Dr. Strangelove’s Nemesis

Dr. John Gofman left us in 2007 at the age of 88. Edward Teller called him “the enemy within” the nuclear research establishment because Gofman warned the public about the dangers inherent even in peaceful uses. (Teller was proud of his own sobriquet, “father of the H-bomb.” Peter Sellers used Teller as a model when he played Dr. Strangelove in Stanley Kubrick’s great black comedy.)

In the early 1940s, while getting his PhD in physics at UC Berkeley, Gofman co-discovered Uranium 233 and demonstrated its slow and fast neutron fissionability. At the request of J. Robert Oppenheimer, Gofman and Robert Connick produced plutonium for the Manhattan Project. (Not even a quarter-milligram existed at the time of Oppie’s request.)

After the war Gofman got his MD from UCSF and began research that linked heart disease to the lipoproteins that transport cholesterol in the bloodstream.

In 1963 the Atomic Energy Commission asked him to establish a Biomedical Research Division at Lawrence Livermore Laboratory to evaluate the health effects of all types of nuclear radiation. Before long, however, the nuclear establishment was ignoring his warnings about the real dangers of low-dose ionizing radiation. Gofman returned to full-time teaching at Berkeley, and took early retirement in 1973. This interview, which ran in the AVA in 1994, was conducted by Shobhit Arora, a second-year medical student, with me sitting in. We started out discussing a Wall St. Journal item: “The White House was surprised –and chagrined– by Energy Secretary O’Leary’s comment about paying compensation to atomic-testing victims. With a super-tight budget, the White House is now scrambling to head off a costly new entitlement.” –FG

Gofman: Secretary Hazel O’Leary is undoubtedly the first breath of fresh air that we’ve seen in the atomic era. I think what she’s doing is great and I hope millions –hundreds of millions of people back her– because she’s going to face a ferocious opposition. It’s going to be like a nuclear firestorm in opposition to her, because she’s doing something constructive. I have for 25 years been an intense critic of the Department of Energy. I say this because Hazel O’Leary stands for compassion, candor and credibility –not because I’ve changed my mind about the DOE, which I think is one of the worst organizations in the history of our government. Unless it’s cleaned out, we’re going to have worse things in the future. The human experimentation that has been done is bad. And it’s good that that’s being cleared away. But for 25 years the DOE has not shown any concern for the health of Americans. Their concern has been for the health of the DOE. Their falsehoods concerning the hazards of ionizing radiation have put not thousands of people at risk, not millions of people, but billions of people.

The worst-case scenario is this. Ever since its inception, the Atomic Energy Commission –then called ERDA, then called DOE– has had one thing in mind. “Our program is sacrosanct.” And they recognize, as I’ve recognized, that their entire program will live or die based upon one thing. If the public should come to learn the truth about ionizing radiation, nuclear energy and the atomic energy program of DOE is going to be dead. Because the people of this country –and other countries– are not going to tolerate what it implies. The key thing –it’s everything in the DOE program– is: “We must prove that low doses of radiation are not harmful…” They have been conducting a Josef Goebels propaganda war, saying there’s a safe dose when there has never been any valid evidence for a safe dose of radiation. Yet the DOE and others continue to talk about their “zero-risk model.”

After Chernobyl, I estimated that there were going to be 475,000 fatal cancers throughout Europe –with another 475,000 cancers that are not fatal. That estimate was based on the dose released on the various countries of fallout from Cesium-137. The DOE put out a report in 1987 –and I don’t think it’s any credit to the University of California that part of this report was done in the Livermore Lab, where I once worked, and part in Davis– saying “our zero-risk model says that at these low doses, nothing will happen, because low doses are safe.”

