Oral History Transcript Crawford F. Sams.

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Transcript: Crawford F. Sams, 1979

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We are speaking today with Brigadier General

Crawford F. Sams, who was born in East St.
Louis, Illinois on April 1, 1902. He received his
Bachelor of Science degree with a major in
psychology at the University of California; a
Master of Science degree in neuroanatomy at
Washington University, St. Louis, Missouri, and
received his M.D. degree at Washington
University, St. Louis, in 1929. In January, 1922,
he enlisted as a private in the 159th Infantry,
California National Guard, and was commissioned
second lieutenant in the Infantry in 1923. He
was transferred to the 143rd Field Artillery and
subsequently promoted to the grade of captain in
1925 While on active duty, he graduated from
the Field Artillery School at Fort Sill in 1925. He
resigned in December, 1925 to study medicine at
Washington University. While a student at the
medical school, he was re-commissioned as first
lieutenant, Field Artillery Reserve. He was
commissioned first lieutenant, Medical Corps,
upon receiving his M.D. degree in 1929 and
ordered to active duty at Letterman General
Hospital, where he completed his internship in
July 1930, after which he accepted a commission
in the regular Army Medical Corps. Dr. Sams had
a distinguished military career, serving in the
United States, in Panama, in the Middle East, in
Europe, and in the Far East during World War II.
His military decorations and ribbons are listed in
his curriculum vitae, which will be placed with
this copy of the oral history interview. His
awards and decorations are really too long to be
listed.
Dr. Sams, you have had such a brilliant and
long career, but I thought first of all we might
start off by asking you why you chose army life.
When I was a boy in high school, I became
interested in the military service through reading
books – historical books – about military leaders.
At the same time, I had an older cousin, who
was a doctor, who let me accompany him on his
house calls in literally the horse and buggy days,
and I was also interested in medicine. My initial
interest was in military service, however. I had
intended to pursue a career in the line – as we
called it – in the field artillery, at the urging of
my commanding officers and other senior
advisers, including the president of the
University of California. The pull to pursue a
career in medicine was very strong and I decided
to combine the two, and therefore, I went on in
medicine at Washington University. My faculty
advisor at the University of California had urged
me to study medicine and said [that] with my
academic standing that since I could enter any
school [to] which I applied, as far as academic
standing was concerned, I should pick the best
school I could in the field in which I was
interested.
Since I had a background in psychology and
done a little research and published my first
scientific paper in that field, I was interested in
[the] functioning of the human brain, as it turned
out to be a transducer instead of a philosophical
vacuum as it was perceived in psychology. In
reviewing the faculties and the curriculum at
Harvard, Northwestern, Washington University,
and Hopkins, at that time, which were the
outstanding medical schools, I decided that
Washington University with [Stephen Walter]
Ranson, the Chairman of the Department of
Neuroanatomy, and [Ernest] Sachs, one of the
five recognized neurosurgeons, second only to
[Harvey Williams] Cushing of Harvard, that this
was the place that I should come to pursue the
particular type of research and training that I
was interested in. Therefore, I entered the
graduate school here to take my Master’s degree
under Ranson. I went to the University of
Minnesota for one summer session to take some
work which Ranson recommended, and then
came back and subsequently worked with Dr.
Sachs.
 Could you tell us a little more about Dr.
Sachs?
Ernie Sachs was one of the kindest gentlemen
I have ever met. He was a terror to the student
class and he had a great (call it) gift – no not a
gift – but use of sarcasm which he used to
embarrass them so that they were always being
embarrassed when he asked certain questions, in
clinical conferences in particular. But when you
really got to know him, as I did, he was a very
kindly and thoughtful man, and I was very
grateful for the opportunity to work under him as
a protégé. Because in those days, we didn’t have
formal lessons, training for specialty boards. The
system then was that a man like Cushing had
[Percival] Bailey and Sachs had [Roland M.]
Klemme, who was his permanent Number 2
man, and then he took younger men. Like when
I was here, Wilkes [ed. note: a Harry Wilkins,
M.D. is listed as a Fellow in Neurological Surgery
in the Washington University School of Medicine
Bulletin dated March 20, 1929] and myself
became protégés and you worked your way up.
This was the old European system of the master
and the protégés; we didn’t have the formal
training in those days.
And so Sachs asked me to do a particular field
of research for him. He had a young daughter
about eleven years old, as I recall it, who
developed a meningococcal meningitis. In
accordance with the recent findings of [Walter]
Dandy, one of the other recognized
neurosurgeons at Hopkins – Dandy had
postulated a circulation of the cerebrospinal fluid
in a different pattern and therefore advocated
trephining and doing an irrigation through the
lateral ventricles down through a cisternal
puncture in the case of meningitis. This was done
by Klemme for Sachs, and the little girl died.
Sachs was, of course, very much emotionally
upset and he said, “Sams, something is wrong
with our knowledge of the cerebrospinal fluid
circulation.” [It was] supposed to originate in the
lateral ventricles and then flow down through the
spinal cord and back up and be absorbed by the
pacchionian bodies and so on. It was called a
“third circulation” in the published works of
Dandy, who had done his work on frogs.
To make a long story short, I developed a
methodology, using dogs, for [doing]
laminectomies, and ventricular functions, and so
on. I was able to show that there was no true
circulation of the cerebrospinal fluid in [the
same] terms as blood circulation or lymph
circulation and so on. The movement and
diffusion of substances injected into the
cerebrospinal fluid follows the laws of physics
and the laws of gravity and so on. This paper
was subsequently published and upset our
previous knowledge. It was also very worthwhile,
according to Sachs, because at that time we
were just beginning to use subdural spinal
anesthetics and nobody knew how to control the
diffusion of spinal anesthetics. Some people were
being killed by rapid diffusion. Of course, this
new knowledge of the diffusion of hyper- or
hypotonic or isotonic solution into the anesthetic,
into the cerebrospinal fluid, subdurally. And then
using gravity as well, we could control the level
of the spread of the local spinal anesthesia. Well,
this was all work under Sachs. So as I say again,
I’m very grateful to Dr. Sachs. For some years
after I went in the military medical service, Dr.
Sachs corresponded with me wanting me to
come back and work here at the University.
 It’s just like Dr. Ranson went from here up to
Northwestern because he didn’t like to even
teach his six weeks. (Laughs) He wanted to
devote full time to research. He became the
Director of the Institute of Neurology up there.
He wanted me to come up and do research with
him. Again, I was flattered by both people, but
particularly by Dr. Sachs who persisted for a
number of years after I went into service, about
five or six years, wanting me to come back here
and work with him as Klemme had done.
But you decided to choose Army life?
Well, after I graduated, I went into the military
service. I was able to combine the military
aspects with my previous line background, along
with the medical field. I wanted to start a
neurosurgical service in the military Medical
Corps because, you remember, neurosurgery at
this time was a new field. The recognized
neurosurgeons were five in this country, that’s
all. There was Cushing and Dr. Sachs, [Howard
C.] Naffziger out at the University of California,
Dandy at Harvard, and [Loyal] Davis. That’s all
there were. And they had trained in England with
– I can’t recall his name now – but the original of
neurosurgeons [ed. note: Dr. Sams is referring to
Sir Victor Horsley]. So I tried to start a
neurosurgical service in the Army Medical
Service for some years. However, I had to give it
up and I was torn very much by my desire to
continue in that field and work on the central
nervous system and my desire to stay in the
military service. Back and forth.
I finally was told after consulting with these
people in the professional service, as we called
it, Chief Professional Service and the Surgeon-
General’s Office, Surgeon-General, that at that
time, there was no opportunity to start a
separate neurosurgical service – a neurological
surgery service as it’s known now. [Because of]
this simple reason of economics – there were so
few cases. In those days, neurosurgery was
largely brain tumor work. For instance, with
Sachs we had an operative mortality of about 35
percent because the people were morbid when
we first operated on them. It was brain tumor
work. In the military service with a young,
highly-selected population of young males, there
were very few brain tumor cases – maybe five or
six a year. So their solution had been to put
Dandy, on the East Coast, on a retainer fee – at
that time $100 a month was quite a lot – and
Naffziger, on the West Coast, on a retainer fee.
When I was out at Letterman [General
Hospital, San Francisco, California] and trying to
get started this neurosurgical thing, they said,
“Well, now, Sams, there are not enough cases
for a full-time man. You can go into psychiatry
since you’ve got a psychological background and
so on. Then if a brain tumor case just comes in,
you can operate on it.” I said, “Well, that’s fine
except how can I keep my technique and my
surgical hands and procedures going?” They
said, “Well then, you can go into general surgery
and if a brain tumor case comes in, you can get
him from the neuropsychiatric service, where
most of them are done.”
