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Oral Histories

Pathologist Clarence Lushbaugh, M.D.


Foreword

Short Biography

Upbringing, Family, University of Chicago

Early Research and Publications in Pathology

Early Days at University of Chicago and Los Alamos

Establishing Safer Radiation Limits

Move to Los Alamos

Pathology Investigations

Early Animal Studies at Los Alamos

NASA-Sponsored Studies

Primate Studies

Investigations of Radiological Accidents

Congressional Testimony on the Use of Whole Body Counting in Medical Diagnosis

Other Human Radiological Studies at Los Alamos

Move to Oak Ridge (1963)

LETBI and METBI Therapy for Lymphatic Diseases

Charges That the Oak Ridge Radiation Therapy Was Not Effective

Questioning the Propriety of NASA-Funded Studies

Radiation Treatment Patients at Los Alamos and Oak Ridge

Institutional Review Board at Oak Ridge

Controversy Over the AEC's Use of Human Subjects in Radiation Research

Interview Wrap-Up

Footnotes

FOREWORD

In December 1993, U.S. Secretary of Energy Hazel R. O'Leary announced her Openness Initiative. As part of this initiative, the Department of Energy undertook an effort to identify and catalog historical documents on radiation experiments that had used human subjects. The Office of Human Radiation Experiments coordinated the Department's search for records about these experiments. An enormous volume of historical records has been located. Many of these records were disorganized; often poorly cataloged, if at all; and scattered across the country in holding areas, archives, and records centers.

The Department has produced a roadmap to the large universe of pertinent information: Human Radiation Experiments: The Department of Energy Roadmap to the Story and the Records (DOE/EH-0445, February 1995). The collected documents are also accessible through the Internet World Wide Web under http://www.hss.energy.gov/healthsafety/ohre. The passage of time, the state of existing records, and the fact that some decisionmaking processes were never documented in written form, caused the Department to consider other means to supplement the documentary record.

In September 1994, the Office of Human Radiation Experiments, in collaboration with Lawrence Berkeley Laboratory, began an oral history project to fulfill this goal. The project involved interviewing researchers and others with firsthand knowledge of either the human radiation experimentation that occurred during the Cold War or the institutional context in which such experimentation took place. The purpose of this project was to enrich the documentary record, provide missing information, and allow the researchers an opportunity to provide their perspective.

Thirty audiotaped interviews were conducted from September 1994 through January 1995. Interviewees were permitted to review the transcripts of their oral histories. Their comments were incorporated into the final version of the transcript if those comments supplemented, clarified, or corrected the contents of the interviews.

The Department of Energy is grateful to the scientists and researchers who agreed to participate in this project, many of whom were pioneers in the development of nuclear medicine.


DISCLAIMER

The opinions expressed by the interviewee are his own and do not necessarily reflect those of the U.S. Department of Energy. The Department neither endorses nor disagrees with such views. Moreover, the Department of Energy makes no representations as to the accuracy or completeness of the informa-tion provided by the interviewee.


ORAL HISTORY OF DR. CLARENCE C. LUSHBAUGH

Conducted on October 5, 1994 in Oak Ridge, Tennessee by Darrell Fisher, a health physicist from Pacific Northwest Laboratory and Roger Anders, chief historian of the Office of Human Radiation Experiments, U.S. Department of Energy (DOE). Clarence C. Lushbaugh was selected for the oral history project because of his research at Los Alamos, his position as pathologist for Los Alamos County, and his research at the Oak Ridge Institute for Nuclear Science. The oral history covers Dr. Lushbaugh's pathological research, his research with human subjects while at Los Alamos, and his total body irradiation research at the Oak Ridge Institute for Nuclear Science.

Short Biography

Dr. Lushbaugh was born in Covington, Kentucky on March 15, 1916. He received his B.S. (Anatomy 1938), Ph.D. (Pathology 1942), and M.D. (Pathology Honors 1948) from the University of Chicago. He has been married twice and has three children. Dr. Lushbaugh began his career as a pathology professor at the University of Chicago (1942-1949). From 1949 to 1963, Dr. Lushbaugh was a staff member in the Biomedical Research Group of the Health Division of Los Alamos National Laboratory and a pathologist at the Los Alamos Medical Center (LAMC). In addition, from 1950 to 1958, he was the Assistant District Health Officer for Los Alamos County. In 1963, Dr. Lushbaugh became Chief Scientist of the Medical and Health Sciences Division at Oak Ridge, where he led the Total Body Irradiation (TBI) Program, a position he held until 1975. From 1975 to 1984, Dr. Lushbaugh became Chairman of the Medical and Health Sciences Division at Oak Ridge and the Chief of Radiation Medicine. During this same period, Dr. Lushbaugh has held the following positions:

