The Plutonium Files (55 page)

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.
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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 “difficult to assess the extent to which radiation had affected the life expectancy of the patients.” 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. “Close similarity seems to prevail,” they added, “between systemic effects produced in cancer patients by whole body X-irradiation and those caused in healthy human beings by nuclear explosions.”
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When the M.D. Anderson experiment was over, Gerstner turned his attention to the civil defense aspects of acute radiation sickness. Like General James Cooney, 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 “useful” lives.
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In a 1960 paper he wrote:

Gerstner, who had witnessed the unpredictability of war in France and on the Russian Front, did not particularly enjoy the civil defense work. “He was not very happy with that aspect,” his widow said, “but he was often called on as an expert.” Gerstner left the School of Aviation Medicine in 1960 and went to the Oak Ridge Institute 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. “There was a connection,” Helga Gerstner said. “They had some joint project. What he did and what they cooperated on, I don’t know. I just know they worked together on something.”

Herbert Gerstner was involved in the first military-sponsored TBI experiment of the Cold War, and Eugene Saenger oversaw the final one. While no documents have surfaced to indicate that Gerstner had any hands-on involvement whatsoever in Saenger’s TBI project, the two scientists, both closely allied with the U.S. military and civil defense planners, had much in common.

Around the time that Eugene Saenger, a young radiologist at the University of Cincinnati, went to listen to a talk given by General James Cooney, he was beginning to wonder if his medical career was ever going to amount to anything more than doing barium enemas and diagnostic X rays.
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Thanks to the Atomic Energy Commission’s aggressive radioisotope distribution program and its concomitant public relations program, nuclear medicine was becoming a hot field, and Saenger was eager to get in on the action. He had taken a training course on radionuclides at the Oak Ridge Institute for Nuclear Studies, where he had learned how to pipette, “how to dilute, how to count,” but he felt sure there was more to nuclear medicine than that.
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Then he heard the presentation by General Cooney, one of the nation’s foremost experts on atomic energy. Perhaps Cooney talked that day about how the power unleashed by the atom could be harnessed to cure the ills of mankind—one of his standard themes as he barnstormed the country in his role as cheerleader for the atom. Whatever he said, Saenger was impressed. He was soon to do his two years of military service and wondered if Cooney might be able to help him find a placement that would take advantage of his training. Afterward he went up and introduced himself.

“Listen, I’d like to [get] into some of this nuclear energy stuff when I get into the Army,” he told the general.
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“Saenger,” the general snapped, “you come and see me.”

When Saenger joined the Army Medical Corps in 1953, he took Cooney up on his word and visited him. I was treated as if “I was king of the mountain,” Saenger remembered.
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“His secretary knew I was coming
and they made a big fuss, and we became very good friends, the Cooneys and my wife and I.”

Saenger was first dispatched to Sandia Air Base in Albuquerque, New Mexico, the field command for the Armed Forces Special Weapons Project. Although Saenger had no interest in attending a weapons test (“you get all this crud coming down your neck, to me it was useless”), he did get a good introduction to “bombology.”
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Six months later he was transferred to Brooke Army Hospital in San Antonio, where he was made chief of the Radioisotope Laboratory. Saenger remained at Brooke, the Army’s leading burn research center, until he was discharged in 1955. While Saenger spent only two years in the Army, he maintained his military connections for the rest of his life.

After his tour of duty was over, he returned to Cincinnati, a sprawling city on the banks of the Ohio River that has the feel of a sleepy southern town but resembles Detroit. Located across the river from Kentucky, Cincinnati historically has been a major connecting point between the North and South. With some 2,000 industrial plants, the city has long been a destination for poor whites and African Americans from southern states. Racial tensions have occasionally run high, and in 1968 the city exploded in riots following the assassination of Dr. Martin Luther King Jr.

Handsome and confident, Saenger had strong ties to the medical school and the city itself. Except for his two-year military stint and four years as an undergraduate at Harvard, Saenger has lived his entire life in Cincinnati. His uncle was the medical school’s first professor of radiology, and Saenger worked in his lab when he was young. After receiving his medical degree in 1942 from the University of Cincinnati College of Medicine, he went on to do his internship and his residency at Cincinnati General Hospital, becoming a board-certified radiologist in 1946. Saenger later directed three or four campaigns that raised millions of tax dollars for the hospital. His “small expertise,”
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he once confessed in a letter to Los Alamos’s Wright Langham, was “political rather than scientific.”

In 1955, the year Saenger was mustered out of the Army, he began preparing a research proposal to study the effects of total-body irradiation on cancer patients. Saenger probably learned of the military’s interest in TBI when he was in the Army. But his proposal was also fueled in part by the chairman of the pediatrics department, who made the offhand comment one day that no radiologist had ever done any decent scientific research. “That really upset me.
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That really annoyed me. I have never
forgotten that,” Saenger told staffers from the Advisory Committee on Human Radiation Experiments. “I sort of thought, dammit, I’m going to show people I know how to do something, not that it’s been very momentous but it’s kept me interested.”

