Roads to Oz. I. A Personal Account of Some U.S.-USSR Medical Exchanges and Contacts, 1942-1962 Michael B. Shimkin Perspectives in Biology and Medicine, Volume 22, Number 4, Summer 1979, pp. 565-586 (Article) Published by Johns Hopkins University Press DOI: https://doi.org/10.1353/pbm.1979.0029

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ROADS TO OZ. I. A PERSONAL ACCOUNT OF SOME

U. S. -USSR MEDICAL EXCHANGES AND CONTACTS, 1942-1962* MICHAEL B. SHIMKINf

Over many hills and dales Far beyond the seas and vales Opposite the sky, on earth. . . . [Peter Ershoff, Konek Gorbunok] I. Arctic Prelude

The Soviet Union, née the Russian Empire, is the largest political area in the world, occupying almost the entire northern quarter of the Eurasian land mass. On the map, the midpoint of a line drawn between the

western and the eastern boundaries of the country will rest close to a dot labeled Tomsk. In this dreary town in a harsh environment I was born in

1912. On many subsequent occasions I have given prayerful thanks for the fact that I was no longer there. Yet it is the accident of my birth, to a Russian physician mother and a civil engineer father, and the fleetness of foot of my parents during the holocaust of the Russian Revolution, that eventually led me to participate in a series of adventures in medical exchanges between the Soviet Union and the United States. My qualifications, in addition to retention of a rather childish level of the Russian language, were a medical education and medical research involvement at the National Cancer Institute. I held a commission in the

Public Health Service, at its lowliest rank. There was only one other officer in the service in 1942 who spoke Russian. He was an older man in the Reserve Corps who had written a book on his experiences with the *Part II will appear in the autumn issue of Perspectives. Prepared with the support of

contract NIH 263-76-C-0419 from the National Cancer Institute.

•(•University of California, San Diego, Department of Community Medicine, School of

Medicine, La Jolla, California 92093.

© 1979 by The University of Chicago. 0031-5982/79/2204-0093$01.00

Perspectives in Biology and Medicine ¦ Summer 1979 | 565

White armies and the pleasures of shooting Bolsheviks; he was not considered to be a suitable liaison instrument with the Soviets.

So it came to pass that on October 10, 1942, there was delivered a letter from the Office of Strategic Services (OSS) to the National Institute of Health (NIH) requesting "by higher authority" that someone prepare a report on Russian experiences in physiological adaptation to

extreme cold. The deadline was 3 weeks. It did not take long for the

marching orders to filter down to me and for me to make a beeline to the

Congressional and Army Medical Libraries in Washington and the Welsh Memorial Library in Baltimore. There on the shelves, gathering

dust, were over a half-dozen Russian journals on the Arctic, each containing relevant references to health and medical situations under arctic

conditions. The extent of the writings, seemingly unknown to people presumably knowledgeable in the field, was mildly surprising. So was one American book on the subject describing the Soviet Arctic convict camps as a species of rest and rehabilitation centers. The author turned out to be a close friend and adviser to the secretary of the Department of the Interior.

The factual information, however, was scant and predictable. The Arctic is a tough environment, requiring that special consideration be given to the clothing, food, and psychological reactions of men assigned there. The Russian literature on the subject stressed the need for vitamin

supplementation, especially of vitamin C, and several papers indicated that conifer needles could be used as sources of antiscorbutic remedies.

Characteristic psychotic manifestations called "menerik" and "emiriak" were considered to be forms of hysteria.

Additional information was sought from a Red Cross representative

who had spent some time in Siberia and from Ales Hrdlicka, the worldrenowned anthropologist at the Smithsonian Institution who contributed extensively to studies of the prehistoric migration of man to America from Asia. Exactly on the deadline date, a report of 1 1 pages

and 23 references was forwarded through channels and disappeared into the maws of the system.

Six months later, a report of some 50 pages, entitled "The Effects of Arctic Conditions upon Human Behavior and Reactions with Special Emphasis upon Russian Findings and Expeditionary Needs," with authors not identified and bearing the mildest stamp of confidentiality, was received for a critical review. It reiterated and extended the information

and served to encourage more attention to studies of the Arctic.

II. American-Soviet Medical Society Soon after the OSS experience I received a telephone call from the

surgeon general, Thomas Parran (1896-1968). "Mike," he said, "would 566

Michael B. Shimkin ¦ Roads to Oz. I.

you go and see Henry Sigerist for me? He wants me to sponsor his

American-Soviet Medical Society." This was vintage Tom Parran: no intermediary secretaries, direct contact with a very junior officer, and

disregard of channels. Henry Sigerist (1891-1957), professor of medical history at Johns

Hopkins, was called, and next day I appeared in his book-filled office. Sigerist, as usual, was jumping with enthusiasm, optimism, and uncontainedjoie de vivre. A roly-poly Swiss scholar, he spoke a dozen languages

and was at home anywhere in the world. He was also an expert on wine and in how to annoy the American medical establishment. His ideas against fee-for-service, what-the-traffic-will-bear schemes for medical

payments and his socialistic schemes for community-based healthprotection plans were anathema. Worse yet, he had visited the Soviet Union and had written a book that was complimentary to its health system [I]. All this made him "unclearable" for government service.

Sigerist informed me that the American-Soviet Medical Society was formed in the glow of the new war friendship of the two countries, but would try to eschew the political and propaganda elements so evident in the American-Soviet friendship groups that were springing up. The proposed officers of the society included such luminaries as Walter Cannon as president, Leo Eloesser as vice-president, and Abraham Stone as secretary. A reviewjournal, with Sigerist as editor, was to be initiated. As

soon as Sigerist learned of my involvement in cancer research, he vol-

unteered me to prepare an article on cancer research in the Soviet Union.

My verbal report to the surgeon general was that this seemed to be a

valid medical group; I added the usual caveats against overenthusiasm and described the possible pitfalls. Parran instructed me to act as an informal observer and his representative to the group. So, it was back to the libraries for me, this time to dig in Russian journals for a review of their cancer research [2]. In addition to the

mouse research at the National Cancer Institute at Bethesda and liaison

with the Tumor Clinic at the Marine Hospital in Baltimore, the assignment to the American-Soviet Medical Society now took me on occasional trips to New York.

