Part 10 (1/2)
Nevertheless, he continued, aWe have a problem to answer, the same thing that General c.o.o.ney says. We are going to have it [the problem of radioactive materials] if we have this type of submarine that we are talking about. The Air Force is going to have it if we get that kind of stuff in their planes.a I think our position in this matter of human experimentation is the same as everybody else. We donat want to do it if we can get out of doing it, but if that is the only way we can get the answer, that certainly is going to be more economical in the long run to take a few chances now and perhaps not lose a battle or even worse than that a lose a war.a Warren said total body irradiation shortened the lives of animals and that he expected c.o.o.neyas planned experiment would also shorten the lives of the human subjects. aWe can say, I think, with a good deal of certainty that 25 R is safe. We know that an appreciable proportion of any group of individuals will be seriously ill at 200 R, and that some will die at 200 R. We can say with a fair degree of a.s.surance that with 100 R, other casualties such as burns will be materially complicated and the lethality of minor injuries will arise, and there is a great deal of permanent damage that is done to the organism as well as transient damage at the 100 R level.a Warren pointed out that the fatigue and stress of battle also would radically alter how soldiers responded to radiation. But c.o.o.ney doggedly insisted that his field commanders needed to make decisions based on experimental data involving human beings.
aWhen I start talking about animal experimentation,a c.o.o.ney said, aas one general said to me: aWhat are wea”mice or men?a a aI think one of the things that is very important is that we are in part mice, and only in part men,a Warren responded.
Stone had recommended that prisoners serving life sentences be used, another idea that Warren had roundly rejected. Toward the end of the meeting, Admiral Greaves brought up the use of prisoners again. Under Stoneas original proposal, the military would have been responsible for making arrangements for the experiments. Although the military was interested in obtaining the data, it would not look good if the armed forces were actually conducting the experiments on prisoners, Greaves said. aThat type of experimental work is a little difficult for the armed forces to engage in.a aIs this civilian prisoners, you mean?a asked Alan Gregg, an ally of s.h.i.+elds Warren.
aYes,a responded the admiral.
aDoesnat that fall in the category of cruel and unusual punishment?a Gregg asked.
aIt would be on an absolutely volunteer basis, and under every safety precaution that could be built up around it. I donat think so, and it didnat strike me as being cruel and unusual,a Greaves responded.
aIt is not very long since we got through trying Germans for doing exactly that thing,a Warren warned.
aThat wasnat voluntary when they did it, they made them do it,a Greaves responded. aI think that there are a lot of prisoners and I am given to understand that there are plenty of people in our prisons who will volunteer for that kind of work.a aAlways for a quid pro quo,a Warren responded.
s.h.i.+elds Warren and his civilian colleagues were successful that day in blocking the militaryas efforts to conduct TBI experiments on prisoners. But it was a Pyrrhic victory at best. Even as they were standing up to the military, the Air Force, unbeknownst to them, was moving forward on a study to be conducted at the M.D. Anderson Cancer Center in Houston.21 Experiments done on sick cancer patients at Anderson were to provide the military with data on human responses to radiation.
The M.D. Anderson study was one of five postwar TBI experiments funded by the military and was the first to be set in motion. The Department of Defense stressed that the military funds paid only for data collection and not for the irradiation of the patients, but one prominent researcher admitted in 1994 that he probably would not have pursued the experiment if he had not received military funding. The five studies and their host inst.i.tutions were as follows: a The M.D. Anderson Cancer Center in Houston, Texas, from 1951 until 1956. This study involved 263 patients and was sponsored by the Air Force School of Aviation Medicine, which performed the early flashblindness studies at the Nevada Test Site.
a Baylor University College of Medicine in Houston, Texas, 1952 until 1964. This study involved 112 patients and was sponsored by the Armed Forces Special Weapons Project or its successor, the Defense Atomic Support Agency, the organization that coordinated the atomic maneuvers in Nevada.22 a Sloan-Kettering Inst.i.tute for Cancer Research in New York City, 1954 to 1964. Sponsored by the Armed Forces Special Weapons Project and later the Defense Atomic Support Agency, this experiment involved 34 patients. James J. Nickson, the Met Lab physician who a.s.sisted in the TBI studies and the Chicago plutonium injections, and who also served as Allan Klineas physician, conducted the experiment.
a U.S. Naval Hospital, Bethesda, Maryland. Funded by the Navy, the experiment was conducted from 1960 to 1961 and involved 17 people.
a University of Cincinnati College of Medicine in Cincinnati, Ohio.23 This study, sponsored by Defense Atomic Support Agency, ran from 1960 to 1972 and involved 90 patients.
