The Plutonium Files Part 4

R: Do you want me to get you some real straight dope on this, just how it affects them, and call you back in just a bit?

G: Thatas truea"thatas what I want.a Then they talk about the burned portions of the bodies are infected from the inside.

R: Well, of course, any burn is potentially an infected wound. We treat any burn as an infected wound. I think you had better get the anti-propagandists out.

G: This is the kind of thing that hurts usa"aThe j.a.panese, who were reported today by Tokyo radio, to have died mysteriously a few days after the atomic bomb blast, probably were the victims of a phenomenon which is well known in the great radiation laboratories of America.a That, of course, is what does us the damage.

R: I would say this: You will have to get some big-wig to put a counter-statement in the paper.

Groves planned to do just that, but first he needed more reliable information on what was happening in j.a.pan. On September 2 two j.a.panese representatives signed surrender doc.u.ments on the deck of the USS Missouri in Tokyo Bay. Six days later, on September 8, Stafford Warrenas team landed in Hiros.h.i.+ma. Always eager to please his volatile boss, Warren cabled Was.h.i.+ngton on September 10 and reported: aNumber dead or injured by radiation unknown, but preliminary survey indicates that there are only a small percent of injured survivors.a19 On the same day the cable arrived, Groves led a caravan of thirty-seven reporters and photographers to the Trinity site. Accompanying him were J. Robert Oppenheimer, Louis Hempelmann, and many other scientists and military officers. The scientists and newsmen donned white booties and shuffled alike kittens with paper shoes tied to their feeta across the fused green sand of the Trinity crater.20 The green gla.s.s, which covered an area eight hundred yards in diameter, was strewn with globs of glazed soil. For three weeks the area had reeked of the stench of death from the small desert animals killed in the blast. The site was still so radioactive, an a.s.sociated Press science writer reported, that it made aspending a day and night right in the crater a possibly risky business.a The writer continued: The touras purpose was dual.21 One, to tell the almost incredible story. Two, to show first hand that the facts do not bear out the j.a.panese propaganda that apparently tried to lay the foundation for claims that Americans won the war by unfair means. This New Mexico bomb was big, its effects comparable to those bombs dropped on j.a.pan. What happened here was studied purposely to avoid the chances the actual bombings would inflict bizarre and non-military suffering.

His brown Army uniform rumpled and stained with sweat, Groves allowed the photographers to take a few pictures of the crater, warning them to be quick or their film would fog. He explained that the lingering radioactivity at Trinity was due to the fact the bomb was detonated from a tower at a much lower height than the two bombs dropped on Hiros.h.i.+ma and Nagasaki. The j.a.panese bombs were exploded high above the two cities, he said, thus allowing the heat of the blast to carry the radioactive debris upward and away. aThere were evidences of some j.a.panese deaths due to radioactive rays, but the information now available indicates that this number was relatively small,a he told the newsmen.22 Wearing his famous pork-pie hat to ward off the sun, Oppenheimer added that the heights of the j.a.panese detonations were selected specifically to ensure athere would be no indirect chemical warfare due to poisoning the earth with radioactive elements and no horrors other than the familiar ones due to any great explosion.a23 Oppenheimer said that one hour after the blast it was probably safe for rescue workers to enter the area. Satisfied with the p.r.o.nouncements by the two prominent leaders, Life magazine opined: aIt seemed certain that the j.a.panese in Hiros.h.i.+ma and Nagasaki had died within the grotesque legality of wartime killing.a24 In reality, Oppenheimer and Groves were engaged in a wholesale distortion of the facts. While it is true that air bursts, such as the Hiros.h.i.+ma and Nagasaki explosions, produce less residual radiation than weapons detonated from towers, some radioactivity nevertheless occurs when neutrons are captured by atoms in the air and soil. Radioactive fallout from the two bombs also delivered significant doses of radiation to j.a.panese who lived downwind of the two cities. Furthermore, Groves told members of the Special Senate Committee on Atomic Energy that the weapons were detonated above the j.a.panese cities not to protect the inhabitants from radiation effects but to agive us the maximum possible explosive force.a25 And finally, Grovesas statement that only a few j.a.panese were dying of radiation injuries was patently untrue. Even as Groves and Oppenheimer were walking like kittens across the green sand, a second wave of bombing victims was dying from internal complications caused by severe radiation damage. But it would be years, even decades, before the rest of the world learned the full extent of the injuries because on September 19, General MacArthur prohibited any further press reports on the bombings.26 On September 15, shortly after the publicity show staged by Groves and Oppenheimer, Harry Daghlian died. When General Groves learned of his death, he instructed Los Alamos officials to cut a $10,000 check for Daghlianas mother and sister and to prepare a legal doc.u.ment that family members were to sign releasing the University of California, the War Department, and the federal government from liability. The transaction was completed on the same day as Daghlianas death.

Notwithstanding the optimistic cable he had sent General Groves on September 10, Stafford Warren had found thousands of j.a.panese dying from radiation exposure when his team arrived in Hiros.h.i.+ma. Many had already been cremated. Thousands more were lying on mats, anywhere there was a roof over their heads. Those who could eat and drink were given rice and tea. The floors of the first-aid stations were slick with vomit and b.l.o.o.d.y diarrhea. Outside the relief stations were piles of wooden sandals from cremated patients. aWhen we got there it stunk terribly, and there were flies everywhere,a Warren remembered.27 aThe flies were so bad that we had to close up the windows of the car to keep them out. You would see a man or a woman with what looked like a polka-dot s.h.i.+rt on, but when you got up close, there was just a ma.s.s of flies crawling over a formerly white s.h.i.+rt.a The j.a.panese who were close to the hypocenter and received the largest doses of radiation often began vomiting within half an hour of the bombing. They suffered from severe and b.l.o.o.d.y diarrhea and intense thirst. The downward spiral closely paralleled the symptoms suffered by Harry Daghlian: coma, delirium, and death.

By the time of Stafford Warrenas arrival, the second wave of death had begun taking its toll, due to the lethal effects of the radiation on victimsa bone marrow and gastrointestinal (GI) tract. The bone marrow is the blood-making factory where new cells, called stem cells, are produced. These cells mature and differentiate, becoming red cells, white cells, and platelets. When the whole body is irradiated, the number of cells in the bone marrow drops immediately, sometimes disappearing altogether. The bone marrow can regenerate itself if the damage is not too great. But if the exposure is large and nothing is done to counteract the damage, eventually fewer cells will be circulating in the bloodstream. The loss of red cells will cause anemia and fatigue; the reduction in white cells will reduce the bodyas ability to fight infection; and the lack of platelets can lead to hemorrhages. The effects of radiation on the bone marrow are most noticeable between twenty and sixty days after exposure.

