Cancer and Cold War Capitalism
Susan M. Chambré


Susan M. Chambré is a professor of sociology at Baruch College of the City University of New York. Her most recent books are Fighting for Our Lives: New York’s AIDS Community and the Politics of Disease (Rutgers University Press) and Patients, Consumers and Civil Society (Emerald Publishing).


Reviewed: Ellen Leopold, Under the Radar: Cancer and the Cold War (New Brunswick, NJ: Rutgers University Press, 2009), 312 pages, $25.95, hardcover.

Health policy histories, like Under the Radar, are especially timely during the current debate about how to reform the U.S. health care system. They provide significant insights into the myriad cultural, social, political, and economic forces that have shaped the U.S. health care system. They also guide policy by identifying the challenges that may serve as barriers to enacting needed reforms.

It is now a well-known fact that the United States spends far more of its GDP per capita on health care than other postindustrial societies, but this substantial financial commitment does not yield favorable population-wide health indicators. With the aging of the population in the future, these costs will spiral. While there are many dimensions to the current crisis in health care, two are covered extensively in this book: the failure to deal with occupational and environmental causes of disease; and an emphasis on treatment with too few resources devoted to prevention.

Cancer, the second leading cause of death in the United States, provides a valuable window into understanding the politics of health care. Ellen Leopold’s book, Under the Radar, offers a provocative thesis about the forces that shaped cancer research and care in the United States. She points out that

Many of the features of our response to cancer today can….[b]e traced back to the aspirations of the Cold War. From the 1950’s through the 1980’s, the disease was uniquely intertwined with the characteristic undertakings and covert operations of the period. Almost every aspect of the current approach to the disease bears the imprint of this Cold War entanglement. The special terror and guilt that cancer evokes, the prominence of radiation therapies in the treatment arsenal, the current bias toward individual rather than corporate responsibility for rising incidence rates, toward research that promotes treatment rather than prevention, toward treatments that can be patented and marketed — all reflect a largely hidden history shaped by the Cold War.

The Cold War’s foreign-policy strategy had important domestic implications. Leading-edge baby boomers, like me, were indelibly affected by the culture and the practices of the early Cold War. Learning to “duck and cover” during early elementary school years — hiding under a desk to practice survival in the event of a nuclear attack (a foolish exercise, given what we later learned about radioactive fallout) — was a formative experience, especially for those who later protested the Vietnam War. I was also taught, early on in my life, about the superiority of our democratic system, in contrast to the countries behind the “Iron Curtain” — an image fraught with malevolent meaning — where one’s father might disappear without warning in the middle of the night (never mind that we were living through the McCarthy era, another very early TV memory).

I not only learned that the United States was victorious in conventional and nuclear warfare, but also in another kind of war — the war against disease. I learned this early in my life, as one of several hundred thousand second graders who were “polio pioneers,” immunized in 1952. Because of my personal experiences, Leopold’s description of the impact of the Cold War ideology on domestic life was quite meaningful.

Put very simply, the domestic policies of the period, in the name of national security, restricted individual freedoms and put social injustices on hold in order to focus on the single-minded pursuit of a nuclear weapons buildup. At the same time, the government made exceptional resources available to private industry in an effort to expedite the nation’s economic recovery and showcase the dynamism of laissez-faire capitalism.

Scientific advances that were byproducts of the development and use of the atomic bomb held important implications for health. The book begins with the narrative of Irma Natanson, a young woman diagnosed with breast cancer in 1955, who was given a radical mastectomy and treated with cobalt radiation, a new treatment thought to be a positive byproduct of the development of atomic energy. As an early recipient of the supposed benefits of the “cobalt bomb,” Natanson experienced “years of prolonged and painful medical treatment aimed not at her cancer but at the damage caused by treatment for it.” Her body was “mutilated” as a result of the treatment. She initiated a lawsuit that charged her radiologist with a failure to warn her of the risks of the treatment and to carry out the treatment properly. Her experience is a powerful reminder of the horrors some people experienced at a time when patients were ill informed, both about their diagnoses and their treatment, and there was no notion of patients’ rights and informed consent.

The Natanson lawsuit coincided with growing recognition of the effects of nuclear explosions as the victims of Hiroshima, Nagasaki, and various atomic tests began to step forward with evidence of the fact that exposure to radioactive fallout caused a host of diseases, most notably, various types of cancers. After five years of trials, a legal settlement awarded Natanson an undisclosed sum for damages. She lived out her remaining years literally and emotionally scarred by the experience of having been an unknowing human guinea pig.

