Sunday, October 28, 2018

PART 1:CHEMICAL WARFARE:SECRETS ALMOST FORGOTTEN

CHEMICAL WARFARE 
SECRETS ALMOST FORGOTTEN 
by James S. Ketchum, MD 
With a foreword 
by Alexander Shulgin, PhD 

A Personal Story of Medical Testing of Army Volunteers with Incapacitating Chemical Agents During the Cold War (1955-1975)
Image result for images from the book CHEMICAL WARFARE SECRETS ALMOST FORGOTTEN

FOREWORD 
My first two interactions with the world of US Government chemical warfare were in the 1950s or maybe the 1960s when I was still a senior research chemist at the Dow Chemical Company in the San Francisco Bay Area. They were totally opposite in the images of secrecy and research process that they presented. I kept no notes, so all is from ancient memory. 

The first meeting was with two or three chemists in dark suits and ties who were introduced to me and a half dozen other research chemists as being government researchers in the area of potentially interesting synthetic organic chemicals. We were not told from which laboratory they came and the only clues to their areas of interest were two synthetic reaction sequences which had been drawn on the conference room blackboard. The man with the chalk told us that these two pictures had been worked out successfully, and their question was: could any of us propose a last step which might link them together. The bottom compounds in the two schemes were followed by arrows which pointed to an empty area at the bottom of the blackboard. I asked them why not draw in the structure of the desired product and they said that they were not at liberty to do so. 

"Oh, nonsense," I said and got up and went to the blackboard and drew the structure of the target. I drew the isomeric homologue of tetrahydrocannabinol with the terpene double bond down in the terpene 3,4-position and a 1,2-dimethylheptyl chain at the aromatic 3- position. "This is the obvious product you want," I added as I returned to my seat, "So why don't we discuss how this coupling could be achieved." 

There was an unmistakable discomfort shared by the gentlemen from Washington. After a bit of discussion I volunteered the statement, "Of course, with three chiral centers, there will be eight distinct optical isomers possible, all of different pharmacology, and some may not resemble marijuana at all in action." The meeting broke up shortly thereafter. A lot of things just couldn't be talked about. 

The second meeting occurred at an informal conference with some thirty people present, located at a retreat north of Los Angeles. This was organized by my good friend (and secret trumpet player) Daniel H. Efron, MD, PhD (1913-1972). This get-together was sponsored by the Washington operation he ran, the Pharmacology program at the National Institute of Mental Health. He told me to sit over there, pointing to an interesting looking man who was a total stranger. We introduced ourselves. I said my name was Sasha Shulgin, and he said his name was Van Sim. "Oh," I asked him, "What is your first name?" "Van is my first name -- I am Van M. Sim." 

We quickly discovered that we were both fascinated by psychedelics (they were called psychotomimetic drugs at that time) and that we were both personally experimenting with them. My art was the synthesis of new ones to compare the difference in activity due to structural changes (this at my laboratory at Dow and in my basement lab at home) and his curiosity was met by varying not the compound so much as the setting and the immediate environment around him (this at his laboratory at Edgewood Arsenal). Oh! A government scientist with whom there was nothing in the world that couldn't be talked about. 

Thus, this foreword is intended to prepare the reader for a story that has never before been told, the telling of the history, the origins and the development of the physical structure and the variety of people who worked at both the Edgewood Arsenal and its precursor, the Army Chemical Center. This it indeed does, with a flood of photographs and names and candid viewings of the people who worked there during the 11 or so years that Jim Ketchum was a major research person in the medical section. There is a mass of small detail, ranging from unexpected visits and unusual interviews to the conversations taking place during some of the drug experiments with volunteer subjects. This is an intimate portrayal of the structure of the research group, and the slow but inevitable changes in attitudes and research goals that occurred over time. 

But to me, this book is much more than an introduction to the Edgewood Arsenal. It is an autobiography of the author himself, from a young man with a developing medical career to an older, articulate analyst of today's world of chemical weapons in general, but particularly the instruments of psychochemical warfare. 

It is a pleasure to be able to contribute to this story. 
Alexander T. Shulgin, PhD

PROLOGUE 
Hot Night in Halifa 
It is 4 A.M. – close to the end of another hot night in the desert. American troops are moving into position on the outskirts of the city, preparing to carry out an unprecedented tactical plan. Actionable intelligence, validated by three sources, has established that several hundred Islamic terrorists are in a particular part of the city, some no doubt asleep while others plan attacks with IEDs (improvised explosive devices). A few may be preparing to strap on suicide bombs. Most of the opposition consists of leftover loyalists; some are members of Al Qaeda and a few are foreign extremists, drawn by religious fanaticism and eagerness to die for Islam. 

During these dark early morning hours, some of the coalition soldiers are understandably nervous. Their charge is to carry out a plan they have never attempted, except in simulated exercises. Each platoon has gone through drills with gas masks for several days, sometimes also wearing the hated, stifling suits that make it so difficult to function. Uncharacteristically, several dozen vehicles, modified to serve as ambulances, have pulled up behind the ring of coalition troops, tactically placed to make undetected exit from the city impossible. Further away, on improvised pads, crews have modified more than a hundred helicopters and are examining them once again to be sure they have done everything right. They chat and periodically glance at their watches. 

Inside each helicopter is a bank of unfamiliar munitions, brought in by armored, remotely operated tanks. They are specially designed smoke generators, each loaded with 100 kilos of sufentanil. According to what medics previously explained to the commanders, this synthetic chemical is so potent that less than half a milligram can quickly produce profoundly incapacitating central nervous system effects. This amount, one of them noted, is about same as the quantity of LSD that they would need to cause a comparable degree of military ineffectiveness. And the mode of action of this drug is quite different from LSD.

Once in the lungs, this tiny dose – less than a thousandth of the amount of powder in a packet of artificial sweetener – less than the weight of a gnat’s wing – will rapidly bring sleep and anesthesia lasting several hours. In larger doses, the drug will produce the same effects but they will come on almost instantly and last longer. No one who inhales sufentanil can stay awake, much less fight. And for added safety, it has been mixed with another synthetic chemical that keeps it from stopping respiration. 

The commander and his key subordinates meet in an improvised briefing room. The colonel who is leading the operation reminds the small group that the participants must maintain synchrony in their actions. He tells them again the importance of not using the radio except for essential communications. Chitchat, although tempting, is prohibited. 

Analysts have advised him that the delivery systems can take out almost every occupant in the entire target area. The smoke generators are the latest in design. They worked extremely well in all the tests, providing a smooth release and a uniform distribution. The colonel puts his hand on the acetate-covered map, dragging tanned fingers across a crayon-shaded area where most of the terrorists are concentrated. 

The junior officers in the room have heard this before, but the final summation somehow jolts them. This will actually happen. It may bring the solution to a big problem. Until now, because they blend into the noncombatant civilian population, coalition troops could distinguish the terrorists only by the rifles and rocket launchers they carry. 

One young captain’s attention wanders shortly as he thinks of some of his Special Forces personnel. Bitter memories of friends cut down by hooded snipers, cowards who fire from the windows of ordinary homes, continue to haunt them. Even when they see them run inside a building, the need to minimize “collateral casualties” forces the coalition units to hold their fire. Their M-16 rifles and highly accurate shoulder-mounted missiles have to wait until the “unfriendly” target is clearly isolated, lest they bring down a mother and child along with a black-scarfed terrorist. 

The meteorologists have reported that the weather is favorable, with a mild breeze, just enough to carry the particles downwind without excessive drifting. If stronger, it would disperse the smoke before it could settle to the ground. If weaker, its spread would be insufficient. By good fortune, a mild inversion condition is present – it will push the air downward. The colonel prays that the calculations are correct and that luck – a needed ingredient – will work in their favor. 

One of the junior officers asks whether the amount of material is enough to cover 100 hectares, roughly half of a square mile. He welcomes a firm reassurance. The terrorists could protect themselves if they could mask in a few seconds, but at this early hour, with limited equipment and training, this is a far-fetched possibility. 

The colonel runs through the rest of the scenario. Once they locate target personnel, lightweight plastic cuffs should be adequate to secure them. When they get the signal that the area is clear, more than 200 medics will move in quickly. Leave the use of the antidote to the aidmen. They have access to more than 100,000 syringes of naloxone (the standard antagonist for morphine-like drugs). A single injector should be sufficient to revive several captives. Once treated, most of the non-combatant civilians will be able to resume their usual activities. Since symptoms may return when the naloxone wears off, medical surveillance of those affected must continue for several hours. 

The amount of panic is hard to predict. Some panic is inevitable, but the battalion medical officer thinks it will be short-lived. Loss of consciousness will soon intervene. A sergeant comments that there won’t be much shooting, an observation the colonel confirms with a grim smile, noting that there will be few to shoot – unless the troops move in too quickly.

There will be injuries, mostly minor. One company commander speaks for the group – they are tired of what they call “Boy Scout rules of engagement.” Like them, he believes the use of their weapons should not require a first move by the enemy. 

There is brief discussion of the “political correctness” that seems to govern everything. The colonel points out that PC is a fact of life, even though the enemy will see it as weakness rather than humane intentions. He reminds the men that it took much courage, both in the Pentagon and higher up, to use an incapacitating agent in the face of almost certain disapproval by the world community. Creative parsing of the Chemical Warfare Convention rules must underlie the decision. This operation will make history, he says – and a mile-high pile of nasty headlines. So, everyone must work together and do everything just right. 

***** 

Thirty minutes later helicopters are in the air and troops are once more testing their state-of the art gas masks for leaks. When it is time to move in and round up the “bad guys” the soldiers will have to wear their hated protective garments, as well. Each of these steam-bath suits has a small strap-on kit, containing a dozen antidote injectors, along with the usual atropine syrettes for nerve gas – there will be no shortage of medicine. 

