(From Hiroshima by John Hersey)
The lot of Drs. Fujii, Kanda, and Machii right after the explosion–and, as these three were typical, that of the majority of the physicians and surgeons of Hiroshima–with their offices and hospitals destroyed, their equipment scattered, their own bodies incapacitated in varying degrees, explained why so many citizens who were hurt went untended and why so many who might have lived died. Of a hundred and fifty doctors in the city, sixty-five were already dead and most of the rest were wounded. Of 1,780 nurses, 1,654 were dead or too badly hurt to work. In the biggest hospital, that of the Red Cross, only six doctors out of thirty were able to function, and only ten nurses out of more than two hundred. The sole uninjured doctor on the Red Cross Hospital staff was Dr. Sasaki. After the explosion, he hurried to a storeroom to fetch bandages. This room, like everything he had seen as he ran through the hospital, was chaotic–bottles of medicines thrown off shelves and broken, salves spattered on the walls, instruments strewn everywhere. He grabbed up some bandages and an unbroken bottle of mercurochrome, hurried back to the chief surgeon, and bandaged his cuts. Then he went out into the corridor and began patching up the wounded patients and the doctors and nurses there. He blundered so without his glasses that he took a pair off the face of a wounded nurse, and although they only approximately compensated for the errors of his vision, they were better than nothing. (He was to depend on them for more than a month.)
Dr. Sasaki worked without method, taking those who were nearest him first, and he noticed soon that the corridor seemed to be getting more and more crowded. Mixed in with the abrasions and lacerations which most people in the hospital had suffered, he began to find dreadful burns. He realized then that casualties were pouring in from outdoors. There were so many that he began to pass up the lightly wounded; he decided that all he could hope to do was to stop people from bleeding to death. Before long, patients lay and crouched on the floors of the wards and the laboratories and all the other rooms, and in the corridors, and on the stairs, and in the front hall, and under the portecochere, and on the stone front steps, and in the driveway and courtyard, and for blocks each way in the streets outside. Wounded people supported maimed people; disfigured families leaned together. Many people were vomiting. A tremendous number of schoolgirls–some of those who had been taken from their classrooms to work outdoors, cleaning fire lanes–crept into the hospital. In a city of two hundred and forty-five thousand, nearly a hundred thousand people had been killed or doomed at one blow; a hundred thousand more were hurt. At least ten thousand of the wounded made their way to the best hospital in town, which was altogether unequal to such a trampling, since it had only six hundred beds, and they had all been occupied. The people in the suffocating crowd inside the hospital wept and cried, for Dr. Sasaki to hear, “Sensei! Doctor!” and the less seriously wounded came and pulled at his sleeve and begged him to go to the aid of the worse wounded. Tugged here and there in his stockinged feet, bewildered by the numbers, staggered by so much raw flesh, Dr. Sasaki lost all sense of the profession and stopped working as a skillful surgeon and a sympathetic man; he became an automaton, mechanically wiping, daubing, winding, wiping, daubing, winding.
The morning, again, was hot. Father Kleinsorge went to fetch water for the wounded in a bottle and a teapot he had borrowed. He had heard that it was possible to get fresh tap water outside Asano Park. Going through the rock gardens, he had to climb over and crawl under the trunks of fallen pine trees; he found he was weak. There were many dead in the gardens. At a beautiful moon bridge, he passed a naked, living woman who seemed to have been burned from head to toe and was red all over. Near the entrance to the park, an Army doctor was working, but the only medicine he had was iodine, which he painted over cuts, bruises, slimy burns, everything–and by now everything he painted had pus on it. Outside the gate of the park, Father Kleinsorge found a faucet that still worked–part of the plumbing of a vanished house–and he filled his vessels and returned. When he had given the wounded the water, he made a second trip. This time, the woman by the bridge was dead. On his way back with the water, he got lost on a detour around a fallen tree, and as he looked for his way through the woods, he heard a voice ask from the underbrush, “Have you anything to drink?” He saw a uniform. Thinking there was just one soldier, he approached with the water. When he had penetrated the bushes, he saw there were about twenty men, and they were all in exactly the same nightmarish state: their faces were wholly burned, their eye sockets were hollow, the fluid from their melted eyes had run down their cheeks. (They must have had their faces upturned when the bomb went off; perhaps they were anti-aircraft personnel.) Their mouths were mere swollen, pus-covered wounds, which they could not bear to stretch enough to admit the spout of the teapot. So Father Kleinsorge got a large piece of grass and drew out the stem so as to make a straw, and gave them all water to drink that way. One of them said, “I can’t see anything.” Father Kleinsorge answered, as cheerfully as he could, “There’s a doctor at the entrance to the park. He’s busy now, but he’ll come soon and fix your eyes, I hope.” . . .