To make a long story short, in those days, in
the early ’30s and so on, it was not possible to
have a full-time neurosurgeon in the military
medical service, so I was very tempted to
respond to Dr. Sachs and come back to
Washington University and work with him. But
some of my senior friends in the military medical
service thought that I should stay in the medical
service. [My] commanding officer at Letterman,
for instance, wanted me to accompany him when
he was transferred to the East Coast. He
flattered me by that kind of thing and suggested
I should stay in the military service. So I did.
That’s how I got out of the neurosurgical
business. Yet when the Second World War came
on, I was able to help Sachs’s son get an
assignment in neurosurgery and he did more
neurosurgery during the second war in Europe
than his father did in his whole lifetime.
Nevertheless, this is how this thing developed.
Sometimes you’re a victim of the environment,
so you can’t always pick what you want.
But I am a very fortunate person in that after I
had gone into many other fields in the military
service, when I retired I was invited by the
University of California to come there to head
some research projects. I was ultimately able to
get back into the field I had started in – doing
research in low-level radiation on the central
nervous system, which is what I ended up with
by doing some far-out work using mathematical
modeling and so on as well. I got my hands back
in operating again – on implanting electrodes
and that kind of thing and measuring electro-
physiological responses. So this has now become
a major field of interest: what are the effects of
low-level radiation on the central nervous
system? (You just see it in the newspapers today
about the little accidents and so on.) I was one
of the pioneers, although I would say that the
Russians have gotten way ahead of us in that
field. You have to stop me because you get me
off; I’m like an old man on a field. I can go off
forever. Sorry.
I’ve read some of your articles on low-level
radiation, but before we get to that I’d like to go
back a little bit. I noticed you were in Panama
and you published an article on your experiences
there with heat.
Oh, the heat syndrome.
[In] 1939. Could you tell us a little about that
before we go into World War II?
Yes. We had a problem. Of course, malaria was
one of the major ones, but in the heat syndrome,
very little work had been done on this and we
had a high rate of pneumonia among our enlisted
men in Panama. You say, “How can you have so
much pneumonia in a tropical climate?” and so
on. So I did a little research on it and found that
I was actually dealing with a phenomena related
to a high humidity, comparatively moderate
thermal combination. We used to say, “Well, your
blood gets diluted if you live too long [in], when
you adapt to the tropics,” and as it turned out, of
course, a red cell count was normal down there
with three and a half million instead of five
million [red blood cells] because you increase
your plasma volume to get rid of heat and so on.
This is why we got interested in that particular
thing. Incidentally, that type of heat syndrome,
or the knowledge of that, was most useful to me
when I was in the Middle East and we had a
different combination of very high thermal
temperatures and low humidity, which caused a
great many deaths, in heat stroke, etc. So, you
get into one field and it helps you somewhere
else, usually.
Yes, I can see that it does. I read your article
on medical problems in the Middle East where
you described the various diseases and the way
in which they were controlled, but I noticed in
the article that you said for reasons of security,
you could not say anything about battle
casualties. I was wondering if you could tell us
now about this.
Everything was secret, you couldn’t talk about
anything. Of course, when I came back after two
years in the Middle East, as I said, I was sent
back up to school at Carlisle and then they put
me on what I call the banquet circuit and all that
kind of thing. You had to be very careful of what
you could say. You couldn’t talk about personnel
and so on or even where we were fighting.
Well, battle casualties, of course, was one of
our major concerns. For the first time in military
medical history, deaths from disease in troops in
wartime were on a one-to-one basis with deaths
from casualties from weapon-produced factors.
That actually occurred first – we got almost down
to that in the First World War and through
immunization, typhoid and so on, we were able
to cut disease down. In the battle casualties in a
combat area, we were fighting around a lot in
the western desert and I was concerned with the
casualties in particular from air attack and from
armored combat. Because in our army we had
never been in armored combat as the Germans
and the British, etc. had, except for a small unit
of old French Renault tanks in the First World
War. The modern concept of whole divisions,
armored divisions, fighting each other as we
were doing in the western desert was new.
While I had been at the infantry school and
was trying to work out two kinds of medical
services, one for airborne casualties and the
other for armored [casualties], one of the things
we tried to learn from what the British and the
Germans had [done]. When I got to the Middle
East whenever there was a good battle coming
up, I had a little system worked out with the
surgeon of the Seventh Armored Division of the
British Eighth Army, which was equipped with our
tanks and so on. He’d say, “Bring up the beer,”
because you know in a war you spend maybe a
week fighting; you spend a month moving; and
the rest of time you’re waiting – to build up
supplies, etc. So I had other work to do, but
when we had a good offensive, or we expected
Germans, I’d go up and take part in the armored
combat. I was able to learn a great deal about
the types of casualties we were actually
incurring, the percentage and so on. More
important, I was able to learn about the
casualties from air attack.
Now I have to digress a moment. After each
war, for political reasons, you’d try to find a
deterrent to prevent the next war. After the First
World War, it was gas warfare and people – you
probably wouldn’t remember – but after that we
even had motion pictures (the movies) about
gassing New York City and so on till somebody
figured out the air currents were such [that] you
couldn’t hold a concentration of gas to gas New
York City if the people stayed in the buildings
and closed the windows. So that failed.
The next deterrent was air power, and so from
the time of Billy Mitchell in 1925 to the Second
World War, [the belief was that] if we ever had
another war, air power would destroy civilization.
Sound familiar? So, the theoretical production of
air casualties, the catching of troops in defiles
and their obliteration was the thesis in which we
were all indoctrinated up until the beginning of
the Second World War.
So, fighting in the western desert then, I was
quite surprised in analyzing British casualties. Of
course, the Eighth Army was a hodgepodge of all
kinds of troops – South African, New Zealanders.
We had the equivalent of American tank troops.
We activated the Ninth Air Force over there and
so on. The idea that you could wipe out troops in
combat by air attack turned out to be completely
fallacious. All you do is to disburse. When you
have an air alert from grounds traffic and so on,
you dig slit trenches whenever you halt so that
you can get below the surface of the ground.
Less than 10 percent of the casualties were
caused by air attacks, and at that time, the
Germans and the Italians had air superiority. So
that any plane you saw was German or Italian.
I’ve been strafed so many times. All you do is
disburse, and if you hold a call for a ten minute
break, anything, you disperse away from the
vehicles. These are the things we learned – in
other words, why you have such low casualties.
The men that got killed by air attack and
grounds traffic were the men that finally got too
lazy to get out of the vehicles after so many false
alarms, you see. They got a little careless, and
then they got caught. I almost got caught up
there in the battle of the Little Maginot Line, we
called it up there, west of Tripoli. In that I had
been up in the front lines for quite a little while
and I came back out and there was an olive
grove and I didn’t dig a slit trench. That would
be the night, and I was under an olive tree there,
when the Germans introduced their butterfly
bombs. This is the thing they make such a big
thing of now, in which you have a bomb and it
explodes at fairly high altitudes, a couple of
hundred feet, and then you have multiple small
bombs – anti-personnel. Well, I really had to dig
on that to get myself below ground; I pretty near
got it that time because the shell fragments had
just come down. So the casualty factor was – I
sent back reports on this – that air power was
not a major casualty producer. But when you
have a whole senior echelon, like in Washington,
indoctrinated over years, growing up with the
idea that you could stop armored columns with
air power and so on, it’s hard to get that
reversal.
I had to do the same thing with the atomic
bomb when I came back. It’s all right to put out
propaganda, but don’t believe your own
propaganda. That’s what happens too often in
this business. That’s why you had the hysteria
about this radiation thing up here. So I had a job
of de-glamorizing, if you like, no that’s not the
word – debunking the myth that air power alone
could win a battle against ground troops, or that
air power could win a war.
How do you go about doing this then?
Oh well, this says you have to make reports
that ____(?) the file. Then you have to do like
you do in the practice of medicine: you have to
give talks to this one group and that one and so
on. Finally, you get, through your senior friends
and so on, access, and this takes quite a long
time sometimes. It took me about four years to
get some facts straightened out about the atomic
bomb at Hiroshima with our high echelon people
and now you’ve got a generation of diplomats
who still are swallowing the old nonsense and
putting it out. But anyway, this has been the kind
of a thing I’ve gotten into, not because of choice,
but because when I found something that
doesn’t fit the generally-accepted thing, I try to
find what’s true and what’s fallacious. In this
case, we found that air power was not the
controlling factor. They had to re-learn it at
Normandy.
We even had in the Middle East a group – now
this is hard for you to believe probably, because
they probably weren’t aware in the newspapers
about this – we had a group of B-17 bombers
come to the Middle East secretly, led by Colonel
[Harry A.] Halverson – called Halpro Group. He
was allowed to pick any crews he wanted to fly
this group of heavy bombers. Now this shows
how far you can go in believing your own
propaganda. This was the beginning of the war.
