The Treatment: The Story of Those Who Died in the Cincinnati Radiation Tests

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Overview


The Treatment is the story of one tragedy of medical research that stretched over eleven years and affected the lives of hundreds of people in an Ohio city. Thirty years ago the author, then an assistant professor of English, acquired a large set of little-known medical papers at her university. These documents told a grotesque story. Cancer patients coming to the public hospital on her campus were being swept into secret experiments for the U.S. military; they were being irradiated over their whole bodies as if they were soldiers in nuclear war. Of the ninety women and men exposed to this treatment, twenty-one died within a month of their radiations.
Martha Stephens’s report on these deaths led to the halting of the tests, but local papers did not print her charges, and for many years people in Cincinnati had no way of knowing that lethal experiments had taken place there. In 1994 other military tests were brought to light, and a yellowed copy of Stephens’s original report was delivered to a television newsroom. In Ohio, major publicity ensued—at long last—and reached around the world. Stephens uncovered the names of the victims, and a legal action was filed against thirteen researchers and their institutions. A federal judge compared the deeds of the doctors to the medical crimes of the Nazis during World War II and refused to dismiss the researchers from the suit. After many bitter disputes in court, they agreed to settle the case with the families of those they had afflicted. In 1999 a memorial plaque was raised in a yard of the hospital.
Who were these doctors and why had they done as they did? Who were the people whose lives they took? Who was the reporter who could not forget the story, the young attorney who first developed the case, the judge who issued the historic ruling against the doctors? This is Stephens’s moving account of all that transpired in these lives and her own during this epic battle between medicine and human rights.
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Editorial Reviews

From the Publisher

“Read this book not only to grasp the horror of what official medicine did to ninety families, but also for the fuel you need to fight such outrageous injustices in our midst.”—Jim Hightower

“Stephens is a skilled investigative journalist, piecing together medical records, Pentagon reports, and firsthand interviews to weave a damning and unforgettable picture of what happened in the basement of Cincinnati General Hospital.”—Eileen Welsome, author of The Plutonium Files: America’s Secret Medical Experiments in the Cold War

“Stephens tells her story in a clear and sure voice, forging a compelling narrative that presents this tragedy in a very human and accessible manner.”—George Annas, author of Standard of Care: The Law of American Bioethics

An invaluable, outstanding work that will endure to enhance respect for informed consent in human research, as hope for vigilant advocates of human rights, and as a case study of how history unfolds.”—Carl Gandola, MD, Cincinnati, Ohio

From The Critics
[T]his shameful episode makes for both fascinating and troubling reading. . . . The Treatment belongs on the desk of every legislator, university president and research scientist in the country. It stands as another stark reminder of the harm that can be wrought in the interest of national security or in the name of medical science.
Publishers Weekly
From 1960 to 1972, a grisly and highly suspect research project was carried out in the bowels of Cincinnati General Hospital. Cancer patients, most of them in advanced stages of the disease, were exposed to massive quantities of radiation over long and continuous periods of time. Nearly all of them (over 100 altogether) died within weeks or months of the start of the irradiation "therapy." In 1971 Stephens, a professor of English at the University of Cincinnati, began to make inquiries about the Cincinnati project; despite the hospital authorities' reluctance, she eventually gained access to files documenting the treatments. They were, she says, horrifying records of misery, incompetence and medical hubris, and Stephens dedicated the next 30 years to publicizing them. Unfortunately, the story she relates here is less concerned with the patients than with herself: only about 70 pages are actually dedicated to a description and analysis of the experiments, while the rest of the book is a detailed, boring and highly self-serving account of the author's experiences with the press and the courts. While there appears to be little doubt that the Cincinnati project was a grotesque abuse of medical ethics and simple human decency, Stephens seems positively to revel in it as proof of the racism (most of the patients were black) and mendacity of the medical and political establishment. And while her dedication in bringing the case to light is admirable, her presentation of the parties involved ("She had believed the doctors, had automatically believed the doctors. I didn't feel she cared about common people but only about important people.") is as tendentious as it is simplistic. B&w photos. (Mar.) Copyright 2001 Cahners Business Information.
Library Journal
From 1960 through 1971, more than 80 cancer patients were treated with partial or total body radiation at Cincinnati General Hospital as part of an experiment conducted on behalf of the U.S. Department of Defense. A number of the patients died a short time after the radiation exposure, which was administered in an attempt to simulate the possible effects of nuclear war on soldiers. While the experiments were kept relatively quiet until 1994, the project raised serious issues relating to informed consent, the appropriateness of the treatment, and the intent of the research. These concerns eventually led to extensive investigations, a congressional hearing, and a lengthy lawsuit. A novelist and former professor of English, Stephens (Children of the World) is active in many social causes and was a member of a junior faculty organization that first attempted to raise awareness of this project in the 1970s. Based on hospital records, interviews with the victims' families, government reports, and University of Cincinnati disclosures, the book provides a shocking example of why we must remain diligent in our review of medical research. Recommended for all collections. Tina Neville, Univ. of South Florida at St. Petersburg Lib. Copyright 2001 Cahners Business Information.
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Product Details

