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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
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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undertook an effort to identify and catalog historical documents on radiation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.
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| ANDERS:
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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.
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| FISHER:
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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.
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| LUSHBAUGH:
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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.
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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.
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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.
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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.
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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.
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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.
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| FISHER:
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You said [that] World War II delayed your degree? Did you do
some military service?
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| LUSHBAUGH:
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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!
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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!
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| LUSHBAUGH:
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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!
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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.
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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.
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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.
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| FISHER:
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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?
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| LUSHBAUGH:
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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.
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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
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| FISHER:
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Which hospitals did you visit, if you can remember?
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| LUSHBAUGH:
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I remember visiting one in Boston, which I think is Brigham
and Women's.
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| FISHER:
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Brigham and Women's? |
| LUSHBAUGH :
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Right. And I visited the Ann Arbor Hospital and I visited
Warthin and Wellerd.
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| FISHER:
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Ann Arbor at the University of Michigan?
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| LUSHBAUGH:
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Right; and I also recall visiting one in New Orleans.
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| FISHER:
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Charity or Tulane? |
| LUSHBAUGH:
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It could have been Tulane, I guess.
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| SIPE:
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There's another one. Did you go to Memorial Hospital in New
York?
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| LUSHBAUGH:
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I went there, but I went there for another reason. They were
offering me a job.
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| FISHER:
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At Memorial? |
| LUSHBAUGH:
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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.
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| FISHER:
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Heubline was then at which institution?
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| LUSHBAUGH:
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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.
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| SIPE:
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They had a cobalt60 [unit] that they made, [and] gave to
[the] M.D. Anderson [Hospital]. We had a "cesium METBI." Cesium137.
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| LUSHBAUGH:
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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.
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| SIPE:
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That was 1.5 per minute. LETBI15
was a 1.5 R/hr [unit].
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| LUSHBAUGH:
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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.
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| SIPE:
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Lauriston Taylor? |
| LUSHBAUGH:
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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 —
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| FISHER:
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Two doctors Warren? |
| LUSHBAUGH:
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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.
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| SIPE:
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Right. |
| LUSHBAUGH:
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We visited some 60 hospitals.
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| SIPE:
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We studied close to 3,000 patients.
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| LUSHBAUGH:
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Really. |
| FISHER:
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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.
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| LUSHBAUGH:
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Right. |
| FISHER:
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For gamma radiation. What did you conclude from this analysis?
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| LUSHBAUGH:
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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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