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Oral Histories

Pathologist Clarence Lushbaugh, M.D.


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


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

FISHER: Do you remember testifying before Congress in 1961 on the use of isotopes in medical diagnosis?
LUSHBAUGH: Yes, I remember that.
FISHER: Applications of whole body counting in clinical diagnosis.
LUSHBAUGH: I remember that I briefed the Congressional committee about that, and I think the chairman of the committee was a physician from the state of Kentucky. His name was Clarence. I do remember some of it. He actually made some derogatory remarks about Dr. Eugene Saenger. I pointed out to him that Dr. Saenger has not been invited to the meeting, that it was inappropriate for him to make remarks about him. What he should do is invite Dr. Saenger to the meeting and then make those same remarks about him, and I would dare him to do that.
ANDERS: Do you recall why he was making those derogatory remarks?
LUSHBAUGH: Yes, he was making the derogatory remarks because Saenger, who is now radiologist emeritus and oncologist at the University of Cincinnati, had a NASA contract in which he was supposed to get, from persons that were irradiated, information concerning their thoughts, psychology. He used patients who were in the University of Cincinnati Medical Center, which was a large medical center for Hamilton County, of which Cincinnati is a part, in which there are huge slums. In such typical slums, these persons don't have any money and they're black and they're poorly washed. These persons were available in the University of Cincinnati Center to Dr. Saenger as persons who needed to be total body irradiated, and they were given total body irradiation by Dr. Saenger. I was on his committee, by the way, and I did review what he was doing, and I thought it was actually well done. These persons received radiation therapy which was really measured and put out by a trained oncological technician. The reason why the sensational Congressional committee member made these remarks about Dr. Saenger was that Dr. Saenger was still being mistreated by Congress for being involved in the Fernald defense in the AEC and DOE. This guy was from Kentucky, right across the river from Ohio and right across the river from Fernald, so he would, of course attack, Dr. Saenger.
ANDERS: He was concerned about safety at Fernald or health of the workers?
LUSHBAUGH: I don't know. All I've heard about Fernald recently and that is that DOE — that means you — has blinked, has paid off the class action suit. So Saenger is no longer in jeopardy.
ANDERS: That's why I was curious about why the joint committee would have perhaps felt this way in 1961.
LUSHBAUGH: I don't know. But I do know that in 1961 Dr. Saenger was beginning to build a whole body counter, which was a chair-type whole body counter with a sodium iodide28 crystal. He was trying to measure some of the people from the Fernald area — some of the people who were supposedly saying that debris from that plant had injured their families and the like.
ANDERS: So the joint committee in Congress had some concerns about him measuring the Fernald workers. Was it because he felt that maybe this was going to reveal something about the classified activities of the plant in those days?
LUSHBAUGH: I doubt that. Because I think he just measured people from the environs around, family members.
ANDERS: Perhaps the concern was that it would show that Fernald was placing radioactive particles in the atmosphere that was getting into these people's bodies?
LUSHBAUGH: I guess so.
ANDERS: I'm curious as to why the joint committee would be concerned in '61?
LUSHBAUGH: I think Clarence was very concerned about a lot of things. He might not be one of my favorite persons.
ANDERS: I'm sure there were other persons on the commission that also felt that way about the joint committee.

Other Human Radiological Studies at Los Alamos

ANDERS: One question, again referring to what you mentioned earlier at Los Alamos. The patients that were coming to you at Los Alamos?
LUSHBAUGH: As head of the laboratory at Los Alamos Medical Center, all of the patients were referred to me from the private practice of medicine in Los Alamos. The physicians who privately practiced had their offices there in the Los Alamos Medical Center. My office was there, too. They were referred to me by their own physicians.
ANDERS: So you would have then seen a social cross section of the Los Alamos community people at all the various occupations, various activities, various parts of the community. Rather than seeing any one particular group of people, you would have seen groups of people from all walks of life and all kinds of backgrounds.
FISHER: Your employer was the laboratory?
LUSHBAUGH: Right, although they got their money from the AEC in Washington. Their monies for me was divided in half. They gave half to Langham and half to the medical staff.
ANDERS: Did you have any more questions on the Los Alamos period?
FISHER: Were there any so-called lethal dose studies on humans at Los Alamos, or were these all in subhuman primates? Do you remember anything about that?
LUSHBAUGH: There was no lethal dose to any human being that was designed ahead of my time there, and then perpetrated.
FISHER: Do you recall experiments at Los Alamos while you were there on the use of fission products to determine biologic and metabolic behavior of fission products in man?
LUSHBAUGH: This is one of the things I did while I was there in Los Alamos. I worked with Langham on the scintillation counters. Langham developed the scintillation counters because he was trying to help some physicists identify some rare celestial event. In the course of doing this he found that all human beings were radioactive, that we all contain radioactive materials from living.
One of the things that I recall him doing, he was a very imaginative fellow and he saw this as a means of measuring body weight, body fat, and how well you were. He had a "males and females" thing. I was one of his guinea pigs in a study where we were weighed in a scale that was in water. You were submerged in water and your weight was determined by water displacement. We were able to show that milk drinkers and men had more muscle than women. So you could tell a woman from a man by the potassium/cesium ratio. The cesium was in his muscle. If he was a milk drinker, the cesium was in the milk from the fallout. He had more cesium than he had muscle by weight. That was one of my situations.
FISHER: Do you remember ever being a participant in a tracer study where you were injected with any isotope?
LUSHBAUGH: I was a guy who liked to study the life span of red blood cells. One of the real problems — and I brought this study with me to Oak Ridge — was telling how long a red blood cell lived by labeling it with radioactive chromium. The trouble with this method was that the red blood cells that were labeled with the radioactive chromium didn't have the same life span of the red cells when done by a woman professor who measured these things using some kind of immunological tag. She could put red blood cells into a person and see what his body fluid was by the dilution of these red blood cells that she added. But you couldn't do that with radioactive chromium. The reason was that the radioactive chromium caused some of these red blood cells to be picked up by the spleen. Radioactive chromium-labeled red blood cells had a longer half-life29 than the normal red blood cells.
FISHER: The mere labeling of the red blood cells changed their biological distribution?
LUSHBAUGH: Right, exactly.
FISHER: In retention and lifetime.
FISHER: How did that relate to the studies? You said you participated in a study?
LUSHBAUGH: I tried to figure this out and I was unable to. I remember giving this talk in front of a group in Los Alamos. It was a group of physicians gotten together by the Biology and Medicine Department who had a review committee that went around and reviewed the various projects. I remember saying, in my usual smart-aleck way, that even a Harvard scientist can make a mistake. The Harvard scientist was the one who developed the system of labeling red blood cells with chromium. The committee's comments was that even Lushbaugh was a smart aleck.
FISHER: Was there a resolution of that chromium­51 labeling problem?
LUSHBAUGH: As a matter of fact, the life span of the chromium worked okay. You just couldn't use whole body counters to do it. You could use sampling in a dilution, but you couldn't use whole body counters to do it because you always assay the radioactivity in the spleen.
Your question reminds me that one of the things I did [was that] I tried to determine thyroid uptake. I determined thyroid uptake there in Los Alamos, iodine­131. I was able to show that the iodine that was in unbound iodine was excreted with a half-life of nine days and that the bound iodine was excreted with a half-time30 of 90 days. That was the radiological decay. We were able to use that in Oak Ridge, by the way, when I came there shortly afterwards. They had a girl who was apparently pregnant at the time that she was given radioactive iodine. She was given the usual dose of radioactive iodine, which was about 10 millicuries. Then, later on, it was discovered that at the time she had been given that larger dose of radioactive iodine, she was pregnant. At that time, we had in Oak Ridge whole body counters, which are very sensitive. (It was as sensitive, in fact, as the tank-type whole body counter that was made by Wright Langham in Los Alamos.)
A young student, whose name I've since forgotten, who was from Germany, wrote this up in an article, in which we showed that by using a very small, safe dose on that infant, we could do a thyroid study. We used something like one-hundredth of the dose. It was like one-tenth of a millicurie. We were able to show that the infant did not have a thyroid gland and that it would need thyroid injections for the rest of its life in order to keep it from becoming a cretin, so the little boy's life was saved.
FISHER: In other words, the woman was injected before it was known she was pregnant for a thyroid condition?
LUSHBAUGH: Right, exactly.
FISHER: And the fetus, the baby, you determined that it would not be born with a thyroid, because the radiation had destroyed it.
LUSHBAUGH: We determined that it didn't have a thyroid.
FISHER: Because it had been destroyed by the iodine.
FISHER: Your determination was that it would need thyroid supplement for the rest of its life.
LUSHBAUGH: Right, exactly.
FISHER: Was there a follow-up on that, do you remember?
SIPE: He came back every six months for years. He got checked up. They watched over him. This was before the days, also, when things like that made people put signs, "Are you pregnant? Is there any chance that you may be pregnant?"
FISHER: Do you remember when it was that there was guidance to physicians not to use iodine­131 on women who were pregnant?
LUSHBAUGH: It was okay to use it if it was a very small dose.
FISHER: Like for example?
LUSHBAUGH: Actually like one-tenth of a millicurie, but you had to have a very highly sensitive counter in order to count this radioactivity, in order to do a radioactive iodine uptake. That's what I was going to tell you about the radioactive chromium, that in that radioactive chromium studies, where I was a self-selected guinea pig. I found that Metracal was the control diet for all kinds of radioisotopes. If you took two cans of Metracal a day plus a martini, you were A-OK.
FISHER: What's Metracal?
LUSHBAUGH: Metracal is a commercially available diet. It contains about 100 milliliters of solution of highly nutritious stuff that, if you were on a diet of Metracal, is one of the ways of losing weight. I think I weighed 160 pounds then.
SIPE: Pretty thin.
LUSHBAUGH: I weigh 175 now.
SIPE: You're working on it.
LUSHBAUGH: I was working on bringing it down.
SIPE: You're bringing it down.
FISHER: So chromium­51 and Metracal. You took Metracal?
LUSHBAUGH: I took Metracal for the iodine, Metracal for the chromium, Metracal for the cesium, Metracal for everything, because it had radioactivity, but it was always the same. The contents of the Metracal was like being on a controlled diet.
FISHER: How did the activity get into the Metracal?
LUSHBAUGH: I guess by its manufacturer.
FISHER: Just as a result of fallout?
LUSHBAUGH: Right, exactly.
FISHER: So when you were a guinea pig as such, it wasn't by injection, it was by drinking the Metracal and then you were measured in the whole body counter?
LUSHBAUGH: Right. We used to have guys from the submarine program come through, and they had a basket where this whole body counter had a thing in it. We'd push this person in the hammock and then we'd drive the person [in] it with an electric motor. This one old captain of the submarine fleet used to always say, "Fire one." [laughter]
ANDERS: Was this at Los Alamos?
LUSHBAUGH: This was at Los Alamos.

Move to Oak Ridge (1963)

FISHER: What was your reason for wanting to leave Los Alamos and going to Oak Ridge?
LUSHBAUGH: They had this great program here in the Medical Division which was concerned with persons with radioactivity. They treated all sorts of persons with all sorts of radiation. This gave me an opportunity to see these persons with the disease who weren't normal people. I was using borderline normals as most. I had a carte blanche of all sorts of radioisotopes that were given in Oak Ridge. I'll never forget the time when some of these outfits came and reviewed the program, reviewed a program that Dr. Gould Andrews had, treating cancer of the ovary. He used to have these patients come in once every six months, when they were counted and were given a shot of some kind of radioactivity, radioactive phosphorous. Then they were taken to surgery at the Medical Division, and they had a laparotomy31 . The surgeon used a counting apparatus to see whether or not there were peritoneal32 metastases from the carcinoma of the ovaries. Whenever they would find one they would take it out. Well, at the time this committee reviewed that program, the minimum survival time of persons with cancer of the ovary with this treatment, was eight-something years. But they said it wasn't a good program. I always thought that was a terrible miscarriage of justice.
FISHER: Explain what the normal survival time was.
LUSHBAUGH: Six months.
FISHER: So six months versus —?
LUSHBAUGH: Eight years.
FISHER: Do you remember the isotopes that were used for that?
LUSHBAUGH: I don't remember. We used to sit around this table and we used to have all these chairs filled with staff members. Different persons were head of the staff. Dr. Gould Andrews was head of the Medical Division. The staff used to decide what patient was brought in, what had happened, and the doctor would present his case. The thing was, What kind of radioactive material would be helpful to him? What would be helpful to his doctor? One of the things that was discovered in the time I was here, by Dr. Lowell Edwards, largely when he was chief of staff at that time. I found it very hard to get people for my program, which was to study these various metabolic diseases and various cell life spans. I found there was a dearth of patients because Lowell Edwards was getting them all first. He was using germanium, because germanium was a very good compound that went to the stimulated reticuloendothelial system.33 In regard to the reticuloendothelial cancers, you could use germanium as a total body tracer to find out whether or not this person had cancer and cancer metastases and whether they had lymph nodes that were involved. It was a very fantastic study. It was so fantastic that I couldn't do anything about it.
ANDERS: In coming to Oak Ridge, did you call Dr. Andrews and say, "I would like to work at Oak Ridge?" Or how did that come about?
LUSHBAUGH: Before that, Dr. Kniseley and I had been friends for a long time. He was a pathologist at Lovelace Clinic in Albuquerque. He helped me when I was chief of staff, at Los Alamos Medical Center [LAMC] trying to replace the LAMC staff. For instance, we had some surgeons there that didn't like to change over to the private payroll from the Federal payroll. So I fired them and had to replace them. In replacing them we had surgeons that went through Lovelace Clinic at some place and time, and we hired some of their staff. Dr. Kniseley and I were sent by the state of New Mexico to the Memorial Hospital in New York to work under the man who was Dr. Papanicolau. We were trained by Papanicolau to do pap smears. Dr. Ralph Kniseley did pap smears down at Lovelace, and I did pap smears up in Los Alamos. Then, when I came to Oak Ridge, Kniseley had left Lovelace at that time and he was now the associate director of the Medical Division at Oak Ridge. He used to live up the street on the hill up on Orchard Lane. I used to come into the Medical Division on occasions and to talk with him when Marshall Brucer was here, and also Ralph Kniseley was here. I used to visit him up there at that time. He was my contact. I'm not sure that Dr. Andrews was too pleased with me, but he was always pleased with whatever Dr. Ralph Kniseley said.
Dr. Andrews' child, who is Ellen Andrews, is now a physician, by the way. She practices in Oak Ridge. She is a pediatrician. I remember being once in her house when her father was still alive and her mother was there. She wouldn't walk for some reason or other. She would slide around the floor on her butt. I remember Dr. Andrews questioning me, did I ever see anything like that. I said, "Yes, there is an easy solution." "What was it?" I said, "You take her diaper away."
ANDERS: Was this one of the reasons Dr. Andrews was displeased?