  • ISBN-13: 9780822328117
  • Publisher: Duke University Press
  • Publication date: 1/28/2002
  • Edition description: New Edition
  • Pages: 350
  • Sales rank: 569,391
  • Product dimensions: 6.46 (w) x 9.60 (h) x 1.30 (d)

Meet the Author

Martha Stephens was for many years Professor of English at the University of Cincinnati. She is the author of The Question of Flannery O’Connor, the novels Cast a Wistful Eye and Children of the World. An activist for many years, Stephens was the first to break the story of this scandalous project and continues to work for justice for the victims and their families.

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Read an Excerpt

Chapter One


The First Public Knowledge of the Tests


It is clearer and clearer to me that life is not held sacred in this country; it is cheap.
—SENATOR MIKE GRAVEL, 1972


Life, we all know, does not run a true course; it twists and turns on us and brings us up against the most unexpected circumstances.

    In the fall of 1971, ten years after the death of Lula Tarlton, new radiations were still taking place in our public hospital in Cincinnati. But the first tentative explorations were being made by the press, and that October a small story appeared in the Village Voice that would restructure my own life for a full year and more, and affect my thinking deeply for many years to come.

    I was a teacher of English, but the research I undertook that winter had nothing to do with literature—I took up the study of radiology.

    What I learned about this science made me so respectful of radiation that I began to refuse to have even a chest x-ray or x-rays at the dentist. My husband and I decided that our children were not going to be irradiated at all except in a genuine medical crisis, and for years we had running disputes on this issue with our doctors and dentists.

    Over that fall of 1971 I acquired—in a curious way which I shall presently describe—certain critical documents on the experiments, and during the December holidays that year, I sat up late at our dining room table, after children were put to bed, amidst a sea of books and paperson radiation, including reports sent to the Department of Defense from the medical school at my university. I was learning that, just as the Village Voice had suggested, medical professors on my campus were conducting experiments on radiation injury, using human subjects, and the experiments were being funded by the Defense Atomic Support Agency of the Department of Defense.

    The trouble was that the researchers were not looking for subjects to study who had been exposed to high radiation accidentally, but were exposing people directly right in the hospital.

    I was studying the case histories of eighty-seven individuals who had already been part of the experiments. Many of these people were coming to a tumor clinic at the hospital run by our College of Medicine at the University of Cincinnati. They were being irradiated over their whole bodies—or sometimes half their bodies—in one fell stream of radiation. The great majority knew nothing about the team's study of radiation injury or being part of any research whatever, and thought they were simply being treated for their cancers. But I was learning that the military radiation they were being given had virtually no chance of improving their health.

    Indeed, twenty-one of these eighty-seven people had died within about a month of being irradiated.

    Very few of these individuals had been acutely ill or lying close to death, and those who survived the severe short-term effects of the radiation, the crucial first month or so when bone marrow is most likely to fail, often lived a long time. A number of patients were still active at home or at work when they were brought in for this treatment; some had only recently been diagnosed with cancer and were in the hospital to be evaluated.

    I was examining closely certain case histories, including that of the domestic worker "L. T.," our "Lula Tarlton," as we would know her in later years—the "Aunt Lula" who loved to ride trains.