The first issue of the American Review of Soviet Medicine appeared in October 1943. Under its editor, Henry Sigerist, and its printer, Robert L. Leslie, it did reasonably well for four volumes, not only in publishing

original papers about Soviet medicine but in being a conduit to other journals, in many instances translating the manuscripts from Russian into English. The publication avoided propaganda as assiduously as possible, and all contributions went through peer review. But as the international climate between the United States and the Soviet Union grew

colder after the war, interest waned, and the contributions from the

Soviet Union dwindled and came to a complete halt. By winter of 1947 Perspectives in Biology and Medicine ¦ Summer 1979

567

the end had come, despite Sigerist's exhortations; the fifth and last volume was a thin product of less than 200 pages. The American Review of Soviet Medicine was a brave effort and, even in retrospect, a worthy and useful one. Had it been supported by governmental funds for its potential value in biomedical science, and as a

translation program of Russian medical literature, better knowledge and understanding of Soviet medical sciences would have been maintained. The need for such knowledge shocked the scientific community of the

United States when the Soviets, within the following decade, exploded the atomic bomb and launched Sputnik. The American-Soviet Medical Society paralleled in its course the fate

of its publication. The core of the society remained in New York, although branches were established in five other cities. Walter Cannon (1871-1945), then in declining health, was succeeded by Stuart Mudd

(1893-1975) of Philadelphia as president. Abraham Stone (1890-1959), the gentle, Russian-born medical director of the Margaret Sanger Clinic, and author with his late wife of a sex manual that emphasized love rather

than acrobatics, was its perpetual secretary. Robert L. Leslie, the publisher and "Uncle Bob" to a host of lost artistic souls, made his composing

room on Forty-sixth Street in New York the headquarters for the society and greeted Russian medical visitors with generous hospitality. Jacob Heiman, a practitioner with long cancer-research involvement at Co-

lumbia University, was another key participant in society affairs.

On the Soviet side, the main link, adviser, and participant was Vladimir V. Lebedenko. Lebedenko had the official title of representative of the Soviet Red Cross and Crescent and was attached to the Soviet Pur-

chasing Commission in the United States. The commission was housed

in a downtown Washington apartment house, through which the aroma

of cabbage soup drifted down from the living quarters on the upper floors. Lebedenko lived there with his wife and a young daughter. My first contact with Lebedenko was in connection with a request to

look into a requisition from the Soviets for ascorbic acid, in ton amounts. I located the only medical man on the commission and met a worriedlooking, solid man with tousled hair and horn-rimmed glasses,

dressed in a heavy suit and thick shoes. He spoke but a few words of English. We soon established a personal relationship in Russian. He was

a professor of neurosurgery who had been in Leningrad during the siege ofthat city. The siege had been lifted in January, and his hands still shook from his experiences. We talked of the war, music, and his impres-

sions of America, and he began to correct my Russian. As for the ascorbic acid problem, the Soviets wanted it in powder

form, whereas our production was geared to turning out tablets of the stuff. The impasse was eventually resolved, but I lost track of it. Lebedenko appeared impatient of his and our bureaucracies, but ac568

Michael B. Shimkin ¦ Roads to Oz. I.

cepted the fact that the tablet form could be delivered immediately, whereas the powder form would be delayed.

Then, and on numerous occasions during the next 4 years, Lebedenko did not flaunt communism or try to convert me to his political views. Correct, businesslike, and increasingly stolid, it was only when he suffered a coronary occlusion that he displayed emotion. This emotion was

evoked by concern for his wife and his growing daughter and how they

would be treated in the Soviet Union. He did die soon after his return,

and I was told that his family was not touched by Stalin, as so many of his servants were after they had been suspiciously friendly to the United States.

Lebedenko participated in all meetings and ceremonies of the American-Soviet Medical Society and appeared to represent the Soviet medical interests here, making many American friends. The medical officers who were attached to the Soviet Embassy obviously recognized him as their superior.

The high point of the American-Soviet Medical Society was probably its second annual meeting in Philadelphia on December 15, 1945. Greetings were received from the White House and from Moscow. The scientific program included Wilder Penfield, I. S. Ravdin, Harlow Shapley, and other medical leaders. Representing Parran, I forecast the formation of an international health agency. The flush of victory and

friendship did not last and was soon to be replaced by the Cold War and

the Iron Curtain, neither entirely of unilateral origin. My participation in the activities of the American-Soviet Medical Society had several consequences. First, I developed lifetime friendships with a group of medical people whom I admired and who fully deserved admiration. Second, I had to answer some silly questions to a committee during the witch-hunting days of the unlamented Senator Joseph

McCarthy. Third, my appetite for information about Russia and the

Soviet system grew unabated, as U. S.-USSR relations obviously held the key to world peace. Last, it provided me with the opportunity to be a member of a medical mission to Moscow.

III. Medical Research Mission, 1944 It was late in October 1943, as I was sitting quietly in my laboratory at

the National Cancer Institute, that I received another call from the sur-

geon general's office. I was to be visited by someone from the Office of

Scientific Research and Development (OSRD) about the possibility of my going on a medical research mission to the Soviet Union. My participation, if I were selected, was approved. It was several years later that I learned that Parran had prevailed in having me designated as a full member of the mission rather than as a secretary-interpreter.

Perspectives in Biology and Medicine ¦ Summer 1979 | 569

Within an hour, A. Baird Hastings, professor of physiological

chemistry at Harvard and member of the medical committee of OSRD, appeared in person. He was a sparse man with a ready smile and expressive hands, with the informal and somewhat disheveled look favored by Ivy League faculty. "This morning," he began after the briefest of preliminaries, "I re-

ceived the first copy of the American Review of Soviet Medicine and there was an article by you in it. We are looking for a Russian-speaking scien-

tist to go on a mission to Moscow, and Dr. Parran thinks you are the man."

