February 21, 1955, my wife and I were married in Kobe. We left ABCC May 18 and arrived in Rochester, New York about two weeks later, unemployed. As a pediatrician with postgraduate training in radiation effects on the human, I had gone to ABCC for experience in the two fields combined, and I served as chief of pediatrics in Hiroshima for 18 months. In choosing a fellowship in radiation biology, I sought to avoid narrowing my interest to one organ system or a subspecialty, such as hematology or neonatology. In looking for a position after working at ABCC, I found I was too narrow; no one needed a pediatrician with knowledge of radiation effects. As I made the rounds, I was repeatedly advised to become a pediatric radiologist, which would require another three years of residency training.

After four months, word came that Frank (Tax) Connell, Ph.D., the professional associate in the ABCC office at the National Academy of Sciences (NAS), was leaving immediately. Here was a position on a month-to-month basis for which I was qualified and from which I could look without haste for an academic position.

We arrived in Washington early in October. R Keith Cannan, Ph.D., the recently appointed chairman of NAS’s Division of Medical Sciences, was responsible for ABCC, among many other activities. He was a biochemist and an outstanding administrator. Much of the time, he oversaw a substantial number of committees that developed reports on questions of national medical importance. Dr. Cannan attended parts of the meetings, and if one was not going well, he put it on track. He was an Englishman who was gifted in speech and writing, and his editing brought committee reports up to his high standard. By observing him, I gained insight into how to enhance committee productivity.

Because Dr. Cannan was not a physician, I helped him with daily ABCC-related medical matters and recruiting. He seldom changed my writing on medicine, but thank-you letters were a different story. He could make each one heartfelt and add a special touch specific for the recipient.

Years later, the position I occupied became much more influential when the Division of Medical Sciences, directed by a full-time top level scientist, was replaced by the Commission on Life Sciences, directed by a committee of scientists who met at intervals.

Soon after Dr. Cannan arrived at NAS, he realized that ABCC was in trouble scientifically and administratively. Advice on its program had been given by leaders of clinical specialties through consultative visits to the clinics in Japan and the periodic meetings of the Committee on Atomic Casualties in Washington. Dr. Cannan, a basic scientist, was the key person in bringing out the importance of epidemiology in the scientific design of the studies in Japan. Clinicians at that time, if they thought of epidemiology at all, considered it only in connection with infectious diseases. Chronic-disease epidemiology was just beginning to emerge, as at NAS’s Medical Follow-Up Agency (MFUA), where World War II veterans were studied regarding the relationship of military experience to subsequent disease. The program, still active, was initiated in 1946 by a surgeon, Michael E DeBakey, and a statistician, Gilbert W Beebe. Although the MFUA, directed by Dr. Beebe, was part of NAS, it had no regular connection with ABCC until 1955.

Having been a recent staff member of ABCC in Hiroshima, I understood well both the research and interpersonal problems that existed there. As an example, while ABCC clinicians collected data from medical examinations of survivors, the biostatistics department estimated radiation exposures as distance from the hypocenter, information which, to reduce observer bias, was not recorded on medical charts. When the clinicians then analyzed their data, they had difficulty getting crucial exposure estimates because the biostatisticians felt the data was theirs alone.

The foibles of the ABCC staff members were magnified by their isolation in a small overseas community. The director had the difficult task of unifying the staff and maintaining a good working atmosphere while relating effectively to Japanese officials, scientists, survivors, news media, and the ABCC workers’ union. Staff morale and scientific design, except for the genetics program, were major problems in 1955, when Dr. Cannan convened the Francis Committee. The committee’s chairman, Thomas Francis, Jr, had just completed the massive Salk polio vaccine trial. As a physician-virologist, he was an expert on infectious-disease epidemiology. Other committee members were Seymour Jablon, an MFUA statistician, and Felix E Moore, chief of statistics at the National Heart Institute, who had served in military intelligence related to Japan during World War II. The group left for Hiroshima just as we arrived in Washington. On the basis of my experience with American consultants to ABCC, I expected they would succumb as usual to VIP treatment and the enchantment of being in Japan and, thus, produce a bland report.

