Report

Don G. Bates Preventing Nuclear War: What Physicians Can Achieve SUMMARY SOMMAIRE On its fifth anniversary, the International A l'occasion de son cinquieme anniversaire, on a accorde le Prix Nobel de la paix a l'Organisation Physicians for the Prevention of Nudear War internationale des medecins pronant la prevention was awarded the Nobel Peace Prize. The de la guerre nucleaire. Deux cardiologues de Boston organization was conceived by two Boston ont concu cette organisation a laquelle se sont joints cardiologists who joined with some Soviet des collegues sovietiques pour creer un forum colleagues to create an international forum for international dont le but etait de considerer les consequences medicales d'une guerre nucleaire et considering the medical consequences of and les moyens de la prevenir. Cet article, ecrit par means for preventing nudear war. This article l'archiviste de l'Organisation, documente la difficulte by the orgarization's archivist documents its de sa progression et sa croissance remarquable. Le difficult progress yet remarkable growth. fait de surmonter des obstacles serieux a contribue a Overcoming serious obstades has added to its augmenter sa force et sa credibilite. L'Organisation strength and credibility: now involving compte actuellement 145,000 membres repartis dans 41 pays. Elle est devenue le porte-parole organizations with 145,000 members in 41 international des medecins preoccupes par la guerre countries, IPPNW has become the nucle'aire. international voice of medicine's concern about nudear war. (Can Fam Physician 1986; Key words: Nudear war, prevention, 32:163-166.) physicians

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Dr. Bates is the Thomas F. sons for taking stock of what has hap- Lown's efforts expanded to an inter- Cotton Professor of the History of pened and what has been accom- national scale as a result of his cardio- Medicine at McGill University and plished. logical research in the 1970s. During Canada's representative on the the Soviet-American collaborative governing council of the Beginnings medical research spawned by d6tente, International Physicians for the IPPNW's beginnings can be traced Lown began to work with Dr. Evgueni Prevention of Nuclear War. to two Boston cardiologists, Drs. Ber- Chazov, Director General of the Na- Reprint requests to: Dr. Don Bates, nard Lown and James Muller. Lown, tional Cardiological Research Centre 3655 Drummond Street, Montreal, professor of cardiology at Harvard's in Moscow. The subject of their re- PQ. H3G 1Y6. School of Public Health, began his search was sudden death in patients public opposition to nuclear weapons with heart disease. It is easy to under- in the early 1960s when he and a stand how their minds could turn to the number of other Boston doctors started problem of nuclear war and its threat W HEN THE International Physi- Physicians for Social Responsibility of sudden death for a large part of the cians for the Prevention of Nu- (PSR/US). Among their most notable world's population. clear War (IPPNW) met in Budapest at activities at that time was a group of Jim Muller's interests in Soviet the end of June, it marked the fifth articles in the New England Journal of medicine and the threat of nuclear war birthday of this remarkable organiza- Medicine 1-5 which outlined the medical were inspired by two events. As a sec- tion. This anniversary, and the fact effects of a nuclear war. Their findings ond-year medical student at Johns that IPPNW is the winner of the 1985 were of such interest that the U.S. Hopkins in 1967, Muller heard a talk Nobel Peace Prize are two good rea- Pentagon ordered 200 reprints! by the president of the Hopkins hospi-

CAN. FAM. PHYSICIAN Vol. 32: JANUARY 1986 163 tal, Dr. Russell Nelson, about his re- tionship became even closer. these preliminary discussions were cent visit to the Soviet Union. Having Muller's experience with Soviet beset by political difficulties until each studied Russian as an undergraduate, medicine, with Chazov, and with the side understood how the other side re- Muller decided, with Nelson's help, to threat of nuclear war, proceeded quite lated to its own government. take a six-month elective at the First separately from that of Bernard Lown. For their part, the Soviet doctors in- Moscow Medical College. Within Yet, by the mid 1970s, both men were volved are closely connected with the months of hearing Nelson, Muller in the same specialty, at the same insti- Soviet leadership. For example, Cha- went to a series of lectures on the tution. Moreover, within cardiology it- zov, Ilyin, and Kuzin are all members threat of nuclear war by well-known self, Muller had come to regard Lown of the prestigious Soviet Academy of Hopkins psychotherapist, Jerome as his teacher and mentor. Medical