Early that day, August 7th, the Japanese radio broadcast for the first time a succinct announcement that very few, if any, of the people most concerned with its content, the survivors in Hiroshima, happened to hear: “Hiroshima suffered considerable damage as the result of an attack by a few B-29s. It is believed that a new type of bomb was used. The details are being investigated.” Nor is it probable that any of the survivors happened to be tuned in on a short-wave rebroadcast of an extraordinary announcement by the president of the United States, which identified the new bomb as atomic: “That bomb had more power than twenty thousand tons of TNT. It had more than two thousand times the blast power of the British Grand Slam, which is the largest bomb ever yet used in the history of warfare.” Those victims who were able to worry at all about what had happened thought of it and discussed it in more primitive, childish terms–gasoline sprinkled from an airplane, maybe, or some combustible gas, or a big cluster of incendiaries, or the work of parachutists; but, even if they had known the truth, most of them were too busy or too weary or too badly hurt to care that they were the objects of the first great experiment in the use of atomic power, which (as the voices on the short wave shouted) no country except the United States, with its industrial know-how, its willingness to throw two billion gold dollars into an important wartime gamble, could possibly have developed….
Dr. Sasaki and his colleagues at the Red Cross Hospital watched the unprecedented disease unfold and at last evolved a theory about its nature. It had, they decided, three stages. The first stage had been all over before the doctors even knew they were dealing with a new sickness; it was the direct reaction to the bombardment of the body, at the moment when the bomb went off, by neutrons, beta particles, and gamma rays. The apparently uninjured people who had died so mysteriously in the first few hours or days had succumbed in this first stage. It killed ninety-five per cent of the people within a half-mile of the center, and many thousands who were farther away. The doctors realized in retrospect that even though most of these dead had also suffered from burns and blast effects, they had absorbed enough radiation to kill them. The rays simply destroyed body cells– caused their nuclei to degenerate and broke their walls. Many people who did not die right away came down with nausea, headache, diarrhea, malaise, and fever, which lasted several days. Doctors could not be certain whether some of these symptoms were the result of radiation or nervous shock. The second stage set in ten or fifteen days after the bombing. Its first symptom was falling hair. Diarrhea and fever, which in some cases went as high as 106, came next. Twenty-five to thirty days after the explosion, blood disorders appeared: gums bled, the white-blood-cell count dropped sharply, and petechiae [eruptions] appeared on the skin and mucous membranes. The drop in the number of white blood corpuscles reduced the patient’s capacity to resist infection, so open wounds were unusually slow in healing and many of the sick developed sore throats and mouths. The two key symptoms, on which the doctors came to base their prognosis, were fever and the lowered white-corpuscle count. If fever remained steady and high, the patient’s chances for survival were poor. The white count almost always dropped below four thousand; a patient whose count fell below one thousand had little hope of living. Toward the end of the second stage, if the patient survived, anemia, or a drop in the red blood count, also set in. The third stage was the reaction that came when the body struggled to compensate for its ills–when, for instance, the white count not only returned to normal but increased to much higher than normal levels. In this stage, many patients died of complications, such as infections in the chest cavity. Most burns healed with deep layers of pink, rubbery scar tissue, known as keloid tumors. The duration of the disease varied, depending on the patient’s constitution and the amount of radiation he had received. Some victims recovered in a week; with others the disease dragged on for months.
As the symptoms revealed themselves, it became clear that many of them resembled the effects of overdoses of X-ray, and the doctors based their therapy on that likeness. They gave victims liver extract, blood transfusions, and vitamins, especially Bl. The shortage of supplies and instruments hampered them. Allied doctors who came in after the surrender found plasma and penicillin very effective. Since the blood disorders were, in the long run, the predominant factor in the disease, some of the Japanese doctors evolved a theory as to the seat of the delayed sickness. They thought that perhaps gamma rays, entering the body at the time of the explosion, made the phosphorus in the victims’ bones radioactive, and that they in turn emitted beta particles, which, though they could not penetrate far through flesh, could enter the bone marrow, where blood is manufactured, and gradually tear it down. Whatever its source, the disease had some baffling quirks. Not all the patients exhibited all the main symptoms. People who suffered flash burns were protected, to a considerable extent, from radiation sickness. Those who had lain quietly for days or even hours after the bombing were much less liable to get sick than those who had been active. Gray hair seldom fell out. And, as if nature were protecting man against his own ingenuity, the reproductive processes were affected for a time; men became sterile, women had miscarriages, menstruation stopped….
A surprising number of the people of Hiroshima remained more or less indifferent about the ethics of using the bomb. Possibly they were too terrified by it to want to think about it at all. Many citizens of Hiroshima, however, continued to feel a hatred for Americans which nothing could possibly erase. “I see,” Dr. Sasaki once said, “that they are holding a trial for war criminals in Tokyo just now. I think they ought to try the men who decided to use the bomb and they should hang them all.”
Father Kleinsorge and the other German Jesuit priests, who as foreigners, could be expected to take a relatively detached view, often discussed the ethics of using the bomb. One of them, Father Siemes, who was out at Nagatsuka [Hiroshima suburb] at the time of the attack, wrote in a report to the Holy See in Rome: “Some of us consider the bomb in the same category as poison gas and were against its use on a civilian population. Others were of the opinion that in total war, as carried on in Japan, there was no difference between civilians and soldiers, and that the bomb itself was an effective force tending to end the bloodshed, warning Japan to surrender and thus to avoid total destruction. It seems logical that he who supports total war in principle cannot complain of a war against civilians. The crux of the matter is whether total war in its present form is justifiable, even when it serves a just purpose. Does it not have material and spiritual evil as its consequences which far exceed whatever good might result? When will our moralists give us a clear answer to this question?”