The Early History of the Nagasaki Laboratory
The Early History of the Nagasaki Laboratory
by James N. Yamazaki, Physician-in-charge, ABCC Nagasaki Laboratory, 1949-51
How a young pediatrician spent 2 years during the late 1940s helping to develop the ABCC-RERF research program that continues today.
From left, the author, Warner Wells (Department of Medicine, 1950-52), and Michinori Hamada (Department of Pediatrics, 1950-53), the only Japanese who responded to ABCC’s advertisement for a doctor
In January 1948, I first learned that a medical investigation of the children of Hiroshima and Nagasaki was being considered. Upon his return from a National Research Council (NRC) meeting in Washington, DC, Dr Ashley A. Weech, director of Children’s Hospital, Cincinnati, asked me to consider participating in the work being planned, promising me an opportunity to be in on the “ground floor” of atomic medicine.
In March, Dr Herman Wigodsky of the NRC’s Committee on Atomic Casualties (CAC) wrote that “. . . the careful study and evaluation of children will be a major part of the project. In addition, it should be apparent that there will be ample opportunity for the study of any special problems in which you may be interested.
“. . . The length of appointment is for a minimum of 18 months,” the letter continued. “It is the belief of the committee that the project will remain in Japan for a minimum of 10 years and we hope for at least 50 years. Consequently, the long-range possibilities of employment with this group are limitless. . . . Employment is contingent upon satisfactory clearance by the FBI and the Atomic Energy Commission.”
By September 1948, I had decided to join ABCC, and CAC Executive Director Phillip Owen approved my preparatory tutelage with Dr Joseph Warkany, Children’s Hospital of Cincinnati. During the preceding decade, Warkany had demonstrated in systematic studies that environmental factors such as dietary restrictions could produce malformations in the mammalian embryo and fetus, and 1 year earlier he had reported malformations in rats following irradiation during gestation. (Since the early 1930s, therapeutic pelvic irradiation of pregnant women had been discontinued due to central nervous system abnormalities and eye malformations in their offspring.)
In April 1949, Owen indicated that my specific assignment in Japan would be the study of congenital malformation in the children of Hiroshima and Nagasaki. In the interim, I had met Dr James V. Neel, who had convincingly explained his unfolding genetics program (RERF Update 1[4]:7-9, 1989; 2[3]:6-9, 1990) and the involvement of pediatricians.
When en route to Japan, I was instructed by CAC to visit Dr Stafford Warren, dean of the newly established medical school at the University of California-Los Angeles. Within weeks of the atomic bombings, Warren had traveled to Hiroshima and Nagasaki.* He related his experiences to me, including his cordial association with Dr Masao Tsuzuki, Tokyo University professor of surgery, who later was a member of the first ABCC mission (RERF Update 1[4]:7,8; 3[4]:12-3, 1991).
*At the time, Yamazaki was not aware that Warren had been the medical director of the Manhattan Engineer District and had been one of two physicians to witness the TRINITY detonation near Alamagordo, New Mexico, on 16 July 1945. Warren also had been the radiation safety officer for the OPERATION CROSSROADS nuclear tests in 1946.
From top left, Wataru Sutow (Department of Pediatrics, 1948-50), the author in 1950, Wayne Borges (Department of Pediatrics, 1949-51), and a scene from a waiting room at the Nagasaki Laboratory
Getting started on the wrong foot
Accompanied to Japan by my wife and 5-month-old son, I arrived in Yokohama in September 1949 to learn that no suitable housing was available in Hiroshima despite written assurances to the contrary. My family remained in Tokyo until several weeks later, when housing was found in the town of Aga. In the meantime, I continued on to Hiroshima, where I met an exceptionally congenial group: Dr William Schull, a geneticist, and three pediatricians–a husband-and-wife team, Drs Wayne and Jane Borges, and Dr Wataru Sutow. Sutow also had met with disappointment upon his arrival. His daughter was unable to attend school during his 2-year tenure with ABCC because the region’s governing British Commonwealth Occupation Forces (BCOF) did not permit the children of Japanese-Americans to attend their schools.** As a combat veteran and former prisoner of war in Germany, I was appalled and angered that members of an NRC-sponsored mission encountered such racial affronts, an opinion I expressed to the first directors of ABCC, Col Carl Tessmer (1948-51) and Dr Grant Taylor (1951-53).