The GI tract, which contains many cells being created and undergoing cell division, also can suffer dramatic damage if the radiation dose is high enough. After 100 rem have been delivered, changes can be seen in the cells lining the mucosa of the small intestine, but the production of new cells will compensate for any cells that are killed or damaged. At doses ranging from 500 to 1,000 rema"the radiation exposures received by many j.a.panese near the hypocentera"the cells that make up the epithelial layer of the small and large intestine are killed or unable to replenish themselves fast enough. Diarrhea and dehydration begin. Bacteria from the intestine can flood into the bloodstream, greatly increasing the risk of infection, called bacteremia, or toxic shock syndrome. With the depletion of white cells, the body is even less able to fend off the infection.

Some of the effects of the bombing would not become visible for weeks, months, years, or even decades. Unlike the bone marrow and GI tract, many organs and tissues are composed of mature cells which are relatively resistant to radiation. These organ systems may not show damage until they require new cells, at which time the stem cells of these organs may be unable to divide. Then the organ may not have all the cells it needs to function efficiently, and its overall performance will be diminished. The result: a shortened lifea"one of the major biological consequences of radiation.

The j.a.panese doctors who were treating the injured with penicillin and transfusions did not yet understand the mysterious sickness that the survivors were suffering from. To their dismay, they discovered that treatment seemed only to increase the suffering. Needle punctures caused aoozing that continued to death,a Warren observed.28 aEven p.r.i.c.ks to obtain blood for blood counts caused oozing that could not be checked.a Warrenas job was not to minister to the sick but to find out whether the two bombs had left any residual radiation, and if so, whether the radiation was causing deaths. Donald Collins, a member of the survey team, said many years later that the group had been instructed by General Thomas F. Farrell, one of Grovesas top aides, that their mission was to aprove there was no radioactivity from the bomb.a29 Apparently they didnat even have to go to the bombing sites to offer that proof because while the team was still waiting to enter j.a.pan, Collins said, awe read in the Stars and Stripes the results of our findings.a Stafford Warren told members of the Special Senate Committee on Atomic Energy that it was impossible to develop meaningful statistics on the death rate because all the records and all the record-keeping organizations had been destroyed. What made the mortality survey even more difficult, he said, were the unreliable memories of the j.a.panese. aIt often took an hour of careful questioning of a patient, even an intelligent one, like a doctor or a nurse, to find out precisely what happened on that day.a30 Our conclusion was that we could trust very little of the factual information that came to us through interpreters, from these j.a.panese, these patients.a He estimated that only 5 to 7 percent of the fatalities were caused by radiation. aI think the radiation has been exaggerated,a he testified.31 (The number of people killed in Hiros.h.i.+ma and Nagasaki is still a matter of dispute; the U.S. Strategic Bombing Survey, which had a.s.sessed the damage of the air attacks on Germany and was ordered by President Truman to survey the destruction in j.a.pan, estimated that 140,000 to 160,000 people in Hiros.h.i.+ma were killed or injured and 70,000 killed or injured in Nagasaki.)32 Two weeks after the Manhattan Project doctors began combing the bombed-out cities, a contingent of Navy officers and scientists arrived in j.a.pan to do their own independent survey. That group, which included s.h.i.+elds Warren, the Harvard doctor who would take over the AECas new Division of Biology and Medicine after the war, reached a quite different conclusion: Most of the deaths in j.a.pan were caused by radiation.

s.h.i.+elds Warren was deeply shaken when he saw Nagasaki. To reach the ruined city, his team first drove through miles of terraced hillsides and farming country. Then they pa.s.sed through a tunnel that had been converted to a war workshop. aWhen we came out the other side of the tunnel we s.h.i.+fted from a view of a peaceful countryside to utter devastation,a he recalled.33 aIt was almost like stepping from the eighteenth century say, into the twentieth centurya"the countryside on the one side, and on the other, modern power.a s.h.i.+elds Warren moved from hospital to hospital, examining survivors and studying slides and autopsy notes made by j.a.panese doctors. As he toured the devastated city, he recorded his impressions in a small diary. At the front of the diary are j.a.panese words that he apparently learned while waiting off the coast of j.a.pan for armistice to be declared: ketsueki, blood; fushosha, wounded person; babsudan, bomb; ikutsu, how many.34 Warren sent transmittal letters and specimens from the bombing victims to the Naval Medical Research Inst.i.tute in Bethesda, Maryland. According to Warrenas diary, copies of the letters were also sent to the director of naval intelligence.

Radiating outward for two miles from the hypocenter was a scene of total destruction, he wrote. aRats, flies, mosquitoes killed.35 No larvae on bodies.a aWeeds + a little gra.s.s starting back.a aHorses & dogs died just like people, only protected ones lived. Even moles etc. were supposed to have died.a aNo crawling bugs. No vermin.a With scant medical supplies and no knowledge of the illness, little could be done for the victims. aFew transfusions given, no plasma.36 Used saline freely and injectable vitamin ABC,a Warren wrote. aSkin ripped off & viscera out from blast effect.a aMost had amnesia 1a"2 days.a aBlast broke tympanun.a aHemorrhages came back.a aMuch GI irritation.a aSome complained of heata"enough to ignite clothes, others felt only mild warmth.a aBrightest light they had ever seen.a aSome ocular hemorrhages, 3 blind, others see dimly at about one meter.a He also jotted down the conflicting death tolls that were being reported at the time: a175,000 killed at Nagasaki.a a40,000 killed instantly.a aEstimates dead at 30,000 +.a Sometimes huge, mottled patches of purple appeared on the bombing victimsa skin. Observers reported that blood often poured from nasal pa.s.sages, eardrums, uteruses, and urethra. Ulcers soon developed in gums, throats, and tonsils. Before some patients died, their tonsils and tissues in the throat area became gangrenous. Those who survived the critical period often succ.u.mbed to pneumonia or some other infection, which their weakened immune system could not fight off.

Warren saw the same astounding damage on the internal organs removed during autopsies: lungs filled with fluid; kidneys, liver, and hearts covered with bright red hemorrhages; depleted bone marrow; congestion in the brains; bizarre-looking cells and ma.s.sive nuclei sp.a.w.ned by the huge radiation doses. aThe injuries were diverse and confusing,a he recalled in an article published in September 1946: A greater number of injuries was probably caused by ionizing radiation-blast effects, gamma rays, and neutrons than by any other type of injury resulting from the explosion of the bombs.37 However, since the effects of this ionizing radiation take hours, days, or even weeks to appear, their importance was largely masked by the great numbers killed by flash burn, fire or wreckage of buildings well before the time that symptoms due to irradiation could develop.

Soon after the Manhattan Project team and the Navy group completed their preliminary surveys, the War Department dispatched 195,000 soldiers to j.a.pan to aid in the demilitarization effort and help supervise the cleanup. The first troops arrived in Hiros.h.i.+ma about sixty days after the bomb had been dropped.38 GIs landed in Nagasaki forty-five days after that city had been bombed.