Smoke now drifts down and spreads, gradually creating a uniform fog. Sufentanil alone might not be visible, but it is part of an aerosol made up of billions of very small drug impregnated particles. Without additional material to piggyback them, even distribution of the sufentanil molecules would be impossible. It’s a fine science. Only in a size range of one to five microns – less than a tenth the diameter of a human nerve cell – will the particles reach the lower lungs, and stay there. 

***** 

4:30 A.M. The smoke has begun to spread and permeate the partially open buildings. Loud shouting is coming from the town. Men, as well as women and children are screaming and most are running. They think they are about to meet the same fate as the Kurds did under Saddam. Five minutes later, however, they are alive but still don’t know it. There is almost no noise on the streets. 

The troops advance slowly, prepared for snipers. Surprisingly, there are none. Dozens of bodies are lying in the dirt. Armed Marines systematically enter buildings in accordance with well-choreographed instructions. Inside, young and old lie motionless on the floor. Others seem to be sleeping normally in rumpled beds. When the Marines find weapons, they place them and the sprawled out men beside them on litters. Coalition soldiers carry the victims to nearby vans and ambulances. Tape covers their mouths; non-slip plastic handcuffs hold their hands behind them. Bigger trucks cart off the larger enemy weapons and munitions. 

Now the medics are on the scene, busily injecting everyone – women and children first, along with the elderly. They check them all to make sure they are breathing. Chests heave slowly, barely perceptibly in some cases, but all seem to be getting enough oxygen. A few victims are more critically affected. But, there is still time to arouse them with naloxone. Sufentanil has a safety margin – enough to minimize the likelihood of respiratory arrest. No guarantee against fatalities, but they will be far less than in a firefight. All those in critical condition will get medical attention, whether enemy combatant or not. 

***** 

8 A.M. A hot sun heats the hazy air and illuminates the streets. The operation is essentially over. More than four hundred suspected terrorists, grouped together in secure fenced enclosures, are under heavy guard. No one is mistreated. Non -combatants, now fully awake but confused, are being reassured by Arabic-speaking personnel. They will be okay – no serious aftereffects and no prolonged restraint. But they will have to stay out of the affected area until it is washed down with a neutralizing chemical, already being sprayed from specially equipped trucks.Sufentanil won’t penetrate the skin, but specks of it on material, clothing or other items, may lead to ingestion – from fingers that later stray to lips. 

Medical personnel tell the drowsy civilians to bathe and wash their clothes. They explain that the sleep-producing chemical will soon be degraded by sun and natural chemical interactions. Danger of secondary contamination will be minimal once the inactivation is completed. Chemical clean-up teams will make sure of this, testing for residual drug before allowing reoccupation of the area. Still dazed, the non-combatants seem to understand. 

Meanwhile, taken by surprise, journalists are now busily gathering data, recording images of both the treated and untreated, and barraging all the senior officers they can find with questions. Already they are sending home live footage that will soon be showing up on TV sets all over the world. 

***** 

Some readers will recoil from the fictional scene described above. It is a dramatic example of “going-it-alone,” violating chemical warfare treaties, and bending or breaking international laws. On the other hand, it illustrates the humane employment of what many still consider inhumane weapons. Justification of the unorthodox attack will become clear when the inevitable period of worldwide uproar subsides. Perhaps repugnance toward all chemical weapons will now be more selective. Eventually, life-sparing drugs, by reducing the acknowledged brutality of conventional warfare, may find acceptance. 

The scenario is fantasy – some would call it science fiction. But, if it is possible, why should it remain in the realm of the unthinkable? To understand the taboo that surrounds this subject, one must examine how the history of warfare has shaped both national and international policies. Such an examination is a major purpose of this book

COLD WAR: CHEMICAL CALL TO ARMS
When I tell people that I’ve written a book about “my life in chemical warfare,” they are generally polite but almost inevitably change the subject. Perhaps it is not surprising, therefore, that no one has ever given a full account of what we did at Edgewood Arsenal during the 1960s. It is unsettling, I suppose, to hear a psychiatrist say he worked for a decade studying chemical methods for “subduing” normal people. That is what I did, however, and this book tells the story. 

And it’s a story that needs telling, one that should have been told sooner. So much of what exists in libraries and on the Internet is incorrect, and so many accounts of what took place are distortions, that a mark of dishonor remains on the escutcheon of our research at Edgewood Arsenal. I ought to know, because I was there and fully immersed in that research. 

Perhaps you have heard of BZ, for example, and believe it was a secret concoction, far stronger than LSD, and able to drive people mad. You may not realize that if you ever had major surgery, you probably received a drug just like BZ before receiving anesthesia, to reduce unwanted secretions into your lungs. You probably don’t know that more than a dozen similar drugs, all related to BZ, were part of our experimental agenda.


Many think that the so-called Army volunteers we tested more than forty years ago were not really volunteers. Some claim the subjects were required to take drugs and then undergo interrogation to see if they would give up their secrets. They believe that the chemicals we tested may have left lasting mental or physical disabilities. In short, they assert that Army testing in the 1960s was unethical, incompetent and carried out in violation of basic human rights. These erroneous beliefs could have been dispelled by authentic information long ago, but very little ever appeared in the public media. 

So why now? As one of the few who are still alive and able to speak from experience about the details of that decade of testing in the 1960s, I was jolted, as were most citizens, by the events on 11 September 2001. Public fears and misapprehensions about the possible extension of such recklessness to chemical terrorism suddenly began to share the headlines. The real chemical story – the story I had long wanted to tell in detail – suddenly seemed to be an important one. I realized it was a remarkable story that few were still able to tell. 

Fear of chemical attack has become an integral part of 21st century life. Such an attack can come at any time and its consequences are difficult to calculate. While weapons experts can provide descriptions of its effects, they speak in terms of possibilities, not probabilities, because the magnitude of the threat is uncertain and the likelihood of its occurrence unknowable.

Fear of chemical attack has become an integral part of 21st century life. Such an attack can come at any time and its consequences are difficult to calculate. While weapons experts can provide descriptions of its effects, they speak in terms of possibilities, not probabilities, because the magnitude of the threat is uncertain and the likelihood of its occurrence unknowable. 

We wonder if a chemical attack will first be unleashed in a school or a football stadium. Will most of the victims recover as in the sarin incident in Japan? Or will thousands lie dead in the streets, as in the Kurdish villages of Iraq? Will we be able to see the lethal cloud as it approaches or will it be invisible? Will it sear our lungs, paralyze our muscles, eat into our flesh or create terrifying hallucinations? Will death come quickly and painlessly or will we linger in agony? How should we protect ourselves? What are the chances of escape? 

Unable to provide definitive answers to most of these questions, chemical warfare specialists continued to repeat what we have already heard: that “a single whiff” of a nerve gas such as sarin, or “a single drop” of a liquid nerve agent such as VX can be fatal. They incorrectly warn us that an enemy can pack enough such poison into a single missile warhead to annihilate thousands of people, perhaps the population of an entire city. They note that even the skin can be penetrated, but then tell us it is even more important to possess an airtight mask.

No wonder the average citizen does not fully understand chemical warfare, when even the best-informed experts do not provide us with straightforward explanations. But perhaps they should not be too harshly criticized. Descriptions of the mechanisms and sequence of nerve gas effects are complex. Efforts to provide the details may produce confusion rather than enlightenment. The deadliness of mortar shells and Kalashnikovs may be familiar, but the complex effects of chemical weapons are not. 

The reasons for this lack of clarity are, of course, not difficult to understand. Chemical munitions must achieve their objectives amidst a multitude of variables. Methods of delivery, devices used for dissemination, wind velocity, barometric readings, air temperature, characteristics of the terrain and existing physical barriers will all affect the outcome. In addition, one must take into account the possibility of escape or evasion, as well as the potency and speed of action of the substance itself. 

And these considerations, although numerous, make up only a partial list of factors influencing the outcome.

Ordinarily, a chemical attack would be expected to seek as many deaths as possible. But there might be goals other than lethality. Kindling of panic and demoralization may have a higher priority. Paradoxical as it may seem, one can use chemical weapons to spare lives, rather than extinguish them. The world watched in fascination when the Russians, in November 2002, chose to deploy a relatively non-lethal chemical weapon in a Moscow theater. Inside were a few dozen Chechen rebels, armed with grenades and automatic weapons, holding hostage almost a thousand innocent Russian civilians. The terrorists were prepared to destroy everyone in the building if the Russians did not meet their demands. Fanatical and desperate, they were not afraid to die along with their victims. 
Image result for images of Russian military personnel and Chechen terrorists were locked in a stalemate – a three-day standoff
Russian military personnel and Chechen terrorists were locked in a stalemate – a three-day standoff. Realizing that the stressed captives could not survive much longer, a Russian commander made a novel, highly unorthodox decision. He ordered a generator, loaded with a still unidentified substance – probably an opiate related to, but far more potent than, morphine – and positioned it where technicians could quietly pump it in as an aerosol from openings in the roof and floor. Within minutes, it rendered the occupants unconscious. Half an hour later, special troops stormed the building, killing the terrorists and freeing the occupants. 

Regrettably, the operation was not entirely successful. Over a hundred hostages died along with the terrorists. Psychological shock and general debilitation, a result of insufficient food and water, no doubt substantially increased the number of mortalities. Lacking access to vital medications, some may have succumbed to unstable diabetes, heart conditions or renal disease. By injecting casualties as rapidly as possible with naloxone (the standard antidote for opioid poisoning) Russian medics saved the great majority. Had they started their rescue mission sooner, it is possible that many more would have survived. 

However ambiguous the result, this dramatic incident stands out as an example of how a potent chemical agent can be used to preserve life, instead of as a “weapon of mass destruction.” Surprisingly, many observers deemed the operation morally indefensible. Still, in the opinion of others, it was a brilliant accomplishment under difficult circumstances. 

