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Remembering Hiroshima
Editorial
The understated title of A Noiseless Flash, the first chapter of John Hersey’s 1946 journalistic portrayal of the lives of six individuals who survived the atomic bomb blast in Hiroshima on August 6, 1945, exposes one of the most curious features of that catastrophic explosion: few of those who survived reported hearing any noise at all. But the effects of the bomb were no less deadly for their mysteriously evanescent origin. The immense heat and power generated by the explosion over Hiroshima was estimated to equal that produced by 20 000 tonnes of TNT. Everything within a mile of the hypocentre was destroyed. People who did not die instantaneously received horrific “flash burns” from the explosion’s radiant heat (the ground below the blast reached temperatures of 3000–4000°C) or were injured by collapsing buildings and burned by the ferocious fires that engulfed the city. Fire storms spread the circle of utter destruction to 4 square miles. The annihilation was so complete that even now, 60 years on, the total number of deaths is not precisely known. Records of the numbers of military personnel in the city were destroyed in the blast, and entire families were wiped out, leaving no one to report deaths. Estimates from the Radiation Effects Research Foundation, based in Hiroshima, of the numbers who died in the immediate aftermath put the total at 90 000–140 000. Deaths attributable to the flash of radiation—emitted during the first second of the explosion—are still climbing. Of the possible effects of radiation on the human body, very little was initially known. Studies of fruit flies had suggested that there might be genetic effects that would be carried through from generation to generation, but the immediate health consequences were unclear. The Lancet, reporting on the bomb blasts a year after they occurred, described the unfurling evidence of a strange syndrome labelled by the Japanese as “Atom bomb disease”. Anorexia, nausea, and vomiting had beset people with no obvious injuries from around a week after the bomb. Bloody diarrhoea, general malaise, and loss of hair followed; many of those affected died soon afterwards. Deaths from this radiation sickness reached a peak at 3–4 weeks after the bomb blast, vanishing altogether after 7–8 weeks. These delayed effects were the first sign that the atom bomb’s legacy would www.thelancet.com Vol 366 August 6, 2005
continue long after its material destruction had been repaired. For survivors in Hiroshima and Nagasaki, the two atomic blasts still reverberate, manifesting as persistent yet indiscernible illness for some, whereas others are crippled by cancers or organ failure. That the deleterious consequences of that one cruel instant in 1945 should linger for 60 years and more was completely unforeseen. Living through the blast has come to represent a sort of physiological branding of survivors—poor health and susceptibility to a huge variety of disorders, an everpresent reminder of their childhood experience. While the extent, variety, and severity of the late effects of the atom bomb continue to emerge through careful cohort studies, ongoing since the 1950s, the stigmatising impact of surviving the blast is all too often forgotten. For women in particular, the unfounded rumour-mongering of the popular press in Japan and abroad, about infertility and congenital abnormalities in children of radiation-exposed parents, made survivors social outcasts by labelling them unfit to marry. Employers were wary of taking on staff that might need excessive sick days. And perhaps most debilitating for survivors themselves was the constant fear for their health, with so little available information about how long the bomb’s effects might persist. There is still much to learn in this respect. In the national census of 1950, around 280 000 people said that they had been exposed to the atomic bombs in either Hiroshima or Nagasaki. Almost half of those who survived are still alive. Already there are volumes of data documenting increases in risk of leukaemias, solid tumours, and radiation-induced cataracts among survivors. But in the past decade a new threat has emerged in the form of radiation-induced nonmalignant illnesses, such as cardiovascular disease; the mechanism of causation remains unknown. The disquieting persistence of health effects so many years later ensures that the appalling devastation of nuclear weapons cannot be forgotten. But this obvious consequence serves also to disguise the real destructive force of the bombs dropped on Hiroshima and Nagasaki. The culprit for this catastrophe is not one single weapon dropped by one nation. It is the unlimited militaristic aggression practised by many nations. ■ The Lancet
Hulton Getty
Remembering Hiroshima
