On September 29, 1987, a stranger appeared in the regional Ministry of Health in the Brazilian province Goiás and shocked governmental officials there with an announcement that parts of the city Goiania, with its 1.3 million inhabitants, needed to be evacuated. He insisted on speaking personally with the minister of health. At first ministry employees tried to brush the man off, thinking that he must be deranged, but they gave in when he became more insistent and began to warn of an imminent catastrophe. At 2:30 p.m., the stranger, who turned out to be a highly qualified physicist, was brought to the minister of health, who immediately recognized the gravity of the situation. Three hours later, the head of Brazil’s nuclear emergency task force NEC boarded a plane in Rio de Janeiro. At a stop in São Paulo, two further specialists, carrying radiation measuring devices, joined him on the aircraft. Meanwhile, the Goiás Ministry of Health contacted the tropical medicine clinic in Goiania, where several severely ill people were already being treated for what doctors believed was a mysterious allergy. The physicians were told that their patients were in fact suffering from acute radiation poisoning and should be immediately quarantined. By the end of day, the government had requisitioned Goiania’s Olympic Stadium so that hundreds of other radiation-contaminated people could be examined and treated. The NEC team arrived in the city shortly after midnight and headed to an abandoned private medical clinic. The police subsequently evacuated several parts of Goiania, including neighborhoods surrounding three junkyards in some of the city’s poorest districts. The organs of the Brazilian state worked quickly and efficiently, as the final act of one of the worst tragedies of the Atomic Age began to unfold.
The accident, which would eventually cost four people their lives, had begun in unspectacular fashion two years previously. In late 1985, the private radiology clinic Instituto Goiano de Radioterapia moved to a new location within the city. Because of a legal dispute, a piece of equipment—an Italian-built Cesapan F-3000 teletherapy unit used to administer radiation treatment to cancer patients—was left behind at the old site. Clinic proprietors had warned the relevant governmental authorities about the potential danger the device posed, but nothing was done. Part of the clinic was torn down, and the section of the building with the treatment rooms began to crumble. Homeless people began seeking shelter there. Over the course of 1987, a salvager of metal named Roberto dos Santos Alves heard rumors that there was plenty of valuable scrap at the site. On September 10, he and an assistant entered the building and discovered the perfectly intact Cesapan F-3000. Not suspecting any danger, and certainly not expecting radioactive cesium chloride, the two men disassembled the device over the next couple of days, unwittingly switching the Cesapan’s radiation head to the “treatment” position and causing it to emit steady bursts of radiation. The two men then transported what amounted to a rapid-fire radiation cannon in a wheelbarrow to Alves’s house and placed it under a mango tree. Shortly thereafter, both fell ill, assuming their sickness was related to something they had eaten. The assistant went to see a doctor, who diagnosed his diarrhea, vomiting, and swollen right hand as an allergic reaction. Meanwhile, Alves attacked the mysterious device with a screwdriver and punctured the capsule, about the size of a billiard ball, that contained the cesium. Mistaking the radioactive material within for gunpowder, he initially tried to light it on fire.
On September 18, Alves loaded up his wheelbarrow with parts from the Cesapan F-3000 and took them to Devair Alves Ferreira, the owner of a scrap-metal yard. When the latter entered his workshop that evening, he saw a strange bluish glow, which made him think that the material could be particularly valuable, and maybe even possess magic powers. He took it home for his family to admire, and in the days that followed, other relatives and friends came by to get a look at the mysterious glowing substance. Ferreira gave a portion of it to his brother and others close to him, and some of them rubbed it on their skin like Carnival glitter. Ferreira’s wife fell ill and went to a doctor, complaining of the same symptoms as Alves and his assistant. She too was diagnosed with a food allergy and sent back home with the instructions to get some rest. Meanwhile, the symptoms suffered by Alves’s assistant, Wagner Mota Pereira, had gotten much worse. He was taken to a hospital and then transferred to the Clinic for Tropical Medicine. Others patients with the same symptoms were soon to follow.
