Human radiation studies: Remembering the early years. Oral history of radiologist Earl R. Miller, M.D., August 9 and 17, 1994

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HUMAN RADIATION STUDIES: REMEMBERING THE EARLY YEARS Oral History of Conducted August 9 and 17,1994 United States Department of Energy Office of Human Radiation Experiments

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her Openness Initiative. As part of this initiative, the Department of Energy Iundertook an effort to identify and catalog historical documents on radiation experiments that had used human subjects.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 r o m a p to the large universe of pertinent information: Human Radiation Experiments: The Depamnenf of Energy Roadmap to the Story and the Recorh @OE/EH-O445, February 1995). The collected documents are also accesThe 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 fiom 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 interThe 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

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Wartime Work on Radiation Exposure ...................................... 2 Remembrances of Joseph Hamilton ......................................... 4 Neutron Therapy Research ................................................. 5 Working for the Manhattan Project and UC Medical Center ...................... 7 Human Applications Committee and Informed Consent ......................... 8 Textbox: About Consent Forms (April 11. 1995) ........................... 9 Work With Soley to Diagnose and Treat Thyroid Disease With Iodine-13 1 Relations Between UC Berkeley and UC San Francisco ......................... 6 Process for Obtaining Radioactive Isotopes ................................... 8 Patient Consent; Contradicting Perceptions .................................. 15 Wartime Plutonium Injections ............................................ 16 Research With Patients From Laguna Honda Home ........................... 19 Radioactive Iodine Uptake in Schizophrenia Patients .......................... 23 Invention of a Baby Holder (1951) ......................................... 24 Technique to Produce Infinite Laminograms ................................. 25 Introduction of Stereoscopy to X-ray Film Making ............................ 27 Postwar Preference for Unclassified Research ................................ 29 Zirconium and Plutonium Injections ....................................... 30 Research With Healthy Volunteers Tracing the Records of Patient Consent ..................................... 32 A Career in Research ................................................... 33 Textbox: Recollections of Research Activities (April 11. 1995) ............... 34 Remembrances of Personalities ........................................... 37

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Tension Between John Lawrence and Stone ................................. 37 Use of Tomography to Diagnose Tuberculosis Patients ........................ 42 Working in the Radiological Research Laboratory ............................ 50 Investigating How Radiologists See Images ................................. 51 Establishment of the UCSF Radiation Laboratory ............................ 52 Remembrances of University Presidents Sproul and Kerr ...................... 53 Work Through the AMA to Improve Radiology Training ...................... 55 Rise of Radiology Specialization .......................................... 56 Study of Pediatric Patients With Congenital Heart Disease ..................... 57 Textbox: History of Radiology. University of California at San Francisco. Recollections of an Old Crock (March 16. 1978) ............................. 67 Activities of Earl R.Miller as Indicated by Published Material (April 22. 1995) .... 97

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The opinions expressed by the intervieweeare his own and do not necessarily reflect those of the U.S. Department of Energy. The Department neither endorsesnor disagrees with such views. Moreover, the Department of Energy makes no representations as to the accuracy or completeness of the information provided by the interviewee.

