Exposed in Cincinnati

A new genre of professionally hyped best-sellers published over the last few years began as magazine articles and quickly puffed themselves into $25 books. They were cool little books–well written and researched, adorned with hip covers, affixed with slick titles, and practically tailor-made for a glowing New York Times review (but not from Michiko, of course). I’m thinking of Michael Paternini’s Driving Mr. Albert, David Brooks’ Bobos in Paradise, and Joe Klein’s The Natural. Enjoyable books, all of them, but nothing too profound.

Martha Stephens’ The Treatment exemplifies, by contrast, what a work of non-fiction should accomplish. Her story pivots on a horrible scandal–the Cincinnati Radiation Tests–that was obscured when it initially took place. As she exposes the inner workings of this elaborate medical atrocity, Stephens pauses frequently to explore the pieces that most authors would have ignored: sub-themes like journalistic integrity, professional secrecy, and class-action law. She brings considerable passion and personality to the muckraking task of her own design, thereby stitching her personal biases onto her sleeve like an embroidered armband rather than assuming the mantle of omniscient authority. To top it off, Stephens, an English professor at the University of Cincinnati, writes with refreshing clarity and verve, trading the clever glibness that characterizes so many pseudo-books for a forthright tone that places her subjects ahead of hersel.

In 1971 as a junior professor at the University, she read a Village Voice article about a series of irradiation experiments being conducted at UC’s hospital. Doctors, according to the Voice, were exposing poor cancer patients to unusually high doses of radiation (whole body radiation, in most cases) in accordance with a project funded by the Department of Defense. In the Cold War context, skeptics quickly and correctly assumed that the DOD was searching for ways to measure the amount of radiation absorbed by military personnel after exposure to an atomic weapon while, at the same time, gauging how much exposure a healthy soldier could withstand. The Village Voice questioned whether or not the very ill patients knew that they were participating in the experiment at all. Stephens, however, decided to go a step further and find concrete answers. “We were living in the tail-end of the 1960s,” she wrote in a 1994 article, “and many Americans had developed a profound distrust of everything that had issued from the DOD.”

Stephens pursued her suspicions through an organization that she quickly patched together called the Junior Faculty Association (JFA). This group, a random assortment of young scholar-activists (none of them scientists) made it their self-appointed task to disclose the true nature of the radiation tests. Not quite sure how or where to begin, Stephens swung for the fences. She visited the director of the UC Medical Center, Dr. Edward Gall, and demanded to see the DOD project’s files. Courteous and diplomatic, Gall shooed her out of his office with reassuring explanations that the documents would be meaningless to an English professor. “I’m sure you wouldn’t want them all,” he explained. But she did. Several more visits ended in polite refusals. Finally, fed up, she charged to his office, ready to explode with impatience, and found, sitting on Dr. Gall’s desk, a lilting heap of documents. They were copies of the reports that UC Medical Center was sending to the DOD. All 600 pages had been copied for Stephens. “To this day,” she writes, “I don’t know why Dr. Gall surrendered these papers to me, and I later realized I was the first person outside the UC Medical School and the DOD to see them.”

“Surrendered” might describe what Gall did, but if this was a surrender, it turned out to be a small one in a large war that would be fought for more than 25 years. Between 1971 and 1997, she fought relentlessly for justice because of the horrors described in the DOD documents. The patient summaries attached to the reports revealed 87 impoverished cancer patients who had been irradiated by UC doctors as part of the DOD project. Eight of them died within days as a direct result of the intensive radiation exposure. Another 25 died within two months. For those who survived longer, Stephens conservatively estimates that most of their deaths were precipitated by the experiments, but the Medical School steadfastly refused to release the patients’ charts to the families. Stephens saw a “tragic and terrible tale” coming together before her eyes, with 13 doctors screening 113 patients over 11 years in order to pursue their DOD investigations. Not one report on cancer emerged from their findings. The stream of publications on radiation, by contrast, made for several impressive curricula vitae, promotions, and careers. Once they completed their radiation tests, the doctors involved in the experiments showed no interest whatsoever in the patients’ welfare, much less the status of their cancer. The process of consent, moreover, was misleading at best. Stephens spent the winter break of 1971 thinking about the Birmingham syphilis experiments and the Nuremberg Trials while reading the DOD documents. That spring, the JFA held a press conference to present their findings to the media.

