2 This set of documents that has now been copied and re-copied in I drove back over to McMicken Hall that day, and I sat out on the campus drive, up on our hill with its beautiful lawn stretching down to Clifton Avenue, and pulled these papers out on my lap to see what I had. I saw that individual patient histories were attached to the backs of each of the nine reports, and I began reading these histories. I read for about an hour, and when I got out of the car, it was as if I could hardly recognize what was around me. Everything I saw looked different to me. I was used to reading in plays and novels about tragic deaths, full of pity and sorrow, but I was not used to this pity, this sorrow. I felt that these experiments had to be stopped, and of course in due time they were stopped. Over that Christmas holiday, I spread these papers out late at night over my dining room table, after our children were put to bed, and I wrote a summary of what had happened to the eighty-seven individuals that had been irradiated. I wrote about how they died. I presented my findings to a meeting of the Junior Faculty Association on January 14, and the group decided to have a press conference, and this we did on January 26 of 1972. I feel now, as I look into the whole matter again, that our report was actually a conservative one. My friends in the JFA had gone over with me every sentence of it. We knew it had to be clear and it had to be right. I introduced a number of qualifying phrases, everywhere we had the least idea that an assertion could be challenged. Today I would not be as hesitant; but at that time it was as if I could hardly believe myself what I was putting down on paper. Still, this report told all the basic truths of the case; it told the truth, and it examined every possible argument the doctors could use to justify what they had done. In some ways it is even more astonishing to me today to reflect on what transpired and to image up the whole scene from the point of view of the patients that were used. Even now, after so much discussion of these fellow citizens of ours, we don't know all their names or where they lived, what they did for a living, what they personally went through, the ways in which their loved ones suffered as they themselves waited helplessly for word of this or that from doctors and nurses that usually could not be found, or stood at bedsides in crowded wards, often dirty wards, as various hospital users of those years have testified. These families I'm speaking of have been < - the invisible people inhabiting all our debates and discussions about this project. I'm thinking, for instance, of a man with stomach cancer who, after his irradiation, never came back to the hospital, bore his painful disease without help, as far as we know, not willing to be treated again after such an experience. I think of an eighty-year-old African American woman, "M. B.," who had lung cancer and suffered a stroke on the operating table in 1969, having her bone marrow aspirated in preparation for her irradiation. She died six days afterwards - "on anesthesia-related death," as the doctors themselves describe it. Did she volunteer to be in an experiment that might end her life? Q. How many patients died? We know that at least 8 patients died of bone marrow failure as a direct result of radiation; for these patients the doctors provide the blood scores that allow us to document these cases of classic radiation injury. Then there were cases like that of M. B. mentioned above. Some of the histories, however, tell more than the others; in the later period, blood scores are no longer being studied and we are not generally told how much bone marrow depression existed at time of death. But there are altogether 26 individuals who died within 60 days of being irradiated and whose deaths were almost certainly hastened by radiation. For some of these short survivors we need to see their full hospital charts and follow-up in the clinics and hospitals to know exactly how they died. Q. Were these cancer patients terminal? Were they people expected to live only a few months, as the medical school has said? 3 The patients who survived the radiation often lived several years. One woman with cancer of the tongue was irradiated in 1961 and lived at least five years after the radiation. We in fact do not know when she died. A later group of subjects were chosen specifically because they were in relatively good shape, were not elderly, and could be interviewed in their homes or workplaces about coming in for this "treatment." They were working, eating normally, with good blood counts. Definitely not bed-ridden, extremely feeble, or about to die. Q. Who were the doctors? It was not a question of one or two or three individuals performing a deadly rite that very few other doctors knew about. A project that goes on for eleven years and involves the screening and Consideration of at least 111 patients had to be known to a great many people. There were thirteen doctors on this team over the years, co-authoring the reports and publications, and many more who assisted in various ways and were sometimes closely involved, in the complex testing of irradiated subjects for mental functioning, for instance. Then we have the doctors who were staffing the Tumor Clinic at the hospital and willing to hand over patients to the chief investigator and his associates, as well as staff at several other hospitals; at least three subjects were "recruited" from Drake, to use the doctors' term, and three youngsters with Ewing's sarcoma were brought over as "volunteers from Children's. Though Dr. Bernard Aron has been put forward by the Medical School as if he were an uninvolved or neutral spokesman, he was himself a member of the team for the final two years of the project. This doctor also served on the Medical School's internal review which cleared the project of any wrong-doing. In general, I believe we do not expect to have the individual who is in the defendant's box also sitting on the jury. Where in fact does the complicity begin and end? The American College of Radiology did not find anything offensive in these trials and in fact termed them "heroic." What should we think about the long list of important medical journals which published the findings of