**An official BCOF memo dated 5 March 1949 defined conditions under which American personnel were granted access to BCOF recreational, shopping, and associated facilities. Persons of Japanese extraction, except when wearing US military uniforms, were not permitted to enter most BCOF facilities.
The assignment in Nagasaki
A few weeks later, I was told by Tessmer and Taylor that I would be sent to Nagasaki as the physician-in-charge, an assignment never alluded to during discussions in Washington, DC. I demurred, stating my lack of inclination and administrative experience and pointing out that I was in Japan solely to undertake a pediatric inquiry. At the time, I could not have realized that this change of venue fortuitously changed my life by initiating a lifelong concern for the children of Hiroshima and Nagasaki.
In November, Taylor introduced me to Nagasaki, where we visited the recently acquired Kaikan building in Sakurababa-machi and verified that remodeling plans conformed to the clinical and laboratory needs of the projected programs. The existing ABCC activities had been scattered. Dr Robert Kurata directed the genetics program from temporary quarters; ABCC doctors and nurses were given space at the Shinkozen “hospital,” one of the temporary clinical units of the Nagasaki Medical School (an elementary school before the bombing); and ABCC records were maintained in offices at the fish market (RERF Update 1[4]:7-8, 1989; 2[3]:6-9, 1990). Even before its renovation, the Kaikan permitted consolidation of these efforts.
The lone American physician in Nagasaki
At the time of my arrival in Nagasaki I inherited myriad administrative duties, including lecturer to the recent medical school graduates hired by ABCC as well as house doctor to ABCC personnel and the US Army detachment and dependents billeted in the area. (I was occasionally called upon to make house calls in the evening.) The radiation effects study I had so eagerly anticipated was to be delayed for longer than a year (RERF Update 1[4]:7-8, 1989).
At the time, our main objective was to parallel in Nagasaki the ongoing ABCC operations in Hiroshima, which had a full complement of internists and pediatricians, a hematologist, a laboratory director, a pathologist, a gynecologist, a radiologist, a surgeon, statisticians, administrators, engineers, nurses, and laboratory technicians. Permanent quarters atop Hijiyama were being built.
Attending a Christmas party at the Yamazaki home in Atagomachi were many of the genetics-program doctors and some ABCC staff members, including Paul Takao, Kazuo Hamasaki, Phyllis Wright, Shiro Tsuiki, and Michinori Hamada. In the front row, fourth from left, is Aki Yamazaki, the author’s wife.
More About the Early Days of the Nagasaki Lab
by James N. Yamazaki, Physician-in-charge, ABCC Nagasaki Laboratory, 1949-51
Setting up daily operations involved carrying out numerous administrative tasks and nurturing a mutually beneficial relationship between ABCC and the people of Nagasaki.
Members of the Nagasaki City Medical Association gathered at Mogi in May 1951 for the author’s farewell party: seated, from left, Harakichi Imamura, the author, Shigekuni Aritomi, Stanley Wright, and Etsu Osuga; standing, from left, Masao Ide, Kihachi Shinagawa, Yoshiro Shibata, Uraji Hayashida, Shunsuke Hayashida, and Yuzo Tomonaga.
First attempts to develop community relations
Through the grapevine, we learned of misgivings about the Atomic Bomb Casualty Commission among the citizenry of Nagasaki, so I felt it was imperative to explain ABCC’s medical mission to the medical community and to governmental officials. Furthermore, because I had not been briefed about the consequences of the atomic bombing, it was incumbent upon me to learn about the experiences of the people of Nagasaki. Kazuo Hamasaki, an ABCC interpreter/translator, assisted me in arranging initial contacts and accompanied me because my proficiency in spoken Japanese was minimal.
