THE GREAT SECRET The Classified World War II Disaster That Launched the War on CancerJennetConant 380 pages including notes, biography and an index, W.W. Norton & Company ISBN 978‐1‐324‐00250‐5.

Abstract

On December 2, 1943 the German Luftwaffe succeeded in surprising the allied defences in the Apulian harbour of Bari and bombed it, resulting in the second largest air raid losses in the Second World War after Pearl Harbor. Seventeen ships were sunk and hundreds of soldiers and civilians died instantly. A quite unexpected and key event was that days later, soldiers who survived the incident without immediate injuries developed skin rashes, lung symptoms and lethargies irreconcilable with their transient exposure to flames and fumes. This led the United States Mediterranean army to dispatch an MD with expertise in chemical and biological warfare from Tunis to Bari. This book tells the story of how Lieutenant Colonel Stewart Alexander painstakingly described his findings on the affected individuals. He observed dramatic changes in their blood counts, especially neutrophils, findings that lead him to strongly suspect exposure to nitrogen mustard, even though the symptomatology did not fit the bill and even though British authorities vehemently denied it. Through hard work and tenacity in dealing with the latter it emerged that one of the British ships did in fact carry vast amounts of nitrogen mustard, whose effects Alexander had previously studied in rabbits. The outbreak was caused by the poison leaking to the harbour basin and mixing with other agents there. That explained the rashes due to direct contact with huge doses, as well as the lung symptoms which were initially light due to the low content of the agent in the atmosphere at the time. There is no doubt that Alexander was the ideal MD on site, compassionate in treating the patients, accurate in the description of their diseases, including harvesting tissues from autopsies, and last but not least in writing a meticulous report. That dismayed Churchill to the extent that he refused to acknowledge the presence of the chemical weapons. Alexander was, however, vindicated in two ways, first during the war itself, and then two decades later, when a college student essay about him resulted in public acknowledgement by the US senate (earlier honours were given in secrecy). These — inadvertent — exposures were among the very first recorded ground-breaking findings on the effects of nitrogen mustard on humans when only effects in laboratory animals were known. You might have expected Dr. Alexander to pursue this area of research after the war. However, he declined offers from Cornelius Rhoades, a noted cancer specialist, who also worked on chemical weapons and went back to the family practice in New Jersey, as he had promised his father before being enlisted. This well-written book has a double theme: one on the Bari bombing and one on how cancer chemotherapy evolved partly from the disaster, in the immediate aftermath of the war. While the first part is a riveting story in itself, the second theme overlaps with other books on the emergence of chemotherapy. It does, however, contain the story of the early beginnings of the Sloan–Kettering Institute by Dr. Rhoades, and how he ultimately fell into disrepute on the grounds of what can best be described as a racist MeToo event. The prose flows easily for this author of other WW2 biographies, and even in its disjointed way there is a clear progression in this story, which is well to invest some time and money on.