(One other large TBI study was done at the small research hospital in Oak Ridge, Tennessee.24 There, some 194 patients were exposed to total-body irradiation in one of the hospitalas two specially enclosed chambers between 1957 and 1974. Some of the money for this TBI study came from the National Aeronautics and s.p.a.ce Administration, or NASA.) In the military studies alone, which spanned 1951 to 1972, approximately 500 people with cancer were exposed to radiation over their entire bodies. Some patients received large, single blasts of radiation. Others were exposed to repeated, low doses along the lines of what Robert Stone had suggested. The TBI experiments were cla.s.sic examples of the dual-purpose studies pioneered by the Manhattan Project. While the patients ostensibly were irradiated for their diseases, doctors collected data for the military on the side.
The official reports on the experiments invariably claim that the exposures made the patients feel better and reduced the size of their cancers. But other records indicate that the radiation caused excruciating pain and led to the premature deaths of a number of patients.
The Army, Navy, and Air Force hoped to obtain data from the patients to predict how soldiers, sailors, and pilots would behave when they were exposed to radiation on the nuclear battlefield. Ever mindful of the devastating radiation sickness they had witnessed in j.a.pan, the military leaders were desperate to learn more about the effects of radiation. When did nausea and vomiting set in? How long before the effects of radiation showed up on the bone marrow? Could exposure impair intellectual and decision-making capabilities? What about the ability to perform simple motor tests? Was there some kind of medicine that could be taken beforehand that would protect the troops? What happened to soldiers exposed to small, repeated doses? The questions were never-ending, and ultimately the answers proved unsatisfactory because, as Robert Stone and his colleagues had recognized at the Carlton Hotel meeting, healthy young soldiers and sick cancer patients donat necessarily respond in the same way to radiation.
In all five of the postwar TBI experiments, the researchers conducted extensive a.n.a.lyses on the blood and urine of the patients in an effort to find a abiological dosimeteraa”that is, some kind of chemical marker that would reveal how much radiation a person had absorbed. In the early days at the Met Lab, Robert Stone had instructed his employees to look for a similar marker but none had been found. The militaryas search for a biological dosimeter was relentless. A simple test administered on the battlefield would help doctors know who was worth saving and who was going to die. aEver since the damaging effects of ionizing radiation in biological systems were realized,a an Air Force official wrote in 1963, ainterested observers have been searching for some biochemical, histological or clinical indicator that would a.s.sess this damage in a manner closely related the magnitude of dose.a25 Significantly, many of the patients used in the TBI experiments suffered from aradioresistanta tumors, or solid cancers of the liver, pancreas, bladder, breast, and other parts of the body, which were usually treated with thousands of rads of local radiation. Total-body irradiation was normally not used on such cases because the doses necessary to destroy the tumors were so high that they could also kill the patients. Other types of cancers that have spread through the body, such as leukemia and lymphoma, are aradiosensitive,a and TBI was considered an appropriate treatment at that time and is still used today. But scientists preferred to use patients with radioresistant tumors because often their blood counts were nearly normal and the radiation effects were not obscured by the products released by the widespread destruction of tumor cells.
Blood cells, chromosomes, amino acids, enzymes, plasma proteins, and lipids of the irradiated patients were intensively studied. But the military doctors never found a reliable marker and ultimately had to rely on the same symptoms of radiation sickness they had first chronicled in the criticality victims and the j.a.panese bombing victimsa”onset, severity, and duration of nausea, vomiting, anorexia, and hair loss. These are to this day the best indicators of the degree of radiation to which a person has been exposed.
34.
HOUSTONaS aPAPERCLIPa DOCTOR.
Air Force leaders had seen the handwriting on the wall long before s.h.i.+elds Warren gave the official AEC thumbs-down to total-body irradiation experiments on healthy volunteers. So they simply did an end run around him. While the TBI proposal was still winding its way through the Pentagonas chain of command and being debated at meetings like the one in which Warren took his firm stand, officials from the School of Aviation Medicine in San Antonio, Texas, began looking for a research hospital where they could piggyback simple coordination and psychological tests onto medical treatments in which patients were irradiated for their diseases. Air Force officials began discussing the studies in March 1950 with Randolph Lee Clark, the director of the M.D. Anderson Cancer Center in Houston. Clark, a handsome, athletic man who had been the National Amateur Middleweight Wrestling Champion, was no stranger to the School of Aviation Medicine, having been its director of surgical research prior to his hospital appointment.