How would a safe level of radiation come about? It could come about in theory if the biological repair mechanisms –which exist and which will repair DNA and chromosomes– work perfectly. Then a low dose of radiation might be totally repaired. The problem, though, is that the repair mechanisms don’t work perfectly. There are those lesions in DNA and chromosomes that are unrepairable. There are those where the repair mechanisms don’t get to the site and so they go unrepaired. And there are those lesions where the repair mechanisms simply cause misrepair. We can say that between 50 and 90 percent of the damage done by ionizing radiation is repaired perfectly. What we are then seeing is harm done by the residual 10 or 40 or 50 percent that is not repaired perfectly. The evidence that the repair mechanism is not perfect is very solid today. What we wanted to have was evidence that as you go down to very low doses –a raed, or a tenth of a rad– is that going to produce cancer? Determing the answer by standard epidemiological studies would take millions of people, and we don’t have that. So it creates a field day for the DOE to say, “Well, we don’t know.” But I looked very carefully in 1986 for any studies that could shed light on that all-important queston. And I presented that evidence at the American Chemical Society meeting in Anaheim.

Q: That the lowest doses will produce cancer?

Gofman: The answer is this: ionizing radiation is not like a poison out of a bottle where you can dilute it and dilute it. The lowest dose of ionizing radiation is one nuclear track through one cell. You can’t have a fraction of a dose of that sort. Either a track goes through the nucleus and affects it, or it doesn’t. So I said ‘What evidence do we have concerning one, or two or three or four or six or 10 tracks.’ And I came up with nine studies of cancer being produced where we’re dealing with up to maybe eight or 10 tracks per cell. Four involved breast cancer. With those studies, as far as I’m concerned, it’s not a question of “We don’t know.” The DOE has never refuted this evidence. They just ignore it, because it’s inconvenient. We can now say, there cannot be a safe dose of radiation. There is no safe threshhold. If this truth is known, then any permitted radiation is a permit to commit murder.

What other things does the DOE use as crutches? “Well, maybe if you give the radiation slowly it won’t hurt as much as if you give it all at once.” Now if you have one track through a cell producing cancer, what is the meaning of slowly? You have the track or you don’t. It comes in on Tuesday or it comes in on Saturday. To talk about slow delivery of one track through the nucleus is ludicrous. But they do it anyway.

There is a more radical fringe that says, “A little radiation is good for you. And all this stuff about radiation causing harm is bad for society because it’s going to prevent the program we think should be instituted, and that program is to give everybody in the country radiation every day as a new vitamin.” This program is called hormesis. “A little radiation will give your immune system a kick and help you resist cancer and infectious disease.” The chief exponent is a man named Thomas Luckey, formerly of the University of Missouri. He bemoans the fact that we can’t get this program into high gear.

Q: Is anybody taking him seriously?

Gofman: The idea is manifestly absurd. But that didn’t prevent the DOE from helping to sponsor a conference in 1985 in Oakland on the beneficial effects of radiation, hormesis. And the nuclear enterprise is really at it all the time. They had another such conference in 1987, and another in 1992.

Q: What are the implications of there being a safe dose of radiation?

Gofman: They don’t have to worry about nuclear waste. NO problem –there’s a safe dose, nobody’s going to get exposed to more than the safe dose. The clean-up and disposal of waste has been estimated to be in the billions, if they’re really going to clean up Hanford and Savannah River and all the rest. Recently, Dr. Robert Alexander in an exchange of letters in the Health Physics Journal –he was with the Nuclear Regulatory Commission, and former president of the Health Physics Society– said there’s no proof that low level radiation is harmful… Anybody who gets half a rad a year from waste disposal shouldn’t be counted, they don’t matter. They don’t matter for somebody who’s apologizing for the nuclear industry. But they matter! And they’re going to matter in the millions, tens of millions and hundreds of millions if, because of statements like Alexander’s, it becomes okay to give people 10 rads. You won’t have to bury things in these fancy vaults. You won’t have to worry about transport. You can even dispose of it in ordinary landfills. That will be the result. That’s what the future will be. If low doses don’t matter, the workers can get more and their families can get more by being in the vicinity. That’s what we face.

Q: What are the limits for lab technicians and other workers wearing badges? What’s the limit now?