They came there and he was to bomb the Ploesti
oil fields; that would end the European war. We
based him there and Raymond David(?) and so
on up in Palestine and what not. Then, that
group was to fly to China. They would end [by]
bombing Tokyo-Yokohama, and that would end
the Pacific war. This was [a] serious mission! Of
course, what happened was that Halverson’s
group got lost and never got to the Ploesti oil
fields. The fact that American aircraft were in
that area became public knowledge when (I
think) five aircraft came down in Turkey and
Turkey interned them. This is the ridiculous kind
of thing you have to debunk.
As you know then again, the myth of strategic
bombing carried on and finally “Tooey” [Gen.
Carl A.] Spaatz, who was an ex-classmate of
mine and so on, was given [command of the]
Eighth Air Force [with] the authority, together
with the RAF, to bomb Germany. And Germany
industrially was to collapse. But of course it
failed. So tactically, we had to unlearn years of
indoctrination. Strategically, we had to unlearn.
So my little part was about the casualties and
the fact that if you dispersed and took cover, you
had [a] very low percentage of casualties from
air attack. This strategic thing was another thing.
It’s just like – I was part of the Strategic Bomb
Survey Group in the theater to assess damage as
we progressed across where we had been
bombing Tobruk, for instance, and supposedly
had cut off [the enemy’s] oil supply. When we
got there, we found, of course, we had knocked
down the warehouses and so on, but he
dispersed his supplies in the desert, so we hadn’t
cut off anything. This is the kind of thing you get
into from a medical standpoint, as well as
combining medical and military knowledge.
What were your experiences in the European
theater when you were there in the winter of
1944 or ’45? Were you assigned there for a
particular purpose?
Yes. This was a case where General [George
C.] Marshall had received a request from the
European theater. At that time I was in G-4 on
the general staff, after I had come back from the
Middle East. He had received a request for
another 100 thousand general hospital beds
staffed. This was in preparation for the renewal
of the offensive. Actually, this was to begin the
final push in the spring. We were scraping the
bottom of a medical manpower bowl here in this
country with a shortage of doctors, so General
Marshall sent me over instead of the Surgeon-
General. That was a personality deal there, I
won’t go into that. [Surgeon-General Norman]
Kirk and Marshall didn’t do well. He picked me
and sent me over as his representative to try to
solve this problem. So I reported to General
[Dwight D.] Eisenhower’s headquarters which I
operated out of.
The army surgeon, theater surgeon, was Al – I
can’t recall his name now – a friend of Marshall’s.
He was on Eisenhower’s staff. The so-called SOS
surgeon, who actually operated the theater
medical services, was down in the SOS staff;
they were both good friends of mine. But there
was a problem. I went all through the theater to
see what the problem was. On Eisenhower’s
staff, Al – sorry, I can’t remember [his last
name] – was concerned with coordinating the
military operations between allies, that is, the
French and British and ourselves. The American
theater really had no commander; Eisenhower
was supposed to be both. The theater surgeon,
the SOS surgeon who actually operated the
hospitals and the ground forces and so on,
medical service – he was back in SOS. They had
a disagreement. He had general hospitals, which
were being used for taking care of prisoners-of-
war, being used as staging areas for battle
casualties coming back from the front. He
wanted to move them up into Twelfth Army and
Sixth Army group areas in preparation for his
offense, but the army group surgeon, under
[General] Omar Bradley, and the Sixth Army
group surgeon wanted those buildings, etc. for
their own things. There was nobody to arbitrate
between the SOS support services and the
combat army group because the man who should
have been able to do it – he was up one level too
high. So I found it was an organizational defect
in the theater of operations, not only pertaining
to the medical service, but to some other
logistics operations.
I came back after making my study and
reporting to Eisenhower and so on, the SOS
surgeon and so on. I reported to General
Marshall that they didn’t need 100 thousand-
man beds. I had found enough German
prisoners-of-war, medical personnel, that if we
turned equipment over to them that was now
being operated by American doctors to care for
American POWs under the Geneva Convention,
and let the German doctors and the German
nurses operate it for their own people, we would
save a good many thousand beds. The German
POWs preferred to have their own medical
people, etc.
Likewise, the medical requirements of the – oh
they had a term for them, I’ve forgotten the
word now – but these were Frenchmen,
Czechoslovaks, Poles and so on who had been
brought into concentration camps in Germany
and used as slave labor and held in camp. They
also, instead of requiring American doctors to
run American hospitals for them which is what
this 100 thousand basis was, had enough doctors
in their own groups that if we gave them the
medical equipment, they could do their own
medical service. So the solution then was – what
we had to do was ship over the equivalent of 100
thousand general hospital beds – station
hospitals, general hospitals, and so on – and
equip them. [We] then turned this over to the
liberated people in their own concentration
camps and the refugee camps that they
eventually got into. And then also the German
POWs and the Italian POWs – let their medical
people look after them. We gave them the
equipment because they were short of medical
equipment.
So this was satisfactory. I will make a
statement – since everybody is dead I guess I
can make it now. General Marshall was a great
administrator – I had great admiration [for him]
– but he had a vicious streak. He always wanted
to can somebody if something happened like this
that was wrong. He wanted to know [if] didn’t I
recommend relieving the Surgeon SOS, the
Surgeon so-and-so, and I said “No.” I knew both
of these men [were] highly competent people; it
was not their fault, it was an organizational fault.
There was nobody to sit on top and arbitrate –
one man too high and one too low. So he agreed
not to relieve those two people. But that’s the
kind of thing that you got into. See you got me
way off.
No, this is very interesting.
So we saved a lot of medical people.
After the termination of the war in Europe,
[you] were assigned as Chief of Public Health
and Welfare Division, Military Government
Section, U.S. Armed Forces in the Pacific and
joined general headquarters in the Philippines.
What problems did you face there?
Well, first, I had been offered many other
assignments [while] in the military service. For
instance, before the end of the war in Europe, [I
had been offered the job] to go as deputy to the
surgeon there. Then I was offered Tenth Army
surgeon and so on in the Pacific, and again
deputy to the surgeon _____(?). I also had been
offered assignments in the line and general staff,
in logistics, where I had been in the War
Department. However, this assignment was
offered to me by John Heldring(?), who was
Head of Civil Affairs in the War Department; we
had served together at Carlisle. General
[Douglas] MacArthur, on John’s recommendation,
approved and asked for my assignment.
This offered a challenge. I had been a theater
surgeon in the Middle East in combat and so on.
I knew responsibilities and what not, but this
was a whole new thing. I had seen what
happened in Europe, as I said; why the military
medical service got bogged down in caring for
the civil population in terms of prisoners–of–war
who were flooding their military medical
installations and in terms of the liberated people
from Germany. I knew, in the plans for the Far
East, we were going to invade Kyushu in
November of ’45 and then the Canton Plain in
April, [and] that we would have a tremendous
problem in freeing our own medical service
(military) of being swamped by the civilian
casualties which would occur when we made
those invasions, as well. After the war was over
– at that time one school of thought [said] it
would be two or three years more and others
thought it might terminate soon – we would have
the job of picking up the pieces (as I call it) and
trying to put the nations back together again –
Korea and Japan. Korea had not been fought
over much, but Japan certainly would have been
badly hit.
So this offered a challenge: to use the
experience of a good many years in various
theaters to tackle what I thought would be the
biggest medical problem I had ever faced in my
life or [that] anybody else [had faced] – take a
nation that’s been bombed and bombed and
bombed and shelled and what not and eventually
overrun, because they anticipated a great deal of
ground fighting. I took this job and had
developed plans as to provide again equipment.
As chief of health and welfare, I knew I would
have a tremendous problem with refugees in the
countries we overran, not only in the medical
field but in feeding, clothing, shelter, all this kind
of thing. So I took this as a challenge in
preparation for the invasion of Japan.
 After Japan was conquered, you were made
chief of Public Health and Welfare Section of the
General Headquarters, Supreme Allied Powers
from the second of October, 1945 until June,
1951. I’ve read your articles, “American Public
Health Administration Meets the Problem of the
Orient” and “Medical Care Aspects of Public
Health and Welfare in Japan.” These articles
describe the efficient system you set up in Japan.
What kind of obstacles did you have to overcome
to set this system up?
(Laughs) Oh, boy! That’s all in a volume about
this thick. Here, I’ll try to summarize. First, I had
fourteen and a half million refugees. Six million
of those were people who were repatriated –
from Manchuria, from Singapore, and so on,
where many of them had been born and raised.
All they could bring back was what they could
carry on their backs and many of them had
never had a home in Japan. The others’ homes
had been destroyed. We had about two million
and a half (roughly, as I recall the figures)
homes destroyed [from] the bombing of the
cities. They had been short of food for several
years because of the naval blockade. These were
some of the problems. All the Koreans who had
been brought into coal mines and so on during
the war and [to] work in factories, were making
a big exodus down near Shimonoseki and so on
and back to Korea. This movement of people
from the bombed-out cities into the countryside
for food and those who had been evacuated from
major cities for protection and so on and so on
trying to get back into the cities, was like a
bunch of ants going all directions. [It was] the
ideal situation for major epidemics to develop,
and they already had started when we got there.
