Read The Plutonium Files Online
Authors: Eileen Welsome
The Plutonium Files (51 page)
Gradually the vomiting and nausea subsided. Cecil began taking small sips of water but could not urinate and complained of severe pain in his right upper abdomen. A nurse wrote, “He described it as a hard knot in his lowest rib which wouldn’t relax.” By midnight Cecil was coherent enough to give his group leader a description of what had happened. He described the heavenly blue glow that had filled the room and the rumbling sound he heard from the tank. Sometime after the interview,
he vomited on the floor. The floor was measured for radioactivity. Wrote Benson, “Vomitus area monitored and is ‘O.K.’ ”
Don Petersen, who retired from the laboratory in 1990 but still serves as an advisor to the Army’s chemical and biological warfare programs, said in his deposition that doctors were having trouble stabilizing Cecil’s blood pressure. The only way they could keep the blood pressure up was to administer fluids. But as Cecil’s body began to shut down and his kidneys failed, the infusion of liquids began creating other problems.
Doris, who was allowed into Cecil’s room after he had been stabilized, remained at his bedside through most of the ordeal. She said her husband knew he was dying. He told her to take good care of their two children, a seven-year-old daughter and a boy about eighteen months old. His brother from Indiana arrived about 3:00
A.M.
and they talked quietly for an hour or so.
Cecil occasionally napped or dozed as the hours ticked away. His right arm, then his left arm, began to swell from the I.V.’s. About 7:00
A.M.
the next morning, a nurse rubbed his back and changed his linen. She noticed that an inflamed area had appeared on his right arm.
At 5:00
P.M.
, some twenty-four hours after the accident, the doctors decided to do a sternal bone marrow biopsy. Several physicians said the biopsy probably was done to determine whether Cecil was a candidate for a bone marrow transplant, which was still a new procedure in the late 1950s. But a document provided to his wife and daughter during the discovery stage of their lawsuit suggests the procedure was simply another way to collect data on the effects of radiation. Writing to a colleague a week after the accident, Los Alamos doctor Thomas Shipman observed:
From the very beginning it was obvious that this man had received a massive dose.
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We are currently estimating it in excess of 12,000 rem. He died in thirty-five hours, but I am sure would have died in two or three hours had we not treated his shock. He was in a state of profound shock on admission to the hospital and this was the principal problem as far as treatment was concerned. Because of the size of the dose, it seemed obvious that he would die a central nervous system death, so we never seriously considered bone marrow transfusions.
The operating room equipment was taken to Cecil’s bedside. His chest was scrubbed with soap, water, alcohol, and draped in a sterile
cloth. Then an incision was made over what was thought to be his sternum. A “good deal” of material was removed, but it did not seem to include any bone marrow.
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The doctor suddenly realized he had made the incision in the wrong place. That wound was closed with fine silk sutures and another incision made. Cartilage, a small piece of muscle, and “a great deal of red marrow was obtained for slides,” physician W. R. Oakes later wrote.
Doris’s stomach churned as she witnessed the procedure: “What they pulled out was slop.
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They put a syringe in his chest and pulled it out. It was just mush.” Cecil lived another ten hours. The nausea and cramping came and went. His arms and legs continue to swell. Six hours before his death he mumbled to a nurse his chest felt as if “it was beginning to thaw out.” But then the restlessness and thrashing set in again. He complained of pains in his chest, abdomen, and arms and finally grew so agitated that he pulled the intravenous needles from his arms. He was sedated with morphine and luminal. He began having “frog type” respirations, which gradually became slower over the next fifteen minutes. “Pulse unobtainable—heart tones quite distant … respiration had ceased—no response—pronounced dead at 3:15
A.M.
,” Benson wrote in Cecil’s medical chart.
42
It was New Year’s Day of 1959, exactly thirty-four hours and forty-five minutes since the accident occurred. In the hospital room at the time of Cecil’s death were physicians John Benson, Robert Grier, and Clarence Lushbaugh, a laboratory pathologist who would soon perform the autopsy. Several visitors who were en route to Los Alamos, including Louis Hempelmann, who had overseen the medical care of Harry Daghlian and Louis Slotin, were contacted and told to go back home.
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Hempelmann said he would be available for consultations by telephone if anyone needed him.
After his death, Cecil’s corpse was dragged by sled through the snow to a steel-lined building that contained a whole-body counter. “He was so loaded with everything, the counter just went berserk,” recalled Earl Kinsley, an Air Force health physicist assigned to the lab at the time of the accident.
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At 6:00
A.M.
on New’s Year Day, Clarence Lushbaugh began an autopsy.
45
Lushbaugh was struck by the waterlogged appearance of Cecil’s tissues. (The physicians had been pumping fluids into him to keep up his blood pressure and had “nearly drowned” him in their efforts, Thomas Shipman would later write.
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) Lushbaugh dutifully recorded the two incisions on Cecil’s chest and the “numerous needle puncture marks” on his
forearms and lower legs. Not surprisingly, he found some of the same kind of hemorrhages that Stafford Warren and Shields Warren had observed years earlier on the Japanese atomic bombing victims. The abdominal cavity, the gastrointestinal tract, and the heart were covered with small hemorrhages. “Rigor mortis is exceptionally strong and the muscles more contracted than usual,” Lushbaugh wrote. Cecil’s heart, lungs, liver, kidneys, adrenal glands, stomach, colon, lymph nodes, gonads, and brain were removed and stored for later analysis.
