Barry Perlman
New York, New York, United States

For much of my eighty-one years, the threat of nuclear war remained a subliminal fear. Recently, its possibility has roared back into my consciousness. The commemoration of the eightieth anniversary of the first, and we pray last, uses of the atomic bombs in war, along with bold headlines announcing revived nuclear saber rattling, the expiration of nuclear arms treaties, and the resumption of nuclear weapons testing, stirred anxiety and curiosity about what from those apocalyptic events resonates today.

On August 6, 1945, the first atomic bomb, named “Little Boy,” was dropped from the Enola Gay, a US B-29 Superfortress bomber, over Hiroshima. Three days later, a second atomic weapon was detonated over Nagasaki. Emperor Hirohito announced Japan’s surrender on August 15, and the Instrument of Surrender was signed on September 2, 1945. It is noteworthy that there was no special remembrance of Operation Meetinghouse, the name given to the firebombing raid on Tokyo on March 9–10, 1945, which killed an estimated 100,000 people in one night. We humans now attach unique dread to the devastation caused by nuclear weapons, surpassing anything else of which we can conceive.

A tradition exists of doctors writing about their own and patients’ fragility, survival, and resilience. As a physician trying to appreciate the human toll of what befell Hiroshima and Nagasaki and how it was processed, I gravitated to the memoirs of three doctors, one Japanese and two Western, whose writings collectively covered the period from August 6 through December 1, 1945.

Dr. Michihiko Hachiya, who lived just a mile from the detonation’s hypocenter, vividly conveys his shock and suffering along with his sense of a doctor regaining his professional perch through his clinical concern. His memoir, which encompasses the interval from August 6 through September 30, describes the harrowing event and then a record of life gradually regaining its recognizable rhythm. Exhausted from night duty as an air warden, his granular diary entries tell how he was startled by the pika, the bomb’s strong flash, and then enveloped by a dust cloud that obscured his demolished home. He cared little upon finding himself naked. Immersed in a nightmare, he moved slowly while his mind raced. Despite all, he felt a duty towards his staff. Self-reflection revealed an unfamiliar dulled sense of empathy. He quickly became reconciled to an environment of chaos and despair. He recorded his medical symptoms and those of survivors who arrived at his hospital, initially attributing their bloody diarrhea to dysentery. Those thought to have dysentery were quarantined. Taking action lifted morale. As though a character in a science fiction novel, Hachiya wondered whether the bomb was a newweapon that had thrown off poison gas or deadly germs. Mundane concerns became indicators of recovery. Within days, he was pleased to note the return of his wife’s vanity and his medical curiosity.

Despite all, Hachiya and his countrymen remained patriots at war. Russia’s entry into the war against Japan had precipitated crushing chest pain, a manifestation of Hachiya’s hopelessness. His emotions rebounded when a rumor spread that Japan too possessed and used the mysterious weapon against America. Believing the tide of the war might be turned, they became ebullient. Days later, the Emperor’s announcement of the war’s end evoked despair, the word surrender eliciting greater shock than the bombing. Hachiya’s emotions whipsawed through periods of psychic numbing, reactive mood elevation, and sadness all tied to the bombing, their undiminished wish for retaliation and victory, and the shame of defeat.

By a quirk of fate, Dr. Marcel Junod, a Swiss national representing the International Committee of the Red Cross (ICRC) flew to Japan on August 9. His mission was to review Japan’s treatment of prisoners of war. Once Japan surrendered, his role changed to organizing the evacuation of POW camps and rescuing severely injured Allied prisoners. By August 14, Japanese investigators found the radioactivity was below hazardous levels in Hiroshima. On September 9, Junod, traveling as part of a commission of inquiry, became the first foreign physician to reach Hiroshima. They flew over the then nonexistent city a day before entering it. He remained for five days, during which he delivered medical relief supplies and visited area hospitals and patients. Junod’s delegation was joined by Japanese doctors including Professor Masao Tsusuki. Tsusuki, who was to play an important liaison role to Western medical delegations, was Professor of Surgery at the Imperial University of Japan and had been an Admiral in the naval medical corps. Having studied oncology and radiation therapy at the University of Pennsylvania in the 1920s, he spoke English perfectly. Tsusuki recounted how in 1923, when studying the use of radiation to treat cancer, he exposed a rabbit to a Coolidge X-ray tube. The rabbit appeared unaffected for several hours before convulsing and dying. An autopsy revealed that the animal’s internal organs all displayed signs of hemorrhage. He reported his findings at the American Radiological Society in 1926. “Tomorrow when you go to Hiroshima you will see the upshot of my experiment, 80,000 dead and 100,000 wounded. The effects of the atomic bomb are almost exactly the same. The magnitude of the experiment is … far greater, but that’s all.”