Gofman: Five rems per year. That’s going to be cut down to one or two rems per year. By the way, medical radiation, from x-ray machines, is roughly twice as harmful per unit dose as Hiroshima-Nagasaki radiation.

Q: Why is that?

Gofman: It’s the effect of linear energy transfer. When gamma rays or x-rays set electrons in motion, the electrons are traveling at a lower speed than the electrons coming out of cesium-137. And as a result, when they’re traveling at a lower speed, they interact much more with each micrometer of path they travel. Therefore the local harm is much greater. So medical x-rays set in motion electrons that are traveling at a lower speed and hence producing about twice the linear energy transfer, and hence twice the biological effect. That’s why alpha particles from radium or plutonium are so much more devastating than beta rays set in motion from x-rays. The alpha particles, with their heavy mass and plus-2 charge, just rip through tissue so strenuosly that they don’t go very far. A deception of the crassest sort are the lectures by pro-nuclear people showing a plutonium or radium source and putting up a piece of paper and showing that the alpha-particle radiation on the other side is zero. “You see, a piece of paper will stop those alpha particles, folks, there’s no problem with plutonium.” Except when that alpha particle is lodged next to an endosteal cell in the bone and producing a horrendous amount of interaction. Or that alpha particle is lodging on the surface of the bronchi –that’s why we’ve got an epidemic of lung cancer among the uranium miners! The fact that they don’t travel far is because they interact like hell!

Q: Do you think medical professionals really appreciate how much potential there is for damage? Regardless of who you are, you go into the hospital and you get a chest x-ray as a routine diagnostic procedure.

Gofman: I’m sad to say, I don’t think 90% of doctors in this country know a god-damned thing about ionizing radiation and its effect. Somebody polled some pediatricians recently and said “Do you believe there’s a safe dose of radiation?” And 45% said “Yes.” They weren’t asked, “What papers have you ever read on this subject that led you to conclude there’s a safe dose?” I think medical education on the hazard of radiation is atrocious. What have they taught you in radiology?

Basically, whenever it’s not necessary, don’t do a radiological procedure. But they have qualified that with the implication that most radiological procedures really aren’t that dangerous –a tenth of a rad here really isn’t too bad. It’s better to get the information from a procedure than not.

Part of that is okay. If you ask me, “Do you stand against medical x-rays?” the answer is no. And I’ve written a book with Egan O’Connor on the health effects of common exams. We take the position: if there’s a diagnostic gain for you –something that can really make a difference in your health and your life– then don’t forego the x-ray. But there’s another part of the picture. Up till recently –it may be a little better now than it was– government studies show that most hospitals and most offices of radiologists didn’t have the foggiest notion of what dose they were giving you for a procedure. Nor did they know that the procedure could be accomplished with a third or a tenth of the dose. Joel Gray, a health physicist at the Mayo Clinic, said there are places giving you 20 times the dose needed for a given picture. And, he said, “If you ask those people and they can’t answer, you can be fairly confident that they’re giving you a bigger dose than necessary.” So Egan and I, inThe Health Effects of Common Exams, took the data on what the average doses were in the United States, versus what has been accomplished by some elegant work in Toronto to reduce the dose to one-third of what was the average practice in 1984, and found that about 50,000 fatal cancers per year could be prevented. That’s a million and a half in a generation! So what is this stuff about “Most procedures don’t hurt you, they’re small?”

Let me say one more thing about the medical profession. It’s my view that we have a really crazy situation with respect to x-rays. You go to a physician– your internist, or a GP, or an obstetric gynecologist, or an orthopedic surgeon– these are the people who send you out for an x-ray. They represent, or should, your ombudsperson. And they, not you, should have to find out whether the facility they’re sending you to sends 5 times the dose needed, or a decent dose of radiation. But if you ask that so-called ombudsperson, “Where you’re sending me, do they know how to keep the dose down? What dose will I get?” He’ll mumble, “Don’t worry about it, no problem.” That’s the fault of medical education in our universities. If we turn out physicians who don’t have the attitude that they’re the ombudsman for things like that, I think they’re not doing the job.

