After toxic shock syndrome nearly killed Lauren Wasser, the former model and athlete has devoted herself to rectifying what she sees as serious problems with the tampon industry.
At 24, Lauren Wasser had the life. She was the 5'11" child of two models, with blond hair, blue eyes, and bone structure that looked like Santa Monica's androgynous answer to Lara Stone. She'd given up a full-ride basketball scholarship at a Division I school in order to pursue modeling—a career that started auspiciously when she was two months old and appeared in Italian Vogue alongside her mother. When she wasn't modeling, she was taking improv classes at the Groundlings, playing basketball for fun, and biking 30 miles a day. She had an apartment in Santa Monica and was embedded in Los Angeles's flashy social scene.
"Everything was based on looks," she says. "I was that girl, and I didn't even think about it." Lauren had so many friends, in fact, that when they gathered around St. John's Health Center a few weeks later to say goodbye to her, the line stretched all the way around the hospital.
It started on October 3, 2012, when Lauren says she felt a little off—almost like she was coming down with the flu. She was also on her period, and ran down to a nearby Ralph's to stock up on her go-to brand of tampons, Kotex Natural Balance. The errand felt completely unrelated to the vague malady permeating her body. After all, Lauren had been dealing with the logistics of her period for 11 years at that point, and Kotex was just part of the ritual. Like most girls, her mom had walked her through the ins and outs of tampon usage when she was 13, showing her how to use the applicator, warning her to change the tampon every three to four hours. The rule was a no-brainer; on that day, Lauren says she replaced her tampon in the morning, afternoon, and again in the evening.
Later that night, she decided to stop by her friend's birthday party at the Darkroom on Melrose Avenue. "I tried to act normal," she says, though by that point she was struggling to stay upright. "Everyone was like, 'Dude, you look horrible.'" She drove herself back to Santa Monica, took off all her clothes, and fell into bed. All she wanted to do was sleep.
The next thing she remembers is waking up to her blind cocker spaniel perched on her chest and barking aggressively. Someone was pounding on the door yelling, "Police, police!" Lauren dragged herself to the door, and a cop came in to inspect the apartment. Lauren's mother, fresh out of surgery, had been worried at Lauren's lack of communication and called in a welfare check.
"I hadn't been able to take my dog out, so there was piss and shit everywhere," she says. She has no idea how long she was in bed, and can't remember if it was day or night. The cop eyed the situation, told her to call her mom, and left.
Lauren managed to feed her dog a few carrots from her empty refrigerator and then contacted her mom, who asked if she needed an ambulance. "But I was so sick that I couldn't make that decision for myself," Lauren says. "I told her that I wanted to go to bed, and that I'd call her in the morning. And that was the last thing I remember happening." The next day, her mother sent a friend over along with the police. They found Lauren facedown on her bedroom floor.
She was rushed to St. John's with a fever of 107 degrees—ten minutes from death, they said. Her internal organs were shutting down and she'd suffered a massive heart attack. The doctors couldn't stabilize her, and nobody had any idea what was going on until they called an infectious disease specialist, who immediately asked, "Does she have a tampon in?" She did, and they sent it to the lab. It came back positive for toxic shock syndrome.
TSS, which got its name in 1978, is basically a complication of bacterial infections, frequently involving staph bacteria (or Staphylococcus aureus). It isn't a female-only condition, but there's been a link between it and tampon usage for decades, due largely to a spike in TSS-related deaths in the 1980s. (A tampon alone is not enough to cause TSS—a person must already have Staphylococcus aureus present in his or her body. About 20 percent of the general population carries the bacteria.)
Tampons and tampon-like objects have been used by women during their menstrual cycles for centuries, but over the past 50 or so years, their composition has changed from natural ingredients like cotton to synthetic ingredients like rayon and plastic, especially among the big tampon manufacturers—Playtex, Tampax, Kotex. These synthetic fibers, along with a tampon's absorbency, can form an ideal environment for staph bacteria to flourish. When Proctor & Gamble debuted an extra-absorbent tampon called Rely in the 80s, it created the perfect storm for TSS, resulting in a number of deaths. According a study conducted by the Yale Journal of Biology and Medicine, "the gelled carboxymethylcellulose" in Rely tampons "acted like agar in a petri dish, providing a viscous medium on which the bacteria could grow."
"It's the most excruciating pain I've ever—I don't know how to describe it to you." —Lauren Wasser
At the hospital, the doctors were telling Lauren's mom to pray—and to prepare her casket. Lauren was put into a medically induced coma. The news of her hospitalization leaked onto Facebook, and friends and acquaintances lined up outside the hospital to pay their last respects.