Typhus was being carried by lice transmitted
from one to the other. They were all lousy
because [in] that kind of a situation people can’t
take baths; they had only the clothes on their
backs and so. So we had a tremendous outbreak
of typhus. Smallpox. We had, of course, the
usual typhoid outbreaks and dysentery and so
on. Diphtheria. The country was paralyzed.
Now theoretically, General MacArthur— You
have to recognize now why this delay. General
MacArthur was made Supreme Commander
Allied Powers for the occupation of Japan. He
was, in other words, the Executive Agent for the
United Nations in terms of – there wasn’t really a
United Nations, but an Allied Council of thirteen
nations who’d taken part in the war, who were
set up in Washington. They were the ones
supposed to set policies and [General MacArthur]
carried them out. People never heard of them,
[in any] publicity back here. He had to make a
decision. One of them was to try— He was the
greatest military commander we had, but he
became the greatest proconsul this country ever
had in history. He perceived that we must use
the Emperor [of Japan] as a symbol, not hang
him, as people thought. We must try to use the
Imperial government, as a symbol, again, to
ensure stability instead of abolishing the
government like we had to do in Korea because
the Japanese had occupied Korea for a couple of
generations and when they were repatriated
[from] Japan, there was nobody to run the
government. So we had to take Americans and
put them in charge, you see.
We tried to use this existing government, or
what was left of it, but they were paralyzed at all
levels. Then we tried to reorganize it and so-
called make a peaceful, stable, democratic Japan
and rebuild the nation. Anyway, this was the
fiction we tried to use. Actually, I was one of the
six men, as he called us, who rebuilt Japan. We
had absolute authority. You had to look on Japan
at that time as a concentration camp in terms
that nobody could leave Japan without authority.
There was actually literally life and death
authority over everybody. If I said, “You’re going
to be immunized against smallpox, the whole
nation,” it was done because I had to see it was
done. I had to set up an organization to do it, for
instance. I tried to keep my own staff very small
and I had people down at the prefecture level. I
had to set up a national – reorganize the whole
government in terms of the health organization
and welfare. They had a head – a so-called
safety-welfare ministry, which had no
counterparts at the prefecture or state levels.
The police ran the health department, and we
abolished the police. That’s kind of the chaos I
had to deal with. So I had to set up a national
organization which could function, not as we do
here where you had a federal government, but
as we had evolved in it, where the federal
government has gotten into everything, because
their federal government controlled everybody
including their thoughts. They used the police,
the national police, to run what things they had.
I had to first reorganize the ministry; then I
had to set up a state Health and Welfare
Department. I had to set up health center
districts. I controlled all the doctors, all the
nurses, all the hospitals, [and] all the medical
schools. I had to change the medical school
system because they had adopted the two-
doctor system like we’re doing now. They had a
second class group— [For comparison] you’d
have to turn our country back till about the
1920s, when we had our major overhaul of our
medical schools, as a result of a survey. I did
away and abolished the so-called, well— Kosekis
[ed. note: Prior to the U.S. occupation of Japan,
the vital statistics of births, deaths, marriages,
etc. were registered at the ancestral home of the
family, known as the honseki. The local
registration office, the koseki, forwarded reports
of these events to a national bureau of statistics,
which then compiled and published national
statistical reports.]. [In Japan] we had
university-grade medical schools and the second
level, shimonosekis [ed. note: Sams misspeaks
here – he likely means to say “senmongakko”],
were like some of our medical schools [used to
be]. [If] you study the history of this medical
school back at the turn of the century, where you
took a kid out of high school [and] gave him a
couple years of lectures – they didn’t even have
cadavers to dissect in anatomy. And then you
made him a doctor. [There was] no examination;
you went out in the country, like my older cousin
practicing over in Granite City. He practiced
medicine and he made his money selling drugs –
not narcotics – but he dispensed his own drugs
and made more money out of selling drugs than
he did out of their professional knowledge in
terms of office fees versus drugs. He always had
three days’ worth. This is the kind of situation I
fixed.
I had to reform the whole thing. I reformed
nursing education, eliminated this shimonoseki
[ed. note: Sams probably means
“senmongakko”], and I concentrated, revised,
and set up an educational council. We changed
the curriculum so that it more or less equaled
our class A medical schools today. We graded the
schools and so on. This was following a pattern
that we had done in this country for over thirty
years. I had to do it in a matter of two or three
years.
At the same time, to control these epidemics I
had to introduce new things. [For instance], they
had never used typhoid vaccine before so you
had to start mass immunizations. I had 360
thousand men organized into so-called sanitary
teams on a nationwide basis. So as the cities
were knocked down, they actually cleaned them
up, they instructed people on insect control and
actually did rodent control because we had
typhus and so on. This is a kind of nation down
on its feet and I had to build up and establish a
nationwide organization. By controlling these
epidemics, the statisticians have said, “Well,
Sams, you saved some five million lives in the
first three years.” This scale of thing had never
been done before. You say, “How do you do it?”
Well, you just have to do the best you can with
what you’ve got and have a sound medical
knowledge as well as organizational capacity. I
used my people, as we called it, behind the
Bamboo Curtain, to direct at all levels after
setting up – I had to set up training schools for
health directors for the prefectures and all this.
Nutritionists set up a nationwide statistical— You
can’t do one [project] without hitting all the
things because it will fall down just like a two-
legged table. You say, “How do you do it?” Well,
this is how you did it. It was a terrible situation
and we were very lucky in controlling it. The
saving of lives was a purely statistical thing of
taking the death rate that was there – at the
pre-war [level], etc. – and three years later we
cut it down to about one-fourth. Then you apply
that to the population and that’s how they come
up with the five million.
 This was a eye-opener to the Japanese. In
terms that, first, we were able to show that
human life was worth something because under
Shintoism, they were the servants and the
Emperor, who was the head of the national
religion and, therefore, the greatest honor was to
die for the Emperor and all that. We had to show
that human life was a part of democracy and its
value was worth something, and so this is why
we gave all this.
You anticipated my next question which was
going to be, “Was there any opposition on the
part of the Japanese to do these things?”
The opposition – well, let’s put it this way.
When I was first controlling – the first year – you
have to set priorities controlling the epidemics
and so on and finally clean up things. I ran into
the Buddhist religion. We had a nationwide rat
control program and I found that the Buddhist
temples were holding memorial services for the
lives of these rats. You see, you’re not supposed
to kill any living thing – it might be your
grandmother. So this was an opposition.
When I was reorganizing the (what we called)
separation of medicine and pharmacy, and
upgrading the quality of medical education and
closing up the senmongakko and so on, I ran
into opposition. I had to reorganize the Japan
Medical Association, which was an organization
to control the doctors and set the fees and so on.
I tried to make it a professional organization
again and so on. I ran into opposition from the
second-class doctors. Now I had, I’ve forgotten,
seventy-six thousand doctors. But anyway, the
opposition came from those who were making a
living out of selling drugs. You can’t just take
those people and say, “Now you’re out of
business.” You have to have a grandfather clause
and say, “Well, you’ve got to die off eventually.”
This is what happened; most of those people are
dead now.
I had to take what they called ten-bed
hospitals and abolish them because many people
were dying. These half-trained people, the
second-class doctors, were trying things in
surgery in a ten-mat room and so on and people
died. Likewise, analysis showed that most of the
drugs used, because the patient always got three
days of medicine, was baking soda, either in
powder form or liquid. For almost every disease,
that was the major drug they were selling –
about 150 yen for three days’ medicine. They got
fifty yen for an office call, diagnosis and so on.
I’d upset this [system]. So you can understand
there was opposition from the medical people
who thought I was going to take their livelihood
away from them. I’d overcome that by direct
orders to begin with, because I had the authority
to order “This will be done.” It was done because
I had the authority to do it. People said, “How
did you do it out there and why don’t you come
back and do it in this country?” And I said, “I
was in a position where I had the full support of
General MacArthur.” As he said, I had shown I
was capable, had been through the test of fire
and so. So he backed me on all these programs.
So when I spoke, it was in his name. But this
took (what do you call it?) political savvy to get
the medical profession, the part who were afraid
they were going to be eliminated, to cooperate in
carrying out these things. Eventually, I just
closed up the medical [schools] like we did in
this country – the diploma mills and so on –
years ago. You always have opposition from
those that are going to be hurt. So yes, I had
opposition, but [that] we overcame and on the
whole then when they saw the benefits.