these doctors over the years? How did their editors and readers regard the deaths they learned about in these reports? What were the attitudes of the local hospital authorities, the state licensing board? Why did the review committees at U. C. fail? In Cincinnati, it can also be said, not one m. d. in the Medical School came forward to offer help to the faculty group studying the project in 1971, or simply to examine their results with an independent eye, though one research biologist did consult with our group anonymously. No doctor in the greater medical community of the town openly expressed any doubts about what had been done. This is that wider complicity that should alarm us more than anything else, and here in 1994 -- when things are supposed to be "better" -- the same situaîton exists. No doctors coming forward. | believe it is correct to say that no reporter here in town has been able to find a single local doctor to examine what our faculty group found. In 1985 an m. d. working here for NIOSH got in touch with me about this project and examined some of the medical histories in my home one night. Since then this individual, David Egilman, has attempted to draw attention to these trials; he bears out the findings of the JFA and has publicly explained the state of medical knowledge about whole body radiation for cancer as it existed at the time of the U. C. tests. He finds 5 no reason for the doctors to have believed that radio-resistant tumors such as most of their patients suffered from could have been helped by the "treatments" administered; the doses given, as deadly as they proved to be for many subjects, was not high enough to reduce tumors or stop the spread of cancer. (Were> Q. Why did the Medical School succeed in drawing a curtain over this whole affair in 1972? If the case against the doctors was as clear as it sounds, why was there not a lawsuit from subjects or a criminal investigation? One needs to understand the role of the media in Cincinnati (and in many other American towns). When the JFA press conference took place, the Washington Post sent a reporter and the New York Times. A crew came from CBS. Our report was entered into the Congressional Record by Senator Kennedy. But there was no real coverage in Cincinnati no way for any of the subjects or their families to know what had taken place. No one here broached the words "radiation death." The Medical School was never compelled to acknowledge any wrong-doing, and yet there was a tacit acknowledgement that such work could no longer be tolerated, for after all the project was stopped. No patient was irradiated after the fall of 1971, even though in the report that would prove to be their last to the DOD, the doctors had announced their plans for more experiments in the year to come. Q. Was there a cancer study being carried out using these patients? There was no publication or report on cancer study during the eleven years of the project. No design for a cancer study was ever produced during the actual course of the experiments, although a study on cancer was issued after the fact and as a result of public revelations. There is no reference to an ongoing cancer project in the DOD reports. There is no evidence of close follow-up by the team of the patients who survived more than 60 days. When the team had completed its radiation-injury tests, it seemed to have no more interest in the patients or their cancers. If there was a cancer project, who were the doctors, where is the design, by whom was it funded, what were its results and how were they being reported? Q. Didn't some people at the university object to what you and your group were doing, feeling that the activities of your medical colleagues were none of your business? 6 A. Of course. But surely events like these are everyone's business. The people who used General Hospital were mostly Cincinnati working people; the great majority of them we now know were paying taxes; they were helping to pay the salaries of those of us in the JFA, and the salaries of the doctors. They were helping to fund this public hospital, not to mention the U. S. war machine of those days (as they do today). One can say that their taxes helped to pay the salary of Ohio Governor John Gilligan, who came, not to their defense, but to the defense of the Medical School and assisted in the cover-up. Gilligan convinced Senator Kennedy to drop U. C. from the hearings on human experimentation which followed the U. C. revelations and those about Tuskegee (where beginning in the thirties men in Alabama with syphilis were denied treatment for their whole lifetimes, and many died of syphilis-related disease or became insane). I grew up among ordinary working people. My father worked for the railroads; my mother had only an eighth grade education. Many of us in the JFA were individuals who tended to side with common people against leaders and experts who wanted to control everything. I think people like ourselves are still hoping that we in the U. S. can grow into a true democracy, that common citizens will take the lead and assume control over their own society. We are a class-ridden country, and actually it should not surprise us when our class conflict results in grievous actions like those of the U. C. doctors, actions, that is, of one potent and protected class against another that is powerless. It was a question here of a conflict between wealthy doctors and administrators in a public institution insulated against public accountability -- and common working people who could not afford doctors of their own choosing. Q. What changes should come out of these revelations? A. First of all, surely it ought to occur to us that if we had had national health insurance of a single-payer kind, that is, of the Medicare type that allows people to choose their own doctors, these fellow citizens of ours would not have been trapped in a public hospital with nowhere else to turn. We need to see who is going to medical school. Is it only the children of the wealthy? often the children of doctors, whose incomes, after all, are within the top one or two percent of U. S. incomes? There should be a public examination of all our admission practises around the country and the way that medical schools are funded and how doctors are trained. |