The contractual details with M.D. Anderson were finalized in October, a month before General James c.o.o.ney and s.h.i.+elds Warren locked horns. Explaining the M.D. Anderson contract to his superiors at the Air Material Command, a young lieutenant said the experimental data was aurgently requireda by the U.S. Air Force in connection with the NEPA Project: It is clear that before attempting to operate its proposed nuclear powered aircraft, the U.S. Air Force must evaluate its radiation hazards.1 There are no scientific data with which to a.s.sess these dangers of the NEPA aircraft in terms of their probable effects upon crew performance and well-being. The most direct approach to this information would be by human experiments in specifically designed radiation studies; however, for several important reasons, this has been forbidden by top military authority. Since the need is pressing, it would appear mandatory to take advantage of investigation opportunities that exist in certain radiology centers by conducting special examinations and measures of patients who are undergoing radiation treatment for disease. While the flexibility of experimental design in a radiological clinic will necessarily be limited, the information that may be gained from studies of patients is considered potentially invaluable; furthermore, this is currently the sole source of human data.
(Although s.h.i.+elds Warren was adamantly opposed to TBI experiments on healthy volunteers, he apparently saw nothing wrong with the School of Aviation Medicineas planned research on sick cancer patients. In 1953, a year after Warren resigned his position at the AEC, he became a medical consultant to the Aircraft Nuclear Propulsion program, the successor to the nuclear-propelled aircraft project, and was present at an organizational meeting in May of 1953 when M.D. Andersonas TBI experiment was discussed.2 There is no record of his posing any objection to the study. Other consultants included Manhattan Project veterans Andrew Dowdy and Simeon Cantril and MITas Robley Evans.) The School of Aviation Medicine a.s.signed one of its newest Paperclip arrivals, Herbert Gerstner, to the TBI project. A stocky physiologist with a saberlike scar on his left cheek, Gerstner had been smuggled out of Germanyas Russian Zone in 1949 and brought to San Antonio, Texas, where a number of his German colleagues were already working.3 By the time he arrived, most of his countrymen had already adapted to their new homeland. The fiery food, the jalapenos, salsa, and chorizo-and-egg breakfast tacos took some getting used to, and when temperatures soared toward the 100-degree mark, many of the scientists undoubtedly yearned for the cool cities of northern Europe. But through the efforts of the schoolas commandant, Harry G. Armstrong, a disarming medical doctor with an infectious enthusiasm, much of the hostility and resentment aimed at the foreigners following World War II had faded away. Intelligent, circ.u.mspect, and hardworking, the Germans had quietly resumed their research in the nondescript laboratories at Randolph Air Force Base.
There were at least twenty German Paperclip specialists at the School when Gerstner and his wife, Helga, a lovely green-eyed blonde sixteen years his junior, arrived in San Antonio in January of 1950. Hubertus Strughold, the intellectual leader of the small band of German specialists and the man whose own retinal burn had inspired the early flashblindness studies at the Nevada Test Site, was probably among those who greeted the couple. Strughold had helped Armstrong select the German scientists recruited for the school and no doubt was also aware of some of the circ.u.mstances behind the coupleas escape.
Gerstneras personnel records, which are on file at the National Archives, show that he was a member of the Hitler Youth from 1935 to 1938, but say nothing about whether he was a member of the n.a.z.i Party. His wife, Helga, said in an interview in 1995 that her husband was not a party member. But The Texas Observer reported in 1997 that Gerstner became a party member in May 1937 and was a.s.signed the members.h.i.+p number 5815500 awhen the party re-opened its ranks to n.a.z.is who had proven themselves active and devoted.a45 Drafted into the German Medical Corps in 1939, Gerstner was first dispatched to France as a soldier and then worked as a doctor on military hospital trains in Russia.6 He was a.s.signed to the Academy for Military Medicine in Berlin in 1940, where he began investigating the effects of loud sound on guinea pigs. The research was stimulated by the constant sh.e.l.ling that German soldiers were receiving in their bunkers. As a result of his work, Gerstner had developed a list of sound intensities and knew how long humans could be exposed to those sounds without suffering permanent hearing damage.