That evening my wife bravely agreed that this was important and that she could manage without me. And next morning I laid aside my uni-

form for a civilian outfit and reported at the National Academy of Sci-

ences building. The Public Health Service varied its uniform from the navy to the army type, depending on assignments. It was not long before a neighbor

reported my changes in attire to police, who squelched rumors of espionage. This could not be reflected in my eventual Soviet dossier, where I may still appear as a shpion, or spy. Years later, one of my medical

Soviet friends indeed did refer to me as "one of our favorite spies." At the academy, I met A. N. Richards, the scholarly pharmacologist

from the University of Pennsylvania who was chairman of the OSRD

medical committee. Of his many achievements, perhaps the greatest was the early recognition of the potentials of penicillin. By mobilizing brewing technology and attracting sufficient funding, a laboratory procedure developed by British scientists became a practical reality that saved as

many lives as were lost during the war. Richards was a polite gentleman and asked me whether I would mind a little quiz on my Russian abilities. This occurred in the wedding-cake building to the right of the White House, which then housed the Department of State. Charles ("Chip") Bohlen greeted me in Russian in his dark, oak-paneled office, and we discussed cigarettes and the weather for all of 5 minutes. "Well," he said, "you know Russian better than I do." The examination was over.

I was given a desk and a formidable pile of papers stamped with large

red letters—"restricted," "confidential," and, later, one marked "secret."

That file was on British antilewisite (BAL), for war gas. Hastings and

others briefed me on the mission, which had been under negotiation for many months, first among the United States, Great Britain, and Canada and then with the Soviet Union. The Soviet Union was not anxious to

receive a mission; what it wanted was the information and the products.1 1E. H. Beardsley's "No Help Wanted: Medical Research Exchange between Russia and the West during the Second World War" [3] provides an interesting review of the negotia-

tions.

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Michael B. Shimkin ¦ Roads to Oz. I.

The Canadians decided to have the British represent them, and the

United States insisted on personal contacts with a more lasting liaison in mind. The specific topics for discussion also were matters of consider-

able negotiation. So the mission shook down to Baird Hastings and myself from the United States, and, for Britain and Canada, Howard Walter Florey, later

to share a Nobel prize and to become a British lord for his work on penicillin, and his assistant, A. G. Sanders. The 10 topics for exchange were BAL, penicillin, typhus vaccine, blood plasma fractions, atabrine, surgical problems of wounds, burns, and shock, insecticides (especially DDT), sterilization of air by glycol vapors, dermatophytosis (or the lowly athlete's foot), and aviation goggles.

The topics generated a thick stack of documents, all of which had to be arranged, cleared, and rechecked. We also were to bring 150 million units of penicillin, plasma fractions, and a sample of arctic clothing developed by the army, which we hoped to exchange for similar Soviet items. We were outfitted with pile hats, coats, trousers, socks, underwear, felt boots in thick rubber overshoes, a parka with a hood, double mittens with a trigger finger, and sleeping bags. With all that apparel, every movement was difficult. Informally, there was also a request for some

inbred strains of mice, but we decided against adding livestock to our encumbrances.

Late in November 1943 the Air Transport Command gave word to proceed to England, where we were supposed to pick up Soviet visas. The document pouches were sealed, our personal effects packed, and

Baird whispered to me that he had a personal letter from President Roosevelt in his pocket.

We expected to be back in a month. It took us 50 days to reach Moscow.

We cooled our heels in London, adjusting to the battered city and British food by visits to academic and research facilities. Hastings held

conferences on BAL at Oxford and renewed his acquaintances at the

Royal Society, where he learned that Niels Bohr had escaped from Denmark, denying the Germans that source of atomic knowledge. I visited the Imperial Cancer Research Fund, where William Gye was concluding his career of unsuccessful espousal of the virus causation of cancer and trying to convince the British public that the latest cancer cure, H11, was useless. We met Florey after he delivered a lecture to the

Royal Society. A precise, cold man, he immediately struck sparks from Hastings. I defined my role in the group by calling Hastings "boss." We attributed the delay in Soviet visas to the Teheran Conference.

When Ambassador Winant returned from the conference, he advised us

to go ahead. We proceeded to North Africa, which by then had been cleansed of German forces, visited the U.S. Typhus Commission, and

Perspectives in Biology and Medicine ¦ Summer 1979 | 571

flew on to Abadan and then to Teheran. There we sat for a fortnight because the weather was such that, as the air force insisted, even the

birds were walking. Florey and Sandersjoined us at Teheran 2 days after

Christmas. Florey promptly developed chills and a fever, diagnosed as

influenza, and insisted on being hospitalized in American rather than British facilities. Intourist, the Soviet visitor's bureau that handles all

arrangements for foreigners, finally called to inform us that the visas had arrived, and transactions proceeded for tickets and currency exchange. On January 13, 1944, we were at last to penetrate into the USSR;

Florey and Sanders were to follow as soon as Florey was able. Now, at last, we really were to engage in medical diplomacy and to learn the facts about some of the wonders of Soviet science being reported by the few journalists who were tolerated in Moscow. These wonders included the

resuscitation of dead dogs; the grafting of extra heads on dogs; use of cadaver blood for transfusions; a rejuvenating serum, ACS; and a cancer

remedy, KR, derived from trypanosomes. We were hoping to be the first of scientific exchanges that would open the doors between our countries following the victorious conclusion of the war. The Soviet airplane was a Douglas C-47, piloted by a major whose

chest, from one armpit to the other, was covered with large, enameled medals. The airplane hopped and strained over the Elburz Mountains and deposited a shaky group of passengers in Baku, ostensibly for lunch. The next stop, after a smoother flight over the Caspian Sea, was Astrakhan, once a center for the Mongolian overlords of Russia, now a

primitive collection of dilapidated wooden houses and cobblestone streets, surrounded by zigzag trenches and a few concrete emplacements. The Hotel Moscow, where we were to spend the night, was not

prepared; the rooms were unheated and some food, plus a bottle of

vodka, arrived 5 hours later. The staff, consisting entirely of women, was apologetic.