“There were so many smoking guns left behind in these original papers for the DOD,” Stephens writes, “that one could hardly make out the papers through the smoke that enveloped them.” You’d think the feeding frenzy would have been ferocious. It was, instead, an exercise in denial. Yes, The New York Times and The Washington Post ran obligatory pieces, and the BBC sent over a team to make a mini-documentary on the project (but nobody in America heard it). In Cincinnati, where the story mattered most, the JFA report generated minimal attention. A few local reporters attended the press conference, but they failed to print the full story, leaving it for the next generation of reporters to resurrect 20 years later. “Indeed,” Stephens explains, “our report was suppressed in Cincinnati, where of course it would have posed the grave danger of alerting victims and their families to what had happened to them.” Frustrated with the low turnout, the JFA arranged for a CBS affiliate to visit the university and cover the story with a sensational 15-second blurb on the nightly news. As the team was preparing to shoot, a fire broke out in a nearby nursing home and the group predictably bolted, never to return. “And so it goes, all too often” Stephens writes, “with American journalism.”

American journalism, in fact, is one of the most interesting layers of this story. Curiously, the more the JFA protested, the less the local media listened. On the one hand, as Stephens explains, “the medical school doubled its efforts to block access to the patients and privately hired special counsel in Washington to fortify the legal wall between patients and potential interviewers.” So the journalist’s job was seriously impaired. On the other hand, there was the city’s major daily, The Cincinnati Enquirer. It became Stephens’ nemesis, the force that “commanded and subdued me, turn[ing] back almost all the efforts I had ever made… to communicate with it.” Printing over 250,000 copies a day, Cincinnati’s major paper, beholden as it was to Gannett and the local cabal of fat cats, avoided coverage of dissent like the plague.

“[T] he Cincinnati case was slipped… very softly away into a deep secret drawer of history.” But in the winter of 1994, after an Albuquerque freelance reporter had succeeded in finding family members of those who had been injected with plutonium as part of military research in the 1940s, the radiation tests came back into vogue as yet another Cold War tragedy. Linda Reeves, a young reporter at the Enquirer, worked closely with Stephens to ensure that this time around her story would be told to the right people–namely, the relatives of the deceased. Gradually, in bits and spurts, and with a new competitor, the Cincinnati Post, breathing down its neck, the Enquirer laid bare the damning facts of the radiation experiments while contacting the sons, daughters, nieces, and nephews of the victims. As they did, the medical establishment went into code-blue spin control, and Stephens wisely stops to explore the impressive wall that this professional community built around itself as a growing swarm of reporters badgered them for comments, information on patients, and expert opinions on full-body radiation. “Deliberate medical violence,” she writes, “is rarely a simple thing to expose,” especially when not a single doctor in Cincinnati would “speak up for those irradiated.” One local physician, after reading the DOD reports, did initially agree to condemn them publicly. However, after a call from city attorneys, she switched gears and explained that she “did not feel I could go against [the UC doctors].” The silence from the medical community was deafening. It made Reeves’ work all the more heroic.

The Treatment has its faults. In a book that impugns sensationalistic journalism, it often engages in it itself: “I remember being very content with a Channel 12 lead in… ‘Old General Hospital’s on the hotseat tonight!'” Stephens too often allows passion to cloud reason (“was [the treatment] any less horrible than a crazed attack with a baseball bat?”). And Duke University Press weakened an otherwise impressive book with a thin index and hasty editing (unidentified names appear that were mentioned more than 100 pages earlier, forcing the reader to consult a haphazard index for clarification). However, by the time you hit the last few chapters, with the medical drama having moved its way into the courtroom and Stephens masterfully intensifying it, these minor flaws hardly matter. What matters, instead, is the larger question of how, once such a tragic case of medical malpractice is exposed, justice can possibly be achieved.

It’s a big question that Stephens underscores with smaller, but no less important ones. Should the victims’ families seek a class-action settlement that demands public apologies and recognition but doles out only about $8,000 per plaintiff? Or, should they follow the lead of a bunch of out-of town lawyers (including one from Houston’s Susman and Godfrey) who descended on Cincinnati like vultures to convince the plaintiffs to reject the settlement, go to trial, and aim for the big bucks? Should the federal judge mediating the settlement interpret the defendants’ immunity plea in the narrow context of conventional legal precedent, or should she invoke the Nuremberg Code used to convict Nazi doctors after WWII? Should the defendants’ personal worth be assessed in order to gauge the depth of their pockets, or should the plaintiffs go after the wealthier institutions involved? As her subjects founder on these questions, self-interest prevails and justice is deferred. Stephens, sadly, must end her book with an eloquent, hypothetical statement that someday might go on a public memorial to the treatment’s victims. Should justice ever get a second chance, I hope Cincinnati listens.

James McWilliams is a writer in Austin.