I had two things as a neurosurgeon. One,
there are people there, the men behind the
Bamboo Curtain, who never run for permanent
public office. They’re like the people in this
country who decide who’s going to be president,
[their] nominee and so on. One [of these] was
the Emperor’s uncle and he asked for a meeting
with me one time. We went to a little teahouse
and he said through the interpreter, “What are
you trying to do in this country?” I explained to
him what I was trying to do with all these
immunizations, because we were doing mass
immunizations that had never been done before
in terms of magnitude, seventy or eighty million
people at a time and so on. I explained to him
what I was doing and why I was trying to
improve the quality of medical care and [how] I
had to set up a nationwide welfare organization
to take care of these [things] and to start
schools of social work. Sanitary engineers – they
had two of them. (Laughs) They were trained in
America; they weren’t even doing engineering
when I got there. So this was a major upheaval.
I explained it to him; then he said, “You will
never have any trouble from the Japanese
government in the Diet or anywhere else.”
Because, you see, our objective was to work
ourselves out of a job. We had absolute power –
we wanted to get rid of that power – just the
opposite of what you have, we’ll say, in
Washington.
When we put into law, later on, all the orders
I’d issued on health codes and all this kind of
thing, standardization of hospital procedures and
all this, a new nationwide reporting system on
disease and so on, and setting up all these
government agencies – these all were then
eventually put into law in ’50 and ’51. Most of
those laws have been unmodified. They have
kept in touch with me all these years. In fact
they have Japanese who are writing books about
this stuff come and visit me, so I know fairly well
what’s been going on.
The other thing was, [Shigeru] Yoshida was
the prime minister, and one of the problems I
had was nutrition in the children. Many of them
had been subsisting on sweet potatoes for quite
a time. They were undernourished and so on and
highly susceptible to things like TB and terms of
resistance and what not. They even had a
disease called “ikiri” – ikiri literally translated
means “cholera.” This actually, we found, was not
cholera, but was a case of children who had
inadequate calcium. They would get bacillary
dysentery or whatnot and they’d die very quickly,
much like a cholera case. [They would] fall down,
were usually dehydrated, [and] they’d die. Well,
in standards of nutrition – and of course, I was
responsible then for the level of feeding of all
these people and [for] setting the nutritional
standards – we started nationwide nutrition
surveys. Again, something on that magnitude
had never been done. In which we actually had
teams go and determine what [the people] were
eating, not just what the ration was – of course
they had gardens and this – but actually what
they were consuming. Then looking for
deficiencies and so on, which we found.
So to get back to Yoshida – I said, “What
you’ve got here and the reason you people over
the years are small—” He was about five foot
tall, as big around as he was tall, and very
sensitive about his height. I said, “Why you are
small is [that] your children are—” This was in
the days in this country even, when we were just
beginning to learn the great primary role, at that
time, of essential amino acids and adequate
nutrition for growth for children. In fact, I had a
nutritionist from here in the Department of
Agriculture who was back in the vitamin days. He
didn’t know about this role of adequate protein. I
said [to Prime Minister Yoshida], “Your people
have been on a rice diet. You are inadequate in
protein as far as the children go.” I started a
demonstration program. I imported powdered
skim milk from this country. Our surplus
commodity corporation was buying—
[Interruption in interview]
This is the continuation of the interview with
Crawford F. Sams, M.D., on May 3, 1979.
[I told] Yoshida that I would take 250
thousand children in the Tokyo area and start a
school lunch program and use powdered skim
milk as a basis to give them adequate protein,
because our nutrition survey showed that they
had never been adequately nourished,
particularly during the war, as far as protein was
concerned. I would use a comparable control
group and I would show that the children who
were on an adequate “complete protein,” as we
called it, diet would have a more rapid growth;
they would be taller and heavier, etc., within one
year. And so we did. Thereafter, I expanded that
to eighteen million children eventually. And
Yoshida, after that first year, was so impressed
that I never (laughs) had any problems with the
education ministry or anybody else in the
Japanese government in getting all the funding I
needed for the schools and so on. Today, the
Japanese who have been raised under that
program of adequate complete proteins are now
from two to three inches taller than their
counterparts were two generations ago. Their
complete proteins, animal proteins you can call
it, have been the basis for that – changing their
dietary habits.
My biggest problem was convincing the people
in the Department of Agriculture that instead of
shipping over shiploads of sugar, which caused
diarrhea in the children – [they] have a buck of
sugar for a week’s rations of food, which they
did, calories times carbohydrates, how they
figured for time – that it was more important to
have the proper quality of food than quantity.
And so Mr. Hoover came over – Herbert Hoover,
on a mission. He had been responsible for
feeding some Belgians and so in the First World
War. He understood what I was talking about. He
got back there to Washington and it was his
lobbying, if you like, that made it possible for me
to get my share, if you like, of powdered skim
milk imported into Japan to carry on this
program. These are the kinds of problems you
have to overcome. Sometimes you have to call in
some unusual people.
Herbert Hoover had been President, [and]
General MacArthur was Chief of Staff of the
Army, and this is how I got invited to the
_____(?) and so on. But that’s how I overcame
this resistance. We were only concerned with
shipping surplus foods. We had a very critical
time, [with] competition between us, the Far
East and the European theaters, both needing all
those foods. We had this Food and Agricultural
Commission set up allocating food between the
various countries. So this was a problem and we
finally worked it out. We changed to dietary
pattern and it’s paid off. All right, I’m sorry to
get so far off in details on this.
No, this is very interesting and something that
probably isn’t written down anywhere.
I’ve put all this down and have written about
this thing and it’s never been published. I wrote
it for my children and I use it as a reference to
refresh my memory when various people who
are doing research in various aspects come to
me and I’m a resource for information.
Among your other responsibilities, there’s a list
here of research projects that you established
and supervised activities on. It’s much too long
to go into every aspect of it although I’m sure
it’s all very interesting. I picked out here the
Atomic Bomb Casualty Commission in Japan
from 1946 to ’51.
You’ll find it’s still in existence. Again, nothing
could be established in Japan by any agency
from the United States without our permission.
The Manhattan Project was very interested in
assessing the damage done by the atomic bomb,
and so other agencies were. The Public Health
Service sent over a mission, the Navy sent over
people. I had a dozen different groups of medical
people in, wanting to know about the effects of
the atomic bomb, which was under my control. I
had taken the first group down on the second of
September, I guess it was – no, no, it was about
the third, because the ceremonies were the
second – into Hiroshima. I sent down six plane
loads and went down to introduce some of our
medical people, Staff [Stafford] Warren and
Shields Warren, from what later was the Atomic
Energy Commission (medical director) [ed. note:
Shields Warren served as medical director of the
AEC from 1947-1952], but at that time they
were consultants to the Manhattan Project that
developed the atomic bomb. They had all these
groups and we had just this one to get into
monitoring radiation levels and all that. We had
the usual furor. When I was first in Hiroshima
and landed this group, got on the radio some
professor from Columbia was saying that
“anybody who got into Hiroshima in the next fifty
years would die of radiation.” We’d get this
nonsense all the time. We just went through it
here a few days ago.
I found that in Hiroshima, when I first went
down there, we didn’t know [what] the reaction
of people would be. We didn’t have any troops in
there. The first directive then came to the
government of Japan to pertain to the civil
population. We had to work out a process as to
who we would address it to, all this, whether it
would be the Emperor, the Imperial Government,
[or] the Imperial General, whatnot. We worked it
out anyway (the staff), giving the Japanese
responsibility for protecting us (that went there).
I found that one of the – [from] what would
correspond to our National Research Council –
Japanese had gotten down there just after the
bombing and figured [from] the effects, that
there was radiation involved. I was able to
contact him and get his first-hand report and so
on. So I decided that I had to get this thing in
hand with all these groups coming and all
wanting to get all the same information. So, the
Atomic Energy Commission was set up by law,
subsequently, and we wanted to do research
because of all this speculation. You know, you
get the extremists, you get a lot of theoretical
physicists or a lot of radiologists who said, “Oh
boy, genetic effects are going to be so-and-so for
this.” We wanted to find out the facts and it
would be a long-term project.
The Atomic Energy Commission then back here
– they had sent over Staff [Warren] and Shields
[Warren] and Warren had been over there
originally – they were interested in setting up an
American research group there. If that was done
then it had to be under my control, and I said,
“No.” I had said “no” to some other things like
this. In the first place, this thing has to go on for
at least a generation. If you set it [up] as an
American thing and excluded the Japanese,
they’re going to throw you out of here as soon as
the peace treaty is signed and your research will
go to the board. So it has to be a joint thing. I
set up, out there then, a Joint Atomic Bomb
Casualty Commission. The American thing was
authorized and financed from the United States –
the Atomic Energy Commission – but we got the
Ministry of Health and Welfare to set up a
commission there and so it was jointly staffed
with the Japanese and so on. We had some good
statisticians, we used Kure as a control group,
and so we set up a long-term project on the
effects of this radiation. Then the reports came
back. Well, I have to tie some things in because
we’re still suffering.