The passengers took a postprandial walk through a neglected park with broken plaster statues of Soviet heroes. The night was broken by announcements of Soviet victories and triumphant songs over a

loudspeaker on the corner of the hotel, blaring at the loudest possible volume which produced an unintelligible cacophony.

Next morning, bleary eyed after a breakfast of tea and cheese, we boarded the bus to the airport. Two hours later we landed on the sacred soil of Stalingrad, where the Russians had broken the back of the Nazi

beast. There was no city left, only rubble, and we were instructed not to wander off the airfield pathway because high explosives were still being encountered.

In another 3 hours we were in Moscow and were soon ensconced at

the National Hotel. The hotel was next to the building occupied by the 572

Michael B. Shimkin · Roads to Oz. I.

American Embassy at that time. Our room had a view of the Red Square and Lenin's tomb. The room was comfortable, in the style of the

nineteenth century, with heavy drapes, a large carved desk and an elabo-

rate desk set and lamp, a tapestried closet, and inlaid tables. The bathroom was adequate and contained toilet paper that was no worse than what passed for toilet paper in England. There was no soap, and hot water was limited to alternate days. We took a quick bath, fell into bed, and slept. Our arrival on a Friday gave us the weekend to get acquainted with our representatives, including Ambassador Harriman. We immediately received two opinions of how to proceed. One was to hand out to the Soviets our reports and materials one at a time and expect reciprocation; the other was to turn over all we had and not engage in haggling. The latter course prevailed. We met the controversial General Deane, who was considered too pro-Soviet, and the medical and dental officers whose functions were to take care of the American colony. In the even-

ing, there were tickets to the opera, and we were promptly seduced by the excellence of the ballet and the music.

Stalin's preference for working at night was reflected by the Soviet bureaucracy; its workday started in late afternoon. It was after 5:00 p.m. on Monday that we were driven to Narkomzdrav, the National Commissariat of Public Health. There we met our official host, Vice-Commissar

Vasily Vasilievich Parin, and delivered to him the reports we had brought. Parin was a dignified, soft-spoken man of 40, with prematurely white hair. He spoke English with but little hesitation and was obviously well educated and cosmopolitan. He had been professor of physiology in Sverdlovsk before his designation as a vice-commissar for research at

Narkomzdrav, and he was organizing the Academy of Medical Sciences.

Parin's life was to be seriously affected by his friendship with us and by his espousal of international relations between medical scientists. Our initial conversations with Parin, and all subsequent contacts,

seemed free of political undertones and on a scientist-to-scientist basis. Yet on some topics, in which the Soviets were less informed, a translu-

cent curtain would descend between us, and by mutual unspoken consent we would delve no further. Thus, even with the most westernized of

their leaders, one became involved in a game of charades, and certain words acquired additional meanings and were perceived as danger signals.

We waited for 3 more days while Parin set up a schedule based on the reports we brought. This gave us a chance to become acclimated to our

environment, the heavy Russian hotel food, and the embassy staff and to await the arrival of Florey and Sanders.

Then, for 3 weeks, we went on a round of visits and conferences, with

Perspectives in Biology and Medicine · Summer 1979 | 573

just enough time in the evening to write up our impressions and to prepare for the next day. Everything was carefully recorded in two documents, one an informal diary of the trip and the other a 96-page official report that was classified as confidential. Following declassification in 1945, our experiences were published in Science [4—6]. By that

time, the Supreme Soviet had abolished the title of "commissar" and substituted the Western equivalent of "minister," but the report retains at least some historical importance. Biographies of Florey [7] and of Hastings [8] contain brief mentions of the mission. We were anxious to obtain an understanding of the philosophy and the organization of Soviet medicine and medical sciences, and our discussions were aimed in this direction as well as at the specific topics on

the agenda. Actually, we learned little if anything new in regard to specifics. American and British technology were obviously superior. The

applications of such technology to the needs of the population, however, seemed more rational under the Soviet system, at least on paper. There was definite emphasis upon preventive medicine in the Soviet Union that was lacking in therapy-oriented Western medicine. The sys-

tematic regionalization of medical delivery also seemed rational and ef-

fective, in contrast with the lausez-faire approach in the United States. Two other characteristics were evident. One was that the Soviet system was not static, but in a constant state of revision. The other was that the

United States served as a model for many of its medical considerations. The medical school curriculum, as an example, resembled the plan followed by American medical schools, although it was divided into three

tracts, of therapeutic, maternal-child, and public health specialization

[9-11]. The similarity of the basic curriculum was not an accident, but

followed the reorganization proposed by Nikolai I. PropperGraschenkov, who had spent a year as a research fellow at Yale University, under John Fulton. The Soviets specialized in research institutes for specific medical topics as the organizational approach to medical research. There were 223

such institutes in 1941, many grouped under VIEM, the Ail-Union Institute of Experimental Medicine, a rough equivalent of the NIH of the United States. This grouping, encompassing autonomous institutions, was being reorganized, with the more prestigious institutes being as-

signed to the new Academy of Medical Sciences [12] and institutes concerned with practical topics of public health application being placed under the direct control of the Ministry of Public Health, via the Medical Research Council. Of course, the top scientific group of the nation was the Academy of Sciences, USSR, which also had its institutes and re-

gional affiliates in each of the republics making up the Soviet Union. We did not learn of any practical developments in medical research which we regarded as definitely superior to developments made by 574

Michael B. Shimkin ¦ Roads to Oz. I.

American and British scientists. The Soviets had an outstanding organi-

zation for the rapid supply of blood to the front. For this, large numbers of donors were the source of fresh blood. The cadaver source was ex-

perimental, limited to the Sklifasovsky Hospital. The Soviets thought that their mouse-lung type of typhus vaccine was superior to our egggrown vaccine and also accepted the principle of attenuated, live vaccines rather than depending on the killed preparations that were more

acceptable in America. They had a penicillin, derived either from one of the American strains or from one of their own, which Florey found to be

quite inferior to our products. The Soviets were not acquainted with DDT; their insecticide was an evil-smelling xanthene, a German discovery which was called "preparation K" and used in soap or as a clothing-impregnating agent. Nor did the Soviets know about BAL.