Under the Radar reveals that the “war on cancer” and other diseases was as much a province of the military as it was the National Institutes of Health. In 1960, the Atomic Energy Commission spent $49 million on “biology and medical research,” and the army spent nearly $16 million — much more than the $34 million spent that year by the National Cancer Institute.

Leopold provides an interesting and carefully researched analysis of the ways that political and economic interests shaped our response to cancer. The idea that the domestic side of the Cold War conditioned our response to disease is an intriguing one. It is, however, an incomplete explanation. The book overlooks some of the significant historical and cultural forces predating the Cold War that played and still play an important role. The secrecy and lack of concern for human rights characterizing the Cold War era have a long history when it comes to medical care and experimentation, as David Rothman carefully documented in Strangers at the Bedside.

Challenges to physician authority and the emergence of patients’ rights began in the 1960s, at a time when the Cold War continued to shape domestic policy. But the willingness of patients to undergo risky experiments in hopes of being cured predated the Cold War era — and is by no means only the result of patients acceding to medical authority or unknowingly participating in risky experiments, as Renee Fox describes in Experiment Perilous. Indeed, this willingness to challenge medical authority represents an important strand in U.S. life and culture, dating back to the early nineteenth century when Americans began to take charge of their health and “battle” or “fight” disease. Further, the book overlooks the important role of cancer advocates and organizations, such as the Laskers and the American Cancer Society (ACS), in shaping the emphasis on treatment to the detriment of prevention, and the ways that corporate funding to organizations, such as the ACS, have contributed to a limited interest in environmental and occupational hazards in cancer diagnoses.

Finally, the culture of disease in the United States, where overwhelming sums are spent in the end stages of people’s lives, is ample evidence of an important legacy that transcends historical eras. We are optimistic about the benefits of medical progress and we are willing to try new technologies that might save our lives. But, as a society, we are less concerned about the kinds of environmental and lifestyle factors that affect our health. In the context of yet another round of thinking about how to refashion the U.S. health care system, Leopold’s book offers keen insights that, along with a broader view of the forces that have shaped the system, point to many of the future challenges we will face.

http://www.monthlyreview.org/091228chambre.php

Cancer and Cold War Capitalism
Susan M. Chambré


Susan M. Chambré is a professor of sociology at Baruch College of the City University of New York. Her most recent books are Fighting for Our Lives: New York’s AIDS Community and the Politics of Disease (Rutgers University Press) and Patients, Consumers and Civil Society (Emerald Publishing).


Reviewed: Ellen Leopold, Under the Radar: Cancer and the Cold War (New Brunswick, NJ: Rutgers University Press, 2009), 312 pages, $25.95, hardcover.

Health policy histories, like Under the Radar, are especially timely during the current debate about how to reform the U.S. health care system. They provide significant insights into the myriad cultural, social, political, and economic forces that have shaped the U.S. health care system. They also guide policy by identifying the challenges that may serve as barriers to enacting needed reforms.

It is now a well-known fact that the United States spends far more of its GDP per capita on health care than other postindustrial societies, but this substantial financial commitment does not yield favorable population-wide health indicators. With the aging of the population in the future, these costs will spiral. While there are many dimensions to the current crisis in health care, two are covered extensively in this book: the failure to deal with occupational and environmental causes of disease; and an emphasis on treatment with too few resources devoted to prevention.

Cancer, the second leading cause of death in the United States, provides a valuable window into understanding the politics of health care. Ellen Leopold’s book, Under the Radar, offers a provocative thesis about the forces that shaped cancer research and care in the United States. She points out that

Many of the features of our response to cancer today can….[b]e traced back to the aspirations of the Cold War. From the 1950’s through the 1980’s, the disease was uniquely intertwined with the characteristic undertakings and covert operations of the period. Almost every aspect of the current approach to the disease bears the imprint of this Cold War entanglement. The special terror and guilt that cancer evokes, the prominence of radiation therapies in the treatment arsenal, the current bias toward individual rather than corporate responsibility for rising incidence rates, toward research that promotes treatment rather than prevention, toward treatments that can be patented and marketed — all reflect a largely hidden history shaped by the Cold War.