Bill Griffin, a Marine who survived the fierce fighting on Iwo Jima, arrived in Nagasaki on November 1, 1945. Occasionally he was ordered to patrol the bombed-out area. aI donat know what the purpose of it was.39 There were no people. All the people had perished,a he said. aThere were no birds, no wildlife, no crickets, no nothing. Itas hard to explain what complete silence is like. You have to experience it.a Griffin said he saw civilians wearing white coveralls and diversa helmets (aThey were all covered upa) taking radiation measurements of soil and water. j.a.panese who came down from the mountains often wore menstrual pads over their faces to avoid breathing the dust. He said the bombing victims, particularly those who were horribly disfigured by thermal burns, had been whisked out of sight so the American soldiers could not tell people back home what they had seen.

As Bill Griffin and other American GIs patrolled the desolate streets of Nagasaki and Hiros.h.i.+ma, top officials of the Manhattan Project went to Capitol Hill to testify before the Special Senate Committee on Atomic Energy that was investigating the problems related to the development and control of the atomic bomb. Brien McMahon, a freshman Democrat from Connecticut, chaired the hearing. General Groves took a seat at the witness table in Room 312 of the Senate Office Building at 10:00 A.M. on November 28, 1945.

By then Groves knew a great deal more about the effects of radiation on the human body than he did when he placed the two panicked phone calls to Oak Ridge the preceding August. He knew, for example, the details of Harry Daghlianas death. He knew fallout from the Trinity bomb had injured livestock and exposed families such as the Raitliffs to a significant amount of radiation. And he was also aware that thousands of j.a.panese were dying from medical complications caused by radiation from the bomb. Intent upon calming the publicas fears and keeping the Manhattan Projectas laboratories and factories open, however, Groves chose to downplay the dangers from radiation.

aThe radioactive casualty can be of several cla.s.ses,a Groves testified.40 aHe can have enough so that he will be killed instantly. He can have a smaller amount which will cause him to die rather soon, and as I understand it from the doctors, without undue suffering. In fact they say it is a very pleasant way to die. Then we get down below that to the man who is injured slightly, and he may take some time to be healed, but he can be healed.a aDoes that come about through treatment or through time?a Eugene D. Millikin, a conservative Republican senator from Colorado, asked.

aThrough time,a responded Groves. aAnyone who is working with such materials, who accidentally becomes overexposed, just takes a vacation away from the material and in due course of time he is perfectly all right again.a Later in the hearing, when Senator Harry F. Byrd, a Virginia Democrat, asked the general if there had been any aoperating accidentsa during the Manhattan Project, Groves gave a response that was a study in obfuscation: aWe had no operating accidents throughout this project that were directly attributable to the unusual nature of the material that was a fatal accident.41 We had one after the bomb was exploded. We then had one we should not have had; there was no reason for having it. It was like all accidents, industrial or home accidents.a The committee was especially interested in the question of whether the two bombs had left any residual radiation in j.a.pan. In fact, a transcript of the hearing shows that was the first question Groves was asked when he took a seat at the witness table. The general stuck to the line that he and Oppenheimer fed to reporters during the Trinity tour. aThere is none. That is a very positive anone,a he snapped.42 When Richard Russell, a Democratic senator from Georgia, pressed Groves about the injuries, he responded, aThere was no radioactivity damage done to any human being excepting at the time that the bomb actually went off, and that is an instantaneous damage.a43 aLet me ask you,a said Senator Millikin, awould the effect be different had the bomb exploded in the ground?a Groves replied, aIf the bomb had exploded on or near the ground, that is, within a hundred feet or so, the effect would have been the same as at New Mexico, I believe; there you would have had lasting effects for a considerable period of months.44 You would have had a considerable number of radioactive casualties, and I think that you would have had an area which should have been banned from traffic. The first mission given to our organization that went over there was to determine that the cities of Hiros.h.i.+ma and Nagasaki were 100 per cent safe for American troops, and to know absolutely that that was a fact so that the men themselves would know everything was all right.a But many of the men who were sent to Hiros.h.i.+ma and Nagasaki do not believe that aeverything was all right.a Not long after Bill Griffin was discharged, his skin flaked off and his hair and teeth fell out. One of his grandsons was born with a club foot; another appears to have an impaired immune system. Griffin is certain that he received a significant dose of radiation while in Nagasaki and that the exposure damaged his reproductive cells. aWe were the first issue of guinea pigs.a Other soldiers stationed in the bombed-out cities said they developed rare cancers and blood disorders, or suffered from premature heart attacks, chronic fatigue, lung diseases, and inexplicable skin afflictions. Many believe their diseases and illnesses are due to the radiation they received in j.a.pan. For decades the Defense Department has vigorously denied that occupation troops were exposed to dangerous levels of radiation, maintaining the doses ranged from a afew tens of millirema to a aworst casea dose of up to one rem.45 The Pentagonas desire to prove the two j.a.panese bombs left no residual radiation became one of the prime motivating factors in the atomic maneuvers that began at the Nevada Test Site in 1951. Thousands of troops were marched through the swirling radioactive dust at Ground Zero over a decade or so. Instead of quelling fears, however, the militaryas strategic plan backfired and thousands of soldiers came to believe that they, too, had been used as unwitting guinea pigs by their government.

12.

THE QUEST CONTINUES.

When the news of the Hiros.h.i.+ma bombing reached Los Alamos, the scientists rejoiced. Some raced to the telephone and booked tables at La Fonda Hotel in Santa Fe. Others stayed at Los Alamos and celebrated. They subst.i.tuted dynamite for fireworks and snaked through the streets banging garbage-can lids. aEverybody had parties, we all ran around.1 I sat on the end of a jeep and beat drums and so on,a recalled Richard Feynman, a math wizard and future n.o.bel laureate.

As the devastation from the bombings became better understood, some of the scientistsa elation began turning to guilt about the past and fear about the future. No one better demonstrated these conflicting emotions than J. Robert Oppenheimer. Deeply fatigued and more emaciated than ever, he departed Los Alamos in mid-October of 1945. In a ceremony before he left, he warned his colleagues: aIf atomic bombs are to be added as new weapons to the a.r.s.enals of a warring world, or to the a.r.s.enals of nations preparing for war, then the time will come when mankind will curse the names of Los Alamos and Hiros.h.i.+ma.a2 General Groves selected Norris Bradbury, a Berkeley-trained physicist who had worked on the explosives aspects of the plutonium bomb, as the interim laboratory director. Bradbury agreed to take the job for six months, but those six months eventually turned into twenty-five years.3 While politicians, military leaders, and even the scientists themselves debated the future of the atomic bomb at public forums and congressional hearings that would continue for the next year, the physicists, chemists, metallurgists, and explosives experts who had built the bombs drifted from day to day, uncertain of their future.