I mentioned deterrents against war. There was
a letter brought over by this first group that
came up to Japan from the Philippines with me,
from the Manhattan Project, in which the
President was looking for a new deterrent
against a future war, because air power had
failed. You know, “If you have another war, air
power will destroy civilization,” and it failed
because it hadn’t even brought Germany to its
knees. A strategic bomb survey over there
showed that military production had increased
actually during our bombings. So the object of
this instruction, called Letter of Instruction, was
“You will play up the devastating effect of the
atomic bomb.” All right? So I was the one who
set the deadline this time. Anybody who had
been in Hiroshima and died within six months,
whether they got run over by a bicycle or
whatnot, would be credited to the atomic bomb.
We had to set some kind of order to this. Most of
the casualties occurred, of course, from thermal
readings. You had the bomb – now I’ll just
summarize this very quickly because all the
reports that came back were the result of these
studies that came over my desk.
The atomic bomb went off and that city had
about 250 thousand people in it. In other words,
you had a high density population exposed,
compared to Tokyo which had a population of
nine million, but where they anticipated being
bombed early in the war after the Doolittle raid.
They had taken all “nonsense” people out so
there were about three million exposed to the
fire and napalm and high explosive bombs that
were dropped there. When the bomb went off,
about 2 thousand people out of 250 thousand
got killed – by blast, by thermal radiation, or by
intense x-ray, gamma radiation. Then, what
happened is like an earthquake. The blast
knocked down houses, hibachis had turned over
and started fires. When you have an earthquake
or an atomic bomb, you start fires and then
people are trapped in the buildings. And again,
by endless interviews, “Where were you?”
“Where was your great uncle?” “Where was
grandma when this occurred?” We built up the
evidence to show on a cookie-cutter basis that it
took about thirty-six hours for about two-thirds
of that town to burn.
You see, it wasn’t “Bing” like the publicity here
[said]: a bomb went off and a city disappeared.
No such thing happened. That was the
propaganda for deterrent. They’re talking about
after that, “One bomb and away goes Chicago,”
you know? All you’ve got to do is look in Life
magazine and whatnot back in ’45, ’46, and so
on. What I’m trying to do is to show how it’s like
“End the war with one B-17.” Well, you have to
keep your feet on the ground. As near as we
could figure then, about twenty-one thousand
people died in thirty-six hours as a result of
being trapped and burned and so on. It’s like
those who died in the ’23 earthquake [and
subsequent] fire. Then, as I say, I set the six
months’ deadline for anybody who had been
there, even though they went away and so on, to
put a deadline on deaths from delayed radiation
effects as far as it takes six months or so for
deaths from (what do they call it?) delayed
effects.
One of us – Norman Trenton(?), somebody –
got a priest there to say he guessed 100
thousand people died when the bomb went off.
Well, you see, it didn’t. There never was 100
thousand people [who] died. I recall the figures
to the ultimate, six months’ deaths from
untreated burns, thermal burns – they didn’t
have any drugs or anything else, except what we
could get in to them – and the delayed effects of
radiation which take several months. You can get
acute death from maybe 3,000 rem [roentgen-
equivalent-man] to the central nervous system;
you can get that right now. Then you get GI
symptoms which cause death in a matter of a
couple of weeks. Then you get the leukopenias
and so on, which occur over a period of several
months. So you have three kinds of radiation
deaths. It was about, 67 or 76 [thousand], I got
my figures transposed, [who] ultimately died in
six months, out of 250 thousand. So we got
things going on treatment of radiation effects
and all this. That’s the facts of Hiroshima.
When I came back to this country, I was
appalled, from a military standpoint, to find that
our major planners in the War Department were
using their own propaganda, 100 thousand
deaths, Bing! And [they were] comparing it –
saying it was the greatest killer in comparing it
to the number of deaths in Tokyo, which had
been literally destroyed by high explosives.
Actually, the atomic bomb was a damn poor killer
in comparison to the exposed population. Tokyo
was dispersed, a third of the total. They were
using the nine million figure back there, you see.
They said, “Well, 250 thousand people were
exposed to it and 76 thousand and whatnot died
in six months.” It took me a couple of years to
get that comparison straightened out in our
official training doctrine in this country. I used to
tell them back in the general staff and so on and
including the chief of staff, “I believe _____(?) if
you can deter a war, for God’s sake, let’s do it
and blow up the effects all you want. But don’t
believe your own propaganda if you are applying
it to your military planning.” Unfortunately, we
created such hysteria in this country that the
mere mention of radiation, or thermal nuclear
power, or a couple of millirems of radiation and
you have a hysteria. So this is a fact. Actually,
the atomic bomb was a poor killer.
Down at Nagasaki, they missed the ground
zero they tried to hit, but there’s still the fact
that it hit Nagasaki Medical School and Hospital
there and killed a lot of patients and so on –
from the _____(?) of the concrete building. But
the blast effected this and knocked down part of
the concrete and so on. But you don’t hear much
about the effects of Nagasaki because actually it
was pretty ineffective. That was a narrow
corridor from the hospital in _____(?) down to
the port, and the effects were very limited as far
as the fire spread and all that stuff. So you don’t
hear much about Nagasaki. It was a different
kind of bomb, but still [dangerous] as far as
radiation and things happening. So you have to
get your facts and keep them in mind and not let
hysteria take over. We’re still paying for that
hysteria following the atomic bomb, which is
deliberately blown up for a very good reason,
and which I participated in, in accordance with
policy of the government. Well, I hope that [this
information] is not too much. That’s all detail and
it’s all in reports. The Atomic Bomb Casualty
Commission, of course, is now running under the
auspices of the Japanese because of the genetic
effects, you see, we have to keep [an eye] on it.
Incidentally, leukemia – you hear about
leukemia all the time – this is technical
questions. (Got a piece of paper?)
Sure.
(Is this on the record – we can take this off
the record.) I’ll show you. Whenever you talk
about leukemia and radiation, I get a little
irritated because they say, “Oh, everybody’s
going to die of leukemia from radiation, from
years age.” [ed. note: Dr. Sams is apparently
writing or drawing something and showing it to
the interviewer.] This is leukemia radiation in the
population – [it] increases with age. I have said
[that] nobody ever proved that leukemia was
ever caused by radiation. Because what
happened in Hiroshima – this was the big thing
everybody was looking for. It went on like this.
Here’s the grade(?) it comes from. Now let’s take
1945. And here’s the age it _____(?). This is
how it went up. And then it came down. In other
words, this area [ed. note: Dr. Sams is
apparently showing the interview something he’s
just written] _____(?). What radiation does is
trigger, not cause, leukemia. You talk to people
here on the faculty and they don’t know this. In
other words, if you look at the charts we
_____(?) what had triggered it early. The total
number of cases – this is what, when I got down
below this, all the people back there began to
[get] quiet. You hear about this propaganda
about the radiation down here and at
Pennsylvania. It won’t [cause leukemia]. All it
does is trigger at an earlier date what was
already going to happen. That’s a very
interesting thing and unknown to a lot of
radiologists. They don’t teach this in medical
school. It was certainly an eye-opener to me
when we got that [report] done.
I noticed that following the outbreak of the
Korean War in June, 1950, you were designated
as Chief of Public Health and Welfare Section,
United Nations Command. What were your duties
in this position?
When that war started, I had had an additional
assignment from ’45 to [194]8, when we had,
literally, American occupation of Korea and tried
to set up a government under Syngman Rhee.
Because, as I mentioned, the Japanese had held
all the top jobs. When they were evacuating,
nobody [could] run the country, so we had to use
American officers at first and then try to find
people. I had a pharmaceutical company [in
which] I had to take the janitor and make him
the president. (Laughs) [That] shows you the
kind of material we had to work with. So we
turned them loose in ’48, then the war came in
’50. Syngman Rhee appealed for help and
supplies when they hit. His army collapsed and
Mr. [Harry S] Truman took the bull by the horns
and first was going to stem the tide by air power.
(Laughs) Which of course, he didn’t. So we had a
little _____(?). And then Syngman Rhee escaped
down to the Pusan perimeter – that was of
course in the Southeast corner – and had his
cabinet down there. He wanted food and clothing
because he had about six million men in his
_____(?).
The boss called me in and said, “Sams, here’s
your baby.” So I gave him what I had done five
years before in Japan. This time, Korea was
devastated. In the first time, we had no qualified
people – I won’t go into detail here – six medical
schools all staffed by Japanese and the
professors all gone, and that kind of thing, we
lacked doctors and so on, but there wasn’t the
physical destruction that we had in the Korean
War in ’50. So I had to do what I had anticipated
doing if we invaded Japan, but which I had to do
anyway when we got there, even though we
didn’t have to invade it.
