• • •
In early September, Nagasaki Prefecture issued a public notice—possibly linked to an (inaccurate) assessment by an American chemist reported in U.S. newspapers—stating that the atomic bomb had contributed a “devastating effect on all living organisms” in the Urakami Valley and that no trees or plants would grow there for seventy years. Nagasaki officials recommended that everyone living in the Urakami Valley relocate. Families with the means to escape had already evacuated in the immediate aftermath of the bomb, but those who remained now faced what they thought was the impending demise of their city. At the same time, torrential storms deluged the city with over twelve inches of rain, flooding the Urakami Valley and washing away the air raid shelters and makeshift shacks where an estimated seven hundred families still lived in the ruins.
Once the city dried out, families reconstructed tiny primitive huts, slept on the floors of train stations, or lived in burned-out train cars. Relief support had faded from the now-demilitarized Japanese armed forces, and emergency food and provisions provided by the Nagasaki Prefectural Government were difficult to access due to still-impassable roads, a dysfunctional streetcar system, and the inability of many victims to get to distribution sites because of injury and illness. Except for the Allied POWs in Nagasaki who were now receiving U.S. parachute drops of provisions and medical supplies, no one in the city had enough to eat. Nagasaki’s municipal water system was still in disrepair, so many people walked long distances to access working wells. An eight-year-old boy drank the water from a vase of flowers set at a gravesite. Two young girls retrieved water each day by crossing a school playground-turned- crematorium covered with ashes and fragments of human bone. Some people washed their clothes in the river as unclaimed decomposing corpses floated by.
Atomic wasteland at Yamazato-machi, along the road leading from the hypocenter (right) to Urakami Church (at left beyond photograph), October 1945. (Photograph by Hayashi Shigeo/Courtesy of Nagasaki Atomic Bomb Museum)
The second wave of radiation illnesses and deaths continued through early October. Wada, too, became ill, one of many who suffered radiation-related symptoms after spending significant time in the Urakami Valley and the hypocenter area as he searched for his missing colleagues, cremated bodies, and hauled rocks and debris from the streetcar tracks. Blood appeared in Wada’s urine and excrement, and he started losing his hair. “Back then we didn’t have shampoo; we had only soap. I wondered if my hair loss was because of that, so I started washing my hair with only water. But my hair kept falling out. Eventually I became bald.”
At the few hospitals providing care, some patients were given medication to help stop internal bleeding and to relieve pain. But this was rare. In the place of nearly nonexistent medicines, physicians and family caregivers devised their own remedies. Doctors treated patients with blood transfusions, rations of fresh liver to boost white blood cell production, and large doses of glucose and vitamins B, C, and K. Dr. Akizuki, long interested in therapeutic nutrition, required his staff and patients to follow a high-salt, no-sugar diet to support the health of blood cells—a regimen to which he attributed his own and many of his staff’s recovery. Dr. Shirabe promoted the drinking of sake. In rural areas outside the city, doctors recommended that their patients soak in mineral hot springs. Mothers and grandmothers treating family members at home served them a raw egg each morning and brewed bitter teas from mulberry leaves, cuttlefish, and Chinese herbs. Wada’s grandmother insisted he drink kakinoha (persimmon leaf) tea. “It tasted pretty bad,” he admitted, “but I was told over and over that if I didn’t drink it, I wouldn’t get well—so I grit my teeth and drank it every day.” For caregivers, holding a dying child’s hand, touching a patient’s back or forehead, or speaking a few kind words was often all that could be done.