Sciences. Moreover, Chazov Frank. Deeply moved by what Frank Both men independently came to the was a member of the medical team had to say, and noting the obvious idea, first in 1978, that there should be looking after Leonid Brezhnev before connection with his coming trip, some kind of joint effort by U.S. and he died. These men could hardly be Muller decided to dedicate himself to Soviet doctors to alert their two coun- expected to dissent from a government improved relations between Soviets tries to the growing peril and conse- viewpoint that they share. For the and Americans. quences of nuclear war. Both knew, Americans, any public stance that ap- Out of his Moscow experience, from first-hand experience, that Soviet peared to be based solely on Soviet Muller learned two things: how to physicians were equally concerned criticism of the U.S. government's po- speak the language, and how indiffer- about the threat. Both believed that sition would destroy their credibility at ent people were to the threat of nuclear they could count on their cooperation home. war. Other American students in in such a venture. To reflect these realities, one of the Moscow thought he was slightly In 1979, Lown wrote a number of ground rules established at Geneva crazy, while their Soviet counterparts letters to Soviet officials but it was was that, in all public utterances, any were studiously unhelpful. Soviet doc- ultimately with Chazov, that earnest criticism of the superpowers would be tors, on the other hand, were sympa- negotiations began. At first Chazov bilateral. Other guidelines included fo- thetic and Dr. Mikhail Kuzin, dean of doubted what could be achieved but fi- cussing their attention exclusively on the medical college, eagerly cooper- nally agreed to meet in Geneva in De- the issue of nuclear war, dealing with ated with Muller in establishing a med- cember, 1980, to establish,. ground it strictly as a consequence of their ical student exchange with Hopkins. rules for some kind of joint confer- professional commitments to protect But, on his return to the United States, ence. Muller and Lown were accom- life and preserve health, and giving Muller found it impossible to arouse panied by Dr. Eric Chivian, staff psy- their activities and findings wide pub- interest in this arrangement. chiatrist at the Massachusetts Institute lic exposure in the two countries. For a time Muller abandoned his ef- of Technology, who had recently been Besides hammering out an agreed forts, but, in 1970, he again found helping Dr. Helen Caldicott to resur- set of principles upon which a confer- himself in Moscow, this time as an rect the long dormant PSR/US. With ence could be based, the Geneva aide to the assistant secretary of Chazov was Dr. Leonid Ilyin, Director founders decided to broaden represen- health, Dr. Roger Egeberg. In this ca- of the Institute of Biophysics of the tation at the coming congress to in- pacity, Muller promoted the idea of an U.S.S.R. Ministry of Public Health, clude Britain and Germany, and, for extensive exchange between the two and chairman of the National Commis- obvious reasons, Japan. countries in the health field, as a way sion for Radiological Protection. By the time of that first congress, in of promoting peace. Egeberg agreed The other Soviet was Dr. Mikhail Airlie, Virginia in March, 1981, the and Muller found himself negotiating Kuzin, now director of the Vishnevsky original concept of a joint conference agreements on the study of cancer, Institute of Surgery. The reunion of had evolved into a fully international heart disease, and environmental Kuzin and his erstwhile student, gathering. Eleven countries were re- health that were subsequently signed Muller, so many years after they had presented by over 70 delegates, in- by Brezhnev and Nixon. In the first of set up the unsuccessful student ex- cluding four from Canada.6 At the a number of remarkable coincidences, change, was largely coincidental. same time, the international situation one result of these agreements was the Kuzin, a friend of Chazov since early had become more precarious. Ronald collaboration between Lown and Cha- postgraduate days, had been chosen Reagan had just been swom in as the zov on cardiac sudden death. for the Geneva discussions because of new U.S. president and the mood of The criss-crossing of Lown's and his experience with war injuries. In- the American delegation was one of Muller's interests do not end there. deed, Kuzin had read the 1962 caution. One false step in the now con- Also in 1970, Muller was assigned to a PSR/US article on the medical effects servative political climate of the delegation of Soviet physicians who of nuclear war when it first appeared. United States would have meant an in- were visiting the United States. That stant loss of credibility for