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Wednesday, April 6, 2011

Chester Aaaron on Over-Radiation of African Americans

Over-Radiation of African Americans
A Conversation with Chester Aaron

By Raynetta James
Chester Aaron, now 87 years old, has published 25 books: fiction and non-fiction, adult and young adult. He has won a variety of awards, including NEA and Primo Levy grants. His books have been translated into Dutch, French and German. He is a WWII veteran and a professor emeritus of Saint Mary's College. His new novel, About Them, is due late this year, and a new collection of ten short stories, Saved for My Pallbearers, is due early next year.

I have been getting creative writing tips from Chester for almost 2 years in a class started by Lolly Mesches to raise funds for the Occidental Center for the Arts. It was hosted at the home of the late Doris Murphy, a long-time labor and justice advocate and a founder of the center. During the year or so that Doris was well enough for us to meet at her house, Chester told me a story that came to mind when the current radiation crisis in Japan began. So I asked him about it:

Q. Chester, you told me that, when x-rayed, African Americans often received more radiation than a white patient of the same age and size. They got a higher dose of radiation than a white person, only because they were African American. Is that right?
A. Yes. The amount of extra radiation varied from tech to tech, hospital to hospital, but it was happening all over the country. The amount of extra radiation ranged from a third more to a half more that a white patient of similar body mass would have received. Radiation, especially in the aggregate, is dangerous; that's why there are lead shields. So over-radiation is likely to have caused many deaths and health problems over the years.

Q. How did you discover this over-radiation?
A. By accident. In the late 60's I was Chief Technician in the x-ray Department of Alta Bates Hospital in Berkeley, California. I was concerned about the lack of standard training and practice of x-ray technicians and I believed licensure would help establish standards. At that time, New York was the only state requiring x-ray technicians to pass a state-sponsored exam to prove they were knowledgeable enough to safely dispense radiation to patients. We had been trying to get similar standards and licensure in California.

I was preparing for state committee hearings, when I learned from Pat, one of the seven x-ray technicians at Alta Bates, that she was giving extra radiation to every African American patient that she x-rayed, regardless of age, gender or the target of the radiation, whether it was bone, soft tissue, organs or the skull. She had been ordered to do so by the Radiologist who trained her. The text she used in training said that African Americans required extra radiation to provide films of acceptable diagnostic quality. Later, I found that the practice was common.

Q. When did it happen? Is it still going on?
A. After I discovered it in the late 1960's, I tried many times to get it stopped and acknowledged. It may have been stopped, in many hospitals, but it was never acknowledged. The question of after-effects on present and future African Americans should be studied and dealt with in terms of health consequences and deaths.

Q. You're saying although it was stopped, we should still be concerned?
A. I am. First, the effects of radiation are long term. Skin cancer, thyroid cancer, leukemia and reproductive harm are all possible. Second, the practice is part of the history of racial inequality in this country, part of the history of African Americans being treated as if they are "other." And the response of governmental officials and institutional leaders is part of the history of African Americans being treated as less than equal. Consider the infamous Tuskegee Syphilis Study of 1932-1972, when 400 Black men were infected with syphilis with secret government support. We don't stop being concerned about the ramifications of that experiment just because it was stopped. In both cases we should recognize that the same practices applied to white people would not be tolerated.

Q. And how did you try to stop it?
A. Over the years, I have contacted more than a hundred people who I thought should and would be concerned. I selected people I thought would do something to stop over-radiation, but I got few responses and less satisfaction. Each time I would send information to someone who should have cared, and either hear nothing or be brushed off. For instance, the last big push I gave it was in 1998, when I sent a letter to Ed Bradley. His program, 60 Minutes, was one that took risks and investigated stories in depth. I offered him a story more than 50 years deep. I told him how I had discovered that in most American Hospitals African Americans were being over-radiated, receiving more radiation than a comparable white patient, and that it had to be disclosed; it had to be stopped. The practice, I said could be more disastrous to African Americans than the results of the Tuskegee Syphilis Study.