However, the Committee was at ABCC for three weeks, where they fanned out and learned from staff members and their wives of virtually all the problems in research design and morale. The Francis Report, dated November 6, 1955, summarized this information and provided a future plan, which is still in effect today. It called for a unified central program, the components of which were a fixed population base, epidemiologic detection or continuing morbidity survey, clinical detection, postmortem detection, death certificate study, and staff requirements. Details for each of these areas were itemized, and the importance of basing the population in the honseki (permanent address) was stressed. (Changes of address and vital events are reported to the office in custody of the records, the records themselves termed koseki. No matter where in Japan a person is, vital events are reported to the office of the individual’s permanent address and entered into the koseki, a system which greatly simplifies follow-up.) These recommendations led to the establishment of the Life Span Study of about 120,000 people, which was based on death certificate study, and the Adult Health Study of about 20,000 people, which was based on clinical examinations. The Francis Report is something of a landmark in epidemiology.

A curious note: In the Washington file on ABCC was a letter written by a well known science administrator before membership in the committee was finalized. The letter said that Dr. Francis was not likely to succeed–a prediction from a clouded crystal ball. About a year later, another acute-disease epidemiologist was sent alone as a consultant to see if he could add to the recommendations. He had trouble adapting his approach through acute-disease epidemiology and was unable to add anything.

Dr. Cannan then turned his attention to recruitment. As director, George P Darling, Dr.P.H. was suggested. He had trained in epidemiology at MIT and Yale, was professor in Yale’s epidemiology department, and had had extensive experience in academic administration. He and his wife came to NAS for an interview, and while Dr. Cannan described the science and administration to Dr. Darling, my wife and I described life in Japan to Mrs. Darling. They agreed to go for two years and stayed for 15, until his retirement in 1972.

Next, continuity had to be established in the Departments of Medicine, Pathology, and Statistics. Dr. Cannan arranged with Yale, UCLA, and the MFUA to provide the first chiefs for the respective departments, and those chiefs were: James M Hollingsworth, M.D. (Yale, Medicine), Sidney C Madden, M.D. (UCLA, Pathology), and Dr. Beebe (MFUA, Statistics). When their terms ran out, they were replaced by the departments from which they had come. This continued for several replacements until each department exhausted its supply of available people. The University of Washington in Seattle replaced MFUA as a source of biostatisticians.

For the medical staff, Dr. Cannan turned for help to his friend, James Shannon, M.D., director of the National Institutes of Health (NIH). The military draft of physicians at the time required all eligible men to serve for two years, usually at the end of internship or residency. An alternative to the army or navy was the public health service (PHS), where the two years could be spent in research at NIH. Dr. Shannon arranged for the men we selected (and his staff approved) to enter the public health service to be assigned to NIH and detailed to ABCC. He also arranged for me to work with one of his administrators on the details of assignment, which at first suffered the complication of no pay checks for several months. Part of my job was to interview candidates and accompany them to meet Dr. Cannan. Some senior people were also interviewed apart from the PHS program. In an effort to make a favorable impression, they usually opened with a long, diffuse statement, something Dr. Cannan could not tolerate. In a single sentence, he would sum up what had been said, and the visitor, realizing he was out of his league, remained silent thereafter. When he left, Dr. Cannan would comment, “He didn’t have much to say, did he?”

The air force assignment of Howard B Hamilton, M.D. came to our attention in 1955. He was a laboratory scientist who was to be given routine clinical duties at an air base, and Louis Hempelmann, M.D., for whom he worked, wrote to ask if Dr. Cannan could intervene to get Howard assigned to ABCC. Howard was assigned to the air force base in Nagoya, and a few weeks later, he was detailed to ABCC, where he served as chief of the laboratories until his retirement 29 years later.

At interviews for the ABCC staff, I tried to develop a question that would predict whether the candidate would enjoy Japan. The question that seemed best correlated was, “Do you like The New Yorker magazine?” With rare exception, the people who liked The New Yorker loved Japan. My explanation is that in each issue a variety of observations can be made from the magazine’s diverse features, which include vignettes about life in New York, cartoons, news breaks, such as “Block that Metaphor,” reviews, profiles, fiction, and poetry. Living in Japan is full of things to discover too.

While at NAS, I heard that a woman had telephoned and told the operator she would like to speak to someone about leaving her body to science when she died. The operator said, “Just a moment. I’ll connect you with personnel.” I sent the anecdote to The New Yorker, which published it three weeks later in “The Talk of the Town” and sent me a check for $25.