    A patient we would eventually know as "Maude Jacobs" was another case that drew my rapt attention. "M. J." was forty-nine, the doctors wrote, when she was irradiated, and she had breast cancer that had apparently spread to her bones.

    But Jacobs had been at home caring on her own for three young daughters, keeping house and cooking supper and so on, when she was called in one day for a "treatment." She had no one to take her to the hospital and had put on her hat and called herself a taxi. Her oldest daughter, from an earlier set of children born to her when she was very young and still living in the Kentucky hills, came in that day to take care of the smaller ones. Jacobs was given a large dose of radiation over her whole body. She went home again, but the next day was so violently ill that she was taken back to Cincinnati General Hospital. She died there twenty-five days later, desperately ill and mostly out of her mind.

    Jacobs's medical profile in the doctors' reports records her white blood cell counts and platelet counts, two classic indexes of radiation injury to the bone marrow. These two blood scores started failing seven days after radiation and went down to almost nothing the day before she died.

    When the bone marrow fails and no new white blood cells can be made by the body, infection swoops in and there is nothing to fight it with.

    Death will ensue.


I HAD LONG BEEN used to reading in plays and novels of tragic deaths, full of pity and sorrow, but as I wrote for a newspaper years later, I had not been used to this pity, this sorrow ... of people sick and confused coming for help and then being brutally abused. It was clear that these tests would have to be brought to an end and that any of us on campus who could help must do so.

    The report I wrote after Christmas that year was issued at a press conference on January 25, 1972, by a group of untenured professors called the Junior Faculty Association.

    Though the experiments had been going on for eleven years, I was the first person, as far as I knew, in Cincinnati or indeed in most of the country, to read as I had the actual case histories. I had been shown the small piece in the Village Voice by a colleague, and did not know at the time that the first person to have unearthed the UC project and to have referred, at least, to possible patient deaths—was an independent journalist named Roger Rapoport, and that the work he was doing on a book called The Great American Bomb Machine had become known among certain writers in the eastern press and was the reason we had been able to read what we had in the Village Voice.

    The Vietnam struggle was still ablaze, and like many other citizens around the country, those of us in the Junior Faculty Association were involved in resistance to that war. In the spring of 1970 there had been the bombing of Cambodia, and then in our own state of Ohio, the killing of four student protesters at Kent State by the Ohio National Guard. Thus, the report we had read in 1971 about Defense Department activity at UC had been discouraging, to be sure, since we would have been happier not to have had any military research on our campus. Still, the details had not seemed extremely alarming. We had read that cancer patients were being irradiated in a project funded by the DOD and that some had been made "ill" by the radiation. They had had "nausea and vomiting" afterward, and the writer questioned whether or not they knew they were part of an experiment, and whether this kind of radiation could reasonably be considered "treatment," even of an experimental kind.

    We had thought about this for a time, and we began to feel we ought at least to look into the matter. We reasoned that, after all, this was our university, and that all of us working there were responsible for what took place and accountable to the citizens of our town who paid our salaries. Surely, we felt, we ought not to have to rely on reporters outside to tell us what was happening; we ourselves should find out and let people know.

    That may sound like perfectly straightforward thinking and just common sense, but of course within universities, and most other institutions, such an attitude is regarded as provocative in the extreme, and above all unprofessional. Nothing is worse than snooping about in your colleagues' activities, in work that is none of your business, especially in departments or colleges other than your own, where—this reasoning goes—you can't possibly understand what is taking place.


ONE DAY, NEVERTHELESS, I had gone over to the medical school looking for information about the DOD project. I had very little to go on but the account in the Village Voice. I met with the director of the medical center, Edward Gall, a large, shy, diffident man with crew-cut gray hair. I recall that in spite of what he told me that day I rather liked Dr. Gall and that later I even regarded him as a little bit of a hero because he had eventually caved in and given us the doctors' reports.

    But what Gall told me, confidentially, that first day, was that he did not feel he had the right to ask the researchers to give him copies of their work for outsiders, and that—besides—these were scientific documents, and English professors would not be able to make head or tail of them. And after all, he said, they were bulky, extensive papers—surely no one would want them all. "We do, though," I remember saying. "We would like to see them all, Dr. Gall." He would look into the matter, he said.