Q: A friend who had a melanoma was told there had been a 20-fold increase in the past 50 years, but “We don’t really know what’s causing it.” It’s as if many in the medical profession don’t want to make the obvious connection between radiation, pollution, pesticides and the cancer rates.

Gofman: The medical profession is implicated directly. I’ve spoken to Dr. Andre Bruwer, who practices in Tucson. He’s a first-class radiologist who does nothing but mammography. And he said, “John, I shudder to think of what we were doing 20 years ago.” We were touting mammography when the dose was four to five rads, and in some cases 10 rads. Now if you give enough women four to five rads, at something of the order of a 2 percent increase in breast-cancer rate per rad –that’s what my analyses show, and I’ve analyzed the world data on x-rays very carefully with respect to breast cancer in particular– it has to be that women irradiated 15, 20 years ago got horrendous doses from mammography compared to now. And therefore, some of the present increase in breast cancer has to be from the radiation they got; but they don’t like to talk about it.

There was a time, 20-30 years ago, when there were mobile x-ray units that gave x-rays of the chest. They didn’t give the 20 millirads [a 50th of a rad] that is possible today. They gave about 5 rads. Children went through those things by the thousands. And we just say “We don’t know why this cancer epidemic is taking place now.” Nobody’s taken account of it. It’s hard to know how many children got it and who they were and follow them up. But you know that a certain number of people are having cancers now as a result of what was done 15, 20 years ago.

Back in the ’50s one woman brought a child in in the middle of the night having real difficulty breathing, and a resident said, “Maybe the thymus gland is enlarged and pressing on the trachea. Let’s give this child a 100 or 150 rads of radiation in the neck.” And as with many disorders, the child got better by morning. And so this resident put two and two together and said, “I gave the radiation, the child got better, therefore I cured him.” And so this became the rage and all kinds of hospitals were using radiation to treat an enlarged thymus.

Q: What’s the danger from an enlarged thymus?

Gofman: There have been careful studies now of these kids that had the irradiation for enlarged thymuses –which, by the way, is no longer believed to have been a disease that existed in the first place– and they’re having an excess of thyroid cancers, an excess of salivary gland cancers. One hospital in Pittsburgh said “Why should we wait till these children come into the emergency room at night with croup?” And they, for a period of over a year, gave x-rays to every child leaving the nursery…

There is this wall that prevents us from relating past experience to the occurence of cancer. The full effects are not known. It’s not just what the average dose was back then, some places were giving horrendous doses. Sometimes they’d get a picture that was too faint. So they’d take another one, with a longer exposure –when the problem was that their developing solution was getting spent. And all they had to do was change the developer. But instead of that they gave the person an extra x-ray with a bigger dose.

Q: What general principles should a patient bear in mind when considering a procedure?

Gofman: If I were a member of the public, knowing what I know: if the establishment told me that something had a certain risk, I’d assume that the true risk was at least 10 times worse. Part of the problem comes from the patient. If a patient goes to a doctor –especially if he’s covered by a health plan– and the doctor doesn’t give him any procedures, they feel cheated. “You didn’t even take an x-ray!” But the medical profession has to be regarded as culpable, along with the DOE. They both have the same conflict of interest: their work exposes people to radiation. For the DOE there have been all kinds of people of shady character in all kinds of government posts. But damnit, the medical profession shouldn’t be shady and corrupt. I’d like to see them really apply the Hippocratic oath to this field.

Q: Could you describe your work regarding the retroactive tampering with databases?