Those who did not fall ill lived in constant anxiety, haunted by the question of when their turn would come. From Dr. Akizuki’s perspective on top of Motohara Hill, death carved a clear geographical path: The first people who suffered and died from radiation-related illness were living inside the Josei Girls’ High School air raid shelter at the bottom of the hill. The illness then climbed the hill, killing people in relative order according to their distance from the atomic blast. When the next tier of people grew sick, they were carried to Akizuki’s burned-out hospital by their neighbors who lived farther up the hill—and the distance between the homes of the sick and his hospital became shorter and shorter. “The Maekawa family, the Matsuokas, and then the Yamaguchis were attacked by radiation sickness,” Akizuki remembered. “I named this widening advance of the disease the ‘concentric circles of death.’” He watched as his neighbor, Mr. Yamaguchi, lost thirteen family members from atomic bomb sickness. After each death, Mr. Yamaguchi carried the body to the cemetery, dug the grave, and called for the priest. After each ceremony, he returned home to care for the remaining family members, all of whom had fallen ill. “They are dying, one by one,” he told Dr. Akizuki. “Who will send for the priest when I am dying? Who will dig my grave when I am gone?”
• • •
Doctors were frantic to understand and stop the mysterious disease that was ravaging the city, but they had little means to conduct research. At the fully equipped Omura Naval Hospital north of the city, however, Shiotsuki Masao, a twenty-five-year-old doctor in training, took on the immense project of performing autopsies on as many dead bodies as possible from the piles of corpses waiting each day for transport to a burial or cremation site.
The hospital had taken in 758 victims on the night of the bombing three weeks earlier. A hundred had died before morning, and over a thousand more had arrived in the days that followed—mostly factory workers, students, and housewives transported out of Nagasaki by relief workers. The hospital’s small two-story buildings had overflowed with patients—sometimes forty to a room—and Dr. Shiotsuki didn’t sleep for three days and nights as he tried to treat the complex burns, injuries, and lacerations that had penetrated his patients’ internal organs, none of which had been part of his training. Once the symptoms of radiation disease began, the rate of death increased so rapidly that at times all he could do was go from one dead patient to another to provide official confirmation of their deaths. Early on, when patients did not yet understand that hair loss was one of the first signs of probable and imminent death, Dr. Shiotsuki gently placed his hand on their heads where patches of hair still remained. “Loss of hair often accompanies burns,” he falsely reassured them. “It should stop in a few days.” It was, in his judgment, the most humane care he could give to patients who didn’t know they would soon die.
Dr. Shiotsuki began his investigations as early as August 13, even before he knew the nature of the bomb or had any hint that radiation exposure was causing these mysterious symptoms. He started by photographing, X-raying, and documenting in detailed written reports the course of his patients’ conditions, treatment methods provided, and their ultimate recovery or death. Observing his patients dying from whole-body radiation exposure, he noted: “There is no conspicuous damage to the heart or the circulatory system, but as the end approaches, the blood pressure plummets. Because of high fever or general weakening perhaps, a pneumonia-like condition is apt to occur. During this period, the body temperature continues to rise. In the final stages, the patient registers the highest temperature; then suddenly it falls and the patient dies. Some patients suffer severe vision disabilities and some receive brain damage. Victims who did not experience brain damage suffered no clouding of consciousness. In fact, in spite of their high fevers, most of them were extremely calm and lucid.”
Omura Naval Hospital, the region’s only remaining advanced medical facility after the bombing, twenty-two miles (by road) north of Nagasaki, where a large number of atomic bomb victims were evacuated. A young hospital physician, Shiotsuki Masao, conducted some of the earliest autopsies of atomic bomb victims here in an effort to understand their deat
hs. (U.S. Army Institute of Pathology/Courtesy of Nagasaki Atomic Bomb Museum)
For Dr. Shiotsuki, however, external observations alone seemed inadequate. To surmount his feelings of despair and helplessness, he became fixated on the idea of conducting autopsies in order to observe and document the internal damages to his patients’ bodies. As a new doctor, Shiotsuki felt that he was too inexperienced to understand everything he would see, but he fervently hoped that both his autopsy specimens and written records would provide more qualified doctors valuable information for later analysis.
The Omura Naval Hospital had no autopsy room, so Shiotsuki and a male orderly named Iyonaga Yasumasa set up a working space in a small shack on the hospital grounds that was used as a mortuary. “The room was hot and stuffy,” Shiotsuki remembered. “Under a dim light covered by a shade, we would lift a corpse onto the table made of coffins, say a prayer, then wield the scalpel. What horrific damage had been done to the tissue! As I made those incisions, how many times did I stifle a gasp or let out a sigh. Everywhere the veins had been torn to shreds, and the blood had seeped everywhere.”