    I bided my time. I went back several times and used several different arguments on Dr. Gall. "We don't know whether the reports we've heard about these experiments have any truth in them," I would say. "We certainly hope they don't, Dr. Gall. We assume they don't. We certainly assume that researchers in your college would not do anything that was not in the best interest of their patients." But people outside were discussing our affairs, I pointed out, and seemed to think we were up to something, so I wondered if some faculty organization should look into the matter and possibly clear it up. He would do what he could, he said.

    One afternoon I drove over from main campus to the College of Medicine to call once more on Edward Gall. When I walked in, I saw a stack of documents on his desk, and that day he simply handed over to me the doctors' reports to the DOD. He said, "Here they are if you really want them." I was surprised, and I thought, "I wonder if I can read this work." I later wondered, and I still wonder, why Gall gave these papers to me, or the research team agreed to it—if in fact they did agree—considering the profoundly serious things they described.

    Gall handed me that day about six hundred pages of double-spaced transcript in several dark brown folders.

    These were the papers I would study over the holidays that year and on which I would base my report for the Junior Faculty Association, but that first day I drove back to main campus and parked way up on the round drive in front of my home building, McMicken Hall. I was so anxious to see what I had that I pushed my car seat back and opened the folders onto my lap. Once I began to read, I read and read and could not stop, and I forgot everything else; when I finally got out of the car, I remember that it was as if I hardly recognized the drive I was parked on or knew where I was.

    I looked away at the sloping lawn of green stretching way down to the city street below, and it was as if I did not know that I had ever seen it before. I felt very, very odd and everything around me looked new and strange to me. The red bricks, the white tower, of McMicken Hall looked strange and as if I had never encountered them before.

    I realized I did not know much about things. I had grown up in a small town in Georgia among uneducated people who knew nothing of the world. My mother and father had never seen a university; it was a concept that meant nothing to us. My mother had taken a business course and gone to work as a secretary in our one office building so I could go to college, and I went to a country college only a few hours away, where still the wider world only barely peeped through; and though of course I read about things, and read, for instance, about life in universities, it was not the same as knowing about them. Then I myself had gone to a university in Georgia, and then to another one in the midwest; at Indiana University I had earned a doctorate degree (what a fine thing to do!), and yet it seemed that it was only then, reading what I was reading in my car on the drive that day, that I began fully to understand what universities are and that there may be no reason to admire or respect a university, that universities do not necessarily intend any good to the human race.

    Now I had not been present in those narrow chambers into which the sick people I had read about had been rolled to be irradiated. I had not seen the attendants composing their limbs and adjusting the dials and beams. I had not seen all that—and it is strange to think that during some of those years I had been getting in and out of my car on McMicken Drive, just as I was on this day when I was reading about those lives. Yet what had happened I felt touched me directly. I was a teacher in the same university, this was my university, and around the corner of McMicken Hall I could see the towers of the hospital buildings where these events had taken place.

    I recall that when I did get out of my car that afternoon, I walked around the corner of the hall where I worked to look over the cityscape of hills and glassy peaks toward the medical towers across the way. I gazed at them in confusion for a long time, and I remember pacing slowly back and forth on the walk, thinking rather chaotically, no doubt, about the awesome things I had been reading about.

    It seemed to me then, and it seems to me now, that we had become a secret slaughterhouse, we had become a death camp. The doctors appended to each of their annual reports profiles for each person exposed, and I could readily see, that first day, that one patient had died six days after radiation, and others on day seven, day nine, day ten, fifteen, twenty, twenty-two, and so on. In the winter and spring of 1969, all but one of the seven patients used in the tests had been given the higher doses of radiation and had died shortly afterwards.

    In this 1969 brigade, a woman of eighty—whom we knew then only as "M. B.," case number 090—had, like certain other individuals, been experimented on twice: not just with a total body exposure of 150 rads, roughly the equivalent of three or four hundred mammograms, but with an operation to remove bone marrow from her chest for later reinfusion—in a crude attempt to keep her blood from being destroyed by radiation. It was she who had died on the sixth day after exposure, of a stroke related to the anesthesia for her bone marrow operation, the shortest survivor of all. Today we know her family and that she was an African American schoolteacher in Hillsboro, Ohio, named Margaret Bacon, and was not acutely ill when she entered the hospital that spring for tests.