Gofman: For years I’ve tried to believe that what was going on in Hiroshima-Nagasaki in what was called the Atomic Bomb Casualty Commission –subsequently renamed the Radiation Effects Research Foundation– was the only place where we had a huge body of data that addressed the question of what happens to people who have been exposed to varying doses. If there is an event like Chernobyl, or Hiroshima, we have to insist on the sacred meaning of collecting an honest database concerning what happens to people — A. doing the very best job of determining what dose they got, and B. doing a follow-up study that is beyond reproach. That is an obligation to humanity that is virtually sacred. If you do anything less than the best in that kind of endeavor, you’re a scoundrel. So all this time I wanted to believe in the work that was being done in the Hiroshima Nagasaki stuidies. In 1986, because of some questions about what the neutron dose was relative to the other forms of radiation –gamma rays, primarily– they did a revision of the doses. Now I don’t have any objection to the revision of doses, provided that you obey the cardinal rules of medical research. The first cardinal rule of medical research is: never, but never change the input data once you know what the follow-up shows. So because they had this idea of changing the doses, they didn’t just change the doses, they shuffled all the people from one dose category to another, with a new dose. So there was no continuity with everything that had been done up to 1986.

Q: Who’s ‘they?’

Gofman: The Radiation Effects Research Foundation in Japan. The director is Itsuzo Shigematsu. The associate director is a guy by the name of Jupe Thiessen who’s from the DOE. It’s a DOE-sponsored endeavor –DOE and the Japanese Ministry of Health. There couldn’t be a worse set of sponsors.

Q: The Japanese have the same kind of commitment to nuclear energy?

Gofman: Absolutely. So I said, “You can’t do this. You want a new dosage, keep the new groupings and just assign the new dose and study [the results].” I call that “constant cohort, dual dosimetry.” So I wrote a letter to Shigematsu and said “This is a violation of the cardinal rules of research. There is a way to do this correctly, and you can keep changing doses all your life, provided you just stick them alongside what you’ve done originally.” Shigematsu’s reply is on my book. [Radiation-Induced Cancer from Low-Dose Exposure, 1990] It’s simple. He said, “Trust us.” Well, the reason for the cardinal rule of research is, nobody ever has to say “Trust me.” Because you set things up with blinding, with appropriate procedures, so that your data base is immaculate. You don’t go changing things and say, “Well we did it objectively.” I said, “Report in the old way –the old dosage– and the new way.” They said, “We won’t do that. But we’ll consider it. And we will give you the data in the old way for three more years.” What’s the shape of the cancer curve with the latest data from Hiroshima-Nagasaki? If I use the old data, it’s like this (diagonal line). What’s the shape of the curve with their new dosimetry? It’s like this (slowly rising line that then goes up abruptly).

Q: Making it look as if the low-level of radiation is acceptable?

Gofman: Exactly. Their ultimate goal is fulfilled.

Q: How did they determine who received what dosage at the time of the explosion? Was it based on how far away they were from ground zero?

Gofman: Distance was the biggest factor, but also whether you were outdoors or indoors, whether you were in a concrete or wooden structure. They tried to do a lot of that. And they shouldn’t keep changing the placement of people! You take people with cancer and say, “Well, I guess the dose they originally got must have been a lot higher. We’ll put that person here [in this dose category] and this one there.” And with that sort of approach, you can make truth whatever you want it to be. And there’s a very important additional lesson. Humanity needs to insist on the emaculate construction of databases concerning any accident or major event. If a crook makes the database, Einstein will get the wrong answer out of it. And then what happens? The Einsteins, with the best credentials, using this lousy, fabricated, false database, put their findings in the medical journals. And then they get into the textbooks. And then it’s taught to medical students for the next 100 years. And what happens? Hundreds of millions of people will suffer from cancer and genetic diseases because the answer will be wrong. The key thing is getting an honest database.

PS 1/31/07 Bill Clinton in due course ditched O’Leary, who had resisted power-industry pressure to privatize government labs and production facilities. By an amazing coincidence she was shown the same door as Lanny Guinier and Jocelyn Elders.

Fred Gardner edits O’Shaughnessy’s, the journal of cannabis in clinical practice. He can be reached at fred@plebesite.com



Fred Gardner is the managing editor of O’Shaughnessy’s. He can be reached at fred@plebesite.com