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June 1995 Setting: August 9 and 17,1994; San Rafeel, CA Interviewers: Anna Berge (Lawrence Berkeley Laboratory Archives and Records Office) and Dr. Gregg Herfcen (Advisory Committee on Human Radiab'on Experiments) Dr. Earl R Miller was selectedfor the oral historyproject because o fhis research at the University o fCalifomia (UC) Medical School at San Francisco, California. This oral history covers Dr. Miller's service involvement with the Manhattan Engi neer District; toted body irradiation; Dr. Ernest Lawrence’s heavy-ion therapy; the division between UCMediccd School and Domer Laboratory; and the receiving o f isotopes made on Berkeley's 60-inch cyclotron. Dr. Mdler cdso discusses his re search on cleftpalates and his infant cardio- and urinary track studies. Two oral interviews were conducted with Dr. Miller at his residence in San Rafael, Califomia On August 9,1994, Ms. Anna Berge o fthe Lawrence Berkeley Labora tory Archives and Records Office and Dr. Gregg Herken o fthe Advisory Committee on Human Radiation Experiments interviewedDr. Miller. On August 17,1994, Ms. Berge met with Dr. Millerfar afollow-up interview. Ear] R. Miller was He was married 1931 and was widowed in 1978. He has two children. By 1931, he had received both his BA. and M A . in Physics from the University of Wisconsin (UW). He attended the UW Medical School from 1932 to 1936. After receiving his medical degree. Dr. Miller interned at Research Hospital in Kansas Chy, Missouri (1936-37), completed a residenry in Radiology at Stanford University (1937-39), and was an instructor in Radiology at Yale University (1939-40). In 1940, he joined frie faculty of the Radiology Department at the University of Califomia Medical School at San Francisco as an instmctor and was board certified in Radiology. He served as chairman of the Department o f Radiology from 1943 to 1945. In 1949, he was made a full professor in Radiology, a position he held until his retirement in 1974. From 1958 to 1974, he was the Director of the Radiological Research Laboratory in the Depart ment o f Radiology. From the mid-1950s until he retired. Dr. Miller spent his mornings in clinical practice and teaching, while his aftemoons were spent in clinical and laboratory research. His research included the introduction and use of angiography; the use of radioio dine; the development and use of x-ray diagnostic techniques, sound movies, and ways to reduce patient exposure; and the study of error in radiologic interpretation. During this same period. Dr. Miller held the following positions: • 1943 to 1945—Director of Health Physics for the Berkeley Division of the Manhattan • 1954 to 1957—Member of the Board of Chancellors of ACR and Chairman from 1957 • 1957 to 1965—Member of ACR’s Commission on Education and Chairman from 1960 • 1960s and 1970s—Served tiuee terms on research panels on radiology for the National Institutes of Health. Among his many honors. Dr. Miller received a Gold Medal award from the ACR in 1972, and the Regents of University of Califomia renamed the Research Radiological Laboratory the Earl R. Miller Radiologic Imaging Laboratory in 1978. Dr. Miller was a pioneer in radiology and has published more than 135 papers.

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Setting: August 9 and 17,1994;S a n Rafael, CA Interviewers: Anna Berge (Lawrence Berkeley Laboratory Archives and Records Office) June 1995 and Dr. Gregg Herken (Advisory Committee on Human Radiation Experiments) Wartime Work on Radiation Exposure BERGE: This is an interview with Earl Miller by Anna Berge and Gregg Herken of the Lawrence Berkeley Laboratory Archives and Records Office and of the Smithsonian Air and Space Museum,’ [respectively,] on August 9, 1994, at Earl Miller’s residence. You were just going to tell us about the relationship between the Division of Medical Physics and UCSF2 and how in fact, you were that contact. In 1942, early on, Dr.Stone: who was the head of the Radiology Department at UCSF, was recruited, I think by Dr. [Arthur] Compton,4to head up the radiation safety of what became the Manhattan Project.’ At that time it was called the Metallurgical Lab! At any rate, that left the PCSF Radiology] Department without a head, and I got called for that. That’s when I learned I would never never ever [want to] be a chairman again. One day, my good friend Staffcord] Warren appeared. He was a professor of Radiology at [the University of] Rochester in [Rochester,] New York. He came then to UCLA’ and became the dean there. He appeared on the scene one day and recruited me to head up the Radiation Safety Division of the Manhattan Project over in Berkeley. This would have been what date? I think it was in early ’43. You worked in radiation safety? Yes, two half-days a week, I directed it. I would leave UCSF at noon, and I would go over to Berkeley. Usually the half-day finished at 10 or 11 or midnight. The work consisted primarily of getting blood countss on people, checking out their radiation dosimeters? and making the rounds of the ’ Dr. Gregg Herken, Ph.D., actually is a Senior Policy and Research Analyst for the presidential Advisory Committee on Human Radiation Experiments. University of California, San Francisco Dr. 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. Dr. Arthur Compton, University of Chicago, a key member of the scientific team that established the the U.S. Government’s topsecret project to develop an atomic bomb during World War I1 created at the University of Chicago early in the effort to develop the atomic bomb. “Met Lab” researchers, led by Dr.EMco Fermi,produced the first sustained nuclear chain reaction on December 2,1942. University of California, LOS Angels the count of the number of red and white blood cells and platelets in a specific volume of blood Dosimeters, or film badges, were worn routinely to measure accumulated personal exposure to radiation.