Following the accident, telegrams poured into Los Alamos from all over the world. They were not sympathy messages but requests from researchers who wanted bits and pieces of Cecil’s body for study. Clarence Lushbaugh shipped Cecil’s brain in a wide-mouthed mayonnaise jar to the Armed Forces Institute of Pathology.
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When Lushbaugh was asked in a deposition who gave him authority to send the brain there, he responded, “God did.”
Scientists at the Armed Forces Institute of Pathology compared Cecil’s brain to the brains of monkeys that were also being blasted with huge doses of radiation.
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The findings were so interesting that one of the scientists, Webb Haymaker, asked Lushbaugh for permission to discuss the case at a meeting at Walter Reed Hospital.
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Pieces of Cecil’s frozen liver and lymph nodes were mailed to Hanford. Twenty-five ccs of his urine were sent to Oak Ridge. For many months after the accident, Los Alamos scientists churned out biomedical and dosimetry reports based on data from the deceased man’s body parts and his clothing, including the brass buttons on his coveralls.
But the most important postmortem study was the one to find out if the plutonium in Kelley’s body matched what scientists had predicted. Using nose counts, urinalyses, and Wright Langham’s formula, the group predicted that Cecil had eighteen nanocuries, or a little less than half of the so-called maximum permissible body burden.
50
When they reduced his organs to solution, they found his body content was nineteen nanocuries. The agreement was so close that Wright Langham considered it “undoubtedly fortuitous.” But the scientists were nevertheless disturbed because the amount of plutonium in the lungs and pulmonary lymph nodes was much greater than they had predicted.
While Los Alamos scientists performed their mathematical calculations and began preparing their findings for publication, officials at AEC headquarters in Washington, D.C., were in a dither about whom to blame. Not surprisingly, Cecil Kelley became the scapegoat. It is difficult to reconstruct from documents exactly how the criticality accident occurred,
but apparently three “improper transfers” of solutions were made that resulted in the excess of plutonium in the tank.
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It’s not clear whether the transfers were made by Kelley or by workers on the preceding shift. Ironically, the lab was in the process of reviewing the safety aspects of its plutonium recovery program when the criticality occurred.
To his credit, lab director Norris Bradbury informed the Atomic Energy Commission that “no single cause” triggered the accident.
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“It was made possible by a complicated set of circumstances and coincidences, no one of which can be considered wholly responsible.” But the AEC nevertheless went ahead and issued a press release blaming the entire incident on Cecil. “The accident was directly attributable to errors on the part of the deceased operator.”
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The AEC press release didn’t sit well with Thomas Shipman. “I feel quite strongly that the statement as given is manifestly unfair to Kelley himself and does not give a true picture of the whole affair,” he told Bradbury.
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Shipman also strongly protested the AEC’s statement in a letter to Charles Dunham, who by then was in charge of all the AEC’s biomedical programs:
In stating that the accident was “directly” attributable to mistakes made by Kelley it was untrue.
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I am sure that you are sufficiently familiar with the facts to realize that Kelley could have continued to do all of the things he did had it not been for things beyond his control and beyond the knowledge of anyone concerned.… On the whole, the people around here know pretty well what had happened, and this new publicity has left them quite bewildered, and they feel that a man who is unable to defend himself—and who possibly could have defended himself—has been very unjustly treated.
Cecil was given a military burial and a twenty-one-gun salute. A three-cornered American flag went to Doris. His daughter, Katie, then a small girl clad in a navy-blue sailor suit and a blue hat, tossed a handful of dirt on the casket. Doris received $7,000 from Los Alamos; another $3,000 went to Kelley’s first wife. Doris, who worked as a secretary at the lab for forty-seven years, said lab officials also promised to pay for her children’s college education, buy her a house, and give her a salary increase.
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But none of those promises were kept. With two fatherless children to raise, the family gradually slipped into poverty.
The laboratory also returned to Doris her husband’s gold Bulova
wristwatch, and his wallet. In the wallet was Cecil’s 1958 Los Alamos Golf Association membership card, his Eight Balls Bowling League card, a New Mexico hunting and fishing license, and a charge card to Pflueger’s Smart Footwear in Santa Fe. Behind the bright-red Atomic Energy Commission identification card, Cecil kept a one-dollar bill, soft as tissue paper and dated May 18, 1914. The dollar bill was given to him by his father-in-law and was supposed to have been his good-luck charm.
With the death of Cecil Kelley, Los Alamos’s human tissue program began in earnest. Between 1959 and 1985 the body parts of 1,712 human beings, including nearly a dozen whole cadavers, were shipped to Los Alamos and analyzed for their plutonium content.
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The original objective of the program was to see if the amount of plutonium in deceased nuclear workers agreed with predicted amounts derived from exposure records.
The Los Alamos investigators obtained organs and cadavers from people who died in other parts of the country for a “control group.” Those analyses also helped scientists estimate how much plutonium the American people were accumulating from the bomb tests. The human organs were dried in ovens, converted into ash, then dissolved in an acid solution so they could be analyzed. For many years, anyone who died in the town of Los Alamos was autopsied, including visitors, whom pathologist Clarence Lushbaugh called “extras.”
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