 

If people like Wilson can advocate on this issue from her small perch, and Springman can face a drill to his hip bone without even Tylenol and the wretched death coming for him, then I can muster the courage to ask him that impossibly painful question — and I do.

What is your final wish in this life on earth?

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His response is immediate.

"I want these guys in orange jumpsuits."

Prostate Cancer: Risks, Symptoms, And The Need For Early Detection

EL PASO, Texas (KVIA) -- Prostate cancer is the second most common cancer among men, following skin cancer. According to the American Cancer Society, all men are at risk for developing the disease, but certain factors can increase that risk.

Dr. Michael Sebesta, a urologist, explains that the disease develops in the prostate gland, a key part of the male reproductive system. He stresses that abnormal cells can grow and spread, potentially becoming life-threatening if not detected early.

"Generally, it's men who are over 40 or 50," Sebesta said, adding that about 250,000 men are diagnosed with prostate cancer each year in the U.S., and around 35,000 die from it.

One of the biggest challenges with prostate cancer is the lack of symptoms in its early stages. Sebesta says signs such as slow urination or frequent trips to the bathroom often only appear when the disease has advanced.

Prostate cancer is commonly detected through a prostate-specific antigen (PSA) blood test. If elevated, it may lead to a biopsy for a definitive diagnosis.

Sebesta emphasizes the importance of regular screenings, which should include both a PSA blood test and a rectal exam. "These tests can be lifesaving," he said.

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