Lauren, of course, remembers none of this. Not the "pray for Lauren" Facebook posts, or the friends shuffling nervously into her room, or even the moment when her long blond hair, matted after days in a hospital bed, had to be shaved off. What she does remember is waking up with 80 pounds of fluid being pumped into her body, disoriented and convinced that she was in Texas.
"My belly was huge. I had tubes everywhere. I couldn't speak," she says. Next to the bed, there was a tube of black toxins that had been flushed out of her bloodstream. She looked out the window and saw a series of little houses outside, which her brain groggily associated with the Southwest. Her body was bloated and felt completely foreign. "I thought maybe I overdosed on food," she says. "I had no clue what was happening."
Read more about Wasser on i-D: How This TSS Survivor and Amputee Model Is Redefining Beauty
Far worse than the disorientation was the burning sensation in her hands and feet that wouldn't stop, no matter what she did. The infection had turned into gangrene. Three years later, as she tells me her story in a Los Angeles coffee shop, Lauren still doesn't have the words to explain how this felt. "It's the most excruciating pain I've ever—I don't know how to describe it to you," she says. She was rushed to UCLA for hyperbaric oxygen therapy, where she was placed in a pressure chamber in an attempt to get the blood flowing back into her legs.
As Lauren waited for treatment, there was a moment when she was alone in the room. Her mother and godfather had stepped out for a bit, and she was sitting in a big chair. There was a curtain, and behind the curtain there was a woman talking to someone on the phone. Lauren could hear her conversation. The woman was insisting that something was urgent, that something needed to happen ASAP. And then she said, "I have a 24-year-old girl here who's going to need a right-leg below-the-knee amputation."
"I thought, Oh my God, she's talking about me," says Lauren. "I'm going to lose my leg."
While Lauren was in the hospital, her mother began a massive lawsuit involving Kimberly-Clark Corporation—the manufacturer and distributor of Kotex Natural Balance tampons—as well as the grocery stores Kroger and Ralph's, both of which sell Kotex Natural Balance. Kotex-brand tampons don't necessarily carry a higher risk for TSS than other major brands, but are named in the suit because they're the brand that Lauren used; ultimately, the family's legal team hopes to make a point about the use of synthetic materials in the tampon industry as a whole. The complaint insists that all of the defendants are "negligently, wantonly, recklessly, tortuously, and unlawfully responsible in some manner" for Lauren's hospitalization for TSS. (A spokesperson for Kimberly-Clark declined to comment for this article as the company "does not comment regarding ongoing litigation.")
Lauren's lawyer, Hunter J. Shkolnik, is accustomed to seeing the darker side of products that most people assume are safe. For example, he handled the litigation over an ingredient in cough syrup that gave people strokes. "I wish I could say [Lauren's case] shocked me, but it doesn't," he says. "The tampon has not been changed since the day of the original TSS epidemic. All they did was put on the label, 'Oh, you can get toxic shock.' The material has gone unchanged for decades." To avoid the wrath of the FDA, he says, companies simply put a warning on the outside of their tampon boxes. He calls this a "get-out-of-jail-free card."
Tampon boxes have been required to print these warning labels since the 80s, but Shkolnik argues that the warnings on Lauren's tampon box weren't clear enough, especially about leaving tampons in at night. Here's the language: "Change your tampon every four to eight hours, including overnight." The family argues that these instructions are unclear. They plan to argue that "overnight" can mean longer than eight hours, especially when it comes to young girls, who can easily sleep nine or ten hours on a weekend. "[Tampon companies] should be telling you, 'Don't sleep in it. Use a pad,'" says Shkolnik.
Of course, most women will recall that there is a warning about toxic shock syndrome on all tampon boxes and though they probably don't process it every time they use a tampon, or even purchase a box, they know, however vaguely, that it's there. It reads:
Tampon use has been associated with toxic shock syndrome. TSS is a rare but serious disease that may cause death. Read and save the enclosed information. Use for eight hours maximum.
Shkolnik admits that the existence of this FDA warning label will be the hardest part of the case. "Part of our job is to show the jury that it's not about the warning on the box—it's about the fact that they've had materials available for 20 years that could make [tampons] safer, and they've chosen not to use them. They call these tampons 'natural,' when in fact it's the man-made materials that make them dangerous. Their marketing makes young women think, 'Oh, these are the natural cotton ones,' but they're not natural, they're not cotton, and if they were, the chance of toxic shock would be down to almost nothing."