But the projectas second string of scientistsa"the medical researchers who had been shunted to the sidelines while the great bomb-building drama unfoldeda"seemed moved to redouble their efforts at this stage. If anything, the Trinity fallout, the deaths in j.a.pan, the demise of Harry Daghlian, had made it even more imperative to obtain accurate information on the effects of radiation. In addition, nose counts and urine counts taken from Los Alamos workers that summer had shown that some employees had been seriously overexposed to plutonium. Were those workers going to come down with the same grisly cancers the radium dial painters had developed? The thought terrified Louis Hempelmann. The contamination was so severe, he warned Joseph Kennedy, athat the situation seems to be getting completely out of hand.a4 Ebb Cade, Arthur Hubbard, and Albert Stevens were more or less on their own as the cataclysmic events of the summer of 1945 unfolded. Toward the end of his hospital stay, Ebb Cade developed infectious jaundice. But by the time he was discharged, athe patient was ambulatory and in good condition,a an Oak Ridge physician observed.5 Ebb moved back to Greensboro, North Carolina, with his wife after he was released from the hospital. On Sundays, he brought sacks of oranges to his nieces and nephews. He encouraged them to stay in school and warned them to be careful when they got behind the wheel of a car. aWe just loved to talk to him,a recalled his niece, Mary Frances Cade Derr.6 aHe would throw his head back and laugh with us.a On April 13, 1953, almost exactly eight years to the day of the injection, Ebb Cade died of heart failure. He was sixty-three years old. His brothers and sisters outlived him by decades. One sister, Nanreen Cade Walton, lived to be more than one hundred years old and went to Was.h.i.+ngton in 1979 to speak with the House Select Committee on Aging. On the eve of her 107th birthday, she told a reporter, aI believe the old days was pretty hard but these days are more wicked.a7 Arthur Hubbard remained in fair condition until August of 1945, when he began complaining of chest pains. Despite the radical surgical procedures he had undergone, the cancer continued to spread rapidly. Confused and in considerable pain, he died on October 3, five months after the injection. Twelve hours after he died, his body was autopsied and his organs harvested and examined for plutonium deposition. The hottest parts were his bone marrow and liver, but scientists were convinced the injection had not affected the disease or hastened his death. They did note that the plutonium did not seem to concentrate in the tumor area, an observation that seemed to rule out the possibility that the radioactive substance could be used for therapeutic purposes.8 Albert Stevens began painting houses again but was soon forced to give it up. aIt got to the point where he wasnat strong enough anymore,a his daughter said.9 Periodically he returned to UCSF for follow-up visits. Robert Stone ordered that a GI series be done without charge whenever Albert returned to the clinic. He had no specific complaints except for his inability to gain weight. Ten years after he was injected, a radiologist noted arather markeda degeneration in the lumbar region of his spine and several degenerating discs.

Albert was to live nearly twenty-one years after he was diagnosed as terminal and injected with a so-called lethal dose of plutonium. His long survival rate is astonis.h.i.+ng considering the amount of radiation he received. In 1995 two Los Alamos scientists calculated that Albert received a dose equal to 6,400 rem during his lifetime.10 That translates to 309 rem per year, or 858 times what the average person receives during the same period.

Just how the plutonium affected Albertas day-to-day health is unknown. The radiation probably caused his bones to thin and become brittle. But it was his heart that gave out first. On January 9, 1966, he died of cardiorespiratory failure in Santa Rosa, California, twelve miles from the town of Healdsburg where he had brought his ailing wife and children so many decades before. He was seventy-nine years old. His body was cremated, and his ashes were placed in a bronze urn and stored in a niche in Santa Rosaas Chapel of the Chimes.

The Manhattan Project medical doctors were not satisfied with the data they had acquired from the three injections. Ebb Cadeas impaired kidney function may have skewed his excretion results, and for some unknown reason, Albert Stevens was excreting plutonium much more slowly than the other two patients. The physicians and scientists soon developed a list of things they needed to find out: What was the minimum amount of plutonium necessary to produce damage in the body? How could it be quantified and detected in wounds or lungs? Did diet affect plutoniumas distribution? How was the liver damaged after intravenous injection? Did existing kidney damage diminish the elimination rate? And as a corollary, should people with kidney damage be excluded from working with plutonium?

The human experiments and ongoing animal studies had only confirmed fears that plutonium was indeed more carcinogenic than radium.11 On May 21, 1945, less than two weeks after Albert had been injected, Wright Langham wrote a letter to Hymer Friedell recommending that the so-called tolerance dose for plutonium be lowered to one microgram. Although Langham agreed with Friedell that the limit was probably much too conservative, he nevertheless supported it because athe medico-legal aspect will have been taken care of, and of still greater importance, we will have taken a relatively small chance of poisoning someone in case the material proves to be more toxic than one would normally expect.a12 Toward the end of June 1945, after the Manhattan Projectas Medical Section had received data on Albert, it officially lowered the tolerance dose to one microgram.13 (In 1949 a group of researchers recommended that the tolerance dose be lowered again, to one-tenth that amount, or 0.1 microgram, after former Met Lab scientist Austin Brues presented results of a rat study suggesting plutonium was fifteen times more damaging than radium. Wright Langham and other scientists vigorously opposed the adoption of such a conservative standard, arguing, among other things, that it would produce aserious delaysa in the labas plutonium operations. The AECas s.h.i.+elds Warren struck a compromise and lowered the maximum permissible dose to 0.5 micrograms.) Sometime in the summer of 1945, the Manhattan Project Medical Section decided to inject more humans with plutonium. In making the decision, the doctors probably were thinking about overexposures that had already occurred as well as exposures that might occur in the future. Stafford Warren knew as early as April of 1945, even before the successful detonation of the Trinity bomb, that the Manhattan District would continue in some shape or form. aIt has been indicated by properly qualified individuals that the operations of the Manhattan Engineer District should and will continue on for peacetime purposes,a he wrote in a letter decla.s.sified in 1995. In short, plutonium and its hazards were not going to go away.14 Over the next two years, an additional fifteen patients would be injected with plutonium: two in Chicago by Robert Stoneas group; another two in San Francis...o...b.. Joseph Hamiltonas group; and eleven patients in Rochester. Before the program ended in the summer of 1947, a total of eighteen people would be injected with plutonium without their informed consent.

13.

THE ROCHESTER PRODUCTION LINE.