the infant delegation was headed by Dr. Chazov organization. with whom Muller developed a close Founding Meet'ing For example, had the U.S. delega- relationship. Five years later, Muller, The three-day meeting in Geneva tion acceded to the Soviet suggestion now a member of the staff of the Har- was not easy. Lown had conceived of that the congress publicly call for a vard School of Public Health, once a conference that would be non-politi- summit meeting between President again headed for Moscow, this time to cal in the sense that it would be limited Reagan and Chairman Brezhnev, do research on heart disease. On this strictly to nuclear weapons, their ef- American public opinion would imme- occasion, he was on the receiving end fects, and methods of preventing their diately have interpreted this as a move of Chazov's hospitality, and the rela- use. But, predictably perhaps, even to side with Soviet propaganda. At the

164 CAN. FAM. PHYSICIAN Vol. 32: JANUARY 1986 time, the Soviet Union was vigorously been firmly established. With little dif- leaven conversation about the death- urging such a meeting and the Reagan ficulty, the organization was able to dealing technology of war with talk of administration was just as vigorously find common ground, not just on the the life-giving technology of medi- opposing it. effects of nuclear war but on the means cine.8 Conversely, had the congress de- of reducing the threat of one. The pub- To strengthen this link, return visits cided against a public appeal of any lic letter that year, addressed to Chair- by Soviet physicians to North America kind, as some of the Americans were man Andropov and President Reagan, have taken place. In February, a dele- advocating, the Soviet delegation called for things like the no-first-use of gation from the U.S.S.R. attended the would have withdrawn and IPPNW nuclear weapons, a freeze, nuclear national PSR/US meeting in Los An- would have died at its birth. Mindful arms reductions, and a comprehensive geles, and toured the United States. In of their Geneva agreement, the Ameri- test ban. April some more made a similar trip to can founders sided firmly with their It was also at the Amsterdam meet- Canada. Soviet colleagues against many influ- ing that the "International Physicians' But nothing has so dramatized the ential members of their own U.S. dele- Call for an End to the Nuclear Arms growth and importance of IPPNW as gation. Tense negotiations, lasting Race" was promulgated. The object of the fifth annual congress in Budapest. through most of the final night, even- this document was to accumulate sig- Fifty-four countries were represented tually resolved these difficulties to natures from health professionals by over 840 delegates and observers. everyone's satisfaction. Public letters around the world, and to bring them to World-wide, there are now 145,000 to Reagan and Brezhnev did go out, the next congress in Helsinki. By June members belonging to physicians' or- but made no mention of a summit. 1984, 1,300,000 people had signed. ganizations in 41 countries that are af- At the 1982 congress, in Cam- As the Soviets had promised in Am- filiated with IPPNW. bridge, England, civil defense threat- sterdam, they brought one million of Individuals enjoy membership in ened to be the subject of further diffi- those signatures from their own col- IPPNW only by being members of af- culties. The plenary session endorsed leagues. filiated, national organizations. In this the conclusion reached by one of its It is not only the experience of the country that means Physicians for So- working groups that there is no ade- annual congresses that has given rise cial Responsibility/Canada which, like quate civil defense in a nuclear war. to good working relations between the all national affiliates, appoints one The Soviet delegation agreed. Experi- two sides. Equally importait has been member to IPPNW's governing Coun- enced observers felt, however, that it the favorable impression that each has cil and sends delegates to its annual was a sensitive issue for them. In view developed of the other's capacity to congresses. of the invasions of their country, and have an effect in its own country. For its work in alerting the world to particularly the terrible devastation Because the Soviet delegation is the dangers of nuclear war, its conse- and loss of life in the Second World composed of high-ranking people, quences, and the means of avoiding it, War, no one in the Soviet leadership IPPNW's message is almost certainly IPPNW has been the recipient of first would be anxious to admit to a defi- getting through to the leadership of the 1984 UNESCO Prize for Peace Ed- ciency in the one thing their people ex- their country. Even more apparent is ucation and more recently the 1985 pect from them above all