Tsusuki guided Junod’s group around the devastated city, talking of the patients as he had talked of the ruins. Of one woman he said, “Infection of the blood … White corpuscles almost entirely destroyed. Gamma rays. Nothing to be done about it. She’ll be dead this evening. That’s what an atomic bomb does.” The professor, abjuring discretion, said, “Yesterday it was rabbits; today it’s Japanese.” As they toured, Junod observed a little grass beginning to sprout amidst the ruins. In 1979, a monument was inaugurated in honor of Junod in the Hiroshima Peace Park.

Averill A. Liebow was a pathologist serving with the 39^th General Hospital, the “Yale Unit,” who flew to Tokyo on September 20 and on to Hiroshima, a city that no longer appeared to exist despite the haunting movement of empty streetcars through desolate streets, on October 12. In Tokyo, recovery from bomb damage was already evident, with the shops along the Ginza bustling. Japanese professional counterparts were assured that their post-war professional advancement would be unimpeded. Liebow described the “terror of the invisible” upon learning of the atomic nature of the explosion. The American team’s mission was to study the casualties, living and dead, whether caused by radiation, blast, or burn; determine protective factors; collect clinical and pathological evidence; and prepare a report on the medical effects of the atomic bomb. They noted that people who had been close to the hypocenter, but had suffered neither burns nor trauma, sickened and died from radiation.

As early as October 19, Liebow writes, “It is astonishing and a tribute to the resiliency of the people, that even at this early time the city is showing signs of revival. The attitude was definitely no longer one of paralysis but one of encouragement and hope despite privation.” The investigators settled into a routine of hard work punctuated by leisure. One Sunday, the binational team enjoyed a luncheon served by charming kimono-clad ladies on a nearby island. Liebow optimistically writes, “Friendships glow; national differences are forgotten; the horrors of the War and the intensity and strain of the work are far below and behind.”

Hachiya and Liebow conclude their diaries very differently. On September 29, the first birth since the pika occurs at Hachiya’s hospital. Hachiya celebrated when the baby appeared completely normal. He summarized, “I am a Buddhist and since childhood have been taught to be resigned in the face of adversity. I have lost my home. I was wounded, but disregarding this, I consider it fortunate my wife and I are alive. I am grateful for this.”

However, the effects of the atomic bombing revolted the Americans. Liebow, in his conclusion, abandons his dispassionate voice to articulate his moral concerns. Presaging long running arguments about America’s use of atomic weapons, he asks whether they had been accessories to a crime against mankind. But, he asserts that once the deed was done, even though it was born of tragedy, there was a moral duty to study and learn from it. Ultimately, the partnership of the American and Japanese researchers transitioned into the work of the Radiation Effects Research Foundation.

Reading these medical memoirs revealed the horrors of August 1945. Unexpectedly, what I read in the wake of nuclear calamity reminded me of what survivors of natural calamities commonly express. Overwhelming loss notwithstanding, they often express gratitude for their miraculous survival. In the midst of ruin, they declare their resolve to rebuild, somehow discerning a path into their future. Those are essential qualities of human resilience. The recovery began almost immediately. Infrastructure was rebuilt, people returned, and within a decade, the nuclear-bombed cities regained their pre-war population levels.

I fear that the resilience demonstrated by the citizens of those cities could be purposely misconstrued. For example, in 2024, Elon Musk seemed sanguine about potentially enduring the risks of a nuclear reactor emergency, comparing nuclear plant fallout to the fallout of the bombings of Japan: “Hiroshima and Nagasaki were bombed. But now, they’re like full cities again … So, it’s not as scary as people think, basically.” Well, yes, it is that scary! The apocalyptic horror of what happened may be too facilely rationalized away. The shrinking of moral and political restraints on the testing or use of nuclear weapons represents a terrifying reversal of humankind’s halting progress towards avoiding their usage. Yes, ordinary people are resilient, but they should never again be forced to recover from such devastation.

References

• Hachiya, M. 1955. Hiroshima Diary: The Journal of a Japanese Physician August 6 – September 30, 1945. Chapel Hill, University of North Carolina Pres.
• Junod, M. 1951. Warrior Without Weapons. London, Jonathan Cape, Ltd. 1982. Geneva, Reprinted with permission by the International Committee of the Red Cross
• Liebow, A.A. 1965. “Encounter With Disaster – A Medical Diary of Hiroshima, 1945.” The Yale Journal of Biology and Medicine 38 (2): 61 -239
• Interview: Elon Musk speaks with Donald Trump on Platform X – August 12, 2024; Time 1:17: 01-06. Roll Call Factbase. https://rollcall.com/factbase/trump/transcript/donald-trump-interview-elon-musk-x-twitter-august-12-2024/