Ferreira’s wife Gabriela, whose condition was deteriorating day by day, was the first one to blame the mysterious powder for the illness. She persuaded one of her husband’s employees to gather up the remaining parts of the strange device and take them to a local hospital. The employee slung them in a plastic bag over his shoulder, suffering serious burns as a result. At the hospital, Gabriela Ferreira told the doctor on duty that a machine was killing her family. The doctor thought the radiation cannon was an X-ray machine and removed the plastic bag from his office, placing it on a chair near an adjacent wall. He then decided to consult with a physicist he knew who happened to be passing through Goiania. The next morning the physicist set off with a highly sensitive radiation detector, a scintillometer, to examine the suspicious scrap metal. The needle went off the scale before he had even arrived at the hospital. Thinking the device was defective, he proceeded to the local office of Nuclebrás, a public institution that monitors uranium mining in Brazil, and borrowed a second radiation detector. It too went wild before he reached the hospital. Realizing that something must be gravely amiss, the physicist convinced hospital officials to close the building. The fire department was called, and it took all of the physicist’s persuasive power to convince them not to just throw the scrap metal in the river. He then succeeded in retracing the Cesapan F-3000’s path back to the now totally contaminated scrapyard. Early that afternoon, the physicist paid a call to the Health Minister, and evacuations and other emergency measures were ordered.
Several houses, including the one belonging to Devair Alves Ferreira, had to be torn down. Tons of soil were dug up and taken away for disposal. The cesium, the plastic bag, and the chair were sealed in concrete and removed under the tightest security. In the city’s Olympic Stadium, more than 200 people with symptoms of radiation poisoning showed up to be decontaminated and treated. Ten critically ill patients were flown from the Clinic for Tropical Medicine to Rio de Janeiro for better treatment. But for some, help came too late. Gabriela Ferreira succumbed to acute radiation poisoning, and two workers at the scrapyard also died. Perhaps most tragically, Ferreira’s brother had given his six-year-old daughter Leide several grams of the glowing substance to play with while she was sitting on the ground eating. She, too, died of the effects of being exposed to radioactive cesium. The final toll of the Goiania disaster: four dead and dozens ill and injured. But without the quick action taken by the physicist and local authorities, this catastrophe would have been far worse.
Irresponsible handling of nuclear medical technology could also lead to an accident in the United States or Europe, if probably not on the scale of the one in Goiania. The biggest danger is not radioactive material left lying around, but rather a bizarre inheritance from the 1970s and ’80s. During these decades, scientists sent atoms on a very special trip through the human body, using plutonium to power pacemakers. This was a logical idea. The batteries in the first generation of pacemakers weren’t very durable and had to be replaced every two years. Researchers thought they might be able to adapt technology, developed by space agencies, that harnessed the thermal energy created when plutonium decays in order to generate electricity. Atomic batteries of the sort also used in nautical buoys and remote radio stations can be made in minute sizes. By the 1970s, scientists felt they had perfected the technology, and it didn’t require a great imaginative leap to picture such batteries powering pacemakers.
Plutonium 238, the element used in the batteries, has a half-life of 87.7 years—an atomic pacemaker thus lasted for a whole human lifetime without needing to be serviced or replaced. The radiation emitted did not harm the recipient, since plutonium gives off alpha particles. Whereas gamma rays can penetrate concrete walls, a piece of paper is enough to shield people from alpha particles, and in an atomic pacemaker, the poisonous radiation is contained within several sealed metal casings. It was highly unlikely that the plutonium would leak out and poison the patient. The situation was more problematic, however, when the patient eventually died. In our modern, mobile world, it is next-to-impossible to keep track of people. In 2009, for instance, an elderly Russian woman suddenly turned up at doctor’s office in the eastern German city of Halle, where she struggled to communicate in her broken German that she was wearing an atomic pacemaker, which had been implanted by Soviet doctors. Where the woman is now, and whether she’s even still alive, is unknown. Like other wearers of atomic pacemakers, perhaps she has died, and the plutonium-powered device is buried in a cemetery somewhere. Or the woman may have been cremated, in which case the pacemaker could have ended up in a garbage dump or in a home. This plutonium problem could have been solved had authorities kept tabs on where the people with atomic pacemakers lived and traveled. But neither the United States nor the Soviet Union—the two countries where the devices were implanted—was particularly diligent about documentation. Many of the pacemaker recipients, and with them the 200-milligram plutonium batteries, simply disappeared. No one knows where the lost pacemakers’ journeys ended.
Nonetheless, even if an obvious mistake was made in this respect, the pacemakers were an undisputed blessing to their users. The problem was simply that people failed to think through all the consequences. Despite individual accidents and shortcomings, the use of radioactivity in medicine has clearly been a great success. X-ray machines, radioactive contrast agents, and radiation therapy have revolutionized the diagnosis and treatment of many diseases.
