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endemic regions, but it has no known causal link to BEN symptoms. Aristolochia has been linked to the symptoms, but it grows all over the place. Tatu suggested that aristolochic acid and coal compounds might be working in combination. He agrees that aristolochic acid is a cause of BEN , and thinks that the biggest remaining question is how exposure to aristolochic acid occurs. He is skeptical about the idea that aristolochia seeds get ground into flour, having found no traces of the poison when he analyzed flour from mills in endemic regions of Romania.
    We had met Tatu in downtown Timişoara, in the lobby of a vast rectangular Soviet-style hotel, and were joined by his collaborator, Nikola Pavlović, a Serbian nephrologist in his 60s, with mild blue eyes. Pavlović’s speech was soft, hesitant yet relentless, each claim accompanied by a stream of qualifications. When the conversation turned to research, he spoke approvingly of almost all the hypotheses. He didn’t seem bothered by the fact that a given risk factor could also be found in non-endemic regions, because maybe those regions weren’t really non-endemic. “How do you know there aren’t two or three cases there?” he asked. He even thought that a BEN -like disease might exist wherever there are lignite coal deposits. Showing us a lignite map of the United Kingdom, he observed that the areas with the most lignites also had the highest rates of undiagnosable renal disease. In the U.S., states with lignite deposits also have some of the highest death rates from certain kidney cancers.
    My father objected that in 40 years of medical practice he had never seen an illness with quite the same profile as BEN , with kidneys so shrunken, fibrosis so severe, and such an advanced state of disease with no hypertension. His own hunch is that radiation is involved. He notes that the pattern of BEN distribution resembles that of radon distribution in the United States, and that radiation causes acute fibrosis in kidneys. If radioactive material were leaching into drinking water in the Balkans, the kidneys would process it in small amounts over the years. There is no hard evidence to support this theory, however. Two Michigan-based environmental scientists working on BEN told me that they think radiation is worth looking into—elevated levels of uranium have been found in the endemic regions—but they haven’t raised the necessary funds.
    Tatu, Pavlović, and my father exchanged news of BEN researchers past and present: who favored the aristolochic-acid theory and who didn’t, who had retired, who had died, who was now producing minerals for laundry detergent. My father had last seen Pavlović in 1988. “I remember him a young man,” he told me later. “I guess he thought the same thing about me.”
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    That afternoon, we drove to the endemic region in MehedinÅ£i County, 150 miles southeast of Timişoara. The trolley lines and the churches soon gave way to rolling countryside. Large haystacks stood in groups. Shaggy, hulking, almost shamanistic, they resembled animate huts. There was something mutable and alive about them, the way they absorbed the light. The leaves were starting to change, and the air was exceptionally clear. Tiny horses stood out against a distant hillside.
    Along the way, Tatu pulled his car over next to a cornfield. It was overrun with aristolochia. In the golden afternoon light, I saw the famous plant for the first time, recognizing its heart-shaped leaves, narrow yellow tubular flowers, and the round brown pods that have given rise to one of its local names: priest’s balls. Tatu broke open a pod. Inside, hundreds of seeds were lined up in two rows, like pupils in a schoolhouse.
    I picked a leaf and smelled it. “If you taste it, it’s very bitter,” Tatu said, chewing on a leaf and immediately spitting it out. “Pah! This is actually not a good idea.”
    In Romania,