Tall, largely bald, alternately arrogant and charming, witty and aloof, Vorobyov was a brilliant scientist who, at this stage in his career, was considered politically sound. But while the career of a man like Ilyn was undoubtedly furthered by his belief in the Soviet system, Vorobyov had good reason to have less forthright ideological loyalties. Both his parents had been scientists, and both had been committed to the Communist cause, but his Russian father, a physiologist, had been shot in 1938 for supposedly plotting the assassination of Stalin, his Jewish mother had spent eighteen years in prison camps, and an uncle, a monk in the Zagorsk Monastery, had spent twenty years in prison. Andrei, aged seven when his father was arrested, was raised first by relatives and then, between the ages of twelve and fourteen, in a state orphanage.
These origins did not impede Vorobyov’s scientific career. When invited to join the highly secret Institute of Biophysics in the 1970s, he raised the question of his parents’ ‘crimes’ against the state but was reassured that Tupolev and Korolyov, the designers of aircraft and spaceships, had done much of their work in the gulags. Further, Mendel was shunned, Maximov lived in exile, Vavilov was imprisoned, Koltsov was dismissed, Sechenov lived under police surveillance and Korchak had died in a camp.
Working in the Institute of Biophysics, Andrei Vorobyov had helped to develop a system of biological dosimetry that could measure a received dose of radiation far more accurately than the traditional method of using a Geiger counter at the scene of the accident. The latter took no account of whether the victim had faced the source of radiation or had only been affected on one side of his body; thus there was no way of knowing which of the organs had been affected.
Biological dosimetry combined an assessment of skin damage with blood and chromosome tests, which enabled doctors to establish the degree of irradiation fairly accurately well before the patient developed the symptoms of acute radiation sickness. Georgi Seredovkin, the doctor who had performed these tests in the hospital in Pripyat on 26 April, had been a graduate student of Professor Vorobyov’s, and it was on the basis of his assessment that the first batch of the most seriously affected – twenty-six in all – had been sent to Moscow that same evening on the same plane that had brought General Ivanov to Kiev.
An additional 102 casualties had followed on two further flights the next day. The most seriously affected – the firemen and operators – were sent to the in-patient department of the Institute of Biophysics at Hospital No. 6; others went to Hospital No. 7. When still more patients arrived, irradiated in the aftermath of the accident, more beds were made available in Hospital No. 12. Initially about 300 people required in-patient care, of whom 203 suffered from acute radiation sickness; 129 came to hospitals in Moscow, and the rest were treated in Kiev. By the middle of May, the number in hospital had risen to 512.
The chief of Hospital No. 6, Angelina Guskova, had forty years’ experience in treating the victims of nuclear accidents and radiation sickness, but had never before dealt with a catastrophe of this scale. To assist her there was the head of the Haematology Department, a former colleague of Professor Vorobyov’s, Alexander Baranov. A tall, bald man with a quiet, gentle manner, he had the melancholy look of someone who had witnessed much suffering and had seen many of his patients die. Beneath him, however, there were only a few junior doctors – mostly young women – who all of a sudden had to lead groups of ancillary medical personnel.
Many of those sent to Moscow by Seredovkin hardly felt ill. Anatoli Dyatlov, Leonid Toptunov, Sasha Yuvchenko, Razim Davletbayev – even Alexander Akimov, whose skin was now a deep brown – had recovered from the faintness and nausea that they had felt in the wake of the accident. In many of them, the worst symptoms at this stage were the swelling and red patches where radioactive water had come in contact with the skin. Guskova and Baranov recognized these as burns caused by beta radiation, which, unlike alpha particles, could penetrate the skin. As the unstable atoms disintegrated, the energy they released in the form of particles and waves had damaged the cells of human tissue and impeded their reproduction. Alpha particles were normally considered less dangerous because they only travel short distances and cannot penetrate the skin, but the doctors knew that if alpha particles were absorbed through wounds or by inhaling radioactive vapour, they could severely damage the lungs and other internal organs.
