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Oral Histories
Radiologist Earl R. Miller, M.D.
Foreword
Short Biography
Part I (August 9, 1994)
Wartime Work on Radiation Exposure
Remembrances of Joseph Hamilton
Neutron Therapy Research
Relations Between UC Berkeley and UC San Francisco
Working for the Manhattan Project and UC Medical Center
Process for Obtaining Radioactive Isotopes
Human Applications Committee and Informed Consent
Textbox: About Consent Forms (April 11, 1995)
Work With Soley to Diagnose and Treat Thyroid Disease With Iodine-131
Patient Consent; Contradicting Perceptions
Wartime Plutonium Injections
Hamilton's Research on Effects of Cyclotron-Produced Radioisotopes
Textbox: Dr. Joe Hamilton (April 21, 1995)
Research With Patients From Laguna Honda Home
Radioactive Iodine Uptake in Schizophrenia Patients
Recalling Dr. Joseph Hamilton
Invention of a Baby Holder (1951)
Technique to Produce Infinite Laminograms
Introduction of Stereoscopy to X-ray Film Making
Postwar Preference for Unclassified Research
Zirconium and Plutonium Injections
Research With Healthy Volunteers
Tracing the Records of Patient Consent
A Career in Research
Professional Contribution
Textbox: Recollections of Research Activities (April 11, 1995)
Remembrances of Personalities
Tension Between John Lawrence and Stone
Textbox: Robert Spencer Stone, M.D., L.L.D. (March 10, 1967)
Part II (August 17, 1994)
Use of Tomography to Diagnose Tuberculosis Patients
Textbox: History of Radiology, University of California at San Francisco, as Seen by Earl R. Miller, M.D. in the Mid 1980's
Working in the Radiological Research Laboratory
Investigating How Radiologists See Images
Establishment of the UCSF Radiation Laboratory
Remembrances of University Presidents Sproul and Kerr
Early Career
Work Through the AMA to Improve Radiology Training
Rise of Radiology Specialization
Study of Pediatric Patients With Congenital Heart Disease
Physiologic Studies
Appendix
Brief History, Earl R. Miller, MD
E.R. Miller's Residency and Career at UC
Recollections of an Old Crock (March 16, 1978)
Activities of Earl R. Miller as Indicated by Published Material (April 22, 1995)
Chronological Bibliography
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1Dr. Gregg Herken, Ph.D., actually
is a Senior Policy and Research Analyst for the presidential Advisory Committee
on Human Radiation Experiments.
2University of California, San
Francisco
3Dr. Robert Stone was an early
researcher at the Lawrence Radiation Laboratory and the UCSF and became a major
figure in radiobiology research. During the Manhattan Project he served at the
University of Chicago as Associate Director for Health under Arthur Compton.
4Dr. Arthur Compton, University of
Chicago, a key member of the scientific team that established the Manhattan
Project
5the U.S. Government's top-secret
project to develop an atomic bomb during World War II
6created at the University of
Chicago early in the effort to develop the atomic bomb. "Met Lab"
researchers, led by Dr. Enrico Fermi, produced the first sustained nuclear chain
reaction on December 2, 1942.
7University of California, Los
Angeles
8the count of the number of red
and white blood cells and platelets in a specific volume of blood
9Dosimeters, or film badges, were
worn routinely to measure accumulated personal exposure to radiation.
10accelerators in which particles
move in spiral paths in a constant magnetic field. The resulting beam of
high-speed particles can disintegrate atomic nuclei and produce radioactive
isotopes.
11a physician who diagnoses
disease, broken bones, and other physical conditions using x rays or other
imaging techniques
12radiation treatment in which
the radiation source is located outside the body
13"kilovolts"—thousand
volts
14Manhattan Engineer District,
the Federal Agency set up to develop the atomic bomb under the top secret
Manhattan Project
15the system of glands, tissues,
and passages involved in generating lymphocytes and circulating them through the
body in the medium of lymph; it includes the lymph vessels, lymph nodes, thymus,
and spleen.