    I assume that I went in that day to teach my afternoon class, but of course I don't remember the class, and I expect it passed for me in a rather dreamlike way.

    I had been learning about radiation, and as it turned out I could read well enough the doctors' reports and their case histories. I knew what radiation death was, and in fact, if you are not a medical investigator trying desperately to camouflage and cover up a rite of human sacrifice, such deaths are not difficult to explain. I assume that children are taught about radiation injury in science class or in the study of the U.S. nuclear attacks on Japan at the end of World War II.

    The report I went on to write, over that December, was to spell out the details of the eleven years of these tests. It spared nothing. It told the simple truth about these citizens' lives and deaths. Yet it also looked at every possible way in which the doctors could attempt to justify what had been done. The record it compiled was accurate, and though it has been hidden and suppressed, mocked and reproved by the researchers and their coconspirators in every way these things can be done, the facts that it records have never been replied to by these investigators, and the point is—they cannot be replied to; and that is why so very few of the researchers have ever spoken of these matters to the public at large, and why we had, in time, a lawsuit and a settlement for the surviving families.

    The report I have been speaking of, seven typescript pages addressed originally to "the campus community," told people that there had been no consent forms of any kind for the first five years of the project, and that according to the doctors themselves the patients were told simply that they were being treated for their disease. "The patient is told that he is to receive treatment to help his sickness," says the first report to the DOD in 1961; and the report for 1963 puts it this way: "The patient is told that he is to receive treatment for his disease." In the 1963 report the doctors say that having now irradiated eighteen people, they are totting up the scores on people's deaths, calculating, they say, in their matter-of-fact, textlike language, with the chill of the sterile laboratory about it, the "importance of radiation in precipitating demise." In 1966 they matter-of-factly refer to the "severe hematologic depression"—the damage, that is, to blood cells—they have found "in most patients who expired."

    The report we issued also registered these crucial facts: that when the project began, no design could be discovered for a study of cancer, and that no patient had been irradiated before the start-up of funds from the DOD for the study of radiation sickness. There was not a single extended publication by the doctors on wide field radiation as cancer treatment during the eleven years of the project, but on radiation injury we found a long series of papers and publications. One could say this, I believe: there were so many smoking guns left behind in these original papers for the DOD that one could hardly make out the papers through the smoke that enveloped them?


THE PRESS CONFERENCE of the Junior Faculty Association in 1972 was held one winter afternoon in the UC student union. Not many people came. After all, no one in Cincinnati could have expected so somber a tale. A year later, one of the doctors, Edward Silberstein, wrote me the only letter—a very brief one—I have received from the team of investigators since the day we released our report. Beforehand Silberstein had been cordial enough and had granted me an interview down in the basement corridors where those specially built radiation rooms were located—he had thought, it seems, that cordiality was all that was required—but in his note to me afterwards, Silberstein attached a letter announcing that the radiation team's colleagues at the University of Texas had awarded them a prize for their work on whole body radiation, and he signed his note to me, penned on December 24, 1973, Yours for bigger and better press conferences.

    Indeed our report had been almost completely suppressed in Cincinnati, where of course it would have posed the grave danger to the researchers of alerting victims and their families to what had happened to them. My colleague in the political science department, Henry Anna, had arranged for publicity, and a television team had appeared in town from CBS, to cover our press conference, but that afternoon, just as the team was finishing up a film on the experiments for that night's evening news, a fire broke out at a nearby nursing home; the team dropped the radiation story like a shot and rushed to the site of the fire. The news that night was of fire, not of the deliberate exposures by our government. (And so it goes, all too often, with American journalism.)

    Still, a stringer from the Washington Post did come to hear us that day and to carry away a copy of our paper, and the tale we told was printed almost entire the next morning by the Post and then entered into the Congressional Record by Senator Edward Kennedy. A number of other papers followed suit, and for a day, at least, some knowledge of the Cincinnati tests winked through the heavy ether of the normal daily news of natural disasters, official government releases, interesting crimes, and so on.