Finally there were the gamma rays, which could penetrate anything but solid slabs of lead or concrete and so irradiate the whole body. Some radionuclides would be expelled from the body, but others were retained by particular organs – iodine by the thyroid gland, ruthenium by the intestine, strontium and plutonium by the bones, barium and molybdenum by the lower large intestine.
Under the supervision of Dr Baranov, samples of blood were taken from the patients, cultivated and then studied under a microscope for damage to the chromosomes. From this Baranov could estimate the dose and prescribe the treatment. The greatest danger was to those organs made up of rapidly dividing cells – the skin, hair follicles, the gastrointestinal tract and the bone marrow, which supplies the body with blood. As a result of damage to the chromosomes, the cells, unable to reproduce themselves, would perish. This was particularly lethal when it came to bone marrow. However, death might not be caused simply by exhaustion of the blood; it could come from damage to internal organs – from suffocation, for example, if radiation had destroyed the lungs, or from peritonitis if the intestines disintegrated – and would be accompanied by a number of grievous symptoms: the painful blisters of herpes simplex on the mouth and face; internal haemorrhage leading to bloody diarrhoea; high fever; subsequent coma; and an immediate susceptibility to any infection.
Those patients who had received a dose below one hundred rems would be cured by their bodies’ own resources. For those who had received doses above six hundred rems, little could be done. It was the patients who had received an intermediary dose for whom the transfusion of undamaged bone marrow from a compatible donor could lead to the regeneration of a healthy supply of blood – or, where a genetically compatible donor was not available, genetically promiscuous blood-producing cells could be extracted from the livers of human foetuses, which, because of the large number of abortions performed in the Soviet Union, were always in plentiful supply.
This treatment was susceptible to numerous setbacks. The patient’s immune system might reject the donor’s bone marrow, or the new white blood cells might attack the recipient. Even where a transplant was successful, the patient remained vulnerable to the slightest infection until sufficient new blood had restored the body’s immune system. This meant weeks of intensive care in sterile conditions.
There were also great logistical difficulties in preparing bone-marrow transplants for so many patients. The hospital possessed only one blood separator and one centrifuge. The patients’ blood types had to be defined before the lymphocyte count dropped too far, and then donors found from among relatives of the patients, blood samples taken and matched. Unfortunately, some of the patients with third-degree radiation disease also suffered from extensive beta burns, so a bone-marrow transplant could not save them; there was nothing the doctors could do but prescribe morphine to ease the pain. On 2 May Dr Baranov predicted that ten would die; later, as the symptoms of severe internal radiation emerged, he increased this number to thirty-seven.
2
Valeri Khodemchuk had been killed in the initial explosion; Vladimir Shashenok had died in the hospital in Pripyat. The third fatality following the accident at the Chernobyl nuclear power station was not any of the patients who had been flown to Moscow but the good-natured chief of the electrical workshop, Alexander Lelechenko.
Called in to repair the electrical circuits in the turbine hall of the fourth unit, which had meant working knee-deep in radioactive water, Lelechenko had seen that there might be a further explosion of the hydrogen, so with V. I. Lopatyuk he had run to close the valves. When, eventually, he had felt dizzy and sick, he had waited for treatment in the hospit
al in Pripyat, but deciding for himself that his sickness was not serious, had gone back to his flat to rest before returning to work at the station at 4.00 p.m. on 26 April.
At eight that evening, Lelechenko had come home to eat supper with his wife, Lubov, a maths teacher, who had never wanted to live in Pripyat because she was afraid of nuclear power. He had told her that he had a dry mouth and a terrible headache and asked for an aspirin. They also drank vodka because he was tense. When she asked him if she should throw away the clothes she had hung out to dry on the balcony, he had told her it was safe to bring them in.
Lelechenko hardly slept that night, tossing and turning on the bed, but the next morning he went back to work at the station. He told his wife that he was needed. ‘You can’t imagine what’s going on there. We have to save the station.’
‘And if there’s an evacuation?’
‘Go. I’ll join you.’