Q. Weren't they interested?
A. I did get a response, from Catherine Kim, identified on her letter as "...a researcher for Ed Bradley." She said Mr. Bradley wanted to visit my California farm to interview me and disclose this unrecognized and horrible piece of American history. I agreed, but three days later a letter from Ms. Kim informed me that Mr. Bradley, having received information that the practice of over-radiating African Americans had stopped since I had first disclosed it some thirty years before, was canceling the pending visit and interview.

Q. That must have been disappointing, to get so close.
A. It was. I wrote back to inform them that though the practice had diminished it had not stopped. Even if it had stopped altogether, the reasons for it to have ever existed had to be disclosed and researched farther for a variety of reasons, only one of which related to our country's history. I told them that Mr. Bradley was certainly over-radiated when he was young because he was a "Negro," and that his parents had been over-radiated because they were "Negroes." Because of that generational over-radiation Mr. Bradley and his children and his children's children, may very well inherit ongoing health problems. And, I asked, what about African Americans who, unlike Mr. Bradley, do not have the benefits of high income and good health care to deal with those predictable and unpredictable consequences?

Q. What did they say to that?
A. I didn't hear a word. Sadly, 8 years later, in 2006, Mr. Bradley died of Chronic Lymphocytic Leukemia. The risk of that disease greatly increases among people who have been exposed (or whose parents and grandparents have been exposed) to high doses of radiation. And the chances are very high that the parents of Mr. Bradley and Mr. Bradley himself, every time they were x-rayed, from childhood, received as much as twice the radiation that would have been given a white patient the same gender, age, size and muscle-mass. Think Hiroshima. Think Nagasaki. Think Chernobyl. In my letter lamenting his death, I included those details, but I never heard from Ms. Kim or anyone else at CBS.

Q. But that wasn't the first time you had tried to disclose and stop over-radiation, was it?
A. Oh no, as I said I had contacted hundreds of people over the years. When I discovered the practice in the late '60s I was in my mid-forties, barely 20 years home from WWII, where I had participated in the liberation of the concentration camp of Dachau. How could I not be sympathetic to the fate of innocent victims? So when I discovered the practice while preparing for hearings on State Licensure, I was astounded. I had received two years training at Cowell Hospital on the campus of the University of California at Berkeley. I had worked as an x-ray technician at Kaiser Hospital, San Francisco for two years and Alta Bates Hospital for three years before being appointed Chief Technician by the three Radiologists serving Alta Bates Hospital. In all that time I never once used the color of a patient's skin to determine how much radiation I should use. 

And my films had been acceptable to the Radiologists; after all they had made me Chief. I had never even heard of such a theory. But then Pat told me she had been ordered to do so by her Radiologist trainer, and her textbooks said that African Americans required extra radiation to provide films of acceptable diagnostic quality. Then I found out that most x-ray technicians had been taught the same thing, and did increase the dosage of radiation for African Americans. Their reasons varied: African Americans had darker skin, African Americans had harder bones, or African Americans' bones contained more calcium. I could find no scientific evidence proving any such reasons were legitimate.

Q. That was when you were fighting for licensure legislation. Did stopping the practice of over-radiation become part of the effort?
A. When our group working for State Licensure traveled to Sacramento to meet with the Committee on Efficiency and Economy in the State Assembly whose Chairman was Willie Brown, later San Francisco Mayor Willie Brown, an African American. I was selected to act as spokesman. To illustrate the need for licensure, I noted that every x-ray technician in the state must learn the truth: that extra radiation to African American patients was not only unnecessary but hazardous. Willie Brown declared the meeting at an end. The Committee had no time, he said, to consider such discussion. Over the following years my letters of further explanation and appeal to Representative Brown received not one single reply. We failed to get licensure at that time.

I got involved in helping the East Bay technicians decide on the union by whom they wished to be represented. The ILWU (the International Longshoremen Workers Union) was selected. In that effort, I discovered through questions added to a survey of x-ray technicians that 72 of the approximately 90 technicians surveyed stated they did routinely give higher doses of radiation to African Americans. I tried to get the ILWU involved in the over-radiation battle, but our local representative and the Union officers could not have been less interested.