16This secrecy was maintained on
an unprecedented scale, as described in "The Bomb Goes Public" (p. 54)
in F.G. Gosling, The Manhattan Project: Making the Atomic Bomb
(DOE/HR-0096), September 1994: "The release of the Smyth Report on August
12 [1945], which contained general technical information calculated to satisfy
public curiosity without disclosing any atomic secrets, brought the Manhattan
Project into fuller view. Americans were astounded to learn of the existence of
a far-flung, government-run, top secret operation with a physical plant,
payroll, and labor force comparable in size to the American automobile industry.
Approximately 130,000 people were employed by the project at its peak, amongst
them many of the nation's leading scientists and engineers."
17Dr. Joseph Hamilton, an M.D.,
conducted important radioisotope research at University of California, Berkeley.
18a part of the Lawrence
Radiation Laboratory at the University of California, Berkeley
19Hamilton died of leukemia. His
peers generally agree that Hamilton's illness was brought on by his cavalier
disregard of the dangers of radiation.
20an elementary particle found in
the nucleus of most atoms and having no electrical charge
21Dr. Low-Beer, M.D., a refugee
from Czechoslovakia
22therapy of cancer using an
accelerator to produce a neutron beam of radiation
23Robert Gordon Sproul, president
of the University of California
24were receiving salaries from
both the MED and the UC Medical Center
25Originally headquartered in
Washington, DC, the MED moved to the new weapons complex in Oak Ridge,
Tennessee, in the summer of 1943.
26relating to the functions and
activities of living organisms and their parts
27Dr. Mayo Soley, M.D., took his
own life, June 21, 1949, at age 42. He had been Dean of the Medical College of
the State University of Iowa since July 1, 1948. The coroner stated that there
was no apparent reason for the act. Source: New York Times; June 22,
1949; p.16.
28overactivity of the thyroid
gland, resulting in basal metabolic rate and other physiological problems
29relating to the study of the
nature, function, and diseases of the blood and of blood-forming organs
30Between 1948 and 1958, Miller
authored or coauthored 17 published papers on thyroid disease and its diagnosis
and treatment with 131I.
31the U.S. Atomic Energy
Commission, predecessor agency to the U.S. Department of Energy and Nuclear
Regulatory Commission (NRC); established January 1, 1947
32a malignant tumor composed of
epithelial tissue—the tissue layer covering body surfaces or lining the
internal surfaces of body cavities, tubes, and hollow organs
33Radiation therapy using
iodine-131 is still the treatment of choice for many thyroid disorders,
including hyperthyroidism, Grave's disease, and thyroid cancer.
34deficient in thyroid
secretions, resulting in goiter, myxedema (thickening of the skin, blunting of
the senses and intellect, and labored speech), and, in children, cretinism
(stunted growth, deformity, and mental retardation)
35having a normally functioning
thyroid gland
36Miller's final publication with
Dailey was, as he recalled, in 1955: Studies with radioiodine. V. Validity of
histologic determination of I131 radiation changes in the thyroid gland. Radiology
65:384–93.
37having an atomic number higher
than 92, the atomic number of uranium; also called transuranic
38In an AEC-funded experiment,
Dr. Kenneth Scott inhaled an active smoke containing zirconium-89. The purpose
of the experiment was to determine the degree to which the lungs would retain
very finely divided active smoke suspended in air. The results showed that
almost 100 percent of the inhaled activity (about 0.5 microcurie of
zirconium-89) was retained within the lungs and upper respiratory tract.