Their chemical for use against arsenical gases was urea peroxide, an oxidizing agent.

If the mission were judged on the basis of exchange of technical information, we had derived very little. Of course, both DDT and BAL soon appeared in the open literature, so the secrets, if any, were very temporary; DDT was a Swiss discovery. It was our hope that the real success of the mission would be to open new channels of lasting com-

munication between our scientific communities, a hope not entirely shared by Florey. In any case, the hope foundered on the realities, or developments, of the political postwar period marked by Stalin's excesses and America's suspicions. Cancer research was not centralized or emphasized in 1944. Oncologic

institutes were treatment centers for patients with cancer. The oldest cancer institute was in Leningrad, headed by the doyen of Soviet oncologists, Nikolai N. Petrov (1876-1964). The experimental pathologist L. M. Shabad had been evacuated to Moscow and there continued his

studies in carcinogenesis with three young assistants, including Helene Pogossiantz, a geneticist who was instrumental in obtaining four inbred

strains of mice from the United States. Only two strains had survived the trip, and on our return we arranged to send replacements. The Soviet inbred strains of mice were derived from these shipments. As for the dramatic achievements reported byjournalists, the attitudes

of the Soviet scientists we met in Moscow were as reserved as ours,

although criticisms were cautiously expressed. The Bogomoletz ACS (anticytotoxic serum), said to stimulate wound healing and prolong life, was a contemporary version of connective-tissue stimulators and not

seriously considered despite the venerable reputation of its sponsor.

Questions about the anticancer preparation KR were turned aside as premature. The famous double-headed dogs and dogs brought back

from death were looked upon as laboratory tricks with only remote applications. Lena Stern's treatment of shock by intrathecal injection of Perspectives in Biology and Medicine ¦ Summer 1979

575

potassium phosphate was not used by the surgeons we interviewed. In general, Soviet medical science did not seem to be very different from ours. Their top figures would have reached top positions in other countries: V. A. Englehardt was a commanding figure in biochemistry; Y. O.

Parnas had been rescued from Lwow in Poland and was given membership in the Academy and a chair in physiological chemistry, and he and

his wife resided in an oversized hotel room.

Soviet laboratories were housed in inferior buildings, and their equipment was antiquated. All facilities were cold and showed other privations of war. The hospitals were overcrowded, with stained, un-

bleached linen and gowns. Library resources were well exemplified by foreign journals that were at least 6 months old. Soviet publications were printed on inferior paper and favored individual pamphlets and book-

lets rather than periodicals.

Our final report included an appendix listing some 30 medical officials and investigators who impressed us in various ways. Many continued to play important roles in Soviet medicine and in subsequent U.S.-USSR

relationships. At the time of the mission in 1944, there were no Soviet directories of scientists, no telephone books, and no maps; all were state secrets.

The Ministry of Health was headed by G. A. Miterev, a stocky internist, with six vice-ministers, two of whom eventually became ministers. These, with the exception of Parin, who did not fit the pattern, were

primarily hard-driving bureaucrats who depended on their underlings for technical information.

There was a group of old, prerevolutionary scientists, all decked out in military uniforms signifying flag rank: L. A. Orbeli, E. N. Pavlovosky,

and A. D. Speransky. Each had made reputations in biology, entomology, or neurology, and their rank was essentially honorific. The surgeon

generals of the Red Army and of the Red Navy, as well as the chief surgeons of the services, of course also were generals and admirals. In full dress, with epaulets and medals, they could compete with their German popinjay counterparts. The most westernized figures, other than Parin, included N. I. Propper-Graschenkov, director of a neurology hospital, and S. S. Yudin, chief surgeon of the Sklifasovsky Hospital. Graschenkov (who dropped

the hyphenation after 1946) had spent a year at Yale and had been a vice-commissar for medical education. He dared to retain portraits of foreign neurologists on the wall of his office and spoke English and German. Despite his lack of clinical experience, he went to the front and

applied his experimental surgical techniques to war casualties, and he had performed over 1,000 operations on the brain and spinal cord. Yudin, a 53-year-old, slim, dynamic man with a compelling personality, was only a colonel, and his indiscreetly candid descriptions of front576

Michael B. Shimkin ¦ Roads to Oz. I.

line medical conditions got him into increasing trouble with authorities. We met him while he was doing a subtotal gastrectomy under local

anesthesia. He complimented the American syringes he was using, left the closure of the case to an assistant, and began a nonstop tour of the hospital. Yudin had performed over 6,000 gastric resections and several

hundred esophageal resections and was recognized internationally as an outstanding surgeon. He eventually became an honorary member of the American College of Surgeons and of the Royal College of Surgery. The conferences and tours at the institutes and hospitals followed a set pattern. The senior staff assembled in the director's office, and the re-

port on the appropriate subject we had brought was commented upon,

questions were asked, and the institution's work was described. Then followed visits to the laboratories and clinical facilities, with guides stationed in each position to answer questions. Toward the end of the mission, Ambassador Harriman held a recep-

tion for the scientists we had met, inviting the ambassadors of Great Britain and Canada. In turn, a reception was held by Commissar Miterev at the cultural-exchange building (VOKS), with a banquet, endless toasts in vodka, wine, and even carbonated water, motion pictures of an engagement on the Ukrainian front, and ballet and musical performances,

followed by a band playing dance music. Figure 1 pictures some of the attendees. Hastings won more hearts by leading female scientists to the floor and displaying his terpsichorean talents. At both receptions, no wives of Soviet guests appeared. The only spouse we met was that of Parnas, but he was a Pole, not a Russian.

On February 11, 1944, we departed from Moscow, leaving Florey and

Sanders to complete their penicillin demonstrations. We were pleased with our achievements, considering ourselves as successful diplomats as well as forgers of international links between scientists. We carried a bulky collection of papers and reports and cultures of the Soviet penicillin strain.