Lubov was evacuated to a village near Ivankov, where she continued teaching the children from Pripyat in a borrowed classroom at the local school. When the deputy chief engineer Lyutov came to visit his wife, who was billeted in the same house, he told Lubov that her husband was fine. On 30 April Lubov visited her daughter in Kiev, but returned to the village on 1 May. That night, Lyutov woke her to say that Alexander was in the hospital in Kharkov.
Lubov spent much of the following day in the post office, telephoning friends in Kiev and the friends of friends in Kharkov. Lelechenko was not there. Eventually, their daughter Ylena rang from Kiev to say that she had tracked him down at the Institute of Radiology there. ‘Things are bad,’ she told her mother. ‘You must come at once.’
Lubov applied for a permit to leave the school and go to Kiev. When she arrived at the Institute of Radiology she was told that her husband was under intensive care. She went up to the special wards. Her husband came out wearing a dressing gown and underpants. His whole body was red. Lubov had brought him an apple, but he could not eat it.
‘Cheer up, Sasha,’ Lubov said. ‘You’ll survive.’
‘I had to shut off the hydrogen,’ he said. ‘If I hadn’t shut it off, it would have exploded.’ He asked her to bring him as much liquid to drink as she could. Then he went back into the ward: he could not stand for long.
Lubov now tried to find a doctor. The first told her that her husband was no worse than any of the others; the second, a woman, confessed that his condition was serious.
‘Why wasn’t he sent to Moscow?’
‘He wouldn’t survive the journey.’
‘What are you going to do for him?’
‘We’ve ordered a blood transfusion.’
The next day Lubov Lelechenko went to the office of the Council of Ministers to complain that her husband was not receiving adequate treatment. They assured her that the doctors were doing their best. She returned to the dormitory where her daughter Ylena lived, and together the two women made a special soup. They also brought red wine and caviar, which they took to the hospital with the soup. They were allowed in to feed him; his lips were covered with a yellow oil. A doctor asked Lubov if Alexander had a young male relative who would act as a donor for a bone-marrow transplant.
The next morning – it was now 7 May – Lubov returned to the hospital with more soup. Ylena was waiting in the reception room. The two women went up to the ward. Alexander was not there, and both the chair and the bedside table were gone. A nurse asked Lubov if she was his wife.
‘Yes. Is he conscious?’
‘The doctor will tell you.’
The doctor led Lubov into a small room and told her that Alexander was dead. She wept. They called Ylena to comfort her, then gave her an injection to calm her down. ‘Please don’t cry,’ the doctor said, ‘but think about where you would like him to be buried.’
3
In Moscow the unprecedented scale of the accident obliged Guskova to call upon resources from outside both the Institute of Biophysics and Hospital No. 6. Not only were the less seriously affected patients sent to Hospitals No. 7 and 12 and the Institute of Radiology in Kiev, but a detachment of Pikalov’s chemical troops set up camp in the grounds surrounding Hospital No. 6. The patients themselves were radioactive, and the soldiers washed down the floors of the wards four times a day. There was some danger to the doctors; the more seriously affected patients emitted as much as twenty rems per day from the radioactive caesium in their bodies, and some doctors received doses of as much as two rems per day. It was reported to the government medical commission on 4 May that medical personnel working with irradiated patients had asked for an increase in their pay, and the next day a 25 per cent increase, to bring their salaries on a par with those of the radiologists, was approved.
There were offers of help from abroad, but most of them were rejected. On 2 May, Professor Vorobyov advised the medical commission against importing stable iodine because its use as a prophylactic was no longer effective. At the same meeting the commission decided to respond to a telegram offering help from the World Health Organization ‘with a polite “no”.’ Private offers met with the same rejection. As early as 29 April, the celebrated French haematologist Dr Henri Jammet came to Hospital No. 6 with the scientific attaché from his embassy to offer to fly badly irradiated patients to Paris for bone-marrow transplants. After discussions with Guskova around the polished table in her office, he agreed that the Soviet doctors could cope.
However, on 1 May Guskova received a call from the Politburo to say that an American specialist in bone-marrow transplants, Dr Robert Gale, would be arriving at the hospital the following day with equipment donated by the American businessman Armand Hammer. Guskova had never heard of Gale. She was familiar with the work of other American specialists from their publications, and if consulted would have preferred their assistance, but the command came from the highest level that this Dr Gale was to be made welcome.