While I was at NAS, the report of its Committee on the Biologic Effects of Atomic Radiation was being prepared. This was the first use of ABCC data for radiation protection. Among its conclusions: The greatest exposure of the general population was from radiology, especially fluoroscopy for diagnoses that could be made as well or better at much lower exposure by x-ray film studies. A similar report was being prepared by William Court Brown and Richard Doll for the (UK) Medical Research Council. For that report, Sir Harold Himsworth visited Dr. Cannan to seek unpublished ABCC data. Dr. Cannan asked me for whatever we had. Without sufficient thought, I gave him a copy of the newest leukemia data, which Court and Doll analyzed and published, ahead of Niel Wald and his hematology group at ABCC.

The Committee on Atomic Casualties, which advised on ABCC research, was convened whenever Dr. Cannan accumulated a full agenda for it. The Committee’s influence is reflected in the lack of reference to it in ABCC histories, except for a failed attempt by John Z Bowers, M.D., who, as I recall, based much of what he wrote on the minutes of the Committee’s meetings. I remember only one meeting during my time at NAS. The chairman was Lee Farr, M.D., a pediatric nephrologist in full-time research at Brookhaven National Laboratory. I helped plan the meeting, at which I spoke briefly on our new findings in children ten years after exposure to the bomb. As I told of small head size and mental retardation after in utero exposure and the excess leukemia after childhood exposure, I could hear stage whispers of ridicule by Drs. Eugene Pendergrass and Richard Chamberlain, chairman of Radiology and his successor at my alma mater. In those years, radiologists were hostile to reports of adverse radiation effects in the human. When I finished, Dr. Farr joined them by thanking me for my “recitation.”

I was involved not only in recruitment but also in recommending replacement of professional staff. Lowell A Woodbury, Ph.D., a neurophysiologist, was chief of Biostatistics at ABCC. I expressed concern to Dr. Cannan about his future as his contract came up for another renewal. He was not trained in statistics, and the longer he stayed in Japan, the fewer opportunities he would have for a position in the U.S. when he finally returned. However, soon after returning to the U.S., he found a position with WHO to improve vital statistics in Thailand, where he spent the rest of his career.

Arthur W Pryde, M.D., chief of Radiology, had spent eight years at ABCC and was getting increasingly far from new radiological procedures. Same worry as with Woodbury. Pryde had had his residency training at the University of Pennsylvania. After marrying in Japan, he decided it was time to get re-established in the U.S. He took a six-month refresher course at the university and quickly found a position in California, where he remained for the rest of his career.

We wondered where we would find his replacement from the high-salary field of radiology when along came Paul M St Aubin, M.D., who had trained at Massachusetts General Hospital. He spent two years at ABCC before returning to Boston, and later, he was radiology chairman at the University of Nebraska from 1963 to 1965.

While at NAS, I realized that my main interest was in disease etiology as studied epidemiologically. James V Neel, M.D., Ph.D. visited Dr. Cannan from time to time to discuss a study of the effects of inbreeding as evaluated in the unexposed children who were in the ABCC Genetics Study of 1948 to 1954. Jim needed a pediatrician to supervise the clinical examinations of about 7500 children in Hiroshima and Nagasaki. At that time, about 5% of marriages were between first cousins and another 2% were between 1-1/2 or second cousins. By spending a year with Jim at the University of Michigan, I could help prepare the study and obtain an M.P.H. in the School of Public Health. I would then spend one year with the team in Hiroshima and another in Nagasaki and return to Ann Arbor for a final year at the School of Public Health on a dissertation using study data for a doctorate in public health (epidemiology). Dr. Francis, professor of epidemiology, accepted me for training in the school beginning in September 1957.

Early in our Washington stay, Mrs. Cannan telephoned my wife, whose English was not yet fluent, and invited us to dinner at the Cosmos Club. I asked my wife where we were to meet the Cannans, and she said, “The ladies’ room.” It turned out to be the ladies’ entrance to the club, which was sex-specific in those days. After two years in Washington, as the time for our departure for Ann Arbor neared, I said to my wife that Dr. Cannan may not realize how much I helped him. However, he and Mrs. Cannan again invited us to the Cosmos Club–this time for a farewell luncheon, which proved to be a surprise party attended by division staff.

Soon after Dr. Cannan’s retirement in 1967, he was elected a member of NAS, an honor he truly deserved.