The trip back took a week and took us through Africa, across the

Atlantic to Brazil, to Puerto Rico, and to Washington. We were separately "debriefed" by unidentified people, I was put behind a desk to complete the reports, and life resumed its previous channels. But the warm feelings we developed on the mission persisted for a long, long time. IV. UNRRA and WHO

The war was proceeding satisfactorily for the Allies by mid- 1944, the tide having turned in the Pacific and the invasion of Europe being an accomplished fact. During the summer of 1944 I returned to cancer research and was putting together the first monograph to issue from the National Cancer

Perspectives in Biology and Medicine ¦ Summer 1979 \ 577

Fig. 1.—Commissar Miterev's reception at VOKS for the American-British mission, February 10, 1944. Left to right: Clark Kerr, British

Parin; A. B. Hastings; unidentified interpreter; I. G. Rufanov; unidentified interpreter; Z. V. Yermolieva; W. H. Florey; M. K. Krontovskaya.

Ambassador; G. A. Miterev; Averell Harriman, American Ambassador; M. B. Shimkin; S. V. Kemenev, president of VOKS; A. G. Sanders; V. V.

Institute, on mammary tumors in mice. The U.S.-USSR medical relations that came to my attention were limited to a visit of two Soviet

virologists who were in the United States at the invitation of the U.S. Typhus Commission.

The visitors were Anatoli A. Smorodintzev of Leningrad and Vladimir

N. Soloviev of Moscow. Smorodintzev was a short, dour man and

Soloviev a tall, handsome charmer, and they obviously disliked each

other. Neither commanded English, so their interpreter was a medical officer from the Soviet Embassy, and Lebedenko was part of the entourage when they were in the Washington area. I was called to help interpret conversations about typhus vaccines, influenza, and hepatitis. Smorodintzev espoused an influenza vaccine administered by nasal in-

sufflation, with which Soloviev was impatient.

In the fall of the year, preparations began for the relief and reconstruction of Europe after the war, to be effected through the United Nations Relief and Rehabilitation Administration, or UNRRA. The

Public Health Service was designated the source of medical personnel. I was shifted from the navy-type uniform of the NIH to the army type

and was enrolled in a course in Polish. My assignment was to be the UNRRA deputy public health officer for Poland, with a fellow officer, Henry Holle, as my superior twin. These leisurely preparations were interrupted by a rumor of imminent German collapse, and we were rushed over to London. But the attempted assassination of Hitler failed, the war continued, and the UNRRA contingent sat in its office, occasionally ducking the Vl and V2 rocket bombs but otherwise being unemployed. The deputy surgeon general of the Public Health Service, Warren F. Draper, had been assigned to the European theater of war to head public health in the G5, the new army branch concerned with civil affairs in occupied territories. Before he moved with the Supreme Headquarters, Allied Expeditionary Forces, headquarters to the Continent, he volunteered some of us for interim duty with G5. Holle stayed back and eventually served Poland, but I and a sanitary engineer, Omar Hopkins, were assigned to Patton's

Third Army. We reported late in November to his G5 medical officer,

Major Igloo, at Lucky Rear, the code name for rear headquarters of the Third Army, then sitting on the outskirts of Nancy, France. The next 6 months were a kaleidoscope of assignments to various G5 units scattered in the area, inspections of medical facilities for civilian populations and displaced persons camps, and surveillance for epidemic diseases, especially typhus. Since G5 was a new concept, the rules and duties were made up as we went along, which gave us considerable

freedom. All headquarters really wanted were reports, to be assured that

nothing was impeding military operations, or to be alerted so appropriate actions could be taken. The G5 units were assigned to enemy

Perspectives in Biology and Medicine ¦ Summer 1979 \ 579

territory to be occupied, and their roles and locations in France, Bel-

gium, and Luxembourg were temporary, spaced to be out of the way of the army and of each other.

Two outstanding events in relation to the Soviets occurred before and

after the last German offensive in the Ardennes.

On December 9 the army liberated and bypassed a prisoner-of-war

camp at Creutzwald. The status of Soviet prisoners was not clear. Stalin's orders were that his soldiers were to fight unto death, so officially no prisoners were recognized, and, in fact, they were traitors if they were alive. The United States Army Gl, which is responsible for prisoners of

war, decided that Soviet prisoners were a civilian matter to be handled by

G5. The only trouble was that G5 had no resources, and the prisoners,

patriots or traitors, were warm bodies that had to be fed, housed, and otherwise attended to. The camp at Creutzwald had over 800 such souls, with a few Poles, Yugoslavs, and Serbians mixed in with Russians. The

leader was a sanitary officer, Peter Shatalov, and the barracks were under good discipline. The prisoners sent a flowery telegram of thanks to Patton for their liberation, stood at formation for the 10-man G5 unit,

and proceeded to make their own internal adjustments as soon as sufficient food arrived in American trucks. The adjustments were to filter out all non-Soviets and to identify informers and some veterans of Vlassov's Soviet units that had gone over to the Germans. Some of these

disappeared, and since only the Russians had a roster of the inhabitants, there was no way in which the G5 unit could have changed the course of events. Guards were posted at the main gate, but what went on inside was as dark as the wintry nights.

Shatalov was obviously nervous, since he did not know what the status of the prisoners was, what he or they were to do, or what their fate would be. The situation was not improved by the arrival of a Soviet captain, an

arrogant, loud oaf who proclaimed to the assembly that all would be returned to the great Union of Socialist Republics, and there it would be

determined whether they could be forgiven or judged to be collaborators. Morale took a nose dive, and desertions over the wall and

suicides began to occur. Shatalov, who had held the group together for 2

years, appeared shattered. The group was moved west, somewhere, and was eventually "repatriated" forcibly amid more actions of desperation.

Many evacuations of displaced persons and Russian prisoners took place during the Ardennes offensive, to get the people out of the way. I was assigned as medical officer to one that proceeded to Angouleme, in southwest France, on New Year's Eve, loaded with 1,200 Russian dis-

placed persons that included 300 women and children. The move was supposedly under Captain Sharon L. Hatch, a pleasant Mormon known

as Captain Ice Cream, myself, two French medical officers, and three 580 J Michael B. Shimkin ¦ Roads to Oz. I.