  • 1974 to 1977 — Director, Radiation Emergency Assistance Center/Training Site (REAC/TS) of the Medical and Health Sciences Division, Oak Ridge
  • 1979 to 1982 — Acting Director, Center for Epidemiologic Research, DOE Health and Mortality Studies at Oak Ridge
  • 1980 to present — Adjunct Professor of Epidemiology at the School of Public Health, University of North Carolina, Chapel Hill
  • 1981 to 1989 — Director, World Health Organization International Collaborating Center in Radiopathology and Radiation — Accident Preparedness, World Health Organization.

Dr. Lushbaugh has published many times on total body irradiation; the effect of nuclear accidents and proper procedure for nuclear accidents; the effects of the use of isotopes; and radiation treatment. Additionally, he has focused on the subject of human radiobiology.




Upbringing, Family, University of Chicago

ANDERS: This is Roger Anders. I'm here with Darrell Fisher. We're in Oak Ridge, Tennessee, at the Oak Ridge Institute of Science and Education, in the Medical Department conference room on the second floor. It's Wednesday, October 5, [1994,] and we're interviewing Dr. Clarence Lushbaugh. Mrs. Ann Sipe is here with us, assisting us with the interview. Having said that, we're ready to go.
FISHER: My name is Darrell Fisher. Dr. Lushbaugh, you participated in the golden era of radiation research, when radionuclides were discovered and then tested for biological and medical properties. But even before that, you did your medical training, and graduated before the Manhattan Project. One of the things that we would like you to do is tell us about how you became interested in the field, not only of radiation medicine, but pathology, and how your career developed after you graduated from medical school. Go ahead and feel free to talk.
LUSHBAUGH: Looking at my CV [curriculum vitae] here, which Ann Sipe just gave to me, I note that I was born on March 15, 1916. It fails to mention a fact, and it was a very big factor in my life, which was that my father died in the flu epidemic of World War I when I was age two and a half. He died in October of 1918. I, at that very early age, developed an interest in death, [a] fear of death, and became interested in becoming an M.D. I was helped greatly by my mother, who, as a widow, never remarried. She received the magnificent sum of $300 from my father when he died. I had many expenses, of course, involved in my medical education. When I finally graduated as an M.D. in 1948, I received from my mother the same $300 that she had saved all those years.
To start out from the beginning, I started in school there in Cincinnati, which is across the river from where I was born in Covington [Kentucky]. We had just come back from living with my grandparents in Bridgeport, Connecticut. I, living with my mother, became enrolled in Hyde Park Grade School. I went through eight years of grade school there. Then I went to Walnut Hills High School[, which is also in Cincinnati]. At Walnut Hills High School, I graduated with honors and was also president of the senior class. That was in 1934.
Then from Walnut Hills High School, I went to the University of Cincinnati and there took the premed [courses]. Much to my horror, Dr. Arthur C. Bachmeyer, who was then head of the Cincinnati General Hospital, left and became the dean at the University of Chicago. So, of course, I followed him there. I got my bachelor's in Anatomy in 1938. That was about three [years] at University of Cincinnati and one year at Chicago. Then I became a fellow in pathology and sort of diddled and daddled about getting my M.D. I finally got a Ph.D. in Experimental Pathology in 1942. This was the same year that I was married, for the first time, to Mary Helen Chisolm, who was a nurse there at the University of Chicago.
I had three children from Mary Helen. One, a son, [born in 1944], who is now a full professor at the University of Mississippi and a professor in the Department of Preventive Medicine. Another son, born in 1949, who became a staff member at X-10, at [Oak Ridge] National Laboratory. He then was transferred to Y-12 and then transferred to K-25, where he is now a consultant. It is from him I have my three grandchildren: Jeffrey, who is now age 16; Sarah, age 13; and Kimberly, age 10 — two girls.