else-protec- the widespread coverage it is receiving Nobel Peace Prize, two tangible marks tion from war. Despite extensive in their mass media. Over the past four of its success. But that success would coverage of all of IPPNW's other find- years, Soviet people have become never have been possible if there had ings, would the Soviet media be will- much more aware of the effects of nu- not been, from its very beginning, two ing to broadcast this fundamental limi- clear weapons as a result of their doc- essential ingredients present among tation to its government's civil defense tors' campaign. the half-dozen physicians who met in capabilities? Conversely, Soviet observers to the Geneva: the will to cooperate and the In a Moscow television studio, on national meeting of PSR/US, in Jan- trust that that will was mutually an unrehearsed and uncensored pro- uary, 1984, were impressed by the ac- shared. gram, three American and three Soviet tivities of this organization, now re- The theme for this year's congress physicians from IPPNW discussed the porting a membership of over 30,000. in Budapest was "Cooperation not effects of nuclear war, just two months As one of these observers explained to Confrontation". Besides being a fit- after the Cambridge meeting. Lown me, the Soviet people see U.S. doctors ting topic for the fifth-anniversary brought up the subject of civil defense as both conservative and influential in meeting, it could well serve as a sum- and reported the negative findings of their society, so that their efforts in the ming up of IPPNW's brief history. the congress to an estimated viewing cause of preventing nuclear war are re- audience of over 100 million Soviet garded as significant by their counter- people. Whatever they felt, the Soviet parts in the Soviet Union. Nobel Prize Aftermath authorities accepted Lown's interven- On the strength of these experi- This article was submitted before tion without complaint.' ences, direct exchanges of doctors be- the 1985 Nobel Peace Prize had been tween East and West are taking place. announced, so a further word is in After the Helsinki congress, 100 dele- order. What follows is a revised ver- Confidence and Trust gates from PSR/US, along with an- sion of a statement published in The The give and take of many experi- other 50 from other parts of the world, Globe and Mail, Dec. 11, 1985, and ences like these have helped to build including Canada, toured several reprinted by permission of author and confidence and trust. By the time of major Soviet cities. It was a welcome publisher. the third congress, in Amsterdam in change to meet with now familiar col- When the Nobel prize choice was 1983,7 a pattern of cooperation had leagues in their own backyard and to announced two months ago, bouquets

CAN. FAM. PHYSICIAN Vol. 32: JANUARY 1986 165 were quickly followed by brick-bats. come to look similar to IPPNW policy, to a single issue-the prevention of "Soviet propaganda wins the prize," not the reverse. IPPNW's views may nuclear war. When Amnesty Interna- declared the New York Daily News. A be at odds with the thinking of the cur- tional won the Nobel Peace Prize in "Nobel Peace Fraud," fumed The rent U.S. administration, but they are 1977, no one complained because it Wall Street Journal in a scathing edit- at least as consistent with American, did not deal with disarmament. orial, while columnist Colman Canadian and west European public Today, if IPPNW were to comment McCarthy's article in The Washington opinion as they are with the nuclear publicly on human rights issues in the Post was called "The Nobel Prize for policies of the Soviet leadership. Soviet Union it would be an act of self- Scolding." Not all were as strident. In announcing the 1985 Peace Prize, destruction. On the other hand, as pri- Editors of The Globe and Mail initially the Nobel Committee commended vate individuals, or through other congratulated "Doctors for peace," IPPNW for spreading authoritative in- groups, many IPPNW members have but then gently criticized "Peace with formation on "the catastrophic conse- worked on a number of issues that af- a bias" a month later. quences of atomic warfare.'" Detrac- flict the world, including the suppres- Central to many of the complaints is tors have argued that this information sion of human rights. the close connection that leading So- is spread almost exclusively in the viet physicians in IPPNW have with West. This is not true. Conclusion their government. The most obvious According to Harvard law professor IPPNW believes that the first and example is Dr. Evgueni Chazov who, Alan Dershwitz, who has defended greatest human right is for all people as a cofounder and copresident of Soviet dissident Anatoly Scharansky on earth to be spared the consequences IPPNW, shared the spotlight in