Even in his own country Dr Robert Gale was hardly a household name. His great-great-grandfather had been an immigrant from Belorussia called Galinsky. His grandfather had earned his living as a tailor in Brooklyn; it was his father, who worked in insurance, who had changed the family name to Gale. His mother, who came from a similar background, had a brother who had made good in Hollywood and a sister who had married a prominent attorney. His family’s saga was similar to that of many other Jewish emigrants from Eastern Europe in the nineteenth and early twentieth centuries.
At the time of the accident at Chernobyl, Gale was an associate professor of medicine at UCLA Medical Center, dividing his time among teaching, administration, laboratory work and patient care, and was also the chairman of the advisory committee of the International Bone Marrow Transplant Registry. The only blot on his record was a censure by the National Institute of Health for permitting experimental bone-marrow transplants in 1978 without the NIH’s approval.
It was not his professional qualifications, however, that brought Gale to the attention of the Soviet authorities in the wake of the Chernobyl accident, but his friendship with the singular American businessman, Armand Hammer. Like Gale’s grandfather, Hammer was the child of Jewish immigrants from Russia, and like Gale he had studied to be a doctor. Impelled by the same altruistic impulse that was to inspire Gale, Hammer had travelled to Russia in 1921 to treat the victims of typhus. There he had met Lenin, who, with his New Economic Policy in mind, explained that what his country required was not medical assistance but trade.
Back in the U.S., Hammer arranged for the barter of American grain for Russian minerals and furs, and for the next nine years he worked in the Soviet Union as the representative of American companies. He started a pencil factory in Moscow and an asbestos mine in the Urals. In 1930, he bartered these industrial holdings for Russian works of art, which he sold through his own art gallery in New York.
With a genius for business and trade, Hammer bought holdings in diverse enterprises, among them Occidental Petroleum, which he built into one of the largest oil companies in the world. In 1961, he was back
in Moscow as part of an American trade mission, and in the 1970s he secured a large contract for Occidental Petroleum to provide fertilizer to the Soviet Union. As a man whose enterprise had been approved by Lenin himself, the octogenarian Hammer gained unique and privileged access to the highest echelons of the Soviet government and had his own private apartment near the Tretyakov Gallery on Lavrushinsky Street in Moscow.
Hammer was a great philanthropist in several areas, among them cancer research. In September 1984, he had asked the director of UCLA’s tissue-typing laboratory, Paul Terasaki, to advise on an application for aid from a scientist at the Hadassah Hospital in Jerusalem. Terasaki had brought in Gale, whom Hammer then invited to fly with him to Israel on his private Boeing, Oxy One. It was this trip that forged a friendship between the octogenarian Hammer and the thirty-nine-year-old Gale. Despite the difference in their ages and worldly wealth, they had many things in common. Both were descended from emigrants from Eastern Europe, and it could be said of Gale (as Gale was to write of Hammer), ‘Some people feel his actions are motivated by flagrant self-promotion.’
Gale heard the news of the Chernobyl accident on the radio while he was shaving on the morning of 29 April. He realized at once that after an accident on this scale, there might be a greater demand for bone-marrow transplants than Soviet doctors could supply. He therefore telephoned the director of the International Bone Marrow, Transplant Registry, Dr Mortimer Bortin, in Milwaukee to obtain his approval, as well as that of the other members of the advisory committee, to offer the registry’s services.
Knowing how intergovernmental agreements were bedevilled by the posturing of the Cold War, Gale decided to extend the offer through his friend Armand Hammer. Hammer was in Washington for the opening of an exhibition, which he had arranged, of paintings from the Pushkin and Hermitage museums, but Gale reached him by telephone that afternoon, and he agreed to be the conduit. By the end of the day, Gale’s proposal had been approved by members of the Senate Foreign Relations Committee. Hammer then wrote a letter to Gorbachev offering the doctor’s assistance and the resources of the transplantation registry:
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