French nurses, with Private First Class Lincoln Kirstein of art and ballet

fame as guard and interpreter. Kirstein knew French, of course, but was

as afraid of the automatic rifle he was issued as we were of Kirstein so

armed. All of us huddled in one unheated third-class wagon, with the 1,200 people being crammed into more wagons than we could identify, much less be responsible for. The French wanted no Russians scattered along the countryside, especially armed ones, and the train proceeded as rapidly as possible without lights, in bitter cold, with as few stops as possible. Hot soup was made available at two stops, where two adolescent French prostitutes were removed before their aim of servicing all of the men was accomplished.

And there we sat, in one wagon. Attempts to get out of our confinement were hazardous. Hatch looked disconsolate, Kirstein parked his

weapon in a corner, and we huddled with our C rations. The train did make Angouleme, the people were delivered to the camp authorities

there, except for those that disappeared into the night on the way, and

we wrote up our reports. We returned in an empty train, which stopped

in Paris and refused to proceed further east. The rest of the return was made in an American Red Ball truck with a friendly black sergeant who

sang as he drove. By the time we returned the Germans were in retreat, with Patton's

army in pursuit. We inspected the devastation in northern Luxembourg and returned south to the restored army zone. The first cases of typhus among the Eastern European workers now appeared in Trier. It was a big thing for a week or so, with threats of courts-martial for health contingents that permitted such an occurrence. The rear echelons lost interest as it became apparent that there was no threat of a major out-

break. Public health units were issued DDT in ton amounts, and the stuff

was squirted up skirts and sleeves and down collars of all civilians at

strategic crossings. What this did against typhus I have no way of knowing, but DDT was a blessed thing for restful nights in bivouacs infested with fleas and bedbugs.

By spring of 1945 the war became a race, with Jeep accidents on many days exceeding casualties from enemy action. Patton crossed the Rhine at Oppenheim, at the same time as the dramatic episode of the Remagen

bridge, the Palatinate was cleaned up, the French stopped at Strasbourg, and the army was turned south to handle the final redoubt that never came. The horrors of German concentration camps were revealed to the world. I encountered one of my own, at Ampfing, an experience that

impressed me sufficiently to describe and have published [13]. Russians

and other Eastern Europeans were scattered over Germany, and I found that the most effective method of communicating with Germans was to carry a leather whip that could be slapped against the leather legging Perspectives in Biofogy and Medicine ¦ Summer 1979

581

and to issue orders in Russian. The slap of leather and the sound of Russian produced positive reflex responses not evident to easygoing American approaches. Hopkins and I returned to the United States in June and began our rehabilitation. My family was sitting out the war in California, and the European difficulties seemed minor in comparison with trying to rent a

house in Washington and buying a car. It was so much easier to com-

mandeer a Mercedes Benz and to fill it up with free gas at the nearest supply dump. My plans to resume cancer research were quickly dispersed by Parran. He was already working to create a health agency under the United Nations, to continue and expand the health activities of the defunct League of Nations. In health, as in all other affairs, the main determinant was how the United States interacted with the Soviet Union. In

Parran's plans, I would be useful at that interface. Seeing my lack of enthusiasm, he baited the trap with a promise of any assignment I wanted once the international health agency was established.

Plans for the international health agency, eventually called the World

Health Organization, or WHO, were assigned to a new office of International Health Relations (IHR) in the surgeon general's office, with a parallel unit in the Department of State. I became the assistant chief of IHR; the chief arrived later in the person ofJames A. Doull, professor of preventive medicine of Western Reserve and a four-stripe reserve

officer in the Public Health Service. The State Department contingent consisted of an old regular officer wise in governmental machinations, Louis L. Williams, Jr.; an ambitious, driving medical officer, Henry Van

ZiIe Hyde; and an international law expert, Howard Calderwood. The

clash to determine who was on top soon came, and the academician was a rapid and obvious loser. But we did work together, cables flowed between countries, memoranda followed one after another, and the con-

stituent assembly opened in June 1946 in New York.

Wonder of wonders, the Russians sent a full delegation, headed by

Lieutenant General Fedor Krotkov. The Soviet Union had succeeded in

obtaining votes in the United Nations by the fiction of having the Ukraine and White Russia considered as separate countries, and the medical delegation (fig. 2) reflected this lineup. Levko Medved, a handsome young man who boasted of his sexual prowess, was from the

Ukraine, and Nikolai Evstafiev, appropriately very blond, was from Byelorussia. The fourth member, Lev Gromashevsky, was an epidemiologist, a spare for Krotkov. Only Krotkov ever spoke, on policy

or other matters. All were wined and dined by members of the American-Soviet Medical Society and made welcome at medical and art institutes in New York. Krotkov and Parran struck up an excellent re-

lationship, making my task as interpreter easy and pleasant. 582

Michael B . Shimkin ¦ Roads to Oz. I.

Fig. 2.—The Soviet delegation to the Constituent Assembly of the WHO, New York, June 19, 1946. Left to right: Lev V. Gromashevsky, USSR; Levko I. Medved, Ukraine SSR; Fedor G. Krotkov, USSR, head of delegation; Thomas Parran, head of U.S. delegation; Nikolai T. Evstafiev, Byelorussia SSR. Standing: M. B. Shimkin, U.S.A.

The WHO constitution [14] was discussed and adopted, including the French definition of health as the state of complete physical, mental, and social well-being, which was to cause much discussion and disagreement later. Actually, a thornier issue was representation of colonies and trust

territories by natives rather than by their overlords. That was compromised by replacing "shall" with "should" and thus making native representation desirable but not required. After a banquet in which

Stampar of Yugoslavia addressed the guests as "friends and Soviet brothers," Krotkov wagered Parran that Soviet ratification would come before ratification by the United States. Krotkov won. One delay in the United States ratification was caused by the fear of Communist influence

in the Pan-American Sanitary Bureau, which was to become the Ameri-

can branch of WHO. Relations between the United States and the Soviets were deteriorat-

ing, but one unfinished piece of business was the nearly forgotten invitation to Parin to visit the United States, made by the mission to Moscow in

1944. A telegram of invitation was duly dispatched by Parran via the Department of State, and an official acceptance was received within a

week, with Parin following in a fortnight. Perspectives in Biology and Medicine ¦ Summer 1979 | 583

Parran and Parin, amused at the similarity of their names, became immediate friends. Parin brought with him a copy of the Soviet medical Five-Year Plan and samples of the KR anticancer preparation that was

again attracting attention because the author John Günther wanted to have it used on his son, who was dying of a brain tumor. The KR samples were turned over to the National Cancer Institute for testing in animals. Parran agreed to unusual treatment of Parin, now the secretary of the Academy of Medical Sciences. Since Parin spoke English fluently, with rare beguiling slips, it was decided to give him a completely free, un-

guided visit by issuing him a book of travel requests with which he could obtain passage anywhere in the country. There was an embrassing mo-

ment when Parin was asked to sign an employment form that included an oath of allegiance to the United States, deemed necessary for the transaction. The oath was duly modified to read that Parin would engage

in no anti-American activities while on the trip.