    Kennedy was preparing for hearings on medical experimentation around the country, had become interested in the UC case, and was making a strong effort to force the College of Medicine to let his staff interview their subjects. We know now, in fact, that a great deal of the adrenalin pouring off the doctors' desks during those early months of somewhat scattered publicity in 1971 and '72 was directed at blocking this most hazardous of all moves against them—the gaining by anyone of direct access to living victims of the tests or their families.

    From the day of the JFA press conference, Kennedy's aide Ellis Mottur was in daily contact with us—there seemed to be the feeling on his part that these doctors had been penned irrevocably in a very tight corral by our report. "Do you believe what we have said?" I remember asking him. Did his office regard our findings as an accurate measure of what had taken place? Mottur said that the Kennedy office had determined that we were more than credible. "We have sent the JFA report out to our medical sources and they have told us that it makes a very damaging case against these doctors."

    But that is not politics, is it? After our report, the medical school doubled its efforts to block access to the patients and privately hired special counsel in Washington to fortify the legal wall between patients and potential interviewers. Silberstein and Eugene Saenger, the lead investigators, constantly urged noncompliance with all such requests and claimed ever-mounting evidence that the patients themselves did not want to be known.

    The school stepped up its efforts with their political friends to get them off what was now a very sharp hook. Why not get the various "liberals" together, they reasoned, including the new progressive president of the university, Warren Bennis, and talk sense to them about this unfortunate affair? Would it make sense to punish the entire medical school and all the local citizens it served because of the poor judgment of a few doctors in accepting money for their work from the U.S. military—their only misdeed? In time Bennis met with Kennedy and with Kennedy's fellow liberal and friend, Ohio governor John Gilligan, and the three of them made a pact: Kennedy would agree to no interviews with patients and no congressional investigation into the basement chambers, in exchange for the halting of the project by UC, or at least the refusal of any further funds from the DOD.

    This is how it came to pass that the Cincinnati case was slipped, finally, very softly away into a deep secret drawer of history ... meant never to be opened again. The rest would be silence.

    And indeed no word was spoken of those subterranean chambers at UC in the congressional hearings that followed on human experimentation as it existed at that time in these United States.

    New subjects had ceased to be irradiated, and this was, of course, a major victory. Lives would be saved. It was not a full resolution, but those of us who had fought the tests had to be content with that. The Cincinnati papers would not print any of the facts we had outlined about patient deaths, or anything from the individual case histories, so the victims and their families had no way of knowing what had happened to them. At that time, a small number of victims did, in fact, still live, but the UC College of Medicine was not compelled to notify them that they had been used as human guinea pigs.

    The team of doctors lost their project and their funds, and that was bitter for them indeed, as we shall see, but beyond that, they paid no price for what had been done, were not investigated by a congressional committee, by the local Academy of Medicine, or by the state medical board.


EARLIER THAT SAME FALL, the anguished interest of Senator Mike Gravel had been evoked by the work on Cincinnati by Roger Rapoport, and when the Junior Faculty report was issued in January, Gravel became the only elected official who would write to us. In a letter I received from him on February 2, 1972, he said, "It is clearer and clearer to me that life is not held sacred in this country; it is cheap." Dr. Saenger's experiments, he went on, "seem to be a symptom of a very much larger barbarism."

(Continues...)


Excerpted from The Treatment by Martha Stephens. Copyright © 2002 by Duke University Press. Excerpted by permission. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.


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Table of Contents

Preface
Prologue
Pt. 1 The Story of the Press and the Public Campaign
1 The First Public Knowledge of the Tests 3
2 1994 and a Secret Drawer Reopened 15
3 The Press in Full Flower 27
4 African Americans Lost and Found 52
5 The Back Files 83
6 Testimonies 107
7 Author's Intermezzo 131
Pt. 2 The Medical Story
8 The Mother Without a Name 153
9 The Final Years 171
10 The Experiments Must Cease 202
Pt. 3 The Legal Story
11 A Civil Action 225
12 An Angry Judge 244
13 The Case Closed 262
App. 1 Table of Cincinnati Radiations 293
App. 2 Hearing Testimony of Eugene Saenger 296
Notes 307
Sources 335
Index 343
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