The procedures followed in this crisis were remarkably similar to scenarios designed forty years earlier by our own Army doctors. Many of the readers of this book were very young, or not yet born, during that tense, uncertain time in history. After the defeat of the Axis powers in 1945, the Cold War, as Churchill named it, was rooted in the growing mutual distrust between America and the Soviet Union.[But gets get real and recognize that a lot of the cold war was psychological operations directed at the civilian population DC]   

Although it was not a shooting war, the stakes were every bit as high as in the World War that had only recently ended. Most ominously, each nation had the ability to launch megaton nuclear missiles sufficient in number to annihilate the other. The resulting radioactive fallout would then continue to spread, wiping out populations in almost every corner of the earth. Popular novels and films trafficked in visions of “Armageddon” and “apocalypse”. The phrase “mutual assured destruction” became linguistic currency among journalists and commentators. 

Some terrified citizens in the 1950s and 1960s became newsworthy subjects for journalists and photographers, when they built and equipped their own bomb shelters, filling them with essentials required for lengthy periods of underground survival. The most nervous and wealthy property owners sometimes paid contractors huge sums to build structures deep below the surface, cynically designing them to serve comfortably as luxurious apartments. 

Nowadays, average citizens are somewhat less obsessed with the nuclear threat. Most world leaders likewise seem less preoccupied with the idea that radioactive weapons of mass destruction still pose an imminent danger, although countries such as Iran and North Korea continue to evoke considerable anxiety. Indeed, some unstable nations have stolen or bought the secrets of nuclear bomb making and even brag about their atomic capabilities, hinting darkly that, if provoked, they would not hesitate to use them. 

It is interesting to note that even the acronyms for the weapons of mass destruction have changed. We used to be concerned about “NBC” – nuclear, biological and chemical weapons, respectively. Now it is “CBR” – chemical, biological and radiological – devices that provoke the greatest apprehension as we ponder how to plan our defenses. The promotion of “chemical” to the top and the demotion of “nuclear” to the bottom of the list reflect a growing belief – faith may be a more accurate term – that nuclear war is neither highly probable nor easily preventable. A certain degree of fatalism has crept into our national mentality. Many have decided to regard the possibility of nuclear war as too remote to warrant contemplation. The consequences would be too devastating, too unthinkable. If it occurs, it will almost inevitably bring on the final events of our life on earth – hardly worth discussing. 

On the other hand, chemical weapons are not particularly difficult to manufacture and armies have actually used them in modern times. Thus, they are now vociferously touted as the most likely threats. Hastily developed detection measures have been deployed in an effort to locate and destroy deadly chemicals before terrorist groups can make use of them. Specially trained dogs now sniff for them in luggage and clothing. An expanding cohort of sophisticated inspectors is learning to hunt for them meticulously, despite mounting costs and annoying inconveniences to travelers. Scientists and engineers are hard at work developing more advanced imaging and analytic equipment capable of visualizing suspicious objects and materials, even when they are concealed within large vehicles and containers. 

Modern fear of deadly chemical weapons is engendered by the hideous images of World War I, when countless thousands of courageous troops died helplessly in their trenches, fumes of chlorine, mustard and phosgene sweeping without mercy across their battlements. They clearly knew the nationality of their attackers and could have retaliated in kind, were it not for a woeful lack of comparable weapons. Today, however, the enemy does not align itself with a single nation and no one government can be held responsible for its attacks. 

Twentieth century covenants against the use of chemical weapons, such as the Geneva Protocols, now restrain virtually all developed nations. Provisions of the more recent Chemical Warfare Convention (CWC) have further tightened the constraints, outlawing the use of every conceivable chemical weapon. The CWC even bans the use of agents as benign as tear gas (although, ironically, individual nations are not denied the option of using them against dangerous criminals within their own boundaries). And while the CWC prohibitions even extend to drugs and chemicals designed to incapacitate rather than kill, the United States has agreed to abide by them, abandoning the rational argument that prohibition of relatively safe weapons invites more dependence on those that cause more death and suffering.
Image result for images of General William Creasy
Major General William Creasy
Things were much different back in the late 1950s. In striking contrast to today’s total ban, the U.S. legislature enthusiastically accepted the novel concept of incapacitating agents. In 1958, Major General William Creasy, Chief of the Chemical Corps, was invited to engage this august branch of government in a lively session. Captivated and at times even amused by vivid images of a cloud of LSD that could disable well trained troops without causing them physical harm, senators and congressmen voted almost unanimously to endorse Creasy’s proposal to triple the Chemical Corps’ budget and proceed with studies of this and similar agents in Army volunteers. When asked if he could incapacitate members of Congress in a similar manner, Creasy cavalierly quipped that so far he had not considered this necessary! 

President Dwight Eisenhower quickly gave his blessing to this effort. Later, newly elected President Kennedy, almost from the start of his administration, promoted a “Blue Sky” strategy that included incapacitating agents in the growing list of novel military options. Although, as coming chapters will reveal in detail, subsequent efforts to find and deploy humane chemical weapons were not totally successful, this hopeful objective guided secret research for more than a dozen years. Ultimately, even as hope dwindled, the experimental findings remained locked in tight secrecy for at least another decade.

The Edgewood laboratories eventually filed the wealth of data accumulated during these unorthodox studies, leaving them to languish in closely guarded cabinets. Later they moved these documents to even less accessible archives, determined to keep sensitive, classified reports out of the public limelight. Over time, waning interest and fading memories eroded many details of what we had learned, leaving only sketchy summaries and a significant gap in the historical record. This book goes back four decades in an effort to fill that gap. 
Image result for images of President John F. Kennedy
Soon after General Creasy’s visionary project began to take shape, I was assigned to Edgewood Arsenal to play a part in its development. Strict secrecy would surround most of our work, lest the Soviets purloin and make use of our diligently acquired information. Stern, sometimes unreasonable rules prevented more than scant reference to our activities from appearing in the media. Because most of the world’s anxiety focused on the threat of nuclear war, “talking heads” gave relatively little attention to the arcane medical experiments being conducted at our small chemical installation. 

By the time news writers began to report the story in more detail, the program had already begun to wind down. After 1970, the search for a militarily acceptable incapacitating agent had become increasingly out of fashion. 

The years passed and the activities that took place in the Edgewood Arsenal medical laboratories during that decade were soon only vaguely remembered by a few of the former researchers. Civilian commentators sometimes spoke of the Edgewood program as a rather unethical, ill advised and generally sub-standard scientific effort that had yielded little of interest to the field of medicine. The erroneous belief that the program was primarily the brainchild of the CIA, already notorious for its ill-conceived attempts in the early 1950s to gain control of human behavior with drugs, added to these unflattering characterizations. Most participating physicians failed to rise to the defense and refused to grant interviews to investigative reporters, or shifted responsibility to their attorneys. Drawn by the scent of malfeasance, popular authors began to write books incriminating both the CIA and the Edgewood doctors. 

The Edgewood Arsenal program and the earlier shady CIA experiments, involving surreptitiously administered LSD and related drugs, became indelibly linked in the public imagination.
Image result for images of COLORED MAP SHOWING WHERE EDGEWOOD ARSENAL WAS
Regrettably, no one other than those who had done the research seemed to have much solid information about the details of our activities at Edgewood. By default, fantasy and rumor took the place of verifiable facts. I watched with distaste as invidious characterizations of our program appeared repeatedly in paperback books and ultimately on oft-visited websites. In 1979, even the prestigious journal Science published incorrect information about BZ, the very potent atropine-like incapacitating agent most often mentioned in books and on Internet websites. It was hard to blame the journal’s editor. Few who had been at Edgewood wanted to talk about it, and most of the published information was shamefully superficial. 

By the time the original detailed technical reports were declassified (usually at least 12 years after they had first been distributed as restricted documents), most of those who had done the work had quietly moved on. Memories were vague, original data largely inaccessible, and motivation to publish them virtually non-existent. As the first Regular Army psychiatrist ever assigned to Edgewood Arsenal, I was only one of a small but growing number Army physicians actively involved in the drug testing. 

For ten years, I was given the opportunity to play a leadership role in the search for a safe and effective incapacitating agent. The research design was embryonic in 1961, but slowly evolved into a highly structured method for evaluating candidate agents in Army volunteers. I was engaged in measuring the clinical effects of more than a dozen compounds, most of which had arbitrary numbers but no common names, and few of which ever entered the mainstream of medicine. 

In the course of testing psychoactive drugs in more than a thousand subjects, we did not limit ourselves to estimating the potential usefulness of incapacitating agents. Along the way, we also re-established interest in a long neglected antidote that eventually became generally available in emergency rooms. Ironically, very few doctors who use this drug to treat delirium resulting from medication overdose are aware that Army doctors were the first to study it in a controlled experiment and quietly publish their results in mainstream civilian journals. 

In the following pages, the reader will find numerous unvarnished accounts of highly trained soldiers trying to cope with the effects of potent psycho-chemicals – becoming confused and forgetful for hours to days while attentive nurses and psychology technicians carefully measured changes in their ability to function. You will learn the strikingly different ways in which such drugs as BZ, LSD and synthetic marijuana derail thought processes and disorganize behavior. The chapters that follow provide vivid detailed accounts of many bizarre and unexpected incidents, often unearthing forty to fifty year old photographs and videotape transcriptions from my personal files.

Clinical observations are supplemented by verbatim notes made by medical specialists traveling close beside the volunteers on their chemical trips. They recount the bizarre, sometimes wryly amusing, aberrations in speech and behavior sometimes appearing amidst realistic combat simulations. These descriptions clearly illustrate how small doses of a chemical agent can inexorably prevail, despite the high intelligence and thorough training of the subjects. Adding further to the record are the post-test write-ups by the volunteers themselves, which provide unique insights into the subjective side of incapacitation.[It is always in the eye of the beholder,what was incapacitation to the doctor, was called peaking by the tripper.I for one was always amazed at how such a small amount of LSD, could make you a giant of mind DC] 

This volume contains frank discussion of the ethical compass that guided our work, particularly with respect to “informed consent.” Some chapters describe, and occasionally take issue with comments appearing in both military and civilian publications, particularly between 1965 and 1982, when public concern about the Army’s testing of drugs in human volunteers dramatically escalated. 