I had, besides Bill, the firstborn, and Bob, the second-born, Nancy, the third-born. She now works at Y-12 as a technician and as a safety expert. These parallel what I did at the University of Chicago, in that I went to work at the University of Chicago as an instructor, first as a fellow in Pathology and then as an instructor in Pathology, and finally as assistant professor. I remember that in 1949, after I had been in these roles for about 14 years, following my graduation with a bachelor's in Anatomy, and a trainee in Pathology, I did get the Experimental Pathology degree in 1942, but I also married Mary Helen. Then, 14 years later, I got a call one day from Dr. Franklin McLean, who was then professor of Physiology and also head of the University of Chicago Toxicity Laboratory. I had been loaned to the University of Chicago Toxicity Laboratory by Dr. Paul Cannon, who was the head of the Department of Pathology at the University of Chicago. I was the pathologist there and we were extremely, I would say, experimental in that we used only animals.
It was a result of these animal studies and the work with nitrogen mustards, that I came upon the idea which was probably the greatest idea that I ever had in my career. That was the use of nitrogen mustards as a chemotherapeutic agent in the treatment of cancer. Although I was, I want to say, the 13th or 16th person [listed] on the paper that was written by then Dean Leon Jacobsen, who was the hematologist at the University of Chicago. At that time I only had a bachelor's degree. But then I got the call from Franklin McLean. Franklin McLean wanted to know whether I would recommend the person who was a pathologist on the university side. Since I was making only $4,200 and had these three children [and] my wife, who was not working, I decided that the person I could recommend for that job in Los Alamos was Clarence Lushbaugh! So I recommended myself, particularly since the job carried a stipend of $10,000. In 1949 I left the University of Chicago and that was a year after I had gotten my M.D. But my M.D. was delayed by World War II. World War II was long over [by] 1949, when I finally left the University of Chicago.
FISHER: You said [that] World War II delayed your degree? Did you do some military service?
LUSHBAUGH: In the University of Chicago's Toxicity Laboratory where I worked as a pathologist, under Franklin McLean and the National Research Council, NRC, we studied all sorts of chemical poisons that could be put out as war gases. It was in that area that I worked. I worked with mice and rabbits and dogs and the like. It was there that we discovered [that] the nitrogen mustards were much like the sulphur mustards, which had been used in World War I, but which were water soluble. Although they were still vesicants,1 they could be put in a solution and injected into a person so the precise dose could be gotten. Also, I discovered that the nitrogen mustards were lymphotoxic2 and were, therefore, applicable to the therapy of the various lymphomas. It was that idea that I took to Jacobsen that day and had to get permission from Dr. McLean in order to do the work in human beings. The human being research was carried on by Leon Jacobsen and by his resident staff there in the Department of Hematology. Since he was a member of the Department of Medicine, he had all the physicians in the Department of Medicine on the paper plus all the people who had any "swat" at all. So I was C.C. Lushbaugh, B.S., at the end of that paper!
Since that time, my role in that area has been documented by the University of Chicago, although my name Clarence has been changed to Charles and my status as a pathologist has been changed to that of chemist. However, my name is Clarence C. Lushbaugh and I was a "Junior" until my father died. So I bore the name proudly and I resent very much the fact that I'm now Charles S. Lushbaugh from the University of Chicago!