Many of Shiotsuki’s postmortem examinations shared common findings, including hemorrhaging of the lungs and kidneys, and blood clots on the outer membranes of the intestines, spleen, and kidneys. He also observed hemorrhaging in the brain, white spots on the large intestine, and ruptures in the liver, spleen, and lungs. Blood tests revealed that patients’ white blood cell counts were lower than normal by 90 percent or more, their red blood cell counts were half of normal levels, and hemoglobin was significantly diminished.
“No one knew when those mysterious symptoms would suddenly appear and drag another victim to the abyss,” Dr. Shiotsuki wrote. When he himself became ill, his tests showed a white blood cell count 50 percent lower than normal—the result, he believed, of his ongoing contact with radiation-exposed people. He treated himself with glucose and vitamin injections, continued working, and recovered within ten days, which he attributed to his stamina and early care. As he and Iyonaga examined more and more bodies, they placed the patients’ irradiated organs in jars of formaldehyde on the floor, then found a tiny, unused storage room where they stacked more jars. When a senior hospital official deemed Dr. Shiotsuki’s research unnecessary in the face of Japan’s mortifying defeat, Shiotsuki began hiding the specimen jars between the wood paneling and the outside wall of the mortuary hut. “To the inexperienced eye,” he explained, “these organs were merely grotesque lumps of flesh. But for us they were eloquent testimony to a horrible tragedy.”
Dr. Shiotsuki was discharged from the navy in mid-September and ordered to return home to Tokyo. He was gravely concerned about the preservation of the specimen jars, which he imagined would be destroyed upon his departure. Sending them to Tokyo was not an option because Japan’s shipping offices were in too great a disarray to guarantee their safe arrival. His only choice was to carry home as many specimen jars as he could. He had planned to pack as much food as possible to survive since much of Tokyo had been burned to the ground. Instead, Shiotsuki wrapped specimen jars in newspaper, sacks, and clothing and placed them into his baggage. After seeing his patients for the last time, he slung his duffel bag of specimens onto his back, lifted more bags holding his personal belongings and additional specimens, and left for home.
Shiotsuki’s train out of Omura Station was crowded, filled mostly with discharged Japanese soldiers. He was fortunate to get a seat, but within a few hours, a passing soldier lost his balance and stepped on his duffel bag. Formaldehyde began leaking onto the floor of the train, creating a pungent smell. People’s eyes began burning. When some of the passengers became agitated, Shiotsuki explained what had happened, apologized for the smell, and asked for their forbearance. But the commotion grew. Soldiers demanded that he throw the bag out the window. Shiotsuki sat quietly, his head bowed, anxious to protect his research. Suddenly, a commander with whom Shiotsuki had spoken earlier stood up and bellowed, “What do you think is preserved in that formaldehyde? The guts of the people who died in the special bombing at Nagasaki, that’s what. The doctor is continuing his research in order to pray for the repose of those victims. The smell will soon go away, so just put up with it until it does.” Everyone grew quiet, and Shiotsuki continued on his journey without further incident.
He traveled for two days and nights before reaching Tokyo. Once home, he opened the duffel bag to see that only one jar had broken. Two days later, he repacked the bag and set off for Tohoku University, where he had received his medical degree. There, he divided the specimens between the departments of pathology and surgery, “with the prayer,” he later wrote, “that these medical data might prove useful for the peace of the human race.” For the first time since the bombing, he felt, at last, that the war had ended.