Saenger had also learned from one of his close friends, John Lawrence, the brother of Ernest Lawrence, that it was better to get contracts than grants. “We were on a boat one time in Florida and we were talking about grants and contracts and I said to him, ‘These grants are really sort of a pain.’
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He said, ‘You mean to tell me you’re still going after grants?’ I said, ‘John, what should I be doing?’ He said, ‘Contracts, my boy, contracts.’ And it was very interesting because a contract would run forever.”

In 1958, Saenger submitted his application to the Research and Development Division of the Army Surgeon General’s Office.
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The Army seemed like a “logical source of funds,” Saenger told interviewers, because of its interest in the effects of radiation on humans. General Cooney also happened to be the deputy surgeon general at that time.

The year that Saenger submitted his application, the United States and the Soviet Union had just agreed to temporarily halt atmospheric testing of atomic weapons largely because of strong opposition to fallout. Within eighteen months, though, the troops and the cloud samplers would be back in Nevada and the Pacific Proving Ground for another season before the aboveground tests were finally halted for good.

According to Saenger’s original application, entitled “Metabolic Changes in Humans Following Total Body Radiation,” one of the chief goals of his proposed study was to find a biological dosimeter—the goal that for all practical purposes would elude most of the researchers who ever pursued it, to the great frustration of their military sponsors. Saenger stated that he intended to use well-nourished adult males with widespread cancer and exclude women of child-bearing age because their amino acids fluctuated too much during the menstrual cycle.
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Defense Department officials who reviewed Saenger’s application had mixed feelings about his proposal. James Hartgering, a former Armed Forces Special Weapons Project official who was privy to many of the high-level discussions on troop maneuvers at the Nevada Test Site, said he did not believe Saenger’s research would yield anything useful but felt the experiment should be supported anyway. Hartgering wrote, “There are so few radiologists in the country willing to do total body radiation that those that are should be encouraged more.
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His past research experience has been good and I feel that he is a very reliable investigator. If he is supported I am sure he will soon decide that some
other phase of the radiation program should be investigated and switch to this.” Arthur Sullivan, another scientist, believed Saenger’s experiment would “augment” the TBI studies under way at Baylor and Sloan-Kettering and might lead to a “possible biological dosimeter.”
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Only one Army official, Colonel John Isherwood, chief of radiological services, suggested Saenger’s work might have a potential benefit to the patient. “Any correlation of tumor response to total dose of irradiation by such means as prepared by this project would be of great value in the field of cancer.
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In addition if by means such as those proposed accurate knowledge of the total dose of radiation received could be determined it would be of inestimable value in case of atomic disaster or nuclear warfare.”

The first of several contracts between the University of Cincinnati and the Defense Atomic Support Agency, AFSWP’s successor, was signed in early 1960. Saenger headed the TBI project, but he scrupulously avoided choosing the patients who were to be irradiated, leaving that task to others. The first patient who received total body irradiation was a sixty-seven-year-old African American with cancer of the left tonsil.
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The disease had spread to his palate and throat. He received 66 rads and died seventy-three days later. Over the next eleven years, some eighty-nine additional patients were administered TBI.

In the ten reports that Saenger submitted to the Defense Atomic Support Agency or its successor, he says almost nothing about the therapeutic effects of TBI on the cancer patients. “These studies,” he wrote in his first report, “are designed to obtain new information about the metabolic effects of total body and partial body irradiation so as to have a better understanding of the acute and sub-acute effects of irradiation in the human.”
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In his second progress report, he added, “This information is necessary to provide knowledge of combat effectiveness of troops and to develop additional methods of diagnosis, prognosis, prophylaxis and treatment of these injuries.”
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Saenger has said he did not include information in his progress reports on the positive medical effects of the TBI because the military was not interested in that portion of the study.
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The total-body irradiation was administered to the “patients for palliative purposes,” he said. In other words, the treatment would not cure the patients but it might shrink their tumors, reduce pain, and possibly extend their lives. However, no written protocol has been found showing that palliation was the primary purpose of the study. Furthermore, Saenger and his colleagues did not
publish a scientific report comparing the benefits of TBI to other cancer treatments until 1973, a year after the study had ended and the experiment had received widespread negative publicity. In Saenger’s 1973 paper, he states that whole-body radiation and partial-body radiation had some “beneficial effects” in controlling certain advanced cancers and that its palliative effects compared favorably with those induced by other drugs.
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Saenger initially planned to start with doses of 100 rads, gradually increasing exposures to 150, 200, 250, 300, and finally 600 rads. Like Shields Warren, Saenger was aware that individuals varied greatly in their response to radiation exposure and that some people might die at the higher doses without therapeutic intervention. In a handbook on radiation accidents published three years after the study began, Saenger wrote: