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Oral Histories
Radiologist Hymer L. Friedell, M.D., Ph.D.
Foreword
Short Biography
Early Training and Research
Pre-War Radiation Therapy
Pre-War Experience at the University of California
Amount of Information Provided to Patients
Prominent Researchers Working at Berkeley
The Army Medical Corps and the Manhattan Project
Work at the Chicago Metallurgical Laboratory
Inspection of Manhattan Project Facilities and Proposed Sites
Search for Data on Human Exposure to Radiation
Purchase of a Cyclotron; the Manhattan Engineer District's Early Biomedical Program
Plutonium Injection Studies
Patient Consent in the Plutonium Injections
Advisory Role in the Early AEC Biomedical Program
AEC Isotope Distribution Committee
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| FISHER: |
You mentioned to me at San Francisco that he was ill, I think in 1944,
during the planning era. |
| FRIEDELL: |
Oh, yes. That explains one of the reasons why I went to Los Alamos.
Actually, he was a pretty robust person, and I don't quite understand why he was
ill; because he wasn't ill very often. But apparently, this trip to Los Alamos
had been planned. I think it should be clear that of all the places that we used
to visit, this one was sharply circumscribed. We never went there, except under
direction.
For example, if I wanted to know something about the program at the
University of California, I had no hesitation in going to the University of
California and talking with Hamilton or Chakoff or Greenberg, or somebody. And
some of the other people were learning some of the methods that they wanted to
use, for example, in autoradiography. There was a gal by the name of Dorothy
Axelwright who got to be pretty expert at this, and I remember visiting and
seeing how this was done, and so forth.
Paul Aebersold87 was a
part of the program, and I got to know him very well. Although I knew them from
before, from my period before. But the main point was: we never went to Los
Alamos unless we were instructed to go to Los Alamos. It was sort of somewhat
surprising, that I was then instructed to go to Los Alamos to pursue this
program, to examine this program. Obviously, this program had been under
discussion for some time; otherwise, it wouldn't have been developed to this
level, with presumably Dr. Hempelmann88 and Wright Langham.89 |
| MELAMED: |
You're discussing the plutonium injections now? That's the program? |
| FRIEDELL: |
In humans. Remember, they were doing animal work. They had already been
doing lots of animal work. Animal work with plutonium was being done all over
the place. I shouldn't say all over the place, but being done in California [(at
Berkeley's Crocker Laboratory)], primarily, and also at Los Alamos and some in
Chicago. Probably, some of it was done at Oak Ridge under what is known as [the]
X-10 [graphite reactor] (that division of the Chicago project which then moved
down there where the experimental pile was). This program must have been under
considerable discussion.
I can't recall exactly my conversations. Because, very frankly, when Eileen
Welsome,90 who brought this to my attention first, said [that] I had
gone there and approved it, I was nonplussed—because I didn't remember it.
When she sent me the letter, then I began to cajole my brain and I remembered
it.
I remembered—here's some of the instances: For example, Louis
Hempelmann came out to meet me. I'd met Louis Hempelmann before. I knew him not
well, but I knew him pretty well. Louis Hempelmann came out to pick me up at
Albuquerque, I believe, maybe at Santa Fe; I've forgotten. Probably Santa Fe. He
drove me and we got a flat tire on the way, and we had to fix it. So I remember
that. I remember the conversation, and I remember Dr. Oppenheimer91
coming in occasionally.
Now my own recollection is that Dr. Hempelmann was in favor of the program,
but he wasn't wildly enthusiastic. I would say that the one that was more
enthusiastic, was pushing this more, was Wright Langham; because he felt that
the work was coming in showing that there was a special distribution of the
material in the endosteal92 areas, and where the primary bone marrow
is more likely to be affected. They were concerned about that.