Early Research and Publications in Pathology

LUSHBAUGH: One of the things I read as a graduate student there in the Department of Pathology was an article written by Drs. Warthin and Wellerd from the University of Michigan, who spoke about the radiomimetic activity of the sulphur mustards. They were reviewing the sulphur mustards [in their article]. This was about 1920 in the Journal of Pathology. It was they who put out the idea that there was a chemical that was radiomimetic, simulating the effects of radiation!
It was at that time, in talking with Dr. Cannon and the other associates of mine there in the department, that I learned that Dr. Shields Warren was the head U.S. man in radiation pathology and that he had been to the Hiroshima/Nagasaki bombings aftermaths. He had tried to organize the pathologists of the United States and get some concurrence with the lethal dose of radiation in man, and how it would kill when you were exposed to radiation. We found, much to his horror and later to mine, that there wasn't anything such as a radiation pathologist in the United States. In his articles, Shields Warren filled the role of a radiation pathologist in describing the pathology of the liver after radiation and the pathology of the lymph nodes after radiation. [(they were doing what later bacame known as radiation pathology)] He had written [this] as a review of the literature by persons that were on Shields Warren's staff at Harvard University.
It was at that time that I reviewed the Warthin-Wellerd article and learned about nitrogen mustards. I thought that here was a way to get radiation treatment taken away from the radiation oncologists3 and given to the hematologists4 so they could treat their patients in a forthright way. It was at that time that I learned of this first article, which Ann has given me. I guess it's 1946 — Jacobsen, Spur, Baron, Smith, C.C. Lushbaugh. That's not quite the whole list of authors on the article in the JMA5 that appeared there.
My first article in press was actually an article in 1941, about maternal pulmonary6 embolism7 in amniotic fluid. That was the second important thing that I really did, as far as being a pathologist was concerned. There was a disease called "obstetrical shock." This was a disease of unknown etiology8 that occurred rarely in women in childbirth. No one ever knew why this disease caused them to hemorrhage and to clot and to die. It was a fatal disease. Except that one day, as a pathologist working at the University of Chicago, I did the autopsy that was the sine qua non of autopsies then on a person who died of this disease. The dead woman had not burst her membranes, but she had died with the fetus still attached by a placenta to the placental membranes. So having Dr. Paul Steiner there as a mentor and as a professor in the Department of Pathology, we had always been interested in this disease. He came down and supervised my autopsy so that I did it properly. We were able to show that it was the contents of the amniotic fluid which contained the smegma, which was the sebaceous secretions from the child's skin and feces, and contained the cells and debris from the gastrointestinal tract of the child, and also the other debris, which were the cells of the skin which were present, plus any blood that happened to be there. In the histology9 of that case, Dr. Paul Steiner and I were able to show that the amniotic fluid embolism was the cause of death in obstetrical shock. We were able to show this also in dogs, and so we wrote this paper up.

Early Days at University of Chicago and Los Alamos

FISHER: You started to mention reasons for leaving Chicago and going to Los Alamos. [There is] one question I'd like to interject if you don't mind. While you were in Chicago, were you aware of any of the activities of the MET10 Lab under the Manhattan Project in Chicago?
LUSHBAUGH: No, but I almost got fired by the secretary of our Chicago Toxicity Lab group who was there, and she also knew about the metallurgy project at the University of Chicago. I had come to the conclusion from listening around that the University of Chicago was somehow associated with the pathology of radiation damage, and that this pathology of radiation damage involved bone marrow, and therefore they were interested in anemia! I mentioned this to her one day, that the focus of the metallurgy [project] was on the pathology of radiation damage. For that reason, she accosted me for having broken the secret and had threatened to fire me. I explained that I had arrived at those conclusions all by my own and that I did not have to be fired at that point.
Following, in 1948 and '49 when this question came through to me as to whether this pathologist on the north side [of Chicago] should be recommended for the job in Los Alamos, Dr. McLean was the go-between between the University of Chicago at Chicago and the University of California at Los Alamos. He was part and parcel of the medical staff at the University of California laboratory at Los Alamos. That's where I went in 1949, not knowing what the problems were in radiation death and the amount of radiation that would cause death in a person. That's what Shields Warren and his group had been working on. I learned [that] later from an article, and I don't know the title of this article anymore. But it was written by the NRC11. It was a journal of experimental medicine, and it listed in there all the persons who had ever studied persons who were irradiated, and then investigated, and then treated in various kinds of ways. So we had a whole list of persons there, since the article was very thorough [in its coverage] of persons who had irradiated people. That study involved my third major contribution in my pathology career, which was, I went around and visited all of these hospitals and laboratories and physicians who had irradiated people and tried to find out what was the human LD50.12
FISHER: Which hospitals did you visit, if you can remember?
LUSHBAUGH: I remember visiting one in Boston, which I think is Brigham and Women's.
FISHER: Brigham and Women's?
LUSHBAUGH : Right. And I visited the Ann Arbor Hospital and I visited Warthin and Wellerd.
FISHER: Ann Arbor at the University of Michigan?
LUSHBAUGH: Right; and I also recall visiting one in New Orleans.
FISHER: Charity or Tulane?
LUSHBAUGH: It could have been Tulane, I guess.
SIPE: There's another one. Did you go to Memorial Hospital in New York?
LUSHBAUGH: I went there, but I went there for another reason. They were offering me a job.
FISHER: At Memorial?
LUSHBAUGH: Yes, in New York City. Heubline was one. Where [the] Heubline name comes into my career was the organization here at the Medical Division at the University of Tennessee, part of the Oak Ridge Associated Universities. This outfit had a Heubline-like unit. They had a METBI,13 a medium-level unit. It was made with cobalt­60. (glancing at an article held up by Sipe) Is that the article? This is by Heubline himself. He was the one who developed this method of low-level spray radiation and he called it spray radiation, in that he had x­ray tubes in this large ward which he shows in this paper.