Although my own work at Edgewood was primarily dedicated to the evaluation of potential incapacitating agents, this book includes a discussion of nerve agents – the lethal substances that cause the greatest concern. It closes with a personal assessment of the current threat and a critique both of the facts released to the public, and the limitations of our government’s information policies. 
Image result for images of Edgewood Arsenal, now part of the larger Aberdeen Proving Grounds, in yellow on the upper right.
Edgewood Arsenal, now part of the 
larger Aberdeen Proving Grounds
For many years, it was my intent to summarize our psychochemical inquiries in the 1960s – a unique decade of experimentation. Predictably, other activities supervened. But when events in the Middle East reawakened world concern about chemical warfare, I felt an obligation to carry out this long postponed intention. 

What follows is a personal perspective on the clinical study of incapacitating agents investigated in the 1960s. Although in retirement, I felt it important to document the fascinating and informative details of a decade of scientific work might otherwise be lost forever. 

Writing what follows required not only vivid recollection of specific events, but close review of previously classified reports, many of them generated while I was still at Edgewood Arsenal. Personal notes, as well as some original data I retained, helped immensely. Most of these exist only in my file cabinets. Interwoven among the names and numbers, are memorable anecdotes, some personal and some that shed light on the dynamics of a military bureaucracy including some political overtones. 

Our work took place in a setting where morale was high, curiosity was often rewarded with discovery, and surprisingly strong support was provided by civilian peers, military supervisors and elected officials. Thus, this book often presents an upbeat view of an otherwise somber mission. It frankly recreates the experiences of a psychiatrist who, with much help from others physicians, nurses and technicians, had the unique opportunity to build what eventually became a sophisticated research program. 

While focused on experiments, this narrative also depicts the personality of many colleagues. More important, it underlines the patriotism and courage of the many volunteers who trusted us enough to take strange drugs whose effects were not yet fully known. They knew the risks and willingly accepted them. It was the volunteers, more than the researchers, who were the true explorers. They deserve great credit for their starring performance in the offbeat, at times quixotic, drama that took place on a secret stage called Edgewood Arsenal.

For readers, ranging from apolitical scientists, physicians and teachers to ideologues and conspiracy theorists; from historians to incurably inquisitive thinkers; the contents of this book will provide interesting, previously unpublished facts – as well as some new, at times entertaining insights – about an extraordinary decade of now almost forgotten research.


INCAPACITATING THE ENEMY: 
STRANGE FRUIT AND STRAY SMOKE
Chemical warfare has its roots in antiquity. Periodically, armies have used drugs, mostly extracted from poisonous plants, against their opponents. In more recent centuries, chemical laboratories have gone on to produce new and more sophisticated compounds along with more effective devices for their delivery. The American army paid little or no attention to this type of weapon, however, until the 20th century. When German troops used toxic gases in World War I, they found the U.S. and its allies almost totally unprepared. 

Although chemical warfare goes back at least 3,000 years, its use has always been sporadic and short-lived. Ingenious attempts to find effective substances and ways to deliver them in the battlefield almost always failed. On the rare occasions when they proved effective, the parties involved often agreed to ban them in the future. The agreements, however, were never international in scope and opinions differed as to whether or not to outlaw chemical weapons. For every condemnation of their use, there were countervailing arguments in their favor. 

The effects of lethal chemical weapons are, of course, abhorrent, even when they account for only a small fraction of the total number of killed and wounded. When toxic chemicals strike, they tend to annihilate specific groups rather than scattered victims. Historically, victory is supposed to go to the courageous and most skilled, but chemicals make courage and training irrelevant, leaving no heroes. Eerily, most deaths resulting from lethal chemical agents leave corpses without wounds. The victims of gas attacks rarely go down in legend. 

For these reasons and no doubt others, it has generally been the most despotic and underdeveloped nations that have had the least compunction about their use. In more “advanced” countries, certain “noble traditions” of warfare seem to have created a natural aversion to anonymous killing by poison, the use of which is usually associated with cowardice and treachery. Accordingly, it has generally proven useless to argue as some military experts did (especially after WW I) that war was not “playing marbles” and if chemical weapons could achieve victory more swiftly and with less loss of life, they should be used. (In WW II, a similar line of reasoning ultimately prevailed. President Truman unleashed the atomic bomb for that very purpose – to conclude a war and avert useless deaths on the battlefield.) 

Attempts to ban chemical warfare always fell short of success. Even though the United States signed the 1925 Geneva Protocol, the Senate would not ratify it.

After World War I, some military analysts pointed out that we should have taken the threat of chemical attack more seriously. Had we provided gas masks and training to our troops, tens of thousands of dead soldiers could have remained alive. Many thousands more (unless exposed to blister agents) “could have lived out their lives free of painful disabilities. In a 1932 letter to Secretary of State Henry L. Stinson, US Army Chief of Staff General Douglas MacArthur argued that staying abreast of technical advances in the field required continuing research and testing. As with nuclear weapons, many asserted that a retaliatory chemical capability was necessary to make aggressors think twice before using such weapons. 

Recognizing our earlier naiveté, the War Department established the Chemical Corps in 1922, centered at Edgewood Arsenal in Maryland. Over the next forty years, the U.S. escaped a repetition of the chemical atrocities of the First World War. Ironically, it was mostly Hitler’s personal phobia of chemical retaliation that saved us from the thousands of tons of nerve agents already synthesized and stockpiled by the Nazis. 

In the 1950s, heightened awareness of the threat led to renewed U.S. efforts to build a sturdy chemical defense, including improved methods of training, detection, protection, decontamination and treatment, along with contingency stockpiling of the very nerve agents we almost faced in WW II. Although we subsequently armed ourselves with similar weapons, we made it clear that we would never use them first. Franklin Roosevelt, in particular, emphatically stated that chemical weapons were despicable. Accordingly, the policy of no “first use” became an axiom of military planning. 

Jeffery Smart has described the 1960s as the “decade of turmoil” in the Chemical Corps. During this period, the U.S. made serious efforts to develop a new class of weapons: the “incapacitants” – otherwise referred to as “non-lethal agents.” And it is here that this book picks up the story. 


Incapacitating Agents 
What is an incapacitating agent? Simply defined, it is any physical or chemical agent that can render target personnel unable to carry out their duties for minutes to days, with low probability of death or persistent injury and a very high likelihood of complete recovery. Although physical agents such as deafening noise, blinding light, microwaves, electric shock and ensnaring devices may all be considered to be incapacitating weapons, this book is about chemical agents. 

While the term “incapacitating agent” seems to have first appeared in the 20th century, the concept is extremely old. Not only have armies used chemical weapons against both enemy troops and civilians, but criminals have also employed chemical agents to simplify robberies or to buy extra time necessary to carry out complex illegal activities.

Historical incidents illustrate various attempts to use drugs in a military setting. Some of the substances used bear a striking similarity to modern chemical weapons and provide useful illustrations of their potential military effects. As we initiated our own research at Edgewood Arsenal in 1961, we concentrated on incapacitants, focusing on anticholinergic (atropine-like) drugs. A review of the existing literature seemed like a good place to start. We asked Ephraim Goodman, a psychologist in our clinical laboratory, to search for historical records of the behavioral effects of high doses of atropine and similar agents. He scoured the stacks in several libraries and after several weeks submitted a draft report that exhaustively summarized both military and non-military uses of atropine to produce either intoxication or death. 

Physicians have, of course, used atropine for many centuries as treatment for a variety of conditions. Therapeutic doses generally range from 0.5 to 2.0 mg. At doses above 10 mg, atropine causes profound mental changes. Following massive overdose (above 100 mg), the outcome can be lethal. 

Goodman visited the Library of Congress and other archives in his persistent search. He waded through 100 years of The Journal of the American Medical Association, as well as The Boston Medical and Surgical Journal (continued as The New England Journal of Medicine), Lancet and The British Medical Journal.

His fluency in German also allowed him to review other specialized sources in detail, including Fuehrer-Wielands Sammlung von Vergiftungsfällen (continued as Archiv für Toxicologie) from 1930 to 1962 and Deutsche Zeitschrift für die Gesamte Gerichtliche Medizin from 1922 through 1939. An examination of standard medical literature indices from 1880 to the present reveals additional major reports in other sources. Never published, Goodman's draft manuscript nevertheless remains a treasure trove of incapacitating agent history, extracted from more than 300 articles both for medicinal and non-medicinal purposes. The latter include robbery, seduction, Satanism, tribal justice by ordeal, location of precious objects and stolen articles, individual thrill-seeking and practical joking. With more positive intent, these plants were revered by some primitive religions and were sometimes used to initiate youths into adulthood. 

Accidental overdoses were especially common. Of 576 cases of atropine intoxication, almost half were due to oral ingestion of plant material, particularly by children below the age of five. Ophthalmological, liquid medicinal, parenteral and percutaneous overdoses made up the remainder. Significant differences in the source of the drug occurred among age groups, however. Individuals above the age of 61, for example, were inclined to encounter overdosage from eye drops or medicinal plasters. 

Although not as common nowadays, in the period from 1950-55, 10% of live admissions of children under five years of age to Scottish hospitals were for intoxication resulting from ingestion of atropine-containing plants. Among pediatric admissions to a South African Hospital during the same period, fully two-thirds were victims of solanaceous alkaloids. Surprisingly, physicians frequently failed to recognize that atropine was the basis for the clinical features they observed. Often, they wrongly attributed the signs and symptoms to syphilitic paresis, postpartum psychosis, dementia praecox (schizophrenia), acute manic-depressive psychosis (bipolar disorder), or any of a variety of infectious or traumatic conditions. 

The signs and symptoms of atropine intoxication have been wryly summarized by H. P. Morton (1939), in the form of five easy to remember similes: “Hot as a hare, Blind as a bat, Dry as a bone, Red as a beet and Mad as a hen.” In more professional language, atropine intoxication (as observed by Forrer and Miller during their atropine coma treatments in the late 1940s) consists of two sequences: the first neurological, the second, behavioral. 