LUSHBAUGH: Anyway they did it, they took her diaper away and she stood up and away. Because they had a rug made out of hemp.
SIPE: She came along a little late in life and it was very much of a surprise. I don't think she walked because they were so proud to have had such a surprise. She was so special. Dr. Andrews was not a real healthy human being, either. They were so surprised to have her. I think she could probably crawl even now.
ANDERS: And they still would have been just as pleased.
SIPE: I was trying to find that isotope in any of this stuff. The gallium-72 is the only thing that stands out that they used a lot of, but they never did corner it into the ovarian gallium-72 for metastasis. I can't find that it said ovarian-type products. I've looked. That was one of the ones that they were using an awful lot.
FISHER: When you mentioned that you had more opportunities at Oak Ridge to work with isotopes, was that because there were more available from Oak Ridge National Laboratory in close proximity to the Lab?
LUSHBAUGH: I don't know about that, because all AEC divisions had some chemists. At Los Alamos, there were chemists doing chemical refining. Los Alamos was nice; I liked working in Los Alamos. We used to have high-explosive accidents there, in which trucks carrying various Spanish-Americans from down the hill would get blown up. I as a pathologist, I autopsied 150 percent of the persons who died in the Los Alamos Medical Center. We used to find that the best ways to find missing parts in an explosives accident was to go out with a pair of binoculars and watch the birds around radioactive dumps. You'd see the crows come in and take parts of persons that had been blown up into the trees. I remember once we had a woman who had a malignant melanoma34 and who had an upper arm resection35 . It was the whole arm, including her clavicle36 and scapula37 which were removed. I was given the arm, because I was given all of the surgical specimens. I used to be given every foreskin that was ever taken off in Los Alamos. Given this upper arm, I thought, "Why didn't I dissect that? Who has the skeleton of an upper arm, a perfectly normal upper arm?" She was dissected because of the lymph nodes underneath the arm. So I put it in the cooler, and then the person died within six months. I did get around to dissecting this muscle off the skeleton. Six months later this woman died from cancer of the lung, from a metastasis from her lymph node. I remember I gave the arm back to the undertakers so they were able to bury the whole body. They were appreciative.
SIPE: That's very important to people.
LUSHBAUGH: They didn't understand it, but they thought it was pretty good.
I also solved the problem of a murder there in a little town called Cebolla. Cebolla is the Spanish word for onion. That's why I know it very well. This fellow had some kind of lesion in his scalp. He had died during the night and the police brought him in. The New Mexico police took very good care of me. They'd bring in all the strange persons that had died. In this case, this fellow and his friend were two very drunken woodsmen and they were playing a game which I later called, "your mother's a son of a bitch." And the other guys would say, "No, she isn't; your mother's a son of a bitch." The way you played this was with a double-headed axe like all woodsmen use, and you sit there in front of each other with a whiskey bottle here [(pointing down)], and then you have an axe between you. One guy would try to hit the guy on the right temple and the other guy would pull it over, and try to get the guy to stop him from doing that by pushing it back. I was able to draw a cartoon using cardboard of a double-headed axe and fit it into the slice and show that this guy had died as a result of having lost the game fairly and squarely. You haven't heard of that game?
ANDERS: No, I haven't heard of that game. Did the police consider it a fair-and-square loss and forget it at that point?
LUSHBAUGH: Yes, they knew that when I said something it was usually true. They brought me the [vehicle] radiator of a person who was in their jail in Taos, New Mexico, because he had obviously been involved in a hit-and-run accident in which a man was killed. I looked for a man's red cells, and found bird red blood cells, which are nucleated38 and oval. The human red blood cells are not nucleated. It was a matter of just taking a little bit of dried blood off this radiator and making a suspension of it and looking under a microscope and seeing all the nucleated red cells proving it was bird blood. They had to go up and put his radiator together back on his car and let him out of jail.

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