Dr. Philip M. Tierno, a professor of microbiology and pathology at the NYU School of Medicine who has done serious independent research into the link between tampons and toxic shock syndrome, agrees that cotton would be safer. "Most major tampon manufacturers make tampons with either mixes of viscose rayon and cotton, or pure viscose rayon, and in either case those tampons provide optimal physical-chemical conditions necessary to cause the production of the TSST-1 toxin if a toxigenic strain of Staphylococcus aureus is part of the normal vaginal flora in a woman," he says. "Toxic shock syndrome may result if a woman has no antibody to the toxin or low antibody. Therefore the synthetic ingredients of a tampon are a problem, whereas 100 percent cotton tampons provide the lowest risk, if any risk at all."
In the hospital, Lauren was confronted with a nightmarish situation: signing the papers to authorize the amputation of her own right leg below the knee. "Both of my legs were starting to mummify," she says. "I had to act quickly." The heel and toes of her left foot were badly damaged and doctors thought about amputating her left leg as well, but Lauren fought to keep it. "I saw it as a 50/50 chance," she said. "We did two baby foreskin grafts, which—miraculously, thank God—were the only thing that saved my foot. Today, my toes are gone. My heel finally closed up, but it's super sensitive, and I have no fat pad there."
Since Lauren is still young, her body is producing calcium in an attempt to fix her damaged foot, which is ironically increasing the damage done. "I'm walking on rocks, basically," she says. She goes in for frequent maintenance surgeries, and is still in pain three years later. Doctors have told her she may need to have another amputation later in life, when she's 50 or so.
"It took me a while to figure out if I was still worthy, if I was still pretty." —Lauren Wasser
"I wanted to kill myself when I got home," she says. "I was this girl—and then all of a sudden I don't have a leg, I'm in a wheelchair, I have half a foot, I can't even walk to the bathroom. I'm in a bed, I can't move, and I felt like those four walls were my prison." She would occasionally spring out of bed, tricked by phantom limb syndrome, and immediately fall to the floor. The only thing that kept her from self-harm was the thought of her little brother, who was 14 years old at the time. "I didn't want him coming home, finding me, and knowing that I gave up," she says.
Lauren says it took her a long time to come to grips with her new identity. "I would cry on a little stool in the shower, with my wheelchair outside waiting for me," she says. "It fucks with you. You live your whole life and think, 'I'm an athlete,' or, 'I'm a pretty girl,' but this was something physical that I had no control over. It took me a while to figure out if I was still worthy, if I was still pretty."
She was helped along by her photographer girlfriend, Jennifer Rovero, who took hundreds of pictures of Lauren as she recovered, treating the process as a sort of therapy. While shooting around town, the two make a habit of asking young girls if they've heard of toxic shock syndrome, or if they even believe that it's real. Most say no.
In the fall, Lauren hopes to appear in front of Congress with Representative Carolyn Maloney. The New York Congresswoman is trying to pass the Robin Danielson Act, named after a woman who died of TSS in 1998. It would "establish a program of research regarding the risks posed by the presence of dioxin, synthetic fibers, chemical fragrances, and other components of feminine hygiene products." It has been blocked before coming to a vote nine times already.
To be clear: It's transparency, not necessarily zero-tampon-usage, that Lauren and her lawyers and Maloney are seeking. Tampons are convenient, and when it comes to stopping up menstrual flow, they make sense.
But to this day, Lauren can't stand watching tampon commercials—the girls frolicking on the beach or shimmering down a playground slide in spotless white shorts—because they usually have no warning about toxic shock syndrome. "I can't go on a slide, I don't really want to be in a bathing suit, I couldn't go jump in the ocean if I wanted to," she says. "That product fucked me over."
Like cigarettes, she wants tampons to be marketed with a bigger, clearer warning about their potential risks. "You know cigarettes can kill you, so when you use them, it's your choice," she says. "Had I known all the info about TSS, I would never have used tampons." And she'll never use them again.
Lauren and her girlfriend don't usually shoot photos of her prosthetic leg, choosing instead to focus on her face. But today, they show me pictures of their latest shoot. In the portraits, Lauren wears heavy black eye makeup, and she's standing on her feet. Her prosthetic leg is framed in New Balances. She's got the alert, dispassionate stance of a model-who-plays-ball. It's been three years since the black vat of toxins next to her hospital bed, the hyperbaric chamber, the prosthetic-limb salesmen coming into her hospital room to present options that she couldn't even bring herself to think about. Today, she can even crack jokes about the situation—she calls her legs "little leg" and "little foot," respectively.
I ask if she still plays basketball, thinking of lives split into before and after and wondering if there's any leeway there, any way of bringing some parts of yourself across that great divide. "If you have game, you have game forever," she responds.
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