Nagasaki Police Department supervisor describes the aftermath of the bombing
Katsuji Deguchi, a supervisor in the Police Department, had been the assistant chief of the anti-air raid unit for Nagasaki when the atomic bomb exploded. His story provided my first insights into the events of 9 August 1945.
He described in considerable detail the exodus of survivors that had passed by his office in the Katsuyama Primary School, which was about 3000 m from the hypocenter. Those who were able to walk crossed the mountains at Kompira and found their way through to the Nishiyama valley because all other exits were ablaze. No part of the city had been spared. Despair and demoralization was pervasive. The injured were so numerous that rescue efforts did not reach some for nearly 2 weeks, and cremation and burial efforts lasted for a similar period. People from nearby villages and towns helped to feed the survivors for more than a month, and a large segment of the population fled from the city.
Governor of Nagasaki Prefecture
Sojiro Sugiyama, prefectural governor, was very cordial from the onset, and he introduced me to other officials at dinners where exchanges of opinions developed more easily. He introduced us to life in Nagasaki by inviting us to many social functions. When word leaked that my wife, Aki, was becoming disenchanted with my evening absences because of these meetings, Gov Sugiyama sent his charming wife to visit. During one such visit, Mrs Sugiyama brought Aki a very beautiful kimono.
The Nagasaki Medical School
A very cordial relationship developed between the Nagasaki Medical School and ABCC (RERF Update 2[1]:9, 1990). I first met with the dean of the medical school Dr Naomi Kageura and Surgery Professor Raisuke Shirabe in Urakami just as the reconstruction of the medical school was beginning. The first unit to be rebuilt, the office of the department, was offered to ABCC for a cataract survey to be conducted by Dr Sam Kimura (ABCC Department of Medicine, 1949-50). The university’s professor of ophthalmology, Kinnosuke Hirose, was already involved in such a study.
The ABCC autopsy efforts complied with the university’s ongoing pathology and anatomy program, and because ABCC physicians were not licensed pracitioners in Japan, Dean Kageura agreed to sign each autopsy permit. ABCC autopsies were performed in Urakami by the university’s autopsy surgeon.
The dean requested that the young physicians employed by ABCC–most recent graduates of the medical school–be coached in American medical practices. In response, regularly scheduled lectures were given to the physicians by myself and visiting ABCC staff members from Hiroshima. University officials arranged that fulltime ABCC Department of Pediatrics physicians Masahiko Setoguchi (1949-51) and Atsuyoshi Takao (1948-52) also could retain their faculty appointments.
Later Dr Shirabe suggested that I explain ABCC’s program at a meeting of the university’s department chiefs. Although I had brought our interpreter, Mr. Hamasaki, Dr Shirabe suggested that it would be more appropriate and better appreciated if I were to deliver my talk in Japanese. Thus, I gave my first presentation in Japanese. I don’t think they had ever encountered Japanese the way I spoke it, and I thought their serious demeanor eased as I spoke.
At my request, a roundtable discussion by survivors from the medical school was held on 7 June 1950, and Dr Kimura, William J. Schull, and Koji Takeshima from Hiroshima attended. During conversations with me, Dr Shirabe later related additional personal experiences. His report, The Medical Survey of the Atomic Bomb Casualties, was presented to ABCC and was later translated into English for publication (Milit Surg 113:251-63, 1953). It was, in fact, the first summary report of the medical effects of the atomic bombing. The report of the Joint Commission was not issued until the following year, April 1951 (in six volumes, the last was declassified on 30 November 1954). Before publication of the Joint Commission report, ABCC physicians with whom I had talked had not been briefed on its content.
Nagasaki Medical Society
At the society’s general meetings, at dinner parties, and at sectional meetings of pediatricians and obstetricians, the ABCC program was explained. Considerable interest was expressed about medical practice in the US.
