Under the Radar: Cancer and the Cold War, and: Contested Medicine: Cancer Research and the Military (review)

Both of the books reviewed here address the role of the Cold War—and more specifically, the new technologies and politics associated with the atomic age—in shaping postwar medical practice and research. This is part of a larger historiographical trend toward assessing the civilian consequences of the Manhattan Project, including innovations in the life sciences from ecology to biochemistry as well as the development of new therapeutic and diagnostic tools.¹ These two new works focus on the medical field most directly connected with both the military and civilian uses of atomic energy: nuclear medicine. More specifically, both address new radiation treatments aimed at treating cancer, which occupied a central node in the domestic politics of atomic energy. And both discuss human radiation experiments that have come to represent some of the worst abuses of military experimentation and government secrecy.

Ellen Leopold's Under the Radar is a well-researched examination of how the Cold War distorted medical approaches to cancer both metaphorically, by framing cancer therapy in terms of war, and technologically, through the application of newly available radiation sources with which to treat patients. At the center of Leopold's book is a lawsuit over the injuries that Irma Natanson sustained from treatment with cobalt radiation therapy following a mastectomy in 1955. Natanson suffered severe radiation burns that resulted in the removal of several of her ribs and chest tissue as well as extensive skin grafts. She sued her radiologist for failure to warn her of the risks of treatment and for failure to administer the treatment properly. The jury rejected the charges of negligence and malpractice, but on appeal, the court in 1960 found the doctor guilty of negligence in not having sufficiently disclosed the nature, consequences, and risks of (as well as alternatives to) radiation treatment.

Natanson vs. Kline is usually cited for its importance to the emerging concept of informed consent,² but Leopold uses it as the starting place for a much wider exploration of the collusion of military, industry, and government interests in expanding the medical uses of nuclear technologies. Chapters addressing the development of cobalt-60 radiotherapy (with so-called "cobalt bomb" machines), the fallout controversy, cancer research, radiation protection standards, and emerging notions of risk and individual culpability provide a richly detailed landscape for the interpretation of Natanson's treatment as emblematic rather than merely tragic. But Leopold's ultimate interest is moral, not historical, and she adopts a prosecutorial tone. She relies on a contemporary ethical framework to indict the U.S. government, particularly the Atomic Energy Commission (AEC), as responsible for the endangerment of Natanson and other civilians through its weapons testing and biomedical program. The government's promotion of radioactivity as a way to combat cancer was driven by the "imperatives of postwar industrial expansion" (p. 56) on one hand and its "military mindset" (p. 74) on the other. Physicians, already "practiced prevaricators" when it came to dealing with terminal illness (p. 94), failed to protect their patients, eagerly exploiting the experimental technologies made available by the AEC. Instead, Leopold observes, the public figures who raised questions about the hazards of radiation exposure and whether the environmental dissemination of radioactivity would lead to increased cancer rates were considered dissident scientists. In the last chapter, she expands the litany of the ills of the Cold War to include industrial carcinogens and clinical trials.

Leopold's critiques of the AEC continue a long tradition of investigative journalism, Congressional hearings, and scholarship on this agency.³ Nuclear medicine provides a valuable and understudied locus for assessing the role played by the AEC in the trajectory...