Dispelling the specter of nuclear holocaust.

Abstract

This “image of health” is the inverse of a peace image, but it is also a powerful reminder of how crusading anti–nuclear-war physicians and others in the public health community banded together in the midst of the Cold War to extend the peace and reduce the threat of the world’s disintegration into nuclear holocaust. The medical and public health campaign against the proliferation and possible use of nuclear weapons began in earnest in the late 1950s. Among its early leaders were psychiatrist Jerome Frank and pediatrician Benjamin Spock. In response to growing fear of radioactive fallout from the atmospheric testing of thermonuclear weapons, the US Public Health Service started monitoring the nation’s milk supply in 1958.1 Tensions increased in the early 1960s, when President John Kennedy’s call for a massive US fallout shelter campaign intensified fears that the nation was preparing for nuclear war, and public concern rose to new heights in 1962, when the Cuban missile crisis brought the world to the brink of an actual nuclear exchange.2 The most effective and influential response by the medical and public health community was led by a new organization formed in the early 1960s, Physicians for Social Responsibility (PSR). This group published an influential book, The Fallen Sky: Medical Consequences of Thermonuclear War,3 and an important series of articles in the New England Journal of Medicine.4,5 In 1963, the United States, the United Kingdom, and the Soviet Union signed the Limited Test Ban Treaty, which prohibited atmospheric or undersea nuclear testing. Concerns over radioactive fallout and nuclear weapons proliferation now abated, partially displaced by concerns over civil rights and the Vietnam War. Nuclear tensions returned at high pitch in the late 1970s and early 1980s. One of the reasons for this was worry about the environmental dangers of nuclear power, a concern that greatly intensified in early 1979 with the Three Mile Island disaster. In addition, the Carter administration in its last years took a more aggressive nuclear posture, which included contingency planning for limited nuclear war.6 When the Reagan administration took office, anxieties multiplied as key officials issued statements about waging nuclear war “rationally.” In 1982, President Reagan proposed a $4.3 billion civil defense program centered on the “crisis relocation” of America’s urban population, which would supposedly allow 80% of the US population to survive a large-scale nuclear attack.2 Once again, physicians and others in the public health community mobilized against the threat of nuclear holocaust, this time on an international scale. PSR, which soon grew to more than 40 000 members, helped create International Physicians for the Prevention of Nuclear War (IPPNW). Bernard Lown of Harvard, one of PSR’s original leaders in the 1960s, worked out a multinational governing structure for IPPNW that included PSR as the North American affiliate and in which he served as copresident with Yevgeny Chazov of the Soviet Union. IPPNW became influential worldwide and held a series of international conferences that drew participants from more than 30 countries. In its publications and at its conferences, IPPNW made a powerful case that there could be no adequate medical response in the aftermath of nuclear war and that prevention of nuclear engagement was the only meaningful medical and public health response to the threat. On December 10, 1985, Lown and Chazov accepted the Nobel Peace Prize on behalf of IPPNW.