Two years later, Gerstner was transferred to the University of Leipzig, where he focused on the effects of electricity on animal and human skin. At Leipzig, he studied the victims of aelectrical accidentsa and concluded that they died from an extraordinary increase in blood pressure when blood was squeezed out of peripheral vessels and into their hearts and abdominal cavity. In subsequent studies he noted that aelectrical skin resistancea was higher in cancer patients. aIt has not been investigated, however, whether a diagnostic method for cancer can be developed from this. (Resumption of work on this problem is difficult since all statistical data have been lost due to war events),a Gerstner wrote.
Gerstner had just begun working at the University of Griefswald in northern Germanyas Russian Zone in 1949 when an intermediary for the Central Intelligence Agency contacted him, his wife said.7 The couple made inquiries about the visitor through a trusted friend. Then Gerstner camouflaged himself and went to the CIAas offices in West Berlin. aAs a citizen of Russian-occupied Germany, you canat go to the CIA in West Berlin and think that youare going to be safe coming back or not disappear or whatever,a Helga Gerstner said. aSo they indeed camouflaged him and made him look like an American GI. They insisted he had to come there in person because none of this information would be given out other than one on one.a A CIA official explained Operation Paperclip to Gerstner, but the scientist was worried that the Americans were more interested in denying him to the Soviets and were planning to adumpa him in the United States. So he again camouflaged himself as an American GI and went to Heidelberg where he was able to confirm that there was, in fact, a job waiting for him in the United States.
The Gerstners were flown from Berlin to Frankfurt by a military aircraft in a snowstorm around Christmas of 1949. From there they took a train to Landshut, Bavaria, the collection point for Paperclip scientists. A telegram dated December 27 stated that Gerstner was aavailable for s.h.i.+pment to U.S. in Jan. 50.a Gerstner was one of thirty-four Paperclip specialists employed by the School of Aviation Medicine.8 The Army and the Navy, even some private companies, also recruited the scientists. At least 1,600 German specialists and their dependents were imported to the United States by Paperclip and its successor projects through the early 1970s.9 Many of the nationas most brilliant scientists, among them Albert Einstein and Hans Bethe, opposed the importation of German researchers.10 The Manhattan Projectas Leslie Groves also had warned against letting Germans worm their way into Americaas atomic energy programs. But the American military could not be dissuaded. Not only did the Army, Navy, and Air Force crave the Germansa ingenious inventions and scientific data, but, just as Gerstner suspected, they also wanted to keep the information and the scientists from falling into Soviet hands. By 1950, less than a year after the Soviets had detonated their first atomic bomb, security concerns about n.a.z.is had been subsumed by ma.s.sive preparations for nuclear war. Communism, not n.a.z.ism, had become the greatest threat to the free world. aTo continue to treat n.a.z.i affiliations as significant considerations has been aptly phrased as abeating a dead n.a.z.i horse,a a Bosquet Wev, a Navy captain who directed Project Paperclip, wrote in a 1948 letter to the State Department.11 Ostensibly Gerstner was recruited for the School of Aviation Medicine because of his expertise in acoustics. Instead he was a.s.signed to the new radiation project at the M.D. Anderson Cancer Center. Gerstner had no expertise to speak of when it came to ionizing radiation. aHe really got into the radiation effects area once he came to the School of Aviation Medicine,a Helga Gerstner said. aIt was a field of interest to him but it was not his first and foremost one.a The M.D. Anderson was Houstonas pride and joy. Named after a wealthy cotton broker who left his fortune to agood worksa and administered by the University of Texas, by the early 1950s the hospital was rapidly becoming one of the most respected research inst.i.tutions in the country. Gone were the large noisy wards and drab corridors of yesteryear. Pictures were changed often in the private and semiprivate rooms, but if a patient couldnat stand a painting any longer, he could turn it around to a acontrasting but harmoniousa color.12 The exterior of the hospital was covered by an inch of pink Georgia marble.
Most of the patients used in the TBI study were outpatients capable of alight tasksa and many apparently were African Americans, according to the minutes of a 1954 Air Force Research Council meeting. The purpose of the TBI treatment, wrote Gerstner and two coexperimenters, was to find out whether TBI would provide some apalliativea relief from cancer symptoms.
During the first phase of the study, 233 patients were exposed to doses ranging from 15 to 200 roentgens. During the second phase, an additional 30 patients were exposed to a single dose of 200 roentgens. School of Aviation Medicine scientists had found the first part of the experiment in which the patients were given small doses aunproductive.a13 But when cancer specialists at M.D. Anderson began increasing their doses, the military researchers felt they, too, were beginning to make headway.