Establishing Safer Radiation Limits

FISHER: Heubline was then at which institution?
LUSHBAUGH: Memorial [Hospital, New York]. [He was] treating continuous radiation of the entire body at long distances. He had, in the various corners of the room, these x­ray tubes that were on swivels that were driven by motors that would sort of spray the whole room with radiation. Oak Ridge Associated Universities made a similar unit, but using, cesium­137 as the source of gamma radiation.
SIPE: They had a cobalt­60 [unit] that they made, [and] gave to [the] M.D. Anderson [Hospital]. We had a "cesium METBI." Cesium­137.
LUSHBAUGH: That was a medium-dose-rate irradiator. It used gamma rays from the cesium. I think that its output was 1.5 roentgens14 (R) per minute.
SIPE: That was 1.5 per minute. LETBI15 was a 1.5 R/hr [unit].
LUSHBAUGH: I had the opportunity to choose the radiation dose rate in the so-called LETBI facility, which was the low-exposure big facility that Ann and I ran for a long time. The radiation dose rate was expected to be a factor that was easy for me to remember, like 60. Since the rate of exposure in the METBI facility was 1.5 per minute and then the LETBI became 1.5 R per hour. All I had to remember was the time in hours. So it was 1/60th of the other one. We went around to discuss these various things. At one of the meetings, it was the national NCRP, National Council on Radiation Protection and Measurements, which was at that time chaired by a gray-haired elderly gentleman who subsequently retired.
SIPE: Lauriston Taylor?
LUSHBAUGH: Yes, Lauriston Taylor. He told me when I asked him how it was that the Army concluded at the time of the bombings at Nagasaki and Hiroshima that the dose was 450 R total body radiation. He said that everybody in the armed forces in the United States knew that number because that was the number that was given to them in their training that they got when they joined the armed forces. They had to know what the radiation dose was. The story was that Dr. Shields Warren and Dr. Stafford Warren, who was then head of the Manhattan District —
FISHER: Two doctors Warren?
LUSHBAUGH: One was Stafford Warren and the other was Shields Warren, and they stood at a bridge where a group of Japanese workers had been working at the time of the bomb drop at Hiroshima. Since 50 percent of the persons had been killed and their measurements seemed to indicate that 450 R was the magic number, that was [set as, determined to be] the LD50 for man, since 50 percent were involved. This number was picked up by the Army and was diffused through the Army Medical Corps, so it became the number that was known to everybody who was involved in the Hiroshima bombs. It was also the number that I tried to find some basis for in the various kinds of radiation which were done with the Heubline equipment. I was unable to do that in the various kinds of hospitals that I visited. I think we studied the records of 260-some-odd patients that were involved in this study.
SIPE: Right.
LUSHBAUGH: We visited some 60 hospitals.
SIPE: We studied close to 3,000 patients.
LUSHBAUGH: Really.
FISHER: So what you're saying is you looked at data on up to as many as 3,000 patients who had received whole body radiation to determine what the LD50/30 was.
LUSHBAUGH: Right.
FISHER: For gamma radiation. What did you conclude from this analysis?
LUSHBAUGH: I was thinking about this the other day and my conclusion was that 450 R was as good as anything. Subsequently, roentgens became rads and rads became rem, so 450 R became 400 rads or 400 rem — I invented in one of my articles that I wrote in Radiation Research, the epigastric16 rad. My dear friend and high school chum who is presently emeritus professor of radiation at University of Cincinnati, Dr. Eugene Saenger, took askance at the epigastric rad. I think if I ever want Dr. Saenger to burst into a fit of laughter, I need only mention "epigastric rad" to him. He loves it. But the Britisher, Robin Mole, who was a radiation therapist and who was a physician and a physicist, subsequently wanted to reduce that number, I believe. I think it ought to be reduced, too, but I'm not certain by how much it should be reduced.




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