On September 5, 1945, just three days after j.a.pan formally surrendered, Los Alamos chemist Wright Langham sat down with scientists working at the Manhattan Annex, the secret research facility at the University of Rochester to plan the most comprehensive set of plutonium injections yet undertaken. This new round of injections would be a collaborative effort. Langham would supply the plutonium; the Rochester doctors, the patients. According to doc.u.ments made public in 1994a"1995, the Rochester segment of the plutonium experiment was part of a larger, planned study in which fifty patients were to be injected with radioisotopes of plutonium, polonium, uranium, lead, and radium.1 Rochesteras Manhattan Annex was originally located across the street from the medical school and connected by a tunnel. There, as at all Manhattan Project sites, secrecy was closely guarded. Constructed in five months, the Annex employed 350 people by the end of the war. Its activities were s.h.i.+elded from intruders by Army guards, and the occupantsa backgrounds were thoroughly investigated to make sure athey were loyal American citizens, that they were discreet, and that they could be depended upon to keep secret work which contributed toward the development and production of the atomic [bomb].a Rochester was far from the noisy industrial plants and hectic laboratories of the Manhattan Project.2 Oddly enough, though, the cold, industrial city had numerous links to the bomb project. Rochester was the home of George Eastman, the founder of Eastman Kodak Co. A subsidiary of his company, the Tennessee Eastman Corp., was the first operating contractor of the gigantic Y-12 plant in Oak Ridge where enriched uranium was produced.

Stafford Warren, who had gotten to know Eastman when he was in Rochester, said Eastman had been a man so painstakingly meticulous he painted the shapes of tools on the walls of his workshop so he could tell immediately whether things were in their proper position. At home, diagrams of cutlery were outlined on the kitchen walls. In his hunting lodge, the shadows of his guns were painted behind the gun rack. On March 14, 1932, Eastman asked his personal physician to draw the image of his own heart on his skin. Then, at the age of seventy-eight, according to Warren, he shot himself in the middle of that drawing. aHe, of course, was very meticulous about his own hygiene and was always dressed very nicely and properly, shaved and barbered, and so on,a recalled Warren.3 aBut then he began to get feeble and developed some incontinence and had to hire a nurse to take care of him. After a while, he began to wear the equivalent of diapers so that he wouldnat have a mess on his hands. He decided he wasnat going to tolerate this.a William McCann, the physician who drew the heart on Eastmanas chest, was one of the men present at the September 5 planning meeting.

At the time of the meeting, less than six months had elapsed since Wright Langham had sent that first ampoule of plutonium to Oak Ridge to be injected into Ebb Cade. But the world had changed radically in those months, and Langham, the young chemist who once seemed destined for a mundane career on the Oklahoma Panhandle, now found himself in the vanguard of that change. He had bucked across the desert at the Trinity site in an Army jeep, bulky radiation detector in hand, as the purples and golds of the first atomic bomb ascended into the New Mexico sky. He had worked alongside the scientists responsible for Little Boy, the bomb dropped on Hiros.h.i.+ma, and Fat Man, the bomb that exploded three days later over Nagasaki.

The meeting that Langham attended in Rochester had been ordered by Stafford Warren (who was to land in Hiros.h.i.+ma in three days). Most of the men present were Warrenas colleagues or students from his prewar days. Among them were Robert Fink, William Bale, Andrew Dowdy, and Harold Hodge. At the request of the Manhattan Engineer District, Bale had aactivateda a metabolic ward at Rochesteras Strong Memorial Hospital to carry out acertain tracer studiesa with long-lived radioisotopes.4 The ward, at least in the early years, appears to have been used exclusively for the radioisotope studies.

The protocol for the plutonium injections, which was written by Wright Langham and not made public until 1995, disclosed that the experiment was a result of the Rochester meeting as well as anumerous conversations with Col. Warren, Col. Friedell, and Dr. L.H. Hempelmann.a5 According to that protocol, only two subjects were to be admitted to the metabolic ward during the first six weeks of the program.6 Once the technicalities were worked out, however, scientists hoped to handle four patients simultaneously.

The patients were generally transferred to the ward from other parts of the hospital. The small ward where the injections were administered and the excretion samples collected was supervised by Samuel Ba.s.sett, a pleasant-looking doctor educated at Cornell University who had also attended the September 5 planning meeting.

Each patient was a.s.signed the initials aHPa followed by a number. According to one doc.u.ment, the aHPa stood for ahuman product.a The doctors were on the lookout for patients who had relatively normal metabolisms.7 Langham wrote: At the meeting it seemed to be more or less agreed that the subjects might be chronic arthritics or carcinoma patients without primary involvement of bone, liver, blood or kidneys.8 It is of primary importance that the subjects have relatively normal kidney and liver function, as it is desirable to obtain a metabolic picture comparable to that of an active worker. Undoubtedly the selection of subjects will be greatly influenced by what is available.

Under the tentative plan, the group decided that each patient was to be injected with an average of five micrograms, or five millionths of a gram of plutonium. That was five times the amount of plutonium the Manhattan Project scientists had just declared could be retained without harm in the human body and was also more than what Wright Langham and other scientists were willing to risk putting into their own bodies. aWe considered doing such experiments at one time,a Langham wrote in 1952, abut plutonium is considered to be sufficiently potentially dangerous to discourage our doing absorption experiments on ourselves.a9 Though five micrograms was the planned dosage, the actual amount of plutonium injected into the patients varied from 4.6 to 6.5 micro-grams. The c.u.mulative radiation dose received by each patient was dependent on two factors: the amount of radioactive material injected into the body and how long the subjects lived. The longer the patients lived, the larger their c.u.mulative dose.

Six weeks following the Rochester meeting, the program became operational when the first patient was injected with plutonium. In all, eleven patients would be injected there between October 16, 1945, and July 16, 1946. But before that first injection could take place, many housekeeping details had to be worked out.

The patientsa initial two weeks on the metabolic ward were slated as a control period in which they were to be trained to collect their own urine and stool specimens. aThe period of indoctrination,a Ba.s.sett later wrote, ausually required about ten days.a10 After collection, the urine samples were heated in a steam bath for two hours and then cooled. An adhesive mortar was then placed around the top of the jars so that aany leakage which might have occurred would be revealed to the person receiving the urine for a.n.a.lysis.a11 A preservative was added to the stool samples, and the mixture was boiled for ten minutes before it was transferred to half-gallon fruit jars. The excretion samples, as well as periodic blood samples, were to be collected on a strict schedule and s.h.i.+pped in wooden crates to Los Alamos.

According to the protocol prepared by Langham, Stafford Warren had suggested a Lieutenant Valentine perform the injections.12 But Hannah Silberstein, a woman who apparently worked on the metabolic ward, wrote that Ba.s.sett made the first injection.13 Itas not clear from the doc.u.ments, however, whether Ba.s.sett injected all the patients. When Louis Hempelmann was asked about the experiment by AEC investigators in 1974, he said Ba.s.sett prepared the syringes and handed them to a physician who injected the patients. Hempelmann said he was aquite positivea that the physician making the injections did not know the contents of the syringe.14 There is no evidence that any of the Rochester patients gave their consent for the experiment or knew what was being injected into them. In fact, Hempelmann told investigators that a adeliberate decision was made not to inform the patient of the nature of the product that was injected.a15 Amedio Lovecchio, a sixty-seven-year-old Sicilian immigrant whom Ba.s.sett described as awell preserved for his years,a became the first of the Rochester plutonium injectees.16 A proud-looking patriarch, Lovecchio had two fig trees in his backyard. Each fall he bent the trees to the ground and buried them deep in the soil to protect them from the harsh winter. Each spring he gave the first fig to a pregnant daughter-in-law. Lovecchio was admitted to the hospital after an ulcer hemorrhaged so severely that he required a transfusion. Code-named HP-1, Lovecchio was injected at 3:30 P.M. October 16 by Dr. Ba.s.sett awith no ill effects,a Hannah Silberstein reported.17 Lovecchio lived for another fourteen years after the plutonium was administered. He was working as a maintenance man when he contracted pneumonia and died on January 12, 1960.