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Setting: August 9 and 17,1994; San Rafael, CA Interviewers: Anna Berge (Lawrence Berkeley Laboratory Archives and Records Office) and Dr. Gregg Herken (Advisory Committee on Human Radiation Experiments) various parts of the Berkeley Manhattan District. That got me into seeing the work of the physicists at the cyclotrons1° and the chemists. You knew Stone beforehand? He gave me a job as an instructor at UC in the Department of Radiology in 1940. Now we’re going to talk about Stone? Okay. He was an excellent radiologist.” His main work and interest, when I got there, was in radiation therapy, and he was a pioneer in that. When I got there, there was a need for some young buck who had just finished his residency as an instructor in Diagnosis. That’s what I did. You said he was engaged in teletherapy.’* This would be with total body Not total body irradiation. He treated patients with various kinds of malignancies with modalities that varied iiom 100 kVI3up to one of the very early million-volt machines. Yes. He built the tanks and whatever. Stone indicated in the official history that he wrote for the MEDI4 project that he was doing TBIs in the period of 1940. Total body irradiation, TBIs, from 1942 to 1946 under contract of the Yes. It was the case, actually, that there were three hospitals involved. There was San Francisco, New York, and Rochester. The last was Staff Warren. That’s right. It was a h4ED project, a Manhattan Project. They were interested ‘in the effects of radiation upon the workers, and this was a way of finding out how it affected people. They were getting terminal patients in this case. I think there were a total of 32 or 36 in this case. lo accelerators 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. a physician who diagnoses disease, broken bones, and other physical conditions using x rays or other l2 radiation treatment in which the radiation source is located outside the body l4 Manhattan Engineer District, the Federal Agency set up to develop the atomic bomb under the top secret

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Setting: August 9 and 17.1994; S a n Rafael, CA Interviewers: Anna Berge (Lawrence Berkeley Laboratory Archives and Records Office) and Dr. Gregg Herken (Advisory Committee on Human Radiation Experiments) Oh, yes. Okay. I presume that this total body irradiation was for a real Yes, I suppose it was aimed at being therapeutic. That’s important. The idea was to see if there could be an effect, let’s say, on the blood system or the lymphatic system1sthat, influenced by the total body radiation, would do something helpful for the treatment of the cancer. Were you aware, and were the people aware, of that part of the project? That would have been a secret project, it would have been classified at that time [by] the MED, the Manhattan Project. They classified everything. The important thing at that time in that war was a race for a bomb. Even the fact that radiologists were recruited to work was secret, because somebody over in Nazi Germany would have thing which deals with radiation! A radiation bomb!” It was hidden, yes, only from the bad boys over in Germany and from people who would talk out of turn.16 But pretty much, doctors at UCSF knew about what Stone was doing for No, nobody knew what either Dr. Stone or I was doing. I want to go back to that. The secrecy dealt with not giving information to the people we were at war with. Remembrances of Joseph Hamilton HERKEN: Hamilt~n’~is another figure that we’re interested in. Can you tell us a bit about how you met him,when you met him? I assume it’s about this time. He was running the 60-inch cyclotron in the Crocker Lab.lS He was doing really fmtastically important work checking up with animals on the effect on every organ of every radioactive isotope. As I say, he did a great great job. Ken Scott was involved in some of the chemistry parts of it. Ken was quite an inventor, too. Is the system of glands, tissues, and passages involved in generating lymphocytes and circulatingthem through the body in the medium of lymph; it includes the lymph vessels, lymph nodes, thymus, and spleen. l6 This secrecy was maintained on an unprecedented scale, as described in “The Bomb Goes Public” (p. 54) in F.G.Gosling,The Manhattan Prqject: Making the Atomic Bomb @OE/HR-O096), 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 filler view. Americans were astounded to learn of the existence of a far-flung, govemmentrun,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.” l7 Dr. Joseph Hamilton, an M.D., conducted important radioisotope research at University …