Q. Where did it go from there?
A. I kept gathering information about the possibly homicidal practice of over-radiating African Americans, and I heard about a physicist at Oak Ridge National Laboratory (Dr. Karl Z. Morgan, Time Magazine, Sept. 8, 1967) who stressed the hazards of x-rays, inconsistent dosage and lack of training for many who gave x-rays. We exchanged letters of support for each other's work.
I heard from technicians all over the country who were as angry and helpless as I was and who gave me details of the textbooks and their Radiologists (many who "ordered" their techs to give extra radiation to African Americans.)

Senator Jennings Randolph (D. West Virginia) sent me a letter of strong support. He worked for many years to get Federal legislation to establish minimum standards for the accreditation of x-ray machine operations.

By the early to mid '70s I had a collection of letters and research documents totaling about 50 pages. By the late 90's, I had sent perhaps 50 copies to officials in the NAACP, in Health, Education, Journalism and Government, including my own senators Feinstein and Boxer and Representatives Lynne Woolsey and Ron Dellums, and to Representatives Shirley Chisholm and Maxine Waters, pleading for support. Maxine Waters sent me a card informing me that she was referring my letter to my Representative, Lynne Woolsey.

Rep. Woolsey did take the matter to the Office of the U. S. Department of Justice, Civil Rights Division. I received a letter from Bill Lann Lee, Acting Assistant Attorney General, Civil Rights Division, dated May 20, 1998, which said that the practice did not, quoting here "appear to indicate ongoing violation of CRIPA (Civil Rights of Institutionalized Persons Act), i.e. the circumstances you have described do not involve practices to which individuals confined to or residing in public facilities (let me emphasize that phrase) presently are being subjected. Under these circumstances we have no authority to initiate an investigation under CRIPA of your allegations...."

Rep. Ron Dellums, my own representative from my own city did not reply. A few years later, when I informed him that I intended to disclose this information to the then-very conservative Oakland Tribune, his Oakland Office Manager called and suggested I come to the office. I did. His greeting: "I understand you have a problem." My response: "I don't have a problem. You do. And Representative Dellums does. You are both black and I am white." He said he had not read the report I had sent to Congressman Dellums. I got up and left the office.

At meetings of my own American Society of X-ray Technicians I was hooted down and more than once called a Communist or agitator or both.

Q. Did you have any success at all?
A. There was a ray of hope in the early 70's: an African American Nurse at my own hospital, Ethel Jellins, RN, sent a copy of my document collection to her cousin, John A. Williams, a WWII vet and author and journalist at The Amsterdam News, New York.

John and I had several telephone conversations before he published an article in the Amsterdam News disclosing the practice of the over-radiation of African Americans. But I did not receive one response.
And, as another hopeful sign, Ralph Nader was introduced to the issue by Dr. Karl Z. Morgan. Mr. Nader did his own research in several hospitals and testified before a U.S. Senate subcommittee, I think in 1971, to publicize the issue, citing my work. His statistics about the practice of over-radiation bore mine out.

The following day, several newspapers all over the country had Nader's testimony about the over-radiation of African American patients on their front pages. The stories included reference to my name and my work. David Perlman, Science Editor of the San Francisco Chronicle, interviewed me on the phone for a half hour. The day after that the Chronicle ran the science editor's report.

The day after that I was given notice by the Assistant Administrator at Alta Bates Hospital, Richard Adams, to clean out my desk and be off the premises in two hours.

When I informed Mr. Nader of the consequences of his testimony he very kindly said that if I wanted my job back he would come out to California to help me. I refused his offer. I should have accepted it.
Thinking myself more than qualified to be a Chief Technician I was sure I would have no difficulty getting a job. But over the following year every hospital and private office I applied to turned me down, except one: Ross General in Marin County. I lasted not quite two months. I was fired when I protested that the Chief Radiologist was not permitting the technicians to have their coffee breaks.