39a tube or box fitted with a
screen coated with a fluorescent substance, used for viewing deep body
structures by means of x-ray or other radiation
40the branch of medical science
dealing with tumors, including the origin, development, diagnosis, and treatment
of cancer
41a thin, flexible tube inserted
into a bodily passage, vessel, or cavity to allow fluids to pass into or out of
it, to distend it, or to convey diagnostic or other instruments through it
42relating to metastatis, the
spread of disease-producing organisms or of malignant or cancerous cells to
other parts of the body by way of the blood or lymphatic vessels or membranous
surfaces; or, the condition so produced
43opaque to radiation; hence,
visible in x-ray photos and under a fluoroscope
44of or pertaining to veins
45the formation and growth of
neoplasms (tumors)
46million electron-volts
47accelerators in which protons
are raised to very high energy levels (currently several billion electron-volts)
48pertaining to vessels that
convey blood, such as veins and arteries
49one of the clinics at
University of California, San Francisco Medical Center (a psychiatric unit)
50Dr. Soley left UCSF in 1948 to
become the Dean of the University of Iowa Medical School. He planned to open a
thyroid clinic and an iodine-131 diagnostic and treatment clinic. While helping
the university prepare the iodine lab, Soley engaged in clinical work for about
six months before he died in 1949.
51See Miller's first boxed
editing insert, preceding, under "Human Applications Committee and Informed
Consent."
52E.R. Miller. "A Device for
Immobilizing Children During Radiographic Examinations." Radiology 58:421–23,
March 1952.
53dosimeters
54an elasticized bandage, usually
in a continuous strip, for securely binding an injured joint
55In the early '70s Dr. Miller,
together with E.M. Curry and B.B. Hruska, coauthored two papers on this subject
in Radiology: "An Infinite Number of Laminograms from a Finite
Number of Radiographs," Radiology 98:249–56, Feb. 1971; and "A
Simplified Procedure for Viewing Multiple Films to Create an Infinite Number of
Laminograms," Radiology 110, No. 2, Feb. 1973.
56the point about which a lever
pivots
57a technique for changing an
alternating current (ac) into a direct current (dc)
58a sensitive television-camera
tube in which a beam of low-velocity electrons scans a photoemissive mosaic
59x-ray images produced by x-ray
examination of the heart and its blood vessels following intravenous injection
of radiopaque fluid
60of the brain, especially the
forward and upper part, which governs voluntary movement and conscious processes
61a radiopaque substance
introduced into a part of the body to provide a contrasting background for the
tissues in an x-ray examination
62the use of a stereoscope, an
optical instrument through which two pictures of the same object, taken from
slightly different points of view, are viewed, one by each eye, producing the
effect of a single picture of the object, with the appearance of depth (like a "3-D"
photo)
63horizontal distance between the
two lenses of a stereoscope
64face-down
65from the side
66formerly called UC Radiation
Laboratory; now Lawrence Berkeley Laboratory, a National Laboratory on the
campus of University of California at Berkeley
67the nations against whom the
Allies fought, consisting chiefly of Germany, Italy, and Japan
68Low-Beer, B.V.A., K.G. Scott,
J.G. Hamilton, and R.S. Stone. "Comparative Deposition of Zr95 in a
Reticulo Endothelial Tumor to Normal Tissues in a Human Patient." Berkeley,
CA: University of California Radiation Laboratory, UCRL-68.
69In 1946, at UCSF and the
Crocker Radiation Laboratory at Berkeley, AEC-sponsored research was carried out
to study the uptake and deposition of zirconium. The subject, a 55-year-old
female patient with a reticulo endothelial tumor that had arisen in the spleen
and then metastasized to the liver and left leg, was given a test dose of
zirconium-95. She was administered 1.76 millicuries of zirconium-95 in saline by
intravenous injection 24 hours prior to a scheduled midthigh amputation of the
left leg. Samples of the tumor, as well as normal tissue, were later obtained
from the limb for zirconium-95 assay.
70(if injected before the
amputation) if the body part was going to be removed anyway; or (if injected
afterward) if the body part was already removed
71that is, to tell you whether
blood or lymph circulation was [or had been] reaching that body part
72The President's Advisory
Committee on Human Radiation Experiments
73Lawrence Berkeley Laboratory
Archives and Records Office, where Berge works
74For the transcript of the
interview with Durbin, see DOE/EH-0458, Human Radiation Studies: Remembering
the Early Years; Oral History of Dr. Patricia Wallace Durbin, Ph.D. (July
1995).