We had epidemics started of smallpox and
typhus and we had these people living in the
fields and perimeter and all this. In this case, I
had built up the pharmaceutical industry in Japan
_____(?) so I was able to get most of our stuff
there. We had our vaccine program and used
that as a base, and saved the American dollars,
in that sense, and time. I set up medical supplies
and what you call mobile hospitals and so on to
take care and instruct the Korean doctors I could
find. We took departmental staff over there and
we had to provide food, clothing, shelter, medical
care, etc., and control communicable diseases.
Then, as we broke off, after the Inchon invasion,
we broke out of Pusan perimeter. Then we went
north into North Korea, [and] I found there that
– as we encountered the civilian population –
that the North Korean medical service was
almost, almost non-existent. In [treating] battle
casualties, they’d throw the inhabitants of a
village out and put [the wounded] in their village
in the huts and they’d either live or die – this
kind of thing. They were being swept by
epidemics of smallpox, typhus, typhoid, the
usual.
I was working through Intelligence and
interrogating prisoners and so on for an outbreak
of the plague, because plague is endemic in
Manchuria. And the Chinese, when they entered
– you see, I had gone up into North Korea and
tried to reorganize, so I could control what I
called the “little bonfires” of these epidemic
diseases occurring – tried to control them before
they became a wipeout. _____(?) and all this
and I had my people supervise. Well, I was
concerned about plague because when the
Chinese Communists came in, they came from
Manchuria. I was also concerned about cholera.
But they captured a lot of our supplies when they
swept down that we had left there with the
Koreans in ’48, and they were using them
_____(?).
When the Chinese Communists came in and
we had to pull out – we were ordered to
withdraw from North Korea – I had about 100
thousand North Korean civilians who wanted to
come down with us, and we evacuated them. So
I had about 100 thousand refugees. I’d seen the
smallpox and typhoid cases occurring up in there
and I knew they would become really epidemic
after we pulled out, but they been out of control.
I found they had a so-called institute in
Pyongyang headed by a woman, a Russian
doctor. Their typhoid vaccine, we checked it, and
it was non-potent. (Chuckles) So was their
smallpox vaccine, so I knew they had no means
of controlling anything. I used to teach at the
entry(?) school, the impact of diseases on war. I
don’t know – [for instance,] Canada might have
been a part of this country if it were not for
measles, and so on. [Unintelligible sentence] So
diseases frequently have affected military
campaigns, more than all the bullets. Measles
killed more people [than bullets] in the Civil War.
I did a paper on that at one time, and all those
complications of pneumonia. But anyway, I was
concerned about this plague. So, when we pulled
out I left intelligence agents behind – rather, we
had Korean agents left behind – and we pulled
out of Wonsan and so on and Hwangju, to report
on troop activities, but one intelligence question
that I [wanted answered] was to report any
increase in the epidemics. Pretty soon I got
reports that they had what they called the Black
Death. This was very important to us from a
military standpoint. Plague starts out (and I’d
seen plague in the Middle East) – as bubonic
plague transmitted by rat fleas, but it can then
become pneumonic plague. It spreads like
influenza and has a very high mortality rate. At
that time, we didn’t have any drugs to stop it.
Now, if we were going to launch a counter-
offensive and go back to North Korea again, our
troops were not immunized against bubonic
plague because that was a very unstable
vaccine. You don’t immunize with that unless you
have a _____(?). But I knew it would
incapacitate the Chinese Communist troops, and
this kind of report was very important from a
military standpoint.
I got bits and pieces of reports [from]
interviewing prisoners: “Half my unit’s sick. They
turned black when they were dying” and so on.
We got reports of villages being practically wiped
out. So it was necessary to find out what this
was. So I ran to the G-2 and Chief of Staff.
[Unintelligible sentences] I took a good
commando, a navy boy by the name of Clark,
and two Koreans, and got the Navy to take me
up off of Wonsan. We tried to get ashore there in
fishing boats and I had a little LST, but the
Communists knew I was out there. Because
there were a couple of islands out in the Wonsan
Harbor and I’d found terrific epidemics of
smallpox and typhus and _____(?). I wanted to
get in to see some of these cases of this Black
Death. So I got the Navy people to take me
down. Every time we tried to approach the
shore, they were looking for an invasion and
they’d open fire on us and so on. So I finally had
to get the Navy to take me down to a little town,
_____(?) a few miles down below Wonsan
Harbor, and then we went in a whale boat and
then in a rubber raft to try to get in and they
damn near got us. They had gotten some of our
agents, tortured [them] and so on, broke them
down, and they said, “An American General’s
trying to get in.” So they were looking for us.
They didn’t know a code word for the people we
had left in there.
So anyway, we got ashore and found that this
was not bubonic plague or pneumonic plague,
which they themselves thought, the Chinese. But
it was hemorrhagic smallpox, which can kill you
damn near as fast as plague. So we got out. This
was very important because had General
MacArthur been permitted, we could have walked
back up to the Yalu [River] because their troops
were just being decimated by it – hemorrhagic
smallpox – and they couldn’t control it. From a
military standpoint, this again is a case where
the impact of disease on military operation was a
major factor. But, of course, you know the
political situation. General MacArthur was not
permitted to go north, not permitted to win the
war, so we couldn’t take advantage of it. But this
was a very critical thing and in his own memoir,
of course, he mentions it. This is what the
Korean War was. I had the same responsibility
[for problems of] food, clothing, and shelter. But
this was a special operation.
Was this the military operation listed in your
biography as a special mission, September ’50 to
June ’51?
Yes. This was the impact of these epidemics on
the Chinese Communist forces. It was actually in
March that we made a little three man
amphibious invasion.
I see. And you got out to tell about it.
Well, we were lucky because we got hit. Our
Air Force people were hitting the Chinese
Communist convoy coming down just along the
coastal road there, out by ____(?), a little fishing
village, when we were trying to get in, and there
were Chinese running all over the place while I
was trying to pick up some of these people. So
we were lucky to get out.
In your curriculum vitae, it says that you
retired from the military service on the thirty-
first of July, 1955 and became a research
physician with the Operations Research Center,
University of California, Berkeley, and a research
physician with the Department of Neurology,
University of California Medical Center, San
Francisco. Could you tell us about some of your
work there?
Yes. I was asked to join the University of
California there at the Institute of Engineering
Research and Operation Research Center
because the University had a contract with the
Defense Department to attempt to determine a
basis for radiological defense of this country.
Being known somewhat as an authority by that
time on the effects of atomic weaponry on big
populations, I was asked to head up the medical
part of this program, and we did determine that
there was – you could – using existing shelters
save about 90 percent of our population, if you
used it, from destruction from a thermonuclear
war. This was our recommendation.
As an incidental part of this, I was interested
in pursuing the effects of low-level radiation on
the central nervous system because I’d seen the
high level and what it can do. I found the usual
biphasic curve, just as though you have drugs.
You know, you give somebody an anesthesia
ether and he becomes excited and then becomes
depressed and so on. The same thing occurs [in
radiation]. You excite the nerve cells – you can
excite tactile sense, you can excite the retinal
cells, [the] auditory cells with low level radiation.
You can measure the electro-physiological
response. So I was doing two things. After the
major conclusions, then the University asked me
to continue this research to medicine. We were
doing _____(?) and doing low-level radiation on
beagle dogs and so on.
But the main thing, and the important thing is,
again the hysteria. I want to emphasize this. We
have adopted a policy in this country as a result
of the attempt to use mutual terror [as] it’s
called diplomatically – we adopted a policy that a
nuclear war is unthinkable. Therefore, because
we’ve used it as a deterrent against war,
therefore we will take no steps to protect our
civilian population. On the other hand, the
Russians know as much as I know about the
effects of radiation and the probability and
possibility of saving 90 percent of your
population from an all-out nuclear war, and they
have taken steps to protect [their population].
This is one reason today we are in such a bad
shape in this country and why now you hear the
President talking [about] maybe we’ll revive civil
defense and so forth. We have enough protection
in our building right here in this complex, for
instance, as we find on a nationwide basis – we
did a system analysis and so on – to really
survive, our people. I don’t mean we’re not
going to have a few million killed, but it’s better
than this ultimate threat. If we reach a
confrontation sometime about 1985, the
Russians will have completed their rearmament
program by then. [If] we have a confrontation,
and I’m afraid with the hysteria – this thing just
shocked me the other day – hanging over from
Hiroshima, we’ll have the people in this country
say, “Well, better Red than dead; we can’t do
anything.”