Parin's arrival coincided with that of a group of oncologists, who somehow attached themselves to his visit. As a group they went to Boston

to be entertained at the Harvard Club by Baird Hastings, and then Parin

went on a tour that took him to San Francisco, he being passed from one unit of the American-Soviet Medical Society to another. He was a success everywhere. The oncologists limited themselves to cancer institutes on the Eastern seaboard. They included Y. Kavetsky, from the Ukrainian

institute that introduced the ACS serum, who in retrospect was a premature oncologic immunologist; A. I. Serebrov, a gynecologist from the Leningrad Oncologic Institute, an older, solid clinician and editor of the paramount Soviet cancer journal, Voprosi Onkologii; and M. K. Pobedinsky, chief radiologist of the USSR Ministry of Health (fig. 3).

Upon the completion of their visit, Parin and the oncologists were again feted in New York. Parin was presented with three fishing poles

and reels, for his sons and himself. I received a strange farewell letter, written on hotel stationery, and subsequent events made only too plain the reasons for Parin's foreboding. He was arrested on his return, accused of collaborating with the United States and of illegally transmitting Soviet medical secrets. He was sent to an obscure Siberian medical post

and barely escaped a sentence of death or long imprisonment [15].

All honors and posts were stripped from him. A play, in which Hastings and I had roles as foreign spies, with Parin as our dupe, was performed in Moscow.

Parin was "rehabilitated" following the death of Stalin, and I was to see him in 1956, still wan and red eyed and with shaking hands. He was readmitted to appropriate academies and given directorship of an insti-

tute of physiology. Later, restored to health and again in command, he became chief physiologist to the Soviet space exploration program and 584

Michael B. Shimkin ¦ Roads to Oz. I.

Fig. 3.—Soviet medical visitors to the United States, October 1946. Front row, left to

right: Rotislav Y. Kavetsky, pathophysiologist from Kiev; Vasily V. Parin, secretary of

Academy of Medical Sciences, USSR; Rolla E. Dyer, director of NIH, U.S.A.; Mikhail K. Pobedinsky, chief radiologist for Ministry of Health, USSR; Alexander I. Serebrov, gynecologist and director of Oncology Institute, Leningrad, USSR. Second row, left to right: R. Spencer, M. V. Veldee, C. Armstrong, M. B. Shimkin, A. Scheele, W. H. Wright, and F. Daft, all of NIH.

accompanied the Soviet cosmonauts on their visit to the United States. Parin died in 1971, in his sixty-eighth year. Parin's history is an excellent example of the dangers of friendship with foreigners, one of the more inhibiting factors in U. S.-USSR relationships. The visit of Parin and the oncologists had another important consequence. Armed guards were placed around the institute in which Roskin and Klueva were experimenting with Trypanosoma cruzi preparations against cancer, and they also were punished for providing KR to Parin for transmission to the United States. Stalin's interest was aroused in

cancer research, the budget for cancer was increased, and a surgeon,

Nikolai N. Blokhin, was appointed to reorganize and expand the Mos-

cow Institute, which became the Institute of Experimental and Clinical Oncology. Attempts to verify the antineoplastic properties of the KR samples, and of other preparations of T. cruzi, were made at the National Cancer Perspectives in Biology and Medicine · Summer 1979 | 585

Institute and at the Lankenau Hospital in Philadelphia [16]. No positive results were obtained, and the investigators began to plan a visit to the Soviet workers. They acquired full complements of arctic clothing, but Soviet approval was not forthcoming. Theodore Hauschka, at least,

found good use for his clothing upon his move to Buffalo.

And, true to his word, Parran approved my return to the National Cancer Institute and the detail to the University of California in San Francisco, to establish the Laboratory of Experimental Oncology. REFERENCES

1.H. E. Sigerist. Socialized medicine in the Soviet Union. New York: Norton, 1937.

2.M. B. Shimkin. Am. Rev. Sov. Med., 1:43, 1943. 3.E. H. Beardsley. Med. Hist., 22:365, 1978. 4.A. B. Hastings and M. B. Shimkin. Science, 103:605, 1946. 5.A. B. Hastings and M. B. Shimkin. Science, 103:637, 1946. 6.A. B. Hastings and M. B. Shimkin. Am. Rev. Sov. Med., 3:453, 1946.

7.L. Bickel. Rise up to life: a biography of Howard Walter Florey, who gave penicillin to the world. New York: Scribner's, 1972.

8.A. B. Hastings. Annu. Rev. Biochem., 39:1, 1970. 9.M. B. Shimkin. Am. Rev. Sov. Med., 1:465, 1944. 10.M. B. Shimkin. Am. Rev. Sov. Med., 4:271, 1974.

11.M. B. Shimkin and C. M. MacLeod. J. Med. Educ, 34:795, 1959. 12.M. B. Shimkin. Am. Rev. Sov. Med., 5:82, 1947. 13.M. B. Shimkin. Sci. Mon., 63:281, 1946. 14.M. B. Shimkin. Science, 104:281, 1946.

15.W. B. Smith. My three years in Moscow. Philadelphia: Lippincott, 1950. 16.T. Hauschka, L. H. Saxe, Jr., and M Blair. J. Natl. Cancer Inst., 7:189, 1947.

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