Looking Back in Anger
The Plutonium Files: America's Secret Medical Experiments in the Cold War, by Eileen Welsome, New York: Dial Press, 576 pages, $26.95
In the 1970s, Americans might well have wondered if they were captive to a cadre of lunatic research doctors. Throughout the decade, disclosures of strange experiments conducted on unwitting citizens by their own government popped up with unnerving regularity.
The initial revelation came in 1972. A press report disclosed that during the previous 40 years, the U.S. Public Health Service had systematically studied 600 syphilitic black men. Centered in Tuskegee, Alabama, the study involved denying treatment to 400 of them so that Public Health Service doctors could observe the course of their illness. Several died from complications of syphilis, clueless that they had been in an experiment concocted by their amiable health care providers.
Public anger about the callousness of the study was intensified by its racist overtones. The project and its sponsors were castigated, and institutions around the country that sponsored human subject experiments began to establish panels to review their safety and ethics.
Meanwhile, reports about other disquieting experiments began to surface. Two years after the Tuskegee story, the public learned that during the 1950s Central Intelligence Agency researchers had slipped mind-altering substances into the drinks of unsuspecting victims to watch the effects. The drugs sometimes induced psychotic episodes that in at least one case led to a victim's death.
In 1976 came a news story about an odd Army program. From 1949 to 1969, scientists had conducted biological warfare tests by releasing bacteria and chemicals from sprayers, automobiles, and airplanes over American cities and states. During that 20-year period, millions of citizens were unknowingly breathing in the Army's test agents. The purpose was to see whether the microorganisms would spread and survive and whether the country would be vulnerable to an attack with lethal germs.
Army spokesmen contended that the test bacteria, which included Serratia marcescens, were harmless. But they evidently ignored reports that had appeared in the medical literature years before the tests indicating that the bacteria were dangerous to people in weakened conditions. Indeed, a 1950 Army test in San Francisco should by itself have been a show-stopper. Three days after the city was blanketed with Serratia bacteria, patients at a local hospital began coming down with Serratia infections. Eleven patients were infected, one of whom died. Yet Army scientists continued to spray citizens with so-called harmless bacteria for the next 19 years.
All these revelations appeared notlong after people discovered they may have been at risk from the country's nuclear weapons programs. The United States, the Soviet Union, and several other countries had agreed in 1963 to ban aboveground nuclear testing because radiation poisons could travel far beyond the test sites. Before the ban, more than 500 bombs had been exploded outdoors, mostly by the two superpowers. In the process, millions of people were exposed to radioactivity that increased their risk of cancer. People who lived downwind from the sites were particularly vulnerable. So were thousands of American troops who in the 1950s were made to drill in radiation-filled environments after nuclear explosions.
Eileen Welsome's The Plutonium Files deals with radiation-related experiences and experiments. But her uncompromising brief against government, scientific, and medical officials who ran the radiation programs echoes earlier criticisms by others of Tuskegee, the CIA, and the Army germ warfare tests. Her interest in the subject began in the late 1980s. While reporting for the Albuquerque Tribune, she came upon Army documents indicating that at the dawn of the Atomic Age humans had been injected with plutonium to learn how much their bodies retained. She obtained more documents and tracked down survivors, family members, and officials. Her findings led to a series of Tribune articles in November 1993 about the plutonium experiments.
Those articles were something of an epiphany for then-Secretary of Energy Hazel O'Leary, whose department guarded mounds of classified documents about long-ago radiation tests. That inventory included information about experiments under the department's predecessor agency, the Atomic Energy Commission, and before that the Manhattan Project, which produced the first atomic bomb in 1945.
A month after Welsome's articles appeared, O'Leary announced that she was "appalled and shocked" about the plutonium injections. President Bill Clinton then ordered federal agencies to open all records on human radiation experiments, and he appointed an Advisory Committee on Human Radiation Experiments to review the matter. The committee learned that hundreds of tests had been conducted. Thousands of documents and interviews later, the committee's 1995 report empathized with the many people who had been victimized by "arrogance and paternalism on the part of government officials and the biomedical community."
Welsome is most effective when describing the poor, often uneducated souls who were unwitting guinea pigs. One subject's daughter lamented that telling her father that he was injected with plutonium "would be like telling him he was injected with ice cream." Names and addresses were hard to come by because identities were buried in anonymous aggregates or referred to by code.