William Purcell, a forty-eight-year-old hemophiliac who was a.s.signed the number HP-2, was injected five days after Lovecchio. Purcell was a cheerful, red-haired Irishman who had been admitted to the hospital thirty-eight times.18 He was well known and well liked by the staff and was listed as the proprietor of a cigar store on his death certificate. Ba.s.sett confessed in a letter to Wright Langham and Louis Hempelmann that he had been unable to get the three control samples of blood from Purcell prior to the injection. aThe reason being that he is a hemophiliac who has been in the hospital for studies of blood clotting.19 This had led to a thrombosis of one of his veins which we felt should be given time to heal, and hence, we kept our venous punctures down to a minimum. I will be able to furnish the requisite number of post injection blood [samples].a Purcellas condition eventually improved, and he was injected with plutonium on October 23. He died on August 4, 1948, two and a half years later, from what doctors described as abrain disease.a Eda Schultz Charlton, HP-3, and Jean Daigneault, HP-4, were both injected on November 27. Charlton, a housewife, was to live for another four decades. Daigneault, who was only eighteen years old, died on April 19, 1947, a year and a half after the plutonium was administered. Daigneault suffered from Cus.h.i.+ngas syndrome, a metabolic disorder characterized by a moon-shaped face and excessive weight in the trunk. She was studied intensively by doctors interested in that disease. On one occasion, when she was put on a rice and raisin diet, she told her sister that she craved a hot dog. As a teenager, she had won the western New York womenas breast stroke swimming champions.h.i.+p.20 Paul Galinger, HP-5, a tall, thin man with trembling hands and slow speech, was fifth in line. He was a machine shop foreman whose handicapped son had died the previous year. Doctors diagnosed Galinger, then fifty-six, as suffering from depression and an incurable nerve disorder now called Lou Gehrigas disease. aSo far he has cooperated quite well but has a difficult personality,a Ba.s.sett confided to Langham.21 aThe prognosis is poor and fatal termination can be expected within a year.a Galinger was injected on November 30, 1945, and died on April 29, 1946. Even before he was dead, Ba.s.sett had begun making plans to retrieve his organs. aThis may be counting our chickens before they are hatched but I thought it might be well to settle on some of these details before we are confronted with the necessity of obtaining specimens.22 I presume you would like a sample of blood from the heart or lungs?a Ba.s.sett inquired in a letter to Langham.

His carefully laid plans notwithstanding, Ba.s.sett learned only by chance that the much-antic.i.p.ated autopsy was under way, and he had to rush to the hospital to lay claim to the specimens he wanted from Galingeras body. aWe arrived after all the dissection had been completed and only had about thirty minutes in which to get the material together,a he told Langham.23 In another letter he added, aThe specimens from both the large and small bowel so nearly filled the jars that there was an insufficient s.p.a.ce for the alcohol and hence a good deal of decomposition has occurred.24 This probably holds true for the liver samples also. I have added a little formalin to each of the intestinal samples to try to reduce formation of gas.a By the end of 1945, five of the eleven injections had been completed and the Rochester program was beginning to have the efficient feel of an a.s.sembly line. But there were still a lot of messy details to work out, even acts of G.o.d to cope with. As the holiday season approached, Ba.s.sett worried the experiment would grind to a halt. aIt begins to look now as if we might be without patients at Christmas.25 No one seems to want to be in the hospital on that particular day. I will do what I can, however, to keep the production line going.a Ba.s.settas efforts were unsuccessful and there were no new injections in Rochester during the month of December and January. They resumed February 1, 1946, with John Mousso, HP-6, a gentle-tempered handyman from East Rochester, a village seven miles east of the city. Mousso, forty-four at the time, was admitted to the hospital for multiple infections on his eyelids and toes, but the underlying illness that plagued him was Addisonas disease, an adrenal gland disorder that made him nauseated, lethargic, and achy. Mousso was a familiar figure in East Rochester: sweeping out the fire hall, shoveling snow from the church steps, emptying the penny meters along leafy streets named Elm, Oak, and Hickory. Ba.s.sett described Mousso as a awell developed, but thin male with deeply pigmented skin.a26 Supported by his deep love for his wife, Rose, Mousso was to live for many decades after the injection was administered. But he returned to the hospital often, and on several occasions, doctors surrept.i.tiously gathered excretion samples from him.

Edna Bartholf, HP-7, was injected February 8. Edna was fifty-nine years old and suffered from rheumatic heart disease. Except for the amarkeda swelling that extended from her hips to her feet, she looked healthy. But when Ba.s.sett placed his stethoscope to her chest, he heard the irregular heartbeat. Bartholf had spent her life in Morganville, a tiny hamlet near Rochester that today has a population of 150. She was active in the Congregational Christian Church, the Womenas Christian Temperance Union, the Ladiesa Aid Society, and other groups. aHer church was the thing she was most interested in,a her niece, Winifred Thater, recalled.27 Bartholf lived another nine months after the plutonium was administered, dying on October 27, 1946, of pulmonary failure.

Next was Harry Slack, a sixty-nine-year-old janitor at a local YWCA and an alcoholic suffering from malnutrition and cirrhosis of the liver. Little is known about Slackas life. He enlisted in the Army at the age of twenty-one to fight in the Spanish-American War, but his company made it only as far as Virginia. Slack had been admitted to the hospital on December 12, 1945, because he had been having trouble breathing and his abdomen was enlarged. Ba.s.sett described him as a apoorly nourished, weak, thin male who is slightly confused.a28 Slackas health continued to decline while he was in the hospital, and he was amoribunda when the plutonium injection was administered on February 20, 1946. Six days later he died of pneumonia. Apparently surprised by Slackas sudden death, Ba.s.sett dashed off a letter to Wright Langham: aI hope this next part of the letter will not prove too much of a shock to you since we have run through an acute experiment.29 No collections of urine or feces were made in this instance.a The experiment hadnat been a total loss, however. An autopsy had been performed less than six hours after Slackas death, and researchers would have his organs to a.n.a.lyze. aWe were somewhat pressed for time and perhaps did not obtain as much in the way of bone samples as we might have,a Ba.s.sett added.30 He was certain, though, that the plutonium had mixed sufficiently in Slackas body and would be detectable in the harvested organs.