Besides that,
they'd had an accident in which some of the—there was a minor explosion,
and some of the material [(plutonium)] had been impacted into one of the
individuals. They felt that some studies should be done in humans. This must
have been approved by Stafford Warren. I shouldn't say, "approved." It
must have been reviewed by Stafford Warren before I went. |
| MELAMED: |
What was the date that you went, do you remember, or the time? |
| FRIEDELL: |
I don't know the date, but there is a letter. I saw the letter, but I can't
put my hands on it right now. There's a letter that indicates when it was done.
Because the letter was written to Colonel Warren, stating who was present at the
meeting; the date, of course; and was written by Oppenheimer and not by
Hempelmann, asking that it be approved.
So the approval formally was to
be given by Stafford Warren, I believe. But in the letter, it said I had
reviewed the program—I had seen no objections to their pursuing it. But
what was not in there was some conditions that we talked about. Those are useful
because it's understood that that's what we would do. |
| FISHER: |
What were those conditions? |
| FRIEDELL: |
One, it should not be done at Los Alamos; because it required sophisticated
studies where patients could be handled properly. Two, it should be done in
patients where you could get real data. One of the ways in which you could get
real data, besides excretory data, would be where you could get some
postmortems. So we used terminal patients, where there was a chance of getting
data. And three, that we ought to use the doses that were in the vicinity of
what were considered body burdens, from calculations from radium.
So those were the general conditions that we felt ought to be pursued. We
saw no reason that appropriate patients couldn't be gotten for these studies. I
personally was not terribly enthusiastic about the program. I said, "We've
got to do it." The reason is that it was fairly late in the game.93
Secondly, the real problem was interdiction. The real way to handle a problem
where they don't know anything about it, but suspect, is make sure that you
can't come in contact with it [(the radioactive material)] in various ways.
On
the other hand, you couldn't argue that there couldn't be accidents. And
therefore, you ought to know something more about it. So my enthusiasm wasn't
wild, but I certainly couldn't object to the studies. Therefore, they seemed to
be earnest, wanted to do it. They had enough background, and understanding of
the problem, both from their own studies. If I remember correctly,
Wright Langham and Louis showed some of the data, and we were aware of the data
that was already coming out from Joe Hamilton's place [(Crocker Laboratory)]. |
| FISHER: |
So you reviewed the excretion data from the worker with impacted plutonium.
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| FRIEDELL: |
Yes, but more than that, excretion data in animals, which was quite
voluminous. |
| FISHER: |
Was there some discussion about the lack of agreement; the animal excretion
rates with the human excretion rates? |
| FRIEDELL: |
That I can't recall. But there was some discussion, yes, because that was
one of the arguments for doing it in humans. There was a discrepancy, they felt,
in what they observed in this [in] man and [in] the animals.94 |
| FISHER: |
Was there any connection drawn between your experience before the war, or
early in the '40s, with injection of strontium, and the contemporary injection
of plutonium? Was there any connection drawn? |
| FRIEDELL: |
No, none. The only thing that occurred was: there was some discussion of
radiostrontium, and something that I don't remember. But Dr. Hamilton wrote a
letter much later, somewhere in the '50s I think, to Shields Warren95
about radiostrontium; in which he apparently got ahold of the data that I had
done before I was ever involved in the Manhattan Project. And [the letter]
indicated that I had injected so much strontium into a patient that, apparently,
I considered such-and-such a dose lethal. Exactly why I considered it, and how,
I [couldn't begin to] recall unless I was confronted with the data and had a
chance to study it for a month. My experience was of this nature.
However, I do not recall whether we did—I shouldn't say "we,"
but a patient was injected with plutonium at Oak Ridge, Tennessee, when I was
there. I didn't know the patients. I'd never had any contact with them. I know
who injected it. It was a young man by the name of—I'll think of it. It was
done under Dr. Warren's auspices, because obviously [someone] could not obtain
plutonium, unless they got it from a formal source. They couldn't get the
plutonium and have it properly prepared to inject into this patient.