The patients who were given 200 roentgens purportedly had diseases that were so far advanced that conventional treatments offered no benefit. Yet, they were still ambulatory and clear-headed enough to take the battery of pre- and postirradiation tests prepared by the schoolas doctors. Three psych.o.m.otor tests were administered before the patients were irradiated: The Air Force SAM Complex Coordination Test required partic.i.p.ants to coordinate movement of a stick and rudder bar to match the position of three red lights and three green lights.14 The Two-Hand Coordination Test required patients to operate two crank handles to keep a cursor positioned on a moving target. And the Rotary Pursuit Test required partic.i.p.ants to follow a rotating target with the tip of a stylus. The tests were repeated the day after the TBI treatment and again nine days later. aThese tests were chosen because of their proven relations.h.i.+p to the skills required in basic pilotry,a School of Aviation Medicine scientists stated.
Just as s.h.i.+elds Warren had predicted, the patientsa response to the radiation varied greatly. A thirty-three-year-old minister who was irradiated with 200 roentgens went home and had a meal and his customary one-hour nap. Then he worked at his ministerial duties till 9:00 P.M. and ten hours a day on the succeeding days. At the other end of the spectrum was a young man suffering from testicular cancer. After he was irradiated with 200 roentgens, he developed such severe nausea and vomiting that he had to be transported by stretcher and required a liter of intravenous saline solution.
Thirteen of the thirty patients who received 200 roentgens of TBI died within sixty days of the treatment, the time frame in which the effects of radiation damage to the bone marrow generally will appear.15 The average survival time was 4.4 months. All thirty patients died within twenty months. Because of the variability in subjects and the lack of a control group, the experimenters said it was adifficult to a.s.sess the extent to which radiation had affected the life expectancy of the patients.a But for a small group of lung cancer patients, the researchers concluded that the radiation may have actually extended their lives by a few days.
As for the cancer itself, the scientists admitted that the TBI treatment did not really significantly alter the course of the disease, but it did seem to produce a transitory and clinically unsupported sense of well-being in three subjects. aClose similarity seems to prevail,a they added, abetween systemic effects produced in cancer patients by whole body X-irradiation and those caused in healthy human beings by nuclear explosions.a16 When the M.D. Anderson experiment was over, Gerstner turned his attention to the civil defense aspects of acute radiation sickness. Like General James c.o.o.ney, Gerstner believed the public was overly frightened of atomic energy and argued that human beings could recover physically from a wide range of radiation exposures and resume ausefula lives.17 In a 1960 paper he wrote: Obviously, nuclear disasters can a.s.sume such dimensions that exposed persons, in order to reach medical facilities, may have to endure several hours of driving or walking through streets congested by vehicles and panic-stricken people.18 Thus, while on their way, they become affected by the disturbance and, thereby, suffer reduction of fitness at a time when ultimate physical and mental efforts are necessary for survival. In a small group of hypersensitive persons, reactions probably will attain such severity as to imperil escape from the disaster area without aid. Therefore, the disturbance must be taken into account by authorities designing evacuation plans and other emergency measures which require active partic.i.p.ation of exposed populations.
Gerstner, who had witnessed the unpredictability of war in France and on the Russian Front, did not particularly enjoy the civil defense work. aHe was not very happy with that aspect,a his widow said, abut he was often called on as an expert.a Gerstner left the School of Aviation Medicine in 1960 and went to the Oak Ridge Inst.i.tute for Nuclear Studies. There he obtained his medical license and worked for a short while in the hospital. Occasionally he went to Cincinnati to see radiologist Eugene Saenger, the lead investigator for the TBI experiment at the University of Cincinnati. Sometimes Saenger visited Gerstner in Oak Ridge. aThere was a connection,a Helga Gerstner said. aThey had some joint project. What he did and what they cooperated on, I donat know. I just know they worked together on something.a Herbert Gerstner was involved in the first military-sponsored TBI experiment of the Cold War, and Eugene Saenger oversaw the final one. While no doc.u.ments have surfaced to indicate that Gerstner had any hands-on involvement whatsoever in Saengeras TBI project, the two scientists, both closely allied with the U.S. military and civil defense planners, had much in common.
35.
CINCINNATIaS BATTLEFIELD.