The neurological sequence, according to these clinicians, is as follows:

1) Progressive muscular incoordination 2) Decreased pain sensitivity 3) Hyperreflexia with development of a Babinski sign (upward motion of the big toe following stimulation of the sole of the foot). 

The behavioral sequence is as follows: 

1) Clouding of the sensorium 2) Disorientation 3) Loss of time-space relationships 4) Distortion of perception with illusions and hallucinations 5) Confusion 6) Coma. (The last of these usually appears only following large overdoses.) 

Historians have described the consequences of mass intoxication as early as in the last half-century BC, when Antony's army was exposed to belladonna by an enemy force and experienced both delirium and deaths, according to Plutarch and case reports. A summary of some of his findings follows. 

“They chanced upon an herb that was mortal, first taking away all sense and understanding. He that had eaten of it remembered nothing in the world, and employed himself only in moving great stones from one place to another, which he did with as much earnestness and industry as if it had been a business of the greatest consequence. Through all the camp there was nothing to be seen but men grubbing upon the ground at stones, which they carried from place to place.” 

As a result of the widespread global distribution of solanaceous plants (atropine containing members of the potato family), a variety of cultures have employed them. Similar poisoning occurred among Colonial troops in Virginia in 1676. The affected soldiers needed confinement for eleven days (a surprisingly long period). On 14 September 1813, while on the march, a company of French Infantry unknowingly consumed atropine-containing berries. Poisoning of monks in a monastery around the same time disrupted their well-learned and habitual rituals. A group of sailors, intoxicated while on board ship in April 1792, was fortunately able to call for help by firing cannons and running up signal flags, allowing some to survive. 

The following excerpt describes the delirious condition in the case of eight East Indian troops poisoned in 1895: 

“Most of them were unable to answer when spoken to, and those who could, had forgotten their own names. Some lay on the ground in a dazed condition; others sat up constantly making fidgety movements with their fingers, picking up small particles of sand or pebbles from the ground or appearing to be searching for something they had lost, and occasionally looking up with a half vacant, half-wild expression.” 

Similarly, the French soldiers who poisoned themselves in 1813 by naïvely consuming wild berries containing solanaceous alkaloids also soon became delirious. M. Gaultier, the attending military physician, described the victims as: 

“...in continual agitation. Their knees sank under the weight of the body, inclining them forwards, and carrying their trembling hands towards the earth, endeavoring to collect little stones and bits of wood, which they always let fall or threw away to recommence the same pursuit.” 

Goodman comments that this grubbing on the ground was typical behavior in belladonna-intoxicated children, as well as adults. (In later chapters, BZ intoxicated volunteers will be seen to exhibit very similar behaviors.) 

Age, health and environmental factors appear to play a significant role in the susceptibility to, and potential lethality of atropine toxicity. The very young and the old as well as those with debilitating conditions such as tuberculosis or hypoglycemia, are especially vulnerable. The presence of a hot, dry environment increases the danger of death through hyperthermia. Belladonna drugs inhibit the ability to perspire, the cause of most of the deaths in hot climates. In cases of extreme overdose, cardiac failure is probably the determining factor.

It is difficult to estimate the lethal dose in man due to the many confounding factors that may be present, as well as the selective reporting of deaths following either unusually high or low dosage (both of which probably have more medical “news value”). One authority has declared a “surely fatal dose” to be about 1200 mg. Most pharmacology texts, on the other hand, tend to give estimates at least ten times lower. 

Based on pooled data, Goodman calculated that 450 mg is the average lethal dose (LD50), about forty-five times the dose that produces delirium. One report in the literature documents a case of recovery from an oral dose of 1,000 mg of atropine. Also, at least one individual has survived 500 mg (from 100 to 150 times the delirium-producing dose) of the related but more potent drug scopolamine. 

The military mass intoxications mentioned above were mostly accidental. But in his review, Goodman also includes a history of the deliberate military use of atropine and atropine-like substances, i.e., hyoscyamine (atropine) and hyoscine (scopolamine), both obtainable from plant sources. In one instance:

“An officer in Hannibal's Army, about 200 BC, used atropa mandragora (mandrake) as a chemical ambush. According to the officer, "Maharbal, sent by the Carthaginians against the rebellious Africans, knowing that the tribe was passionately fond of wine, mixed a large quantity of wine with mandragora which in potency is something between a poison and a soporific. Then, after an insignificant skirmish, he deliberately withdrew. At dead of night, leaving in the camp some of his baggage and all the drugged wine, he feigned flight. When the barbarians captured the camp and in frenzy of delight greedily drank the drugged wine, Maharbal returned, and either took them prisoners or slaughtered them while they lay stretched out as if dead.” 

In the struggle for power between Pompey and Caesar (in approximately 50 BC) troops in Africa were deliberately poisoned by placing substances in their drinking water. Subsequently “their vision became hazy, as in a fog, and an invincible sleep overtook them. Then followed vomiting and jerking of the whole body.” L. Lewin (1929), an expert on psychoactive plants, believes that their difficulties in visual accommodation, muscular excitation and desire for sleep clearly point to intoxication by solanaceae. The widely distributed Hyoscyamus falezlez and Hyoscyamus muticus are indigenous to North Africa and may have been the plant material used to drug the troops. 

The next documented example of the use of solanaceae for military purposes apparently did not occur until nearly eleven hundred years later: 

“In the reign of Duncan 1034-1040 AD., the eighty -fourth King of Scotland, Swain, or Sweno, King of Norway, landed his army in Fife. The Scots retreated to Perth after a battle near Culross. Duncan sent messengers to Sweno to negotiate surrender and during the discussions supplied the Norwegians with provisions. As expected, this was looked upon as a sign of weakness. The Scottish forces under Bancho entered Sweno's camp while the invaders were intoxicated with wine dosed with ‘sleepy nightshade.” (G. Buchanan, 1831). 

Historical evidence of the oral use of the solanaceae for military purposes next exhibits another gap, of over eight hundred years. 

“In 1881 a peaceful railway surveying expedition under Lieutenant-Colonel Paul Flatters of France was proceeding to the Sudan from Algeria, through the territory of the Touareg. These Berbers who, unlike other North Africans, veil the men and not the women are a raider people who did not completely surrender to French authorities until 1943. The Touareg call themselves "The Blue Men" and "The People of the Veil"; the other inhabitants, however, call them ‘The Abandoned of God.’“ Flatters ignored a warning letter and marched into an ambush on 16 February 1881, losing approximately half of his force, or all of the personnel in the area where the ambush took place. On the next day, the five French and fifty-one indigenous survivors started to march to a French outpost. This party was trailed by a force of approximately two hundred Touareg. 



“On 8 March 1881, their supplies having been observed to be low, they were approached by three men who claimed to be members of another tribe. These men offered to sell the party provisions. On the next day, three bundles of dried dates were thrown into the camp, and varying quantities were consumed. The French members of the party apparently ate more than the indigenous soldiers.

“Shortly thereafter signs and symptoms of solanaceous intoxication were manifested. Five of the fifty-six men disappeared in the confusion of the first few minutes. Thirty-one of the remainder were so sick that they were unable to look after themselves. In the evening, some attempted to crawl away into the desert. The Frenchmen had been tied down by the senior indigenous soldier to prevent injury. There was some improvement by morning.” According to R. Leder (1934), “And so they set off, half mad, bent double under excruciating pain, their legs crumbling away under them, their voices shrill, their words unintelligible. 

“On the second day after the poisoning they reached an oasis, where a force of Touareg awaited them. By this time, however, the survivors were able to function as an effective fighting force, and thus the attack was repulsed. Two of the French, said to be under the influence of the drug, rose and marched forward to death. 
Image result for images of Hyoscyamus falezlez
“After more difficulties, the party evaded the Touareg and found water. They resorted to cannibalism to sustain life. On 29 March 1881, twelve Algerian soldiers reported to a French outpost. The poison has been identified as Hyoscyamus falezlez.” 

Other examples cited by Goodman include the poisoning of 200 French soldiers by Chinese reformers in Hanoi on 27 June 1908, all of whom recovered. One of the intoxicated soldiers saw ants on his bed, a second fled to a tree to escape from a hallucinated tiger and a third took aim at birds in the sky. Another incident was the abortive attempt by Soviet agents in 1959 to poison the staff of Radio Free Europe in Munich by putting atropine in saltshakers in the cafeteria. A double agent foiled this effort. 

An example of an early attempt to disseminate belladonna alkaloids as an “aerosol” occurred on 29 July 1672, when troops of the Bishop of Muenster assaulted the city of Gröningen. It proved fruitless. The fumes dissipated in the open air, and the heat of combustion destroyed the active principles of the vegetable poisons contained within the shells. Despite the ineffectiveness of this weapon, the French and Germans soon negotiated a treaty at Strasburg on 27 August 1675, outlawing the use of poisoned shells. 

Goodman submitted his paper for official review prior to publication in 1962 with our enthusiastic encouragement. Dishearteningly, our department chief, Major Claude McClure, declined to sign the necessary approval, even though the manuscript contained no classified information. His comment was that it was too long and detailed to be acceptable as a journal article. 

The draft thereafter languished in our files until 1997, when we took the liberty of extracting portions of it for inclusion in a chapter on “Incapacitating Agents,” subsequently published in the first edition of the Textbook of Military Medicine. Goodman himself was lost to our “tracking station” soon after he completed his compulsory two years of military service. Despite several attempts, we could not find him, hoping to persuade him to complete and publish the manuscript. This is regrettable: it is a masterful scholarly work that students of pharmacological history should be able to access. 

Meanwhile, in modern times, a partly successful use of incapacitating agents was the previously mentioned Russian rescue in 2002 of almost a thousand civilians held hostage in a Moscow theater. Although many died, it seemed clear that unless the terrorists achieved their demands they were prepared to bring about the death of everyone, including themselves. This action broke the taboo against deliberate use by a government of an “incapacitating agent” against humans, but it seems probable that the taboo will be reinstated and continue to remain in full force for the foreseeable future. 


