When A.D.A. Claire Kincaid first meets E.A.D.A. Jack McCoy, he tells her he had relationships with three former assistants in 24 years in the DA's office. This means the character began with the DA's office about 1970, so by the time the series ended in 2010 he would have been with the office about 40 years.
The ability to smell cyanide is actually a genetic trait, only about 10% of the population has it. Hydrogen cyanide has an odor similar to bitter almonds, but other cyanides like sodium cyanide and potassium cyanide have different odors such as dirty socks like the nurse described.
Sam Waterston's first episode as Executive Assistant District Attorney Jack McCoy, full name John James McCoy.
This episode appears to be inspired by two different incidents including:
- The controversy surrounding the use of laetrile to treat cancer. Laetrile was a substance offered as an alternative treatment to cancer in the 1950's. It contained a substance called amygdalin, which is a naturally occurring chemical compound found in plants, but most notably in the seeds (kernels) of apricot, bitter almonds, apple, peach, and plum. Amygdalin is classified as a cyanogenic glycoside, which is basically a sugar molecule bound with a cyanogen, a precursor to cyanide. When ingested the chemical changes amygdalin undergoes during digestion can cause it to release hydrogen cyanide, which is the most toxic type of cyanide. Since the early 1950's, both amygdalin and a modified form named laetrile have been promoted as alternative cancer treatments, often using the misnomer vitamin B17. It was banned in the United States and most other countries shortly after due to a large number of deaths from cyanide poisoning.
- The 1994 death of Gloria Ramirez. Ramirez was an American woman from Riverside, California who was dubbed "the Toxic Lady" or "the Toxic Woman" by the media when several hospital workers became ill after exposure to her body and blood. An investigation by Lawrence Livermore National Laboratory proposed that Ramirez had been self-administering dimethyl sulfoxide as a treatment for pain, which converted into dimethyl sulfate, an extremely poisonous and highly carcinogenic alkylating agent, via a series of chemical reactions in the emergency department.
Dr. Haas mentions "cancer clusters here on Long Island". This is actually true, as Long Island, New York has abnormally high rates of breast, lung, and colorectal cancer, with some townships counting 70% more cases of lung cancer than the rest of New York state.
Another cluster was found in 2008 where "statistically significant rates of leukemia, bladder, lung, and thyroid cancers" were found in 3 Long Island townships. One study showed the rate of lung cancer on Long Island was 56% higher, bladder cancer 50% higher, thyroid cancer 43% higher, and leukemia 64% higher than the rest of New York State.
Another cluster was found in 2008 where "statistically significant rates of leukemia, bladder, lung, and thyroid cancers" were found in 3 Long Island townships. One study showed the rate of lung cancer on Long Island was 56% higher, bladder cancer 50% higher, thyroid cancer 43% higher, and leukemia 64% higher than the rest of New York State.