But her sleuthing identified a subject called "CAL-1" as Albert Stevens, then a 58-year-old house painter who had moved from Ohio to California in the 1920s in search of a better climate for his asthmatic wife. In 1945, diagnosed with cancer, he was injected with plutonium days before portions of his liver and spleen were removed. He had no idea he was part of a radiation experiment even as his urine and stools were collected to measure their plutonium concentrations. The medical insult to Stevens was compounded when analysis of his removed tissues showed no signs of cancer, just inflammation from a gastric ulcer.
No less dismaying was what happened to "CAL-3." That was Elmer Allen, who in 1947 was a 36-year-old railroad porter whose leg was scheduled for amputation. Doctors injected plutonium into his presumably cancerous leg. After surgery the leg was packaged off to a laboratory for plutonium measurements. Neither Stevens nor Allen nor the 16 other subjects injected with plutonium between 1945 and 1947 knew the real purpose of the injections. Nor, a few years later, did the 74 boys at the Fernald school for retarded and troubled children in Massachusetts know they were eating radioactive elements in their oatmeal. Nor did 829 pregnant women know that the "nutrition" cocktails they were drinking at a Tennessee prenatal clinic were laced with radioactive iron. The doctors in charge never let on that the purpose was to measure the amount of radioactive materials absorbed by their bodies.
Most of the radiation experiments, though not all, seem to have caused no ill effects. Welsome herself acknowledges that the small amounts of radioactive materials used in the majority of experiments "probably caused no harm." When she caught up with Elmer Allen's widow in 1992, she learned that he had died the year before from complications of pneumonia at 80. Still, Mrs. Allen spoke touchingly of how her husband had been exploited. "It just gives me a better view of how people will do you when they feel like you don't know better," she said.
But Welsome also reviews a horror project in which subjects knew they would suffer radiation injury. Between 1963 and 1971, 131 men in Oregon and Washington prisons underwent radiation of their testicles in experiments sponsored by the Atomic Energy Commission. The commissioners wanted to learn how much radiation would permanently damage sperm cells. Volunteers received $5 a month while in the program, up to $25 for a testicular biopsy, and $100 for a vasectomy at the end of the program. The tests were halted when some researchers began to wonder whether prisoners, no matter how well instructed about the experiment, could truly be considered volunteers.
So who was doing all these tests, anddo the testers deserve Welsome's unforgiving condemnation? "Beyond everything else," she writes, "the experiments violated a fundamental right that belongs to all competent adults: the right to control one's own body." Doubtless, the experiments commonly ignored the ethical requirement that human subjects be informed about the nature of the experiment and that they participate voluntarily.
From today's perch, the experiments seem indefensible, and their sponsors obtuse if not malicious. Yet there remains a nagging unease about describing the researchers as aberrational or evil. Welsome's own reporting records the eminence of many of the practitioners and their institutions. Indeed, the idea for the human plutonium experiments came from Manhattan Project physicians, led by the project's medical director, Dr. Stafford Warren, a respected radiologist.
Wanting to know more about the risk of plutonium and other radioactive materials, Warren brought the proposal to J. Robert Oppenheimer, the venerated scientific director of the Manhattan Project. Oppenheimer endorsed Warren's proposal, suggesting only that the experiments not be conducted at the project's Los Alamos laboratories. This was evidently for practical reasons, since Oppenheimer said that Los Alamos "was not equipped for biological experiments."
The injections subsequently were given to patients being "treated" at many of the country's finest institutions, including the University of Rochester, the University of California in San Francisco, and the University of Chicago. Similarly, the Fernald boys were part of an experiment devised by scientists from the Massachusetts Institute of Technology. The radioactive iron experiment on the pregnant women was at Vanderbilt University.
Welsome dismisses observers who allow that these and other Cold War era experiments were understandable by the standards of the time. She appears perplexed to find that many surviving scientists still do not "accept the idea that they or their peers had committed any wrongs." Her arguments are not strange to me. In Clouds of Secrecy: The Army's Germ-Warfare Tests over Populated Areas (1990), I expressed similar misgivings about the Army's biological warfare tests.