The
individual who did it, I have somewhere in my notes. I can find it. It's in
Eileen Welsome's records because I gave her the name. I looked it up. I'll think
of it. I can't recall it for the moment. |
| MELAMED: |
Joe Holland? |
| FRIEDELL: |
No, it wasn't Joe Holland. It was someone who had very little contact with
it. He'd come from Chicago. He's a surgeon. Let me think for a moment. It's odd
that I don't remember it. Anyway, it's in the record someplace. He injected it. |
| FISHER: |
Your description of that event— |
| FRIEDELL: |
He injected an individual that was about 60 years of age. He had been in a
fearful accident in which he smashed up all kinds of bones.One of the reasons he
was injected with this is: there was some vague report that it increased
endosteal bone rapidly in animals. They thought, "Here was a chance of
giving somebody some plutonium, which might possibly be useful in the healing
process, and yet would give them some information on something about the
distribution." He was the first individual that I know of that received
plutonium. It was really done in part for some obscure therapeutic reason, but
also, presumably, to collect some data. |
| MELAMED: |
Did General Groves approve this? Do you know if he gave his approval and
knew about it? |
| FRIEDELL: |
That, I don't know. But he would not have interfered.96 It's
possible that Dr. Warren had discussed this with General Groves. I don't know of
it, but it's possible. General Groves liked Stafford Warren and maybe,
indirectly, liked me too. General Groves was a pretty gruff sort of fellow.97
I can tell you this: when he asked me to appear—I remember this very
vividly—he asked me to appear, to go to Boston and buy the cyclotron. I got
there promptly before he got there. I was to be there at eight o'clock so I was
there at quarter-to-eight.
There was a long line of officers waiting to
see him, and he came in and he didn't say hello to them. He was either
preoccupied or very gruff. And then he very nicely asked me to come in before
all the rest of them. All of them outranked me. Then he gave me this letter and
I read it. And it was a handwritten letter, as I said earlier, from James Conant
to him about transferring the cyclotron. He was a rough-and-ready individual.
But I think he left Stafford Warren pretty much on his own unless there was some
serious conflict. |
| FISHER: |
You mentioned to me in San Francisco, when we talked the last time, that
these meetings in Los Alamos and the discussions with Oppenheimer got back to
General Groves; and he was pretty well aware of the plan to test plutonium in
human subjects. |
| FRIEDELL: |
I think he was. I think he would be. But I don't know if from the record.
If I recall correctly, I never communicated with him. But Stafford Warren almost
certainly did. |
| FISHER: |
In the acknowledgments section of the Rochester report on the two or three
plutonium injection cases (the report that was classified and secret for some
time and was declassified)—it's a nice, printed report; I noticed it was
well-typeset. In the acknowledgments of this report, Stafford Warren was
acknowledged as: "primarily responsible for the initiation of the program
under the MED." |
| FRIEDELL: |
I think probably that's right. |
| FISHER: |
That was report LA–1151,98 dated September 20,
1950. I wondered if that would be your recollection. |
| FRIEDELL: |
I wouldn't know whether exactly he did it, but I wouldn't be surprised that
he did. I wouldn't be surprised that this particular notation might not be after
any research they did for this reason. I don't think I'm telling anything that
is necessarily conjectural, but I think that President Vallentine, who was then
in charge of the University of Rochester, probably made a hard bargain with the
Army, saying, "You can have Stafford Warren." Remember Stafford Warren
was also on the essential list, although he was overage. I think he's about 10,
12, maybe 15 years older than I.
They probably made an agreement to
have a research program going on in Rochester, and to build the building then
for them to do it. That was, I don't think, a [hard] bargain, but it was a
bargain: "You can have Warren if you'll do this." I think the Army
probably felt that we needed the research program anyway, and so, they did it.