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Before the atomic bombs were dropped, U.S. scientists conducted no studies on the potential effects of high-dose, whole-body radiation exposure, nor did they investigate or develop potential treatments for the medical conditions that would ensue. The absence of such studies was not due to lack of awareness of the dangers of radiation to the body. In the 1920s, the International X-Ray and Radium Protection Committee had issued the world’s first safety standards both for professionals working with radioactive substances and for patients receiving X-rays or new cancer radiation therapies to specific areas of their bodies. By the 1940s, the risks of small doses of radiation to human organs, tissue, and cells had been explored by scientists worldwide. During the development of the bombs, too, U.S. scientists knew the dangers of radiation exposure, evidenced by the Manhattan Project’s precise handling, hygiene, ventilation, and radioactive monitoring procedures at its sites. To some degree, U.S. scientists and military leaders also understood the dangers of the radiation released at the time of the bombs’ explosions. In a May 1945 memo, for example, Dr. J. Robert Oppenheimer, scientific director of the Manhattan Project, stated: “During the detonation, radiations are emitted which (unless personnel are shielded) are expected to be injurious within a radius of a mile and lethal within a radius of about six-tenths of a mile.”
However, as the bombs were developed and subsequently used on Hiroshima and Nagasaki, serious consideration was not given to the people whose entire bodies would in a single instant be exposed to massive, not-yet-calculable doses of radiation. “The chief effort at Los Alamos was devoted to the design and fabrication of a successful atomic bomb,” wrote physician and radiologist Stafford Warren, chief of the Medical Section of the Manhattan Project. “Scientists and engineers engaged in this effort were, understandably, so immersed in their own problems that it was difficult to persuade any of them even to speculate on what the aftereffects of the detonation might be. Their concern was whether any one of their several designs for the bomb would actually detonate, and, if the detonation did occur, how massive it would be.” Time was also a factor; once scientists had successfully tested the plutonium bomb in the New Mexico desert, they had only three weeks to finalize preparations for the Hiroshima bombing, leaving little time to study the radiation effects of the test blast. Without empirical evidence, no one knew how far or low to the ground the bombs’ radioactive waves would travel, or the extent of their destruction on the internal organs of tens of thousands of Japanese civilians.
Instead, scientists and military leaders had made presumptions. They deduced that as the blast force and heat of the bombs inflicted mass destruction and death, most of the radiation released at the time of the explosion would be captured by the rising atomic cloud. Accordingly, the pilots of the planes involved in the Hiroshima and Nagasaki bombings were trained to get away from the blast areas in less than a minute in order to avoid unsafe proximity to the radioactive clouds. U.S. scientists also assumed that anyone who might be exposed to fatal radiation levels (which had not yet been empirically determined) would be killed by the blast before the effects of radiation exposure manifested in their bodies.
Even less understood was the human impact of residual radiation—nuclear fallout from the atomic clouds (which some scientists anticipated) and lingering radiation through absorption by the soil and debris (which few scientists expected due to the height of the bombs’ detonation points). Manhattan Project director General Leslie Groves demonstrated conflicting assessments of the bombs’ potential residual radiation levels by declaring before the bombings that U.S. troops could safely have moved into the targeted cities within thirty minutes of the attacks. However, in the days between the atomic bombings and American occupation troops’ arrival in Hiroshima and Nagasaki, the general ordered U.S. research teams into both cities to measure radiation levels to ensure that his assumption of no danger was, in fact, true.
U.S. scientists’ and military leaders’ lack of knowledge and grossly miscalculated assumptions, combined with their desire to safeguard the United States’ reputation, led to passionate repudiation of Japanese claims of radiation effects on the people of Nagasaki and Hiroshima in the weeks and months after the bombing. In late August, when U.S. and worldwide media outlets picked up stories from the Japanese press about the mysterious and deadly radiation-related illnesses, General Groves promptly dismissed the reports as pure propaganda, unsubstantiated by U.S. scientific studies. Coming out of a war in which both sides used the media to propagate negative portrayals of their enemy, it may have been reasonable for Groves to assume that the Japanese would exaggerate reports of suffering in Hiroshima and Nagasaki. In this case, however, the reports were true—and Groves neglected to say that Japanese claims of radiation illness and death were unsubstantiated by U.S. scientific studies only because those studies had not been conducted.
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