Langham was a little startled by the news. But he in turn had something even more startling to suggest, which apparently was inspired by rumors he had heard about the experiments taking place in Chicago: Inject the next terminal patient with fifty micrograms of plutonium, he instructed. Such a dose would be equal to fifty times the amount that several researchers, including Langham himself, had estimated could be tolerated without harm in the human body: aThis would permit the a.n.a.lysis of much smaller samples and would make my work considerably easier.31 I have just received word that Chicago is performing two terminal experiments using 95 micrograms each. I feel reasonably certain there would be no harm in using larger amounts of material if you are sure the case is a terminal one.a Ba.s.sett, in a reply dated March 27, appeared to have been troubled by the idea that the plutonium may have hastened Slackas death but nevertheless agreed to try to implement Langhamas plan: This case did turn out to be terminal, but at the time I started the experimental period, there was sufficient uncertainty regarding the outcome to make me feel that the dose should be within the range of tolerance.a32 The larger doses that you mention, particularly 50 micrograms, might be given if a suitable opportunity occurred and if you are very anxious that I should carry it through, I will see what can be done.

Slack was actually the eighth person injected but was given the code number HP-11. The reason for the inconsistency is unknown. Perhaps the experimenters originally planned not to include Slack in their study because of the failure to obtain any urine or stool samples but then changed their minds as they were compiling their data for their final report.

About two weeks after Slackas demise, Janet Stadt, HP-8, a forty-one-year-old woman suffering from scleroderma, a chronic skin disease that hardens and fixes the skin to underlying tissues and eventually disrupts the functioning of the internal organs, was injected. Ba.s.sett described Janet Stadt as a athin and pale femalea and carefully chronicled the symptoms of her disease: Her eyelids were tight and the skin was drawn around her mouth.33 The flesh on her hands was so thick and taut her fingers could not uncurl completely.

Stadtas son, Milton, said at a public hearing in 1995 that his motheras disease was so painful that she eventually became addicted to painkillers. aI had to get up in the middle of the night, sterilize needles, fill them with Demerol, and she would inject herself with Demerol for the pain,a he said.34 To add to her misery, Janet Stadt received 1,000 rem of radiation during her lifetime, the highest dose of any of the Rochester patients, according to calculations performed in 1995 by the Los Alamos scientists.35 She died on November 22, 1975, nearly three decades after the injection was administered. Her death certificate states that the cause of death was malnutrition caused by cancer of the larynx.

Milton Stadt did not learn that his mother had been injected with plutonium until he received a call from Energy Secretary Hazel OaLeary in 1994. aMy mother,a he said, awent in for scleroderma, which is a skin disorder, and a duodenal ulcer, and somehow she got pushed over into this lab where these monsters were.a36 Fred Sours, HP-9, was injected April 3. In the town of Gates, a suburb of Rochester, Sours held the position of supervisor, a job roughly equivalent to mayor. He was sixty-four years old and suffering from dermatomyositis, a rare disorder in which the skin becomes inflamed and the muscles grow weak. His face was red; his eyelids and ears also were red and swollen. aMan appears chronically ill, skin is dry and loose,a wrote Ba.s.sett.37 Sours died on July 2, 1947, of pneumonia, a year and three months after the injection. When the townspeople of Gates heard the news, they lowered the town flag to half mast for four days and the town board issued a proclamation stating: aHis honesty was known to all, and the well-being and interests of the town, of which he was the chief executive officer, were his early aim during his official life.a38 While the people of Gates were mourning Soursas demise, Manhattan Project doctors were harvesting his organs. The plutonium was everywherea"in his liver, spleen, kidneys, and bonesa"everywhere except for his heart.

Ba.s.sett received a steady stream of polite but critical letters from Langham while the injections were under way. The Mason jars containing the urine and stool samples often arrived at the New Mexico laboratory broken or leaking. The samples were sometimes mislabeled, and in some cases, the labels were missing altogether. Too much human material had been stuffed into some of the containers and not enough preservative had been poured into others. Only a month after the injections started, Langham found himself overwhelmed by the volume of urine and stool samples. aI would like to suggest,a he said in a letter to Ba.s.sett, athat the next patients selected be individuals whose conditions will not require high fluid intake and extremely high diet levels of mineral or nitrogen.a39 On another occasion, Langham complained that the iron content in the patientsa diets was interfering with the radiochemical a.n.a.lyses. Ba.s.sett then began sending Langham an inventory of the patientsa diets. Among other things, Jean Daigneault was getting pineapple juice, potatoes, squash, ground round steak, and macaroni. William Purcell, the hemophiliac, was getting lots of vegetables, a slice or two of American cheese, and an occasional cup of coffee. Amedio Lovecchio, the Sicilian immigrant who suffered from a bleeding ulcer, was on a avery peculiara diet prior to the injection, Ba.s.sett conceded.40 aWe took him on short notice with the understanding that we would carry out the medical treatment as already planned.a Before the human injections began, three rats were injected in their tail veins with the same plutonium solution that Langham and Ba.s.sett planned to administer to the patients. Only a small percentage of the plutonium went to the rodentsa livers, which made the two scientists more confident that the plutonium injected into the human subjects awould not be taken up in high concentration by a single organ such as the livers,a Ba.s.sett wrote.41 Belatedly, after ten of the eleven injections had been completed, Langham recognized that they had been overly confident. Dangerous amounts of plutonium were, in fact, acc.u.mulating in the patientsa livers: aThe amazing feature regarding the tissues [of Paul Galinger] was that 48 percent of the material was found in the liver.42 This result is extremely alarming to me. Results obtained at Chicago more or less confirm the finding. The results indicate that complexing the Plutonium with citrate does not prevent the deposition in the human liver as it does in the case of the rat.a Wright Langham and Samuel Ba.s.sett kept their fears about possible liver damage and other long-term consequences to themselves, and eventually the patients were discharged from the hospital without ever having been told what had been done to them. For the rest of their lives, the injectees carried within their bodies the plutonium they had received on Samuel Ba.s.settas metabolic ward. aWith regard to ultimate effects [of plutonium], it is too early to predict what may occur,a Ba.s.sett wrote in a secret, unpublished report.43 For the five decades that followed, it was widely a.s.sumed, and reported in the scientific literature, that the patients were very ill and not expected to live much longer. Incredibly, doc.u.ments released in 1994 and 1995 reveal that that false impression was perpetuated largely by a 1950 Los Alamos report written by Wright Langham, Samuel Ba.s.sett, and two other scientists. The Los Alamos report, ent.i.tled aDistribution and Excretion of Plutonium Administered Intravenously To Man,a was cla.s.sified secret and not decla.s.sified until 1971.