The Cold War’s foreign-policy strategy had important domestic implications. Leading-edge baby boomers, like me, were indelibly affected by the culture and the practices of the early Cold War. Learning to “duck and cover” during early elementary school years — hiding under a desk to practice survival in the event of a nuclear attack (a foolish exercise, given what we later learned about radioactive fallout) — was a formative experience, especially for those who later protested the Vietnam War. I was also taught, early on in my life, about the superiority of our democratic system, in contrast to the countries behind the “Iron Curtain” — an image fraught with malevolent meaning — where one’s father might disappear without warning in the middle of the night (never mind that we were living through the McCarthy era, another very early TV memory).

I not only learned that the United States was victorious in conventional and nuclear warfare, but also in another kind of war — the war against disease. I learned this early in my life, as one of several hundred thousand second graders who were “polio pioneers,” immunized in 1952. Because of my personal experiences, Leopold’s description of the impact of the Cold War ideology on domestic life was quite meaningful.

Put very simply, the domestic policies of the period, in the name of national security, restricted individual freedoms and put social injustices on hold in order to focus on the single-minded pursuit of a nuclear weapons buildup. At the same time, the government made exceptional resources available to private industry in an effort to expedite the nation’s economic recovery and showcase the dynamism of laissez-faire capitalism.

Scientific advances that were byproducts of the development and use of the atomic bomb held important implications for health. The book begins with the narrative of Irma Natanson, a young woman diagnosed with breast cancer in 1955, who was given a radical mastectomy and treated with cobalt radiation, a new treatment thought to be a positive byproduct of the development of atomic energy. As an early recipient of the supposed benefits of the “cobalt bomb,” Natanson experienced “years of prolonged and painful medical treatment aimed not at her cancer but at the damage caused by treatment for it.” Her body was “mutilated” as a result of the treatment. She initiated a lawsuit that charged her radiologist with a failure to warn her of the risks of the treatment and to carry out the treatment properly. Her experience is a powerful reminder of the horrors some people experienced at a time when patients were ill informed, both about their diagnoses and their treatment, and there was no notion of patients’ rights and informed consent.

The Natanson lawsuit coincided with growing recognition of the effects of nuclear explosions as the victims of Hiroshima, Nagasaki, and various atomic tests began to step forward with evidence of the fact that exposure to radioactive fallout caused a host of diseases, most notably, various types of cancers. After five years of trials, a legal settlement awarded Natanson an undisclosed sum for damages. She lived out her remaining years literally and emotionally scarred by the experience of having been an unknowing human guinea pig.

Under the Radar reveals that the “war on cancer” and other diseases was as much a province of the military as it was the National Institutes of Health. In 1960, the Atomic Energy Commission spent $49 million on “biology and medical research,” and the army spent nearly $16 million — much more than the $34 million spent that year by the National Cancer Institute.

Leopold provides an interesting and carefully researched analysis of the ways that political and economic interests shaped our response to cancer. The idea that the domestic side of the Cold War conditioned our response to disease is an intriguing one. It is, however, an incomplete explanation. The book overlooks some of the significant historical and cultural forces predating the Cold War that played and still play an important role. The secrecy and lack of concern for human rights characterizing the Cold War era have a long history when it comes to medical care and experimentation, as David Rothman carefully documented in Strangers at the Bedside.

Challenges to physician authority and the emergence of patients’ rights began in the 1960s, at a time when the Cold War continued to shape domestic policy. But the willingness of patients to undergo risky experiments in hopes of being cured predated the Cold War era — and is by no means only the result of patients acceding to medical authority or unknowingly participating in risky experiments, as Renee Fox describes in Experiment Perilous. Indeed, this willingness to challenge medical authority represents an important strand in U.S. life and culture, dating back to the early nineteenth century when Americans began to take charge of their health and “battle” or “fight” disease. Further, the book overlooks the important role of cancer advocates and organizations, such as the Laskers and the American Cancer Society (ACS), in shaping the emphasis on treatment to the detriment of prevention, and the ways that corporate funding to organizations, such as the ACS, have contributed to a limited interest in environmental and occupational hazards in cancer diagnoses.

Finally, the culture of disease in the United States, where overwhelming sums are spent in the end stages of people’s lives, is ample evidence of an important legacy that transcends historical eras. We are optimistic about the benefits of medical progress and we are willing to try new technologies that might save our lives. But, as a society, we are less concerned about the kinds of environmental and lifestyle factors that affect our health. In the context of yet another round of thinking about how to refashion the U.S. health care system, Leopold’s book offers keen insights that, along with a broader view of the forces that have shaped the system, point to many of the future challenges we will face.

http://www.monthlyreview.org/091228chambre.php