And this, as both a military man and a doctor,
I hate to see. But I’ve been to Communist
countries and I know what they’re like. But this
is again, we know – we’ve made these studies
over quite a few years for our government. If
they surveyed our existing things that we could
provide enough protection from radiation and so
on for our population, we could save nine out of
ten people. Without it, we’re going to really have
a fantastic loss, because we have two different
attitudes. “Well, that’s politics” but “that’s for our
top people to decide.” So, you have a political
controversy now about how inferior we are to the
Russians and so on. But their philosophy is [that]
they can win and survive a nuclear war. Our
philosophy is “No defense, you can’t do
anything.” This is contrary to everything scientific
that we found about protecting our population
from radiation effects. So this is more or less a
side issue, as you call it. It’s personal, but based
on some experience.
It’s a very important aside. Is it based on
things like CNS functional response to
irradiation?
No, it’s based on a study of radiation effects on
the Hiroshima [population] versus high explosive
and napalm bombing of cities and casualty
production both ways and so on. Otherwise –
mass casualty production.
I notice you have a study on that, too.
That was what the university asked me to
come [to do]. In fact, the contract was written
because of the fact that I had raised a question
on the highest levels back in Washington that
this “one bomb and away went a city and
buildings and people all together” [theory] was
false. We wanted to find out what the facts were
– and we tried to – using thermonuclear
weapons with [the] hydrogen bomb.
That report was on the possibility of mass
casualties and how to handle them. There’s one
other area of research we haven’t mentioned
that I know of, and that is the application of
mathematics and computer systems to biological
systems. I read your article on that.
I was one of the pioneers.
You were a pioneer in that?
That was when we working on this radiation
effects. I was a consultant to Rand Corporation,
that’s a think tank, down in Santa Monica. I was
attached to George B. Dantzig, who was one of
the top mathematicians. He’s the father of so-
called linear programming. Remember, you have
to go back to the early days of computers.
George was interested in trying to apply linear
programming and computer techniques to
biological problems, and I had some problems –
this effect on whole body versus partial body
radiation, etc. In the initial studies of effects of
radiation on Hiroshima, it told about whole body
radiation. There is no such thing because of
_____(?) of age, _____(?) of the patient and so
on. It’s different on this side and this if you get
this way, all that kind of stuff. It became too
complex to think it out using a slide rule or
anything else.
So I needed an expert in mathematics. At that
time, Rand had an analog computer down there,
and we had the first one in Berkeley – it was [a]
707 computer, an IBM, and we had a handmade
one. I persuaded (eventually), after working with
George – we commuted back and forth – that we
could solve some of these complex problems,
just like we’ve been talking here about –
membrane transfer, charged particles and so on
– I was interested in membranes, nerve cells,
and others. We found, to make a long story
short, that we could not apply linear
programming techniques; it was not a linear
function. Membrane transfers and so on, and
change in potentials, cell membrane, is a
function of radiation, it’s one of the effects of
radiation – they shouldn’t change.
We actually had to develop – and George
being the theoretical mathematician that he is,
and I did the medical CBM(?) – and it took us a
couple of years before we could talk together. I
had calculus and all that but when he takes off,
he leaves me way behind. But he didn’t know
anything about medicine, so I talked about
metabolic changes and metabolism and all this.
We had to educate each other. Anyway, it worked
pretty good. I finally persuaded him to leave
Rand and come up and join us and we set up
[the] Operation Research Center.
We did a lot of early mathematical modeling
using various compartments, as we called it, on
the fluid movement between the inulin space,
the vascular and the lymphatic system and so
on. As frequently happens in research, you work
on a broad thing and pretty soon you get it
narrower and narrower. We finally got it down to
ion transports and membranes. We scoped some
papers on it. It was the first attempt to develop
complex mathematical modeling. As I said, we
couldn’t use linear programming. George was the
father of this. He wrote the first textbook on
linear programming which is used now over all
the nation, in Washington. This was a far-out
business.
Likewise, when I had a problem of power
spectral analysis on doing
electroencephalographic measurements of these
metabolic changes, because your brain’s nothing
but a transducer converting chemical energy of
activation to molecular energy. You can measure
these things, but I had to know the power
changes within that squiggle. This was
something that no one knew how to approach.
We did an awful lot of struggling and got a lot of
different people involved. I finally got to the
point where I had to get the Navy, who had a
very high-speed analog-digital converter. We
finally had to convert from the analog data, as
we called it, into digital to get a power spectral
analysis. I got the Navy to let me use their high-
speed analog-digital converter – of course, I had
to pay for it out of my research funds – down at
Lockheed, which they use in their rocket
business and satellite business. We were able to
solve this problem and I gave a paper on that for
the Electroencephalographic Society on the
power spectral analysis. But this was, at that
time, after all it’s only ten, twelve years ago,
(laughing) it was hard finding people you could
talk to about it. Now it’s so universal that it’s one
of our major research tools today. I think you
finally have it here in this medical school
computer center haven’t you? For biomedical
research. There was no such thing when I
started in medicine.
Yes. It’s called the Biomedical Computer Lab.
That’s right. Now they’ve all got it. But when I
started there wasn’t anyone anywhere. We didn’t
have at that time – I needed amplifiers that had
to be very small. I was using microvolts, of
course, and people in the field like Bell Labs,
[and the] big research outfit that sponsors
Sandia Corporation, which does a lot of atomic
work at Albuquerque and _____(?) in radiation,
were just beginning to talk about solid state
amplifiers. Now, you can put everything on a
little bitty chip the size of your fingernail. So
when we were working on this, we were feeling –
it’s called far-out. We had no precedents. So that
was a lot of fun and we made a little progress.
Have you retired from active research now?
No, no, no. People, I say, use me more as a
resource. [They] write me stuff and they come to
me, like I said. My field of research now is in
genealogy. I’ve had that as a hobby for many
years and right now after this meeting, I’m going
back to Virginia and get some old records.
That’s very interesting, too.
Tying in with history is interesting. So this is
comparable to this particular thing, but we’ve got
a lot of problems still to solve. [Unintelligible
sentence]
You had such a long and distinguished career.
Are there any other aspects of it that we’ve left
out? I know we haven’t been able to cover
everything, there was just too much to cover.
Oh, there’s too much to cover because you’re
working with a whole mesh, and that challenge
was the greatest thing that ever happened to
me. That was the peak of my life. You couldn’t
duplicate [it]. I had people say, “Why didn’t you
do this in this country?” I was invited to go to
China. I said, “Under certain circumstances, you
cannot do, in the time period—” Well, you can’t
do it in this country with our form of
government. In fact, at an interview after giving
a paper before the AMA four years ago, one of
the science writer/people had an interview; and
the lady said, “Well, now, you’ve cut all these
desks down in doing this, so don’t you think we
ought to change our—?” I said, “It’s because we
had the authority. The form of government we
established there – which was a national form of
government, not a federal government. So you
could do these things on a nationwide basis.” She
said, “Should we have that form of government
in this country?” and I said, “No, you have to
balance one thing against the other and I value
[the] freedom we have in this country more than
being able to do the things I could do by dictate
where I had absolute power.” In Japan, where
you had a form of government if somebody up at
the top says this [gives an order], it goes down.
All the local governments do under that form of
government is carry out what the national
authorities say. Unfortunately, we’re going in that
direction while a few are tearing it down. So,
freedom was more important to me.
But that was the peak. I knew anything I did
back here – and I’ve had many opportunities –
would be an anti-climax because that was a
dramatic thing on a scale that had not been
attempted before. And we were lucky; [we had]
full cooperation.
One of the things the archival program does is
to collect the papers of faculty and alumni. Have
you been approached on this by someone else?
Oh, yes. The Hoover Institute for War and
Peace wanted me to leave my papers with them.
The Army War College wants me to. The
University of Mississippi wants me to— The
[history] department [sent] a fellow out about
this. I’ve had many people interested if I would
turn over my papers. Right now I say, “Well,
people come and ask me about this and I’m
getting old and I have to have them to look at
myself to refresh my own memory because too
many years have passed.” So, yes, I’ve had
 many people [ask].
Well, Washington University is interested too.
You can add us to the list.
That’s fine. I have to someday work this out.
Of all places, York University in Toronto, Canada
sent a historian down. [He] first talked to me –
the chairman of the department – a year or so
ago, and sent a man down. [He] spent six
months [working], spent about four hours a day,
one day a week for that six months, recording
things, all the details. I let him have full access
to my papers and then he would do like we’re
doing, he would ask me questions to get it on
tape. So I don’t know how many reels of tape he
got because he wasted an awful lot of tape. So
there’s an awful lot of junk sitting up in the
archives in York University in Toronto, Canada.
That’s interesting to know that.
But I do appreciate it and as I say, when I get
to the point where I see the end coming, and it
could happen any time, I have to figure where to
leave this junk. [ed. note: Sams’ papers were
left to the Hoover Institution on War, Revolution
and Peace, Stanford University]
We appreciate your giving this interview to us
very much, Dr. Sams.
I’m glad to cooperate with anybody who’s
interested.

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