Still, there were detours along the path of progress that took doctors to their ethical limits and even beyond. Radioactive substances were not always employed for morally justifiable purposes. At the beginning of the Atomic Age, some researchers felt it was acceptable to inject test subjects, including a four-year-old child, with plutonium. By the mid-1940s, the United States was producing industrial amounts of weapons-grade atomic material. Thousands of people were involved in the various phases of this process at the nuclear factory at the Hanford Site in the state of Washington or at the Los Alamos nuclear-weapons facility. Those in charge were concerned about their workers. Little was known about the effects of radiation, and scientists had not yet determined which exposure levels were tolerable and which represented health risks. At first, researchers carried out experiments on animals, but they soon discovered that the results didn’t necessarily apply to human beings. Atomic medical experts were interested above all in how much plutonium the body could eliminate after the substance had been ingested or absorbed. How good were our biological self-cleansing mechanisms? What percent of inhaled or ingested plutonium would be deposited within the body?
As Pulitzer Prize–winning journalist Eileen Welsome detailed in her chilling book The Plutonium Files, scientists in the United States tried to answer such questions by experimenting on thousands of human subjects. The researchers involved, some from prestigious institutions like the University of California, knew that there was no way they could attract volunteers for tests so obviously dangerous. Doctors, however, were not subject at the time to the strict code of behavior they are subject to today. There was no rule stipulating that physicians explain treatments to their patients. The researchers selected subjects who were undergoing treatment in hospitals for serious conditions and who were usually, though not always, considered terminally ill. Under the pretense of treating the patients, researchers injected them with poisonous, radioactive substances—sometimes in minute quantities, sometimes in larger doses. The patients had no idea they were being used as guinea pigs in a large-scale experiment. At regular intervals, the researchers took blood, stool, and urine samples and measured the amount of plutonium that the patients’ bodies had eliminated. One of the eighteen subjects in the first series of experiments was a four-year-old Australian boy named Simeon Shaw, who suffered from leukemia. His parents had him flown to the United States so that he could get the latest and best treatment, but instead of trying to save his life, doctors injected him with a cocktail of plutonium 239, yttrium and cerium. Shortly after returning to Australia, he died an excruciating death.
The cynical calculations underlying this top-secret project, however, had a flaw. Some of the subjects who the researchers thought were terminally ill survived their diseases and were eventually discharged, unaware that their bodies now contained radioactive substances. One subject—a twenty-four-year-old woman named Mary Jeanne Connell—was used as a guinea pig even though she was nowhere close to dying. She had checked herself into Strong Memorial Hospital at the University of Rochester in New York for anemia and low weight. There she got a nasty surprise. A nurse showed her some laboratory rats, mice, and rabbits in cages and asked her if she wanted to “help humanity.” Thinking it was a joke, Connell laughed and declined. Nonetheless, when she woke up on the morning of October 1, 1946, she found herself strapped to a gurney, surrounded by doctors. One of them held a needle full of orange fluid that seemed to make the physicians skittish. This was injected into Connell’s bloodstream. The ampule contained uranium salts, exposing Connell to a level of radiation fifty-seven times as great as the average person would absorb in a lifetime. Years later, she remembered that her body felt like it was lying on hot coals for a couple of days. She nearly lost consciousness. She was kept in the clinic for weeks. A woman watched over her at her bedside day and night.
By 1997, Connell was the only survivor among twelve people known to have been subjects of involuntary experiments at Strong Memorial. The United States government’s human radiation experiments are rightly considered the most shameful chapter in the history of American medicine. As many as 20,000 people may have been subjected in some form to involuntary tests, some of which were carried out long after World War II. In some cases, radioactive substances were injected. In others, the test subjects were made to swallow or inhale radiation. In still others, the test subject’s entire body was bombarded with radiation from a large machine concealed within the wooden paneling of a room.
The methods used were similar to those employed by the secret police in Communist East Germany at their prison in the town of Gera. After the end of the Cold War, a concealed X-ray machine was discovered in a room in which inmates were photographed. The machine was pointed straight at the backs of the prisoners’ heads. Several former East German dissidents have speculated that they were intentionally exposed to radiation as a form of punishment.
Prison inmates in the United States were also bombarded with radiation, as were children in a home for the mentally handicapped. Another group affected were the Inupiat Eskimos in Alaska. In 1950, near the Brooks Range, once the proposed site of Project Chariot and an underground nuclear test, the Inupiat were given pills full of iodine 131 under the pretense of explaining to them how their bodies worked. In fact, the researchers wanted to learn more about the effects of the radioactive substance. In 1996, by way of compensation, the Inupiats were promised a free medical examination, but this was surely insufficient to restore their faith in the government and its medical system.