HELLO, EDGEWOOD ARSENAL!
Image result for images of The “all-purpose room” of our tiny 5th floor no-heat apartment (1954) 
My Christmas surprise in 1955, as I approached graduation from Cornell University Medical College, was a persuasive Army recruiter. 

“You can be among the first to join our newest program for young about-tobe doctors,” he said. “The Army will make you a 2nd Lieutenant, with full pay and benefits without your having to do anything but finish your last year as a medical student.” 

It sounded terrific. I had spent eight years scratching out the cost of my education with the help of scholarships, college loans, and part time work as a sperm-donor, file clerk, common laborer, camp counselor, typist and night technician at a downtown blood bank. I worked straight through summers and almost every vacation break. 

For most of my four years in medical school, I lived like an artist in a garret on East 66th Street, in a fifth floor walk-up tenement, with no heat. The price was right: My roommate and I each paid $9.75 a month for rent, and we were located close enough to walk to Cornell on 69th Street. We had a total of 300 square feet of floor space, a 9 x 12 foot living room and the bathtub was in the kitchen, but somehow it seemed okay. Come to think of it, we were each paying less than four cents a month per square foot of New York floor space. And tuition at one of the best medical schools in the country was only $900 a year in those days (it might be $50,000 by now).

I didn’t even realize we were poor until the Army recruiter held out his offer of $340 a month. It was too much to resist. No longer would breakfast consist of an old pickle jar half-filled with black coffee, loaded with lots of sugar and topped off with half a pint of heavy cream – a thousand calorie meal that cost only about a quarter and produced nothing worse than a mild degree of nausea, and perhaps an extra bit of lining for my coronaries. 

The next week I traveled to Governor’s Island and filled out the necessary forms. I swore that I would be a loyal and faithful officer in the Medical Service Corps 1 and took the ferry back to Manhattan basking in my newfound affluence. 
1 Prior to receiving an M.D. degree, one is not yet in the Medical Corps, but in the Medical Service Corps.
An internship at Letterman Hospital in San Francisco came next. In July, I crossed the country in my recently acquired beat-up 1948 convertible Studebaker and arrived in San Francisco feeling like a courageous pioneer. I delivered 50 babies, performed two appendectomies, and spent my free time cruising the Officers’ Club for female companionship, which was readily available. I could hardly foresee that in four years, my life would change dramatically and I would become a real pioneer, exploring the vast, secret world of chemical warfare at an obscure Army installation called Edgewood Arsenal. 

Following internship, I spent six months at Fort Sam Houston, Texas, learning to be a proper Regular Army Officer; followed thereafter by a hoped-for transfer to Walter Reed Army Hospital in Washington, D.C. There, I learned the basics of psychiatry. I discovered I had less faith in Freud than in the biology of schizophrenia. “Many of Freud’s writings are still in the original German,” commented a fellow resident at a department dinner party.

“Many of Freud’s writings are still in the original German,” commented a fellow resident at a department dinner party. 

“Yes, and thankfully most of them are still untranslated,” I quipped. 

“What a character!” my department chief guffawed. We got along famously after that – he was a notorious iconoclast himself. 

I disciplined myself, in those days, getting up at 4:30 A.M. to study books on cybernetics, and insisting on boring my fellow residents with a computer model I had made from bendable soda straws, tinker toy parts, paper clips and marbles. Success and failure were equally stimulating and nothing seemed to faze me for long. I was young, carefree and passionate. Our department chief allegedly commented to one of my mentors, with a tone of resignation, that I had done very well at anything I actually liked. He had evidently decided to accept my incurable lack of conformity. 
Image result for images of Dr. David Mackenzie Rioch,
Dr. David Mackenzie Rioch, a stern-faced, fundamentally benign man with dark bushy eyebrows, seemingly sensed that I might have been cast from a different mold. He was a relentlessly dedicated scientist who supervised my efforts at outpatient therapy for an hour each week. As civilian Chief of the Neuropsychiatry Division of the nearby Walter Reed Army Institute of Research (WRAIR), Rioch had a prestigious and well earned international reputation. 

At first, I would arrive for my hour of supervision carrying voluminous therapy notes, relying on them for details during our sessions. Eventually, Dr. Rioch told me, with a tinge of exasperation: “I don’t like all those notes.” I had always thought it was cool to write down everything that patients told me. (This remained a lifelong habit.) In this case, however, I felt it best to defer to Dr. Rioch’s wishes; thereafter I presented only what I could remember, a change which he acknowledged with approval. 

Rioch’s illustrious career had started at Harvard in neuroanatomy, after which his interests moved progressively from the structure of the brain to the anatomy of the mind. His span of knowledge was truly awesome. 

In the second year of residency I was allowed a three-month elective in his department where I learned, among other things, the fine art of drilling tiny holes in the skulls of cats and precisely inserting electrode wires deep inside the brain. This experience gave me an idea. I decided to try to teach cats to make their wishes known by communicating with their brain waves. 

On Thanksgiving Day I skipped turkey dinner and, alone in the lab, completed my first successful feline implantation. I was flush with pride but my furry patient was not as fortunate. Although he gave nice brain tracings, and continued to meow effectively when hungry, he never seemed able to learn the niceties of EEG communication. Instead, he ultimately succumbed to the delayed consequences of a wound infection. The veterinarian who was supposed to monitor him while I was away on leave had failed to watch him closely enough. 

I was pretty sad about this. When he became sick, I took him home to my bachelor apartment for two weeks and fed him milk with an eyedropper, as he lay curled up on a blanket in the bathtub. Penicillin cured the local abscess, but my kitty never regained full neurological function.

Resilient in temperament, I decided I had done my best and began a different project. I compiled a lengthy review article entitled “Electrosleep, Electronarcosis and Electroanesthesia.” It won lavish praise from my supervisor, Dr. Robert Galambos. Dr. Rioch liked it as well, but pointed out that the reference material came from confidential Soviet sources and it would be a breach of protocol to publish it. 

That was the second crash landing by a fledgling research bird attempting initial flight. I affected unconcern about my lack of success. That may be one reason Dr. Rioch called me over to his office a year later. 

“Jim, there’s a situation at a place called Edgewood Arsenal, about an hour and a half north of here.” 

“Really?” I said, all ears to situations. 

“Edgewood has a highly classified program on incapacitating chemical agents getting started up there and they don’t have anyone trained in psychiatry. The investigators gave some PCP to five civilian volunteers and one of them ended up in the hospital for six weeks with a paranoid psychosis.” That didn’t sound too encouraging. I was pretty sure I knew what was coming next. 

“Would you be interested in an assignment there when you finish up your residency in December?” he inquired. His Scottish brogue flowed through my inner being like a hypnotic potion. How could I resist? Accordingly, I became a reborn fledgling, this time as a psychopharmacologist.

I wanted to see what I was getting into so I arranged an exploratory visit. The map led me to an unimpressive looking installation five miles off the main highway running from Baltimore to Philadelphia. I showed the guard at the entry gate my official travel orders, and he directed me to Building 355, an unpretentious two-story whitewashed concrete structure. 

Signing the visitor sheet, I entered the office of the Chief of the Medical Research Laboratories, Colonel Douglas Lindsey. He was a slim, wiry man in his early forties, and emanated an aura of relaxed authority. Unlike other senior officers, he was dressed unpretentiously in Army fatigues. The other officers dressed normally, with colorful service ribbons on their blouses and shiny rank insignias on their shoulders. Doug Lindsey’s uniform had evidently been cut from a different bolt of cloth. 

“Captain Ketchum, I presume,” were his first words. “You must be the psychiatrist we’ve all been waiting for.” He led me across the parking lot to some wooden barracks, where World War II Chemical Corps soldiers had once resided. It wasn’t very impressive looking – several cantonment style claptrap wooden buildings joined together by one long narrow hallway, its floor paneling partially covered by a worn rubber strip creased with narrow non-slip grooves. “And this is Dr. Kazuo Kimura,” added Lindsey. “He will be your initial primary supervisor.” A tall massively constructed man, Asian in visage, Kimura offered me a firm but not intimidating handshake. “Welcome to Edgewood Arsenal,” he said.

“Very nice to meet you,” I replied, making an effort to conform to the rules of normal etiquette. “I’ll leave you with your new boss, then,” said Lindsey and off he went, diminutive frame erect, with a stride that signaled “other important things to do.” 
Image result for images of – Dr. Kazuo Kimura
“You’ve come on a good day,” said Dr. Kimura. “We’re running another test with a drug called EA 2277.” I suddenly realized I was about to enter a new world full of secret names and numbers. 

The ward, large enough to accommodate 20 bunks for enlisted troops, contained only half a dozen widely separated hospital-style beds. A young soldier sat on the edge of one of them, restlessly fumbling with his pillow. He was trying to stuff it back into the pillowcase from which he had just removed it. He couldn’t make it fit, so he turned his attention to the sheets. Then, suddenly, he became interested in the buttons on a technician’s shirt. 

“He’s a bit out of it right now,” said Kaz. “So I don’t think I can introduce you. He wouldn’t understand who you are, why you are, or where you are.” 

“So I see,” I commented, watching the soldier’s performance with great fascination. 

“Ain’t that a piece of shit,” the volunteer said unexpectedly, addressing no one in particular, in a slurred but surprisingly loud voice. Then he laughed abruptly. “I knew the fucking IG was coming. That a horse over there?” Abruptly, he went back to “un-making” his bed. 

In rapid succession, I met two of the psychologists, including the previously mentioned Ephraim Goodman. Goodman seemed to feel a need to stand at attention next to the young physician who was busily making notes about the volunteer’s strange behavior. 

“Bill Gordon’s our only Navy doctor,” Kaz explained, noticing that I had my eyes on the blue trousers under Bill’s white coat. “He’s been handling the EA 2277 testing we started a couple of months ago. If you decide to come, you’ll be arriving just in time for him to start his residency.” 