Three of the eleven Rochester patients did die within one year; but three others lived for thirty years or more. After the experiment was completed, Ba.s.sett wrote up a rough draft of what had taken place. In that draft, he noted that the patients selected for injection were aa miscellaneous group of male and female hospital patients for the most part with well established diagnosesa: Preference was given to those who might reasonably gain from continued residence in the hospital for a month or more.44 Special treatments and other therapy thought to be of benefit to the patients were carried out in the normal manner. The necessity of studying urinary and fecal rates of excretion of Pu [plutonium] automatically excluded cases of advanced renal disease or disturbance in the function of the gastrointestinal tract. Patients with malignant diseases were also omitted from the group on the grounds that their metabolism might be affected in an unknown manner.

Ba.s.sett also confessed in his draft report that one of the patients had been misdiagnosed. But his draft was never published. Thus the only published account was the one that came out of Los Alamos under the names of Langham and Ba.s.sett and the two other scientists. It omitted Ba.s.settas description of the patient selection process and his mention of the misdiagnosis. The Los Alamos version, considered for decades the authoritative source on the experiment, states that the patients were asuffering from chronic disorders such that survival for ten years was highly improbable.a45 Other statements later made by Langham himself furthered the impression that the patientsa conditions were terminal. At a chemical conference in 1956, Langham described the patients as ahopelessly sick.a46 And in a 1962 paper, he described them as aterminal.a47 The plutonium experiment was temporarily interrupted in the early summer of 1946 when Langham and Ba.s.sett were pressed into service by Stafford Warren for Operation Crossroads, a joint military exercise in which the first two atomic bombs of the peacetime era were detonated on an remote atoll in the Pacific Ocean. Warren had found it so difficult to recruit radiation monitors that he had been reduced to asking anyone who could read or write to join the operation. Langham was hopeful that he and Ba.s.sett might be able to talk with Warren about the experiment. Itas likely the three men did spend a little time together, although there are no doc.u.ments describing such a meeting.

In their absence, a Rochester physician named Helen E. Van Alstine continued to look for asuitablea subjects. In a July 10 letter to Wright Langham, she said, aWe were finally successful and had admitted to the special metabolic division on July 8th, a 52-year-old negro male with a diagnosis of severe heart disease.aa48 The subject was Daniel Nelson, who was recuperating from a heart attack when he was s.h.i.+pped to the metabolic ward for aspecial studies.a The transfer to that ward was the last of a string of misfortunes suffered by Nelson.49 A cook for most of his life, he had lost all his money in the stock market shortly before the heart attack. He was injected with plutonium on July 16 and given the number HP-10. When he was discharged from the hospital, he had no place to convalesce and finally sought help from a now-defunct rest home for veterans in Mount McGregor, New York. Nelson lived for ten years and eleven months after he was injected, dying of heart disease on June 2, 1957.

Ba.s.sett returned to the United States soon after the first atomic bomb was detonated during Operation Crossroads, and was in Rochester by the time Nelson was injected. But Langham remained to see the second shot, an underwater explosion that pushed a dome of radioactive water high into the sky. aThe second test at Bikini was really a great show.50 I am sorry that you did not stay to see it,a Langham told Ba.s.sett when he returned to Los Alamos. Reinvigorated by their Pacific adventure, the two men were ready to increase the dosage level.

aShall we try for a terminal case or two?a Ba.s.sett queried.51 aI think we should get some terminal cases if possible,a Langham responded.52 But for unknown reasons, Nelson turned out to be the last patient injected with plutonium. The following month Ba.s.sett began an experiment in which enriched isotopes of uranium were injected into six people with good kidney function. The uranium injections were apparently part of the larger study that had been planned by the Manhattan Project after the war and their function was to find the minimum dose that would produce detectable kidney damage. Thousands of people were working with uranium in Oak Ridge, and the bomb doctors were eager to find out more about both its radioactive and chemical toxicity.

While the uranium injections were under way, Langham kept nagging Samuel Ba.s.sett to collect more urine and stool samples from plutonium-injected patients whenever they were readmitted to the hospital. Additional samples were obtained from hemophiliac William Purcell when he returned to the hospital in early January of 1946 for bleeding of the intestinal tract. Samples were also collected from John Mousso, the East Rochester resident, whenever he was readmitted. Eda Schultz Charlton, a lonely, depressed widow, turned out to be one of their most fruitful subjects.

14.

A MISDIAGNOSED HOUSEWIFE.

Eda Schultz Charlton sat on a high stool all day, legs tucked beneath her, inspecting camera shutters at the Kodak plant.1 As she hurried home at night, she may have sensed the winter gathering over the black waters of Lake Ontario. She was a middle-age woman, slightly overweight and filled with vague fears about the future. The war was finally over and the whole country was celebrating, but it was an unhappy time for Eda. Her husband had died of a heart attack a year earlier and her son had not yet been discharged from the Navy. Sometimes she sat up alone in her living room eating handfuls of peanuts and candy. Other nights she just crawled into bed early.

Eda had a touch of hypochondria and a tendency to go on food binges. The hypochondria, almost indiscernible at the time, would flower into a painful obsession during the last two decades of her life. No diagnostic test, no doctoras words, could staunch the fear of cancer that eventually grew weedy and strong in her mind. Eda camouflaged her insecurities with clothes. She wore beautifully tailored suits, stylish felt hats, and carried small pocketbooks with gold latches. Her permanents were always fresh and her nails well-buffed ovals. Even when she was in her eighties, she continued to wear a tortuous corset of lace and elastic that left deep red marks on her body. The youngest of four sisters, Eda had serious dark eyes and wavy brown hair. She was twenty-three years old when women won the right to vote, and she dutifully walked the narrow path laid out for women of her generation. Except for the brief stint at the Kodak plant, she was a housewife for most of her life.

As the autumn turned into the winter of 1945, Eda had developed numerous minor physical complaints and went to doctor after doctor. One physician had given her a thyroid medication that apparently increased her nervousness. Another had given her three or four injections of B vitamins for back pain. She had gained ten pounds from the peanuts and candy.

Not long after the vitamin injections, she broke out in a rash. Small pimples spread from her hairline, down the back of her neck and shoulders, and over her abdomen. Then her legs swelled abruptly. The swelling suggested something serious might be wrong, and she was admitted to the University of Rochesteras Strong Memorial Hospital on November 2 for diagnostic tests. The doctors were puzzled by her symptoms but suspected her diet was the culprit. aHer nutrition has been poor because she eats alone, lives alone, has little interest in food, poor appet.i.te, has subsisted largely on sandwiches and coffee and an occasional gla.s.s of milka"poor protein, poor vitamins,a states the first of many hospital admission notes.2 Her eyes were clear, her lungs and heart normal. With just two days of bed rest and the hospitalas high-protein, low-salt diet, the rash and swelling in Edaas ankles subsided. The doctors thought the swelling was caused by hypoproteinemia, a condition in which abnormally small amounts of protein are found in the circulating blood plasma. That condition, in turn, could have been caused by her poor diet. She might also have been suffering from a mild case of hepat.i.tis.