Oslo in Soviet courts, IPPNW "has re- of a nuclear war, and that the organiza- with his American counterpart, Dr. ceived more television and print cover- tion can make the greatest impact by Bernard Lown. A member of the Cen- age in the Soviet Union than any other sticking to this single goal. The Nobel tral Committee of the Communist non-party-controlled group." Soviet Committee that awarded a Peace Prize Party since 1982, Chazov has been a TV has broadcast documentaries of to Andrei Sakharov, and to Amnesty deputy minister of health and a IPPNW congresses. Hundreds of arti- International, apparently agrees. member of the Supreme Soviet. As a cles about the organization and its The Nobel Prize is really an award leading Soviet cardiologist, he is also a message have appeared in the Soviet to all members of all the national affili- member of the medical team that looks press. ates. As a result, the heightened after Soviet leaders-Brezhnev, An- In 1982, three American and three morale, enthusiasm and renewed de- dropov, Chernenko, and presumably Soviet doctors appeared on national termination which the prize has Gorbachev. Soviet TV for a 60-minute, unedited aroused have been truly world-wide. Far from hiding these establishment discussion about nuclear war. The pro- The opportunities to attract new ties of their Soviet colleagues, western gram was broadcast at 6 pm, Moscow members and funds are incalculable. members have emphasized them as a time, right after an important soccer IPPNW's work is now far better source of the organization's strength. match, and again four days later. On known, and its unique link between Given the way the Soviet system that program Dr. Lown spoke frankly East and West is finally being noticed. works, influencing its policies means about the illusory nature of civil Above all, IPPNW has become a getting the ear of its leaders. defense-a statement which chal- highly credible example of the way in Dr. Chazov has also been criticized lenged Soviet policy. In the United which professionals of all kinds can as one of 40 Soviet scientists who de- States, all three major commercial net- help to make the world a safer place. nounced former Nobel winner Andrei works refused to show the program, * Sakharov. But, as its name suggests, and it was finally aired by the Public IPPNW is about preventing nuclear Broadcasting System. References war, not about reforming Soviet soci- There is more than a little irony in 1. The medical conisequences of thermonu- ety. In order to reduce the threat of a all of this. It is clearly because the So- clear war [Editorial]. N Engl J Med 1962; world-destroying catastrophe, East viet doctors enjoy the confidence of 266:1126-7. and West must cooperate. That coop- their government that their message 2. Ervin FR, Glazier JB, Aronow S, et al. Human and ecologic effects in Massachu- eration cannot await the remodelling has received such wide coverage. setts of an assumed thermonuclear attack of those with whom we disagree. It Moreover, had the coverage in North on the United States. N Engl J Med 1962; works both ways-the Soviet doctors America been as great, more accurate 266:1127-37. are also obliged to suppress their urge information and greater understanding 3. Sidel V, Gieger J, Lown B. The physi- to us. have cian's role in the postattack period. N Engl reform might resulted. J Med 1962; 266:1137-45. Critics see sinister implications in Finally, IPPNW has been accused 4. Aronow S. A glossary ofradiation termni- the fact that IPPNW endorsement of of ignoring Soviet transgressions of nology. N Engl J Med 1962; 266:1145-9. preventive measures like a freeze on human rights. This is only partly true 5. Leiderman PH, Mendelson JH. Some nuclear weapons, a comprehensive test and there are reasons for it. At the psychiatric and social aspects of the de- and the of in in at the fense/shelter program. N Engl J Med ban banning weapons founding meeting Geneva, 1962; 266:1149-55. space, more closely follows govern- end of 1980, Soviet and American 6. Bates DG. Avoiding nuclear war: ulti- ment policy in the U.S.S.R. than in doctors hammered out a common set mate in preventive mnedicine? Can Med the U.S.A. But IPPNW adopted these of principles. One of these, proposed Assoc J 1981; 125:923-30. policies before the Soviet Union did by the Americans, was that IPPNW 7. Bates DG. International phvsicians' group attacks illusions ofnuclealr wtar. Cant and they were first proposed to would not publicly criticize the spe- MedAssocJ 1983; 129:369-71. IPPNW by American doctors. What- cific pOlicies of any government unila- 8. Bates DG. Doctors insist: the tw1ain can ever the reasons, Soviet policy has terally. Another was that it would stick meet. Cani MedAssocJ 1984; 131:354-6.

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