“Oh,” I said. “Well, it actually looks quite interesting. I’m really looking forward to coming.” I said it sincerely because there was no doubt in my mind that working in this strange atmosphere was just the sort of thing that would satisfy my appetite for novelty. 

After returning to Washington, I assured Dave Rioch I would be happy to work at Edgewood. In due course, as my residency drew to a close, transfer orders arrived and I was soon on the road with my wife and our 5-day old infant son. 
Image result for images of hospital beds inside Edgewood Arsenal
By 1962, registered nurses were hired and an adjacent ward housed volunteers undergoing testing with incapacitating agents such as BZ and LSD. Later, padded areas provided much better physical safety.
Edgewood Arsenal (at that time known as the Army Chemical Center) was located at the tip of a peninsula about 25 miles northeast of Baltimore. Its widely separated buildings looked peaceful beneath a fresh snowfall.

A wide airstrip ran north to south along the midline. At its edges, inlets of the Chesapeake Bay Post created watery boundaries. From our new quarters in Grant Court, a dirt road ran through the woods to Skippers Point, where picnics and boating were popular during the summer months. On the north side of the main road, was a nine-hole golf course. In the warmer months, grassy areas surrounded the airstrip and deer nonchalantly grazed there in the twilight hours. 

The Medical Research Laboratories (Building 355) were located about a mile south of our Grant Court apartment, and the larger Chemical Research and Development Laboratories (Building 320) were a mile and a half further down the same road. 

Only about 1,000 military personnel and 5,000 civilian employees were working on the Post (many fewer than the 17,000 personnel assigned there in its more active years). Most of the civilian workforce lived in the neighboring towns of Edgewood and Bel Air, rendering the Post a quiet, almost rustic scene after quitting time.

The Medical Research Laboratory was generously staffed with well educated scientists. In 1955, 32 were college-educated officers, 12 among them being physicians from some of the country’s best medical schools. Three officers had PhD’s and one had earned both PhD and MD degrees. Among the 117 civilian researchers, 55 held Master of Science degrees or higher. 

In 1961, the Kennedy administration gave a generous financial boost to medical research, further increasing the number of professionals. In terms of formal education, the staffing of the Edgewood Medical Research Laboratory was certainly far from shabby. I felt privileged to become part of its research team. 

With surprising dispatch, after my arrival in 1961, I received a temporary Top Secret security clearance and very soon thereafter, a permanent one. Evidently, my past record was reassuringly devoid of red flags. Although almost all the research in progress at Edgewood Arsenal was classified – from Confidential up to Secret – physical security appeared surprisingly minimal. Two single guard entry gates and a simple perimeter of chain link fencing and barbed wire defended the grounds against intruders. The other research buildings usually had solitary security guards who casually checked ID's and the required signatures on entry and exit. The age of metal detectors and bomb-sniffing dogs had not yet peeped over the horizon. 

The “Annex,” where physicians had offices and conducted volunteer studies, also had very little visible security. One could often enter it freely through unlocked doors. I remember coming in at night and feeling a spooky “Twilight Zone” sensation, when walking alone through its deserted halls.

During World War II, the annex had housed Chemical Corps soldiers; later it was refurbished for use by researchers. Of course, there were locked cabinets and that sort of thing, but in general the atmosphere was informal and the safeguarding of documents rather casual. 

It was dark when our family arrived at Edgewood. Our assigned apartment in Grant Court, reserved for junior officers, was cold and contained only a few temporary furnishings. Our baby son had a cough and fever. Remembering that Kaz Kimura had been a pediatrician before he accepted a research job at the Medical Labs, I called him right away and he graciously prescribed appropriate medicine. 

Soon, my adventures in the Clinical Investigation Division began. I spent the first few days learning the names and responsibilities of staff members and observing tests with EA 2277. Before long, however, I became impatient to get off the bench and onto the playing field. 

Specialist-5 Ephraim Goodman, the brilliant psych tech I had met on my initial visit, was pleased that I had arrived. He led me through the established routines for administering chemical agents, entering written observations in charts and evaluating the mental status and degree of incapacitation of the drugged volunteers. 

Goodman had a master’s degree in psychology and was a limitless source of information about almost every aspect of the experiments. He should have been an officer, but was afflicted with an excess of modesty, as well as the compulsive personality of a perpetual scholar. He had no desire to be in charge, preferring to retain the status of a loyal assistant. We therefore got along famously since I had an inordinate need for autonomy and liked decision-making. 

Bill Gordon, however, became progressively miffed, believing I was trying to muscle in on the operation too soon. I had discovered, for example, a whole department devoted to film documentation, located in the Chemical Research and Development Laboratory – nerve center of the Edgewood conglomerate. Soon, with the backing of Colonel Lindsey, I was boldly arranging for the Graphic Arts department to make a short movie of a volunteer under the influence of an incapacitating agent. I assumed the role of examining physician in the film, and had the camera crew take moving pictures of the young man as he bumbled through simple tasks. He became unable to assemble a rifle and dropped the ruler as he tried to measure two points on a military map. He recoiled from the vision-testing apparatus as though it were a hostile aggressor, and then started sipping beer from an invisible can, savoring the taste of its non-existent contents. He had already taken off his upper garments (for no apparent reason) and was quietly singing a little tune. 
Image result for images of hospital beds inside Edgewood Arsenal
Van M. Sim, M.D. (1922-1990) Trained as an internist, he 
was Chief of Clinical Research from 1955-1961 and Chief Scientist 
of the Medical Research Laboratories thereafter.
It made good footage, but it pissed off Bill Gordon who was annoyed to find himself shunted off to the wings in the role of spectator, while I commanded center stage. Some of the psychologists were also becoming restive as I began to change the type and frequency of the performance testing they had put in place before my arrival.

Sensing the discontent of the staff members, who at first had seemed so glad to see me arrive, I decided to do the psychiatric thing – visit the boss and confide my growing discomfort and sense of rejection. 

Kaz was in his office in the main building, leaning back in the adjustable chair that barely accommodated his voluminous frame. He was smiling as I came in, a sort of Asian smile that reminded me of the Zen masters I had read about during my residency. 

“What’s up, Jim?” he began, lifting his gaze from whatever he was doing. 

“I like the work, Kaz, but I get the feeling that I am creating some resentment among certain members of the staff.” I paused, and assumed a mildly hurt demeanor. 

“Well Jim, it’s not that no one appreciates your work,” he said in a fatherly manner. “But when you come charging into your new job like a bull in a China shop, it’s bound to ruffle a few feathers.” 

His metaphors were slightly mixed but his meaning was clear. In return, I reluctantly acknowledged the accuracy of his observation. “I’m doing my best,” I said. “But I don’t seem to be getting much love.” 

“For all you know, you are loved very much.” He smiled again, seemingly amused by my way of expressing myself. “It’s not what you’re doing; it’s your manner of doing  it.” 

“I see.” It was not the first time I was destined to be confused with Napoleon. 

“Okay, I’ll try to be a little more sensitive.” 

“That’s the way,” said Kaz. “Don’t get discouraged. Things will work out. But take it easy, go a little slower. You’ll be running the show soon enough."

I took his advice and things improved. I became a bit more tactful, and even apologized to Bill Gordon for being self-absorbed and intrusive. I told him I realized he had been “the Man” for quite a while before I came on the scene. I confessed that I tended to be overeager at times and was capable of stepping on toes without intending to. Bill seemed surprised by my candor. He quickly forgave me and we had no further problems. 

Things were actually going smoothly by the time he left in June. I was now deeply involved in giving mind-altering drugs and watching their amazing effects. More than once I walked into the ward area in the middle of the night to see how the volunteers were doing after they had absorbed a fairly large dose of EA 2277 (later to be renamed CS 4030, then TK and ultimately its permanent moniker: BZ). It was quite a long acting drug, whose effects did not peak until 8 hours. Then, strange and unpredictable behavior emerged, increased, decreased, and finally faded away a day or two later. 

One night I came in at 2 A.M. Two volunteers, under the influence of a generous dose of BZ, were sitting at a table in the area set aside for meals. Sitting close by, two of the night shift technicians were vigilantly monitoring them, ready to deal with any troublesome behavior. 

The two volunteers seemed not to notice me. I watched with interest as one of them suddenly shouted into an aluminum water pitcher; calling out to someone he evidently thought had fallen into a well. Abruptly distracted by my questions, he then attempted to take a bite out of a non-existent chicken. “This thing is rubber,” he said. He sounded like a politician, jaded from attending too many fundraisers.

Out in the hallway, Van Sim suddenly ambled by, wearing his underwear. “Oh no,” I thought. “I hope he hasn’t been getting into the BZ again.” Van had acquired a long-standing reputation for fearlessness, insisting on trying every chemical agent himself before giving it to volunteers. For such (perhaps ill-advised) heroism, he had received a certificate for outstanding civilian service, based on his bravery and dedication. 

“Hi, Jim,” he said in the deep voice that always seemed to be originating from somewhere in his bowels. “What are you doing here?” 

“I sometimes come in late at night to check on the guys,” I said. “They get pretty interesting around midnight. What are you doing?” 

He had what looked like the glass faceplate of an old-fashioned watch taped to his wrist. “I’m trying to see if LSD has any effects through the skin,” he replied somewhat distractedly. “I’ve got it in some ethylene glycol under this watch glass.” 

“So far it hasn’t had any particular effect,” he added. I was still dubious. For one thing, I was uneasy about people testing themselves and had said as much soon after I began running my own experiments. I also knew that Van had taken LSD by mouth a number of times (for one reason or another) and once or twice by injection. He had also ingested a dose or two of “red oil,” the super concentrated potion of marijuana extract that had enjoyed a few moments of notoriety when it was first produced. Red oil had conjured up images of a safe and possibly somewhat pleasant incapacitating agent in the minds of some commanders. On reconsideration, however, they had decided it was too lacking in potency (and perhaps too socially unacceptable) for military purposes, and shelved it.