Over the years, after I left the Medical Field (I became a professor at Saint Mary's College, where I served for 25 years) I continued to try to get a variety of relevant local and national authorities to act in some way on the issue of over-radiation of African Americans, but they all ignored those efforts. The only protest by a relevant authority came from an article published in the Black Muslim newspaper Muhammad Speaks. There was no reaction.

Enter Jack S. Mandel, PhD, MPH, Professor and Head Mayo Chair in Public Health at the University of Minnesota. In the mid-90's, I began receiving requests from Professor Mandel to participate in a study that was developing information about the effects of possible radiation effects on the health of former x-ray technicians.

I think I answered two different surveys before I sent a letter to Prof. Mandel, along with my collected documentation regarding the over-radiation of African Americans, and asked him if he was including in his study the fact that African American Technicians might have extra concerns because of the cumulative effects of their exposure as patients added to their exposure as x-ray technicians. He did not respond.

I persisted, demanding a reply, or, I said, I would go to higher authorities. I reminded him of the involvement of "scientists" and health officials in Alabama in the infamous and deadly Tuskegee Syphilis Study, where at least 400 African American men died, thanks to scientific research, funded by the same Federal Government that was probably funding much of his work.
I sent a copy of this letter and copies of my documents to a reporter for the leading Minnesota newspaper.

Finally, a reply came from the Professor, dated March 17, 1997, in which he said, "I have talked to many people at the National Cancer Institute and elsewhere about the issue you raised. I was not able to locate anyone who had any information. I spoke to people who are international experts in radiation epidemiology and health physics representing over three decades of research experience. None was able to recollect the Senate Commerce Committee hearings to which you referred or the issue of over-radiation of black patients."

I wrote back pointing out that I had originally brought the issue to his attention ten or eleven years earlier when I first received his questionnaire. I reminded him that I had documented the practice some 25-30 years earlier, that my documentation of the practice was verified and reported before the U.S. Senate Commerce Committee by Ralph Nader, that, in preceding and subsequent public testimony by Dr. Karl Z. Morgan of Oak Ridge National Laboratories, after performing his own research, verified the ongoing practice and suggested that the death of approximately 300 African Americans per year was related to this over-radiation, that David Perlman, the Science Editor of the San Francisco Chronicle had interviewed me and published much of this information in the Chronicle. I reminded him that all of this testimony and documentation was public record. I accused him of willfully denying and ignoring the facts, facts relevant to his study of the effects of radiation of x-ray technicians.

I sent copies of my letter to many people. Dr. Mandel never responded. Of the governmental officials I contacted, only Representative Maxine Waters replied, to inform me she was relaying my letter to my own Representative, Congresswoman Lynne Woolsey, who contacted the Civil Rights Division of the Attorney General's office - I have already described their letter and reasons for doing nothing - as well to 60 Minutes, the results of which I have already described.

I gave up.

Then in 2009, in a brief essay delivered on National Public Radio, reviewing my life, I mentioned (20 seconds in a statement of about five minutes) "... my attempts to stop the over-radiation of African American patients in hospitals 40 years ago...."

Over the next several days I received phone calls and emails requesting more information. I contacted the offices of the NAACP in Baltimore, Maryland. I spoke to Mr. Adam Lee who transferred me to Ms. Wendy Hamilton. Ms. Hamilton expressed serious interest. I suggested I send her copies of those documents I still had. She agreed. I sent the copies. I heard nothing. Is, was, this silence a repetition of the disinterest displayed by the NAACP in the '60s? But why? I sent Ms. Hamilton an email saying that I am now almost 86 years old and I would not be patient and considerate and indulgent any longer. Should I not hear from the NAACP in 5 days I would seek other routes for disclosure. I still have not heard.

Suggestion: if you are an African American - no matter your age, no matter your gender - think about what increased health risks you may now be exposed to because, and only because, you are an African American. Shouldn't we all, but especially the NAACP, be concerned?

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