See World Report page 441
See Lancet 1946; 248: 14
427
The understated title of A Noiseless Flash, the first chapter of John Hersey’s 1946 journalistic portrayal of the lives of six individuals who survived the atomic bomb blast in Hiroshima on August 6, 1945, exposes one of the most curious features of that catastrophic explosion: few of those who survived reported hearing any noise at all. But the effects of the bomb were no less deadly for their mysteriously evanescent origin. The immense heat and power generated by the explosion over Hiroshima was estimated to equal that produced by 20 000 tonnes of TNT. Everything within a mile of the hypocentre was destroyed. People who did not die instantaneously received horrific “flash burns” from the explosion’s radiant heat (the ground below the blast reached temperatures of 3000–4000°C) or were injured by collapsing buildings and burned by the ferocious fires that engulfed the city. Fire storms spread the circle of utter destruction to 4 square miles. The annihilation was so complete that even now, 60 years on, the total number of deaths is not precisely known. Records of the numbers of military personnel in the city were destroyed in the blast, and entire families were wiped out, leaving no one to report deaths. Estimates from the Radiation Effects Research Foundation, based in Hiroshima, of the numbers who died in the immediate aftermath put the total at 90 000–140 000. Deaths attributable to the flash of radiation—emitted during the first second of the explosion—are still climbing. Of the possible effects of radiation on the human body, very little was initially known. Studies of fruit flies had suggested that there might be genetic effects that would be carried through from generation to generation, but the immediate health consequences were unclear. The Lancet, reporting on the bomb blasts a year after they occurred, described the unfurling evidence of a strange syndrome labelled by the Japanese as “Atom bomb disease”. Anorexia, nausea, and vomiting had beset people with no obvious injuries from around a week after the bomb. Bloody diarrhoea, general malaise, and loss of hair followed; many of those affected died soon afterwards. Deaths from this radiation sickness reached a peak at 3–4 weeks after the bomb blast, vanishing altogether after 7–8 weeks. These delayed effects were the first sign that the atom bomb’s legacy would www.thelancet.com Vol 366 August 6, 2005
continue long after its material destruction had been repaired. For survivors in Hiroshima and Nagasaki, the two atomic blasts still reverberate, manifesting as persistent yet indiscernible illness for some, whereas others are crippled by cancers or organ failure. That the deleterious consequences of that one cruel instant in 1945 should linger for 60 years and more was completely unforeseen. Living through the blast has come to represent a sort of physiological branding of survivors—poor health and susceptibility to a huge variety of disorders, an everpresent reminder of their childhood experience. While the extent, variety, and severity of the late effects of the atom bomb continue to emerge through careful cohort studies, ongoing since the 1950s, the stigmatising impact of surviving the blast is all too often forgotten. For women in particular, the unfounded rumour-mongering of the popular press in Japan and abroad, about infertility and congenital abnormalities in children of radiation-exposed parents, made survivors social outcasts by labelling them unfit to marry. Employers were wary of taking on staff that might need excessive sick days. And perhaps most debilitating for survivors themselves was the constant fear for their health, with so little available information about how long the bomb’s effects might persist. There is still much to learn in this respect. In the national census of 1950, around 280 000 people said that they had been exposed to the atomic bombs in either Hiroshima or Nagasaki. Almost half of those who survived are still alive. Already there are volumes of data documenting increases in risk of leukaemias, solid tumours, and radiation-induced cataracts among survivors. But in the past decade a new threat has emerged in the form of radiation-induced nonmalignant illnesses, such as cardiovascular disease; the mechanism of causation remains unknown. The disquieting persistence of health effects so many years later ensures that the appalling devastation of nuclear weapons cannot be forgotten. But this obvious consequence serves also to disguise the real destructive force of the bombs dropped on Hiroshima and Nagasaki. The culprit for this catastrophe is not one single weapon dropped by one nation. It is the unlimited militaristic aggression practised by many nations. ■ The Lancet
Hulton Getty
Remembering Hiroshima
See World Report page 441
See Lancet 1946; 248: 14
427