After all, the well-publicized Nuremberg Code was part of the postwar verdict against Nazi doctors who killed thousands of Jews and others in ghastly experiments. It unambiguously affirmed the ethical requirement of informed consent. Welsome also notes that the Atomic Energy Commission in 1947 and the Defense Department in 1953 had rules "requiring researchers to obtain the consent of sick patients for therapeutic and nontherapeutic experiments."
But the fact that so many reputable researchers were ignoring the standards is puzzling. The likely explanation is that the values of the time were still in transition. The social environment did not yet fully match the newly underscored standards. Moreover, it was a time when authority of many kinds--governmental, scientific, medical--was commonly trusted and deferred to. Citizens had faith in a government that had led them to victory over the Germans and Japanese and now was protecting them against new enemies.
Scientific authority commanded respect by virtue of spectacular scientific achievements, most obviously splitting the atom. Medical authority derived from a longstanding deference to the healer. Doctors traditionally were demigods who were not obliged to detail their treatments to patients. The arrangement was not simply an arbitrary imposition by the powerful over the powerless but was largely accepted by a deferential citizenry. By the 1970s, deference to authority had yielded to increasing skepticism. Disclosures about the array of unethical experiments only enhanced a distrust of authority seeded by the Vietnam War and Watergate.
Appreciating that shift in values would have helped Welsome's presentation. Instead, her division between good actors and bad is too neat and appears self-righteous. She condemns the findings of the president's advisory committee as "disappointing and timid." She condemns the post-World War II atmosphere that encouraged doctors to publish papers and view "patients as little more than white mice." She condemns everyone who ran the Energy Department and its predecessor agencies before O'Leary, calling them an unbroken "line of steely-eyed patriots."
Conversely, Welsome glorifies O'Leary, suggesting that her resignation at the end of Clinton's first term was prompted in part by bureaucrats who resented her shining "the bright light of truth" on the radiation experiments. O'Leary's infamous trade missions "may have been overstaffed," concedes Welsome, but she implies that Republicans overreacted with "hostile questions." Welsome surely understates the magnitude of problems that O'Leary brought on herself. She writes nothing about the $4.5 million that O'Leary spent on foreign trips, including one to India with an entourage of 76 in a plane that had previously been leased by Madonna. O'Leary also was found to have spent $43,000 to find out which reporters were writing favorable articles. And as department records later showed, she routinely manipulated statistics to exaggerate the number of Energy Department contracts with businesses owned by women and minorities.
None of this minimizes the servicethat O'Leary and the administration performed by opening the radiation records or that Welsome performed with her compelling descriptions of the experiments. But the lack of balance in Welsome's treatment of O'Leary mirrors her insensitivity to the value differences between the postwar decades and the present. Public demands for accountability simply were not the same. The distinction is wonderfully, if inadvertently and grotesquely, demonstrated by a scientist who, at a 1955 Atomic Energy Commission conference, estimated that after all-out atomic war, a few people would survive and "keep the race going." According to this scientist, "They might not populate the earth with just the descendants we would like to see. They might not be highly civilized like we are. They might not know anything about atomic warfare, for example."
Cold and ludicrous as such a calculus now seems, there is no indication that it put off any of the scientist's listeners. Unless we believe that he and thousands of other American scientific, medical, and governmental leaders were psychopaths, we must allow that they were acting within the value framework of the time. It would take another generation for values to catch up to the newly codified standards.
Welsome's manner of criticism has implications beyond the radiation and experimentation issues. By using a contemporary template to rigidly judge yesterday's behavior, she implicitly invites future generations to do the same to us. Who is to say which values that today are embraced by large segments of the population could not be viewed with unforgiving contempt in the future? Frying humans in electric chairs? Killing a fetus, or, conversely, denying choice to a pregnant woman? Refusing same-sex partners the opportunity to marry? Whatever one's personal views on these issues, fair-minded observers understand that people of good will may be found on all sides. Of course, some behaviors are so egregious as to deserve condemnation in any era: The Nazi medical experiments, for example, in which victims were injected with toxins or placed in high pressure chambers to observe the manner in which they would die.
To extend a generosity of understanding to earlier generations is not to excuse or defend past reprehensible behavior, but to acknowledge that future generations will almost certainly judge many of our own actions--even and perhaps especially those done for the "greater good"--as harshly as Welsome judges the radiation researchers.