75Dr. Paul Aebersold established
the administrative system for distribution of radioactive isotopes. After
working on the Manhattan Project at Los Alamos, New Mexico, and Oak Ridge,
Tennessee from 1942 to 1946, he served as director of the Atomic Energy
Commission's Isotopes Division at Oak Ridge from 1947 to 1957. He retired as the
Director of the AEC's Office of Isotopes Development in 1965. Two-and-a-half
years later, he committed suicide. For additional information on Dr. Aebersold,
see "Safety of the Nuclear Industry" in the interview with Merril
Eisenbud (DOE/EH-0456, May 1995); "Remembrances of Personalities" in
the interview with Earl Miller (DOE/EH-0474, June 1995); and "Oak Ridge
Committees (Isotope Distribution, Human Use, et al.)" and "Vanderbilt
University Study of Pregnant Women and Iron-59" in the interview with Karl
Morgan (DOE/EH-0475, June 1995).
76referring to Dr. Gregg Herken,
Ph.D., who had participated with Berge in the August 9, 1994 interview of Dr.
Miller
77a method of making x-ray
photographs of a selected plane of the body
78an infectious disease that
usually affects the lungs, causing small, firm, rounded nodules or swelling
79showing or indicating the
presence of disease
80saliva mixed with mucus or pus,
coughed or spat from the lungs or respiratory passages
81Dr. Miller gives a full
explanation of laminography earlier, in "Technique to Produce Infinite
Laminograms."
82cathode ray tube, as used in
televisions and computer monitors, consisting of a vacuum tube generating a
focused beam of electrons, which illuminate phosphors on a screen to form a
visible image
83the rate at which the contrast
of the image changed per unit of distance across an x-ray image. See Dr.
Miller's elaboration, which appears two paragraphs later.
84For more on the role of
contrast in interpreting an x-ray image, see Dr. Miller's paper, "A
Multiple-Film Technique for Contrast Enhancement and/or Reduction of Patient
Exposure," in Radiology 110:2 (February 1973).
85extrasensory perception
86Senator Dianne Feinstein (D-CA)
87American Medical Association
88Dr. Miller is exaggerating, of
course; the highest intelligence quotient ever recorded on the Stanford-Binet
test was below 230; only one person in 50,000 has an IQ of 170 or higher.
89the use of a fluoroscope (a
tube or box fitted with a screen coated with a fluorescent substance, used for
viewing deep body structures by means of x-ray or other radiation)
90National Institutes of Health,
Bethesda, Maryland
91the medical specialty concerned
with correcting deformities or functional impairments of the skeletal system,
especially the arms, legs, hands, feet, and spine, and their associated
structures, such as muscles and ligaments
92the scientific, clinical, and
surgical aspects of the study of the urinary and genitourinary tract
93the practice of reflecting
ultrasonic waves off interior body structures to produce a visual image, or
sonogram, for diagnostics
94computer aided tomography; or,
an x-ray image obtained by examination with a CAT scanner
95magnetic resonance imaging (a
process of producing images of the body regardless of the presence of bone by
means of a strong magnetic field and low-energy radio waves)
96relating to nerves or the
nervous system
97x-ray examination of the heart
and its blood vessels following intravenous injection of radiopaque fluid
98pertaining to the division
between the two thin-walled upper chambers (atria) of the heart
99pertaining to a partition
between the two ventricles (lower chambers) of the heart
100At that time, no radioisotope
had been more thoroughly characterized for its biomedical effects than radium.
101inability to restrain natural
discharges of urine or feces
102a printed stream of paper,
usually perforated for subsequent separation into sheets, that plots variables
against time and emerges continuously from an instrument
103the pronouncing of oral
sounds as nasal sounds
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