There is only one team of scientists still actively researching the cluster, led by Joseph Wiemels, a professor of epidemiology and biostatistics at the University of California-San Francisco. In October, I met Wiemels and his collaborator, Stephen Francis, a doctoral candidate at the University of California-Berkeley Department of Epidemiology, at the Childhood Leukemia Research Center. Wiemels wore wire-rimmed glasses and the studied look of a laboratory scientist. Francis had sun-bleached hair to his shoulders. Wiemels received one of Reid's grants in 2006 to investigate the possibility that a virus triggered the cluster. According to a respected theory, leukemia clusters may arise when waves of transient people spread infection to an otherwise isolated population. Fallon's population shifts annually due to the Navy base; at the time of the cluster, there was a spike in childhood leukemia among families in the armed forces at large.
For his research, Wiemels needed Fallon children's blood samples taken before treatment began. (Treatment obscures signs of prior infection.) He also needed data indicating children's histories of infection. In 2007, he met with Todd, who informed him that the data were gone; his hard drive had been erased when he left the state office. Wiemels contacted the CDC, which had collected similar data, but was told he could not see it without approval from the families. "The problem was that by the time we started working on it, half the families weren't talking to anybody, not even other families," he said. As for diagnostic blood samples, the organization that routinely collects them was in transition during the cluster, and only four from Fallon leukemia patients were saved.
Despite this, the two scientists were markedly uncritical of the state and CDC. They wished diagnostic samples had been preserved and that data were available to qualified researchers. But they compensated by grouping Fallon samples with others from California leukemia patients and cataloging the viruses in each. There is preliminary evidence that the Fallon samples harbor a different virus. It is painstaking work. "The older I get, the more I realize how little we know about childhood leukemia," Wiemels said. He did not fault investigators for failing to find an answer; there simply wasn't enough scientific knowledge to answer the question they had asked.
"It wasn't the CDC's mandate to find the overarching cause of leukemia," added Francis. Nor was Fallon the place that would happen. "I think these investigations will contribute something, but I don't think there's going to be one cause." Scientists have become increasingly convinced that leukemia is the culmination of a long chain of unfortunate events – a "causal pathway," as Francis put it – each link representing a genetic mutation provoked by toxic exposure, infection, or another challenge to the immune system. There is evidence, too, that the pathway begins while a child is in the womb. "So is it an in-utero hit that's the cause? Is it a toxic chemical? Is it immune suppression? Is it a virus? Saying there's one particular cause is a difficult thing to do."
When the two boys at Churchill County Middle School were diagnosed with leukemia in 2012, Superintendant Bus Scharmann called Randall Todd. "We talked about how, because of what had happened, it's so easy to say the wrong thing and get this community all whipped up," Todd said. "I don't mean that we shouldn't tell the truth, but it's how you frame it, whether it creates a panic or not." It was highly unlikely, he advised, that this was another cluster or part of the last.
I called Scott Meihack, now principal at the middle school, to ask how he had handled the news. "No offense, ma'am," he started, "but I understand in your line of work there's pressure to sensationalize." Local papers quoted Ridenour claiming that the cluster had returned. Townspeople responded as before: They sold T-shirts to benefit families. Students inscribed wristbands with the boys' names and shaved their heads. No parent mentioned the cluster to Meihack, though it was on his mind. "The sad part is that it was like, 'Here we go again,' " he said. "One thing that's been so traumatic is all the coverage this community got early on. The damage has been done. That's one of the greatest tragedies aside from the leukemia – not being able to move past it."
It is safe to say that most people in Fallon do not want to talk about the cluster anymore. Only one county commissioner returned my calls. The mayor, according to his secretary, was always "busy" or "away," and when I dropped by his office, he told me that he hadn't even 15 minutes.
One need not look far to find signs of a place struggling to remake itself. Drought and the recession forced dairy farmers to sell their herds. Many businesses are shuttered. The theater is up for sale. In September, a motel advertised $40 nights and "new management." Still, there is a certain stubbornness about the town. It belongs to the only county in the nation with its own telephone company. Many businesses are owned by the same families who first farmed the region, and the "Fallon Fathers," as they are often called, are content to keep it this way.
The insularity is one reason, Tina Kroepel said, why "Fallon is quiet about a lot of health issues." She directed the town's Nevada Cancer Institute satellite office from 2006 to 2012, providing counsel and financial support for patients and their families. "It just comes down to the reality that we are sincerely happy in our rural community, hard-working, very family oriented and extremely PROUD," she wrote me. "I sincerely don't mean that in arrogance, we are just very used to relying on the resources, family & friends that we have."