Van continued to mumble further about his theories of how LSD exerted its effects. His mumbling did not seem much different from the way he sometimes mumbled during the day and his explanation did sound reasonable. I decided he was probably okay after he explained further that he had gone to sleep in his office at the end of the ward in his underwear, and had just gotten up to use the latrine. After all, as one volunteer later commented after an LSD trip, “It’s nothing to get worried about. We’re all probably jacked out of shape a little bit anyway.” 

Edgewood turned out to be as enjoyable a place to work as I had hoped. It even felt good to be among the slightly “jacked out of shape” people of the world, whether they were staff or volunteers. I made sure, however, that no volunteer who was seriously “jacked out” went on a drug test with BZ, LSD or anything that might dislodge his personal stability “jack.” I was not in favor of pushing anyone even close to the edge of a psychiatric cliff, and carefully interviewed every volunteer before allowing him to become a psychoactive drug subject. 

COL Lindsey soon became an empathic friend and my most dependable “on location” ally. He had a colorful personality and a sort of “Go, Army” attitude. Trained as a surgeon, he seemed to be afraid of no man (or woman), including generals. Many legends had sprung up around him. One was that he despised wearing new looking uniforms. When obliged to replace his worn out military cap with a fresh one, for example, he defiantly ran a new cap up a flagpole for 30 days to give it a properly weathered look.

As a lecturer, he displayed a carefree attitude toward lethal chemical agents; even when everyone in class knew that a small drop was more than enough to cause death. While addressing a spellbound audience of young officers, he would sometimes partially immerse one finger in a small beaker of pure VX for a few seconds. Without interrupting his lecture, he would then amble to a nearby sink and casually wash the deadly chemical from his finger. The teaching point was that VX could not enter the skin instantaneously, and that accidental exposure of a small area would not be harmful as long as the site were promptly and thoroughly decontaminated. 

Lindsey engendered other legends. Once, when a doctor asked some volunteers to enter a chamber filled with CS tear gas, Lindsey went right along with them and refused to come out. He found that if he could manage to tolerate the first twenty minutes or so, he would became adapted to the irritant effects and could function normally. This profoundly impressed both volunteers and staff. Ordinarily, even highly motivated soldiers would not submit to more than a few minutes – sometimes only seconds – of exposure to the painful effects of CS on eyes and respiratory passages. 

However, when a young female officer called to inform him that she was in her apartment, intending to shoot herself, Lindsey's confident attitude carried him a bit too far. Ignoring the recommended protocol for such situations, he raced over to her quarters, charged up the stairs and peremptorily shouted for her to put down her pistol “or else.” Unfortunately, this approach proved ineffective. A few seconds later, a single shot rang out, making clear the sincerity of her intent.

All of this was past history by the time I arrived at Edgewood. Lindsey had recovered from this brief lapse of judgment and returned to his usual idiosyncratic and irreverent ways. He wrote official memoranda in a format that was decidedly not in the Style Guide for Military Authors. But, for all his quirks, the lab personnel greatly loved and respected both his eccentric style and his startling creativity. 

His off-the-wall sense of humor emerged unexpectedly one day when I dropped by his office to say “Hi.” 

“Ever hear of the Journal of Irreproducible Results?” he asked me. 

“Actually, no,” I replied. 

“It’s put out every few months by a renegade group of iconoclasts in Israel,” he explained. “Serves as a good counterbalance to some of the puffed-up stuff that scientists occasionally bully editors into publishing. I have an idea for an article to write on the subject, if you’d like to help me.” 

“Sure,” I said. 

“I was thumbing through an old urological journal and one of the authors referred to the Coudé catheter, paying tribute to Dr. Coudé for inventing it.” 

“That was gracious,” I said. 

“The Coudé catheter wasn’t actually named after anyone. It means, ‘curved’ in French. This got me laughing, and then I thought to myself ‘if a so called scholar thinks it was named after a doctor, who knows what other eponyms came about that way.’ ” 

“That’s a great idea,” I said. “We could point out the important contribution of Siegfried Gestalt, who obviously started Gestalt psychology. And how about Max Factor for Factor analysis?”

“Those are good ones,” he laughed. “And don’t forget about ‘Olë Bjorkan,” inventor of the beer-can opener.” By this time, we were both in stitches. 

Within a couple of days, we had drafted an article, filled with reverential recognition of important achievements by under-appreciated non-existent innovators, so rarely acknowledged in the medical literature. It was great fun to see our satire appear in the J. Irreprod. Results a few months later. 

“My first peer-reviewed article,” I commented when he showed me the reprint. “Of course someone should give credit to Dr. Peer for developing that ingenious review procedure.” 
Image result for IMAGES OF Carl Stearn/EDGEWOOD
The workdays were becoming more and more predictable. I would come to the clinical testing facility at 0800 (unless I had been up half the night documenting some volunteer's bewildering antics) and Carl Stearn would already be at his desk. 

A lean, unflappable civilian administrator for the Department, Carl always dressed in a white shirt with dark tie and pants. I don’t recall if he was from Texas, but he had the kind of smooth drawl that made him seem like he would be perfect as a sidekick in a John Wayne movie. 

“Hi, Doc” he greeted me each morning. I liked the way it sounded. 

I hated administrative chores, and was not too happy when Doug Lindsey told me he wanted me to be the rating officer for the other physicians in my branch. True, I was a captain, but they were captains too and all I had on them was date-of-rank. Unfortunately, this was often the key consideration in determining the military pecking order. I anguished for several days about it, since I liked to be liked, and was hesitant to write anything critical about my fellow doctors. Heightening my discomfort, I was first supposed to counsel each of them face-to-face in a private session. 
Image result for IMAGES OF Malcolm Bowers
Malcolm Bowers was no problem, of course. He was an athletic “golden boy” who had been a star quarterback in college, and was already fully trained as an internist. At Edgewood, he had become fascinated with the weird nighttime dreams reported by some subjects after they received a small dose of a nerve agent. I admired this alert observation and was not surprised when he went on later to become a psychiatrist, a professor at Yale, and a world-renowned expert on chemical changes in the brains of schizophrenic patients. 

I had a problem, however, rating an anesthesiologist who had been selected to examine John Glenn, following his historic orbital voyage in a space capsule. After this honorific assignment, I guess he felt no need to continue being particularly energetic back at Edgewood Arsenal. Like many draftee physicians, he probably would never have chosen to be at Edgewood Arsenal in the first place. Nevertheless, for some of the doctors, Edgewood probably seemed like a good place to take refuge from the rigors of ordinary Army doctoring, which might involve having to work in a combat environment.

“Andrew,” I said as we sat down for the counseling session. "You’re certainly a competent physician, but I must point out some negatives that I plan to include in your otherwise very acceptable efficiency rating.” He glared at me as I tried to remain dégagé and impassive. Fortunately, I had brought a list, not wanting to rely on memory, and proceeded to reel off what I considered his shortcomings. He listened in skeptical silence, and I was greatly relieved when he looked grim but decided not to offer rebuttal. We departed in opposite directions and I exhaled gratefully as I headed for lunch. 

Thankfully, I was not usually responsible for rating the enlisted-grade personnel. That was the job of Master Sergeant Ignace Ditchkus, highest-ranking of the non-officers. “Ditch” was slightly grey at the age of 40-something (a seemingly advanced age) but he was energetic and reliable. His assistant was Specialist-5 Rudy Rivera, who made sure the volunteers appeared on time for pre-test physicals, lab work and interviews prior to participation in tests. 

Speaking of Sergeant Ditchkus, I cannot resist telling a story about his skill as a diagnostician, for which I owe him a sheepish debt of gratitude. One morning, I had awakened to find that a horrible, unbearably itchy blister had suddenly appeared between two of my toes. As the days passed, it grew larger and began to exude fluid. Suddenly, I became gravely concerned. 

Time magazine had recently reported some cases of cutaneous anthrax appearing on the European continent. Sandals, made in India and cut from leather cured in cow dung, were the source. Consulting my textbooks, I found a description of anthrax skin lesions that seemed very much like the one between my distal digits. (Of course, I had never seen a case of anthrax, and my pathologist friend Ken Carter later chided me that not a single case of anthrax had been discovered in the United States that entire year.) Remembering that I had indeed recently purchased a pair of imported leather sandals at the PX, and worn them at the swimming pool, I promptly dubbed myself a canny diagnostician. I had managed to connect the dots! 

Delighted by the certainty that I had anthrax, I presented my theory to the Post Infirmary doctor. I even brought along the sandals, hoping he would have them tested for the presence of anthrax spores. He seemed to accept my reasoning and prescribed a course of penicillin. After I had taken it for ten days, there seemed to be no improvement – in fact, my itchy blister was getting worse. 

Early one morning, when there was no other medical expert around with whom to discuss the problem, I finally confided my fears to Ditch. The wise sergeant suggested rather offhandedly that I get some Desenex ointment at the PX and use it for about a week. Sure enough, the blister healed completely! Without saying as much (no doubt drawing on his vast clinical experience in Army shower rooms and barracks), Master Sergeant Ignace Ditchkus had cannily recognized the problem as athlete's foot. 

I went back to the dispensary and apologized to the doctor. I ruefully acknowledged my relative ignorance about athlete's foot and told him that thankfully my sergeant knew what it was and had guided me to the appropriate treatment. The doctor said he was glad it had worked out. As I was leaving his office, he added, “By the way, your sandals are over there on the top shelf.” I thought I detected a slightly derisive tone in his voice, and the hint of an ironic smile briefly crossing his face. 

The sandals were still in the brown paper bag I had brought to the dispensary. It gradually dawned on me that no one had attempted to culture them. The dispensary doctor had consciously been humoring an obviously under-trained, possibly delusional psychiatrist! Worse, there was no way to make a graceful exit. And so it went at Edgewood – a constant oscillation between seriousness of purpose and absurdity......

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