Nagasaki Branch of the Japan Midwives and Nurses Association
Mrs Tei Murakami, president, represented 106 midwives who reported to ABCC on 90%-95% of all the babies delivered in Nagasaki (RERF Update 2[3]:6-9, 1990). She understood the objectives of the genetics program and gave constructive criticism. Meetings of the midwives were held regularly. Dr Schull attended some of these meetings.
Nishiyama fallout survey
In March 1950, Tracer Labs surveyed the residual radiation in the Nishiyama valley upstream from the reservoir. Radioactive samples were obtained from the thatched roofs and from the silt in the reservoir. During their short stay, I accompanied the investigators and thereby learned about the fallout from the bomb. Their findings were not reported to us and did not appear in any ABCC report during that period.
The Korean War
In late June 1950, the conflict in Korea started. Only 10 minutes from Nagasaki by airplane, the conflict prompted considerable conjecture as to whether the program in Nagasaki would close. Soldiers in the Nagasaki-Sasebo area were the first to go, and not one soldier in our area returned. One day I was asked to go to the wharf to treat a merchant marine injured when a vessel had been strafed at sea.
During a lull in the fighting in early 1951, a flotilla from the Pacific Amphibious Landing Force docked in the harbor. We were asked to brief the commanding admiral and his staff about the consequences of the atomic bombing.
Other general recollections
In September 1950, at the height of a typhoon, Stanley and Phyllis Wright (Department of Pediatrics, 1950-52) were welcomed to Nagasaki. This swelled the ranks of the American professional staff to three! The timing was fortuitous because the remodeling of the “Kaikan” was nearly completed, and training of laboratory personnel was almost finished.
Soon after, Dr Masuo Kodani, cytogeneticist (Department of Genetics, 1947-55), arrived because of the closure of the Kure genetics program. He would oversee the genetics program in Nagasaki and continue his cytogenetics studies.
Stanley Wright assumed responsibilities for employee health care, which required close attention because there was a 10% employee turnover rate due to tuberculosis. In October 1950, we began examining patients at the ABCC clinic in Sakurababa-machi. Within months, the patient load was comparable to that of Hiroshima, stimulated by efforts to reexamine 20% of the infants at 9 months of age. Phyllis Wright assumed responsibility for the growth and development program of school children that had been started in 1948 by Dr W. W. Greulich.
The PE57 study of the outcome of pregnancy among Nagasaki women was reviewed for implementation (JN Yamazaki et al, J Cell Comp Physiol 43[suppl 1]:319-29, 1954). Letters from Dr George Plummer of the Department of Pediatrics (1950-52) indicated that PE57 was to be conducted in Hiroshima, too.
The ophthalmological study of radiation-induced cataracts conducted by Kimura and Hirose surveyed about 600 survivors who had been within 1000 m of the hypocenter. Dr Paul Fillmore (Department of Medicine, 1949-51) would later follow up this group of survivors (PG Fillmore, Science 116:322-3, 1952). The examination of 175 children for OP46, as the study was called, was completed in March 1951, although I am not aware that its results were ever published.
In early 1951, John Bugher, deputy director of the US Atomic Energy Commission’s Division of Biology and Medicine, and John Lawrence, chairman of the University of California-Los Angeles Department of Medicine, spent 1 week in Nagasaki evaluating the program.
In June, I left Nagasaki a few months earlier than planned due to the illness of my wife.
In the fall of 1950, the Nagasaki Midwives Association met at ABCC. Standing behind the midwives, from left, are Stanley Wright, Masuo Kodani, the author, and interpreter Kazuo Hamasaki.
This article was originally published in RERF Update 4(3):8-9, 1992.
The first part of James Yamazaki’s recollectionswas published in RERF Update 4(3):8-9, 1992.
The second partof James Yamazaki’s recollections appeared in RERF Update 4(4):8-9, 1992.