Coping with nuclear accidents and terrorism: Report from the fatherland

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My father’s generation had turned their backs on the beer business. They spoke good American English, not German. They married Daughters of the American Revolution, not always with the best results. They took on callings of their own. My father, William, became chief litigator at Sullivan & Cromwell in New York city. Uncle Gerard became owner, editor and publisher of Scientific American magazine, and bought a house on Lakeville Lake. Dr. John co-founded a childrens’ hospital in San Francisco. Mary and Rita married out. David launched a cartoon company. And so it went. No more beer.

Piels did revisit the fatherland for one reason or another, notably in uniform during two world wars. I "returned," so to speak, paid for by Uncle Sam, as the 2nd and 4th Armored Divisions tore up the German countryside, compensated German farmers for destruction of their orchards, "occupied" beer halls, dated the locals, and handed out chewing gum and candy to German children, especially orphans at the kinderheim. In return, Americans were showered with praise and flowers, easily the most beloved people on the planet. Lately, this has not been the case.

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As a result of all the above-mentioned experiences, I have always seen a natural affinity, a shared sense of postwar can-do optimism and idealism, among Germans and Americans. All we have to do is exploit it. Among the best fields for such potential, of course, is scientific cooperation generally, and more recently and specifically, collaboration in preparing for, dealing with and minimizing the adverse effects of radiation exposure due to accident or acts of terrorism.

My current visit to Germany is to meet with Professor Theodor M. Fliedner, former rector of Ulm University, chairman of the WHO Advisory Committee on Health and Medical Research, director of a WHO collaborating center dealing with emergency preparedness, and active member of the European Bone Marrow Transplantation Group and the Radiation Medicine Research Group at Ulm.

While working at Brookhaven, N.Y., in the 1950s and ’60s, Professor Fliedner was the first person to theorize and then prove that adult stem cells are circulating throughout the human blood system. This insight contributed to the successful stem cell transplantation treatment and cure of thousands of victims of nuclear accidents, most notably patients from Chernobyl, as well as certain diseases such as leukemia.

Ulm now offers the world very advanced international courses on a range of cutting-edge technologies, including research and training in stem cell transplantation to save lives and reverse damage in cases of acute radiation syndrome. Ulm, in cooperation with WHO’s REMPAN program, is taking steps to create international networks of research institutions and individual scientists to accelerate progress in basic research, technology and organization for radiation emergency management.

With the emergence of worldwide terrorism, the need for rapid, effective response to nuclear catastrophes is all the more vital. It is gratifying to report that the U.S. Department of Health and Human Services, the National Institutes of Health and the National Cancer Institute are developing a "Radiation Event Medical Management Program," and are seeking the scientific input of Ulm for that purpose.

Not everything Ulm has proposed has been picked up, however, partly because some of the American actors see themselves bound by the constraints of "higher level national policy makers." Yet the need for scientific consensus and action should stand higher than the need for political correctness and compliance with imposed ideology of the moment.

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Imagine this scenario: Suicide terrorists manage to bring radioactive Cs-137 into a Manhattan subway, remove the shielding, and thus expose thousands of New Yorkers to gamma radiation. Are we prepared for this eventuality? How would our first responders react?

Could victims be transported to the hospital on time? Could our hospitals handle such a sudden case load? Would the appropriate diagnostic and treatment capabilities be in place? Could they act swiftly enough? Would action be delayed by waiting for the results of conventional laboratory tests to determine exposure dose? Should patients be "triaged," and if so, for what purpose and how? This is where we have to mobilize the best brains and resources — before tragedy strikes. Ulm has some very precise knowledge and experience to offer here.

Professor Fliedner and his colleagues at Ulm have demonstrated the effective role of hematology in rapidly coping with the disastrous effects of radiation accidents and nuclear terrorism. They have developed a novel approach to rapid diagnosis, using blood cell count change patterns (e.g. granulocytes, lymphocytes, and platelets) to determine which patients are suffering reversible damage, and thus will recover, and which patients have irreversable damage, and require immediate hematopoietic stem cell transplantation — without having to wait for the result of conventional laboratory analysis of dosage exposure.

Ulm’s successful experience comes to the United States of America free of charge. Will the United States pick it up? The answer is not clear.

Meanwhile, more basic research is needed to understand exactly how stem cells work. There are limits to what adult stem cells can accomplish. We need to pursue nucleus transfer methods involving unfertilized embryos, for example. Will the United States be able to do its share of this work, or will other policy considerations prevail over good science and humanitarian purpose?

In the last several years, the U.S. administration has blocked more than 150 American scientists from attending WHO expert meetings, simply because they do not toe the current political line. Too often the administration has appointed persons to head important task forces and programs who are not scientifically competent, or whose hands are politically tied.

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This is an illustration of a more general problem: The current U.S. administration gives every evidence of disdaining international cooperation and scorning hard science — from global warming to stem cell research. How do you cooperate with a neocon dominated executive government that wants to "go it alone" and build an "American empire" in an "American century"? What do you do when a major world power turns its back on that American-created institution, the United Nations?

How can you converse intelligently with a White House which makes no effort to understand the concept of biological evolution, and "believes" that the universe was created in exactly six days, and in any case only within the last 10,000 years? What do you do when a world power opposes family planning worldwide? How, under these circumstances, do you persuade such an administration to examine stem cell therapeutic science closely enough to see that it does NOT conflict in fact with traditional religious values?

I had long thought, and hoped, that the United States and Germany would become leading co-equal partners in the worldwide development and application of stem-cell therapeutic technologies for humanitarian purposes, such as the repair of heart function, spinal injuries, Parkinson’s and a range of cancers — as already successfully demonstrated in animal models, and in some human cases.

However, both countries have shot themselves in the foot — or in the head. Germany, in fear of repeating its own history of misapplied eugenics, has recently adopted legislation outlawing further research using so-called "embryos" (actually a misnomer). The United States of America, misunderstanding both the science and the theology involved, has done much the same by blocking funding for such stem cell research at the federal level, leaving it to individual states and private funding sources to act sensibly and humanely. One effect is to cause brain drain, and already we are seeing this. More importantly, it means that we will be unnecessarily vulnerable to nuclear terrorism, radiation accidents and disease.

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Maybe the new threat of nuclear terrorism will change this. For this could force us to turn to diplomatic and scientific solutions rather than military ones.

What we need to do is stop the mistaken, wasteful and tragic loss of human and economic resources spent on the war of choice in Iraq, and redeploy some of the energy and resources to undermine the root causes of terrorism, block the actual terrorists, and minimize the possible tragic human consequences of acts of terrorism if they occur.

Resources should be redirected to medical and other means of fighting disease and infirmity. We need to launch a new, purpose-driven "Manhattan project" to bring the benefits