Undoubtedly, in the contract someplace, it probably outlined some of the studies
that could be done—I know that I visited many times there before the
building was built—and what the general program might be like. |
| FISHER: |
At Rochester? |
| FRIEDELL: |
At Rochester. |
| FISHER: |
What was your involvement in the analysis of the results from the plutonium
injection studies? |
| FRIEDELL: |
As a matter of fact, I never really had an opportunity to analyze them.
First of all, almost all the studies were done after 1946. Do you know the exact
dates? |
| MELAMED: |
They were '45 and '46. I can get you the exact dates. |
| FISHER: |
The dates were compiled by Dr. Durbin; starting in April 9 or 10, of 1945
and continuing on to about January of '46, I think. Something on that order. |
| FRIEDELL: |
I would say that probably. |
| MELAMED: |
Here's a document we picked up from one of the records, that just listed
all of the injections by code and the dates. They skip around. Here's the Oak
Ridge one in 4-10-45. You see, you've got one down in '47. |
| FISHER: |
One as late as June and July of 1947, in San Francisco. |
| FRIEDELL: |
In a way, I'm surprised that 11 of them were done at Rochester. |
| MELAMED: |
There were quite a few at Rochester. |
| FRIEDELL: |
I don't remember that. I have to confess that I don't really know anything
about the results. I should have, probably. I don't recall any report that
outlined what. There probably wouldn't be. It's fairly early. First of all,
they'd probably be doing excretion data primarily. After all, what else could
they do. They would do all kinds of metabolic studies: what happened to the
white count, and what happened to kidney function, and what happened to various
other studies. It wouldn't be surprising that the first reports weren't made
until somewhere in '46.
So about that time, I was leaving the Army. I may not have even seen any of
the reports. The obvious reports would have to be, first of all, what
observations were made. There would have to be excretory data. There would have
to be peripheral metabolic studies of various kinds: hematopoietic system, maybe
bone marrow studies. Maybe—I'm sure they looked at the bones and got x rays
before, and were going to do periodic x rays. As a matter of fact, Dr.
Hempelmann at one time, some time in the late '50s when he went to Rochester,
asked me to examine a patient and do some x ray studies on him; which I did.
They
must have been looking at some of these patients and just doing a general
surveillance. I'm sure they must have been hoping to get postmortem studies,
because those are the ones that would really tell them something about the
distribution [of plutonium within the body]. They may even have done some
peripheral radioisotope studies, like: "What happens to the thyroid
function?" for example, or, "Could we identify their kidneys by using
appropriate radioisotopes?" All of these studies probably would have been
done. But to get the reports—after they injected, which was late '45 and
'46—I don't know when the first report came out. It was probably—well,
I would guess, either early in '47 or late in '46. |
| FISHER: |
That raises a couple of other questions. Nichols, who was the chief in Oak
Ridge—what was his outlook on this experimentation, do you remember? |
| FRIEDELL: |
He may not even have been aware of it, if it was reviewed. After all, it
originated from Los Alamos. Therefore, it may even be that Nichols didn't know
what was going on in Los Alamos; because General Groves kept this thing very
tightly under control. |
| FISHER: |
Do you feel in anyway that your work with the plutonium injection study was
misrepresented by anyone? |
| FRIEDELL: |
No, I don't think so. They say I had approved it, and in fact I'm the one
closest to this and I had approved it. I can't deny it. The records indicate
that I did. The records indicate that I visited. But after that, I had no
contact with it. |
| FISHER: |
Were these experiments delayed, pending the development of radioanalytical
methods by Wright Langham at Los Alamos? |
| FRIEDELL: |
You mean the human experiments? |
| FISHER: |
Yes. As he developed— |
| FRIEDELL: |
I don't think so, for this reason. First of all, you didn't know when you
could get tissue to examine this; sporadically spread through long periods of
time. So they must have taken whatever patients they could. |
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Patient Consent in the Plutonium Injections |
| MELAMED: |
Do you remember any discussions at all, that you were party to in any way,
involving consent issues, or what you would tell the patients who were going to
be injected—given the secrecy of what was going on? |
| FRIEDELL: |
I never saw any of the patients, never had contact with any of them,
wouldn't know them. It may be that this was tightly compartmentalized, again for
secrecy, because plutonium was involved. |
| MELAMED: |
You never heard any discussion, by people who were involved in planning, of
how you would treat the actual contact? |
| FRIEDELL: |
No. I think Stafford Warren must have done this; because the program sort
of came out of the blue. I'll say this off-the-record. I think one of the
reasons this program was pushed—this will be off-the-record. |
| MELAMED: |
You can excise it later, if that would be all right. I'll just leave it on
the tape, and when you get the transcript. |
| FRIEDELL: |
Will it come on the tape? I'm holding my hand over this thing. |
| MELAMED: |
I don't know. Do you want me to turn off the tape? |
| FRIEDELL: |
Turn it off. |
| (tape interrupted) |
| FRIEDELL: |
—when we get into controversy about this. In a way, it's conjecture. I
don't really, can't, read their minds, and so on. One could argue that the very
fact that I bring this up shows that I have that kind of devious approach to
this, and I don't. I can't help feeling that it lingered there. |
| FISHER: |
Because so few people are still alive who can remember. Maybe you're the
only one; I don't know. But in those planning meetings in Los Alamos in 1944, or
was it 1945? It would have been early 1945, March or so. Was there any concern
about "What do we tell either the patient, or his family, about injecting
with plutonium?" |
| FRIEDELL: |
I have to be honest and say, "I do not recall any discussion."
But Louis [Hempelmann] was a very, very sound, in my opinion, careful
individual. He, I don't think, would subject patients to any unusual risk. And
remember, in those days when we said, "Here we're thinking of using
terminal patients," we're going to use what would be considered doses on
the order of a body burden. Therefore, there should be very little hazard.
It
[has] got all kinds of hazards they're already involved with. If we generally
considered it was minimal hazard, and the thing would ordinarily not have been
discussed at great length. Because the limitation of doses, we were talking
about doses at what was then considered the body burden level. |
| FISHER: |
(to Melamed) Do you want to move beyond the plutonium studies, or
did you have any more questions? |
| MELAMED: |
I have just one more question in this area. Do you know of any other human
experimentation that Dr. Hamilton might have been involved in in this period,
other than this specifically, any involvement he might have had? |
| FRIEDELL: |
The only human experimentation, I would say, were these. Of course, before
the Manhattan Project, I think he did a fair amount of work in metabolic studies
with iodine; possibly even with radiophosphorus. He may have done it with Dr.
Lawrence. It's conceivable. He probably did some work with some of the other
biochemists and biophysicists who were also interested in certain metabolic
studies. They may have done some studies of that kind in humans.
I'm sure they did studies which they considered to be trivial in hazard.
They wouldn't cavalierly do this. I can't believe that. Although Dr. Hamilton is
accused of being very cavalier in this. I think it was—if there is any such
element in it—it could be due to the fact that we generally considered
these tracer doses of no real consequence. That's how it might occur. When you
look at it and look at the doses, it's true that they had an added risk. But the
added risk, compared to the natural risks that existed, say in oncological
diseases, was trivial.
What if your chances were increased from 1,800 per
10,000 to 1,810 or 1,820 per 10,000? That's not the kind of risk that is of real
consequence. Generally, it would be ignored. Nobody made such calculations.
These are the kinds of calculations we make now. When we do the linear quadratic
(that's the term I was looking for earlier) or the linear extrapolations, you
can come to some decisions about the kinds of risks. When you put it into the
general risks, in those days, it didn't look very serious. |
| FISHER: |
After the end of the war and after your return from Hiroshima, Japan,99
you went back to Western Reserve University? |
| FRIEDELL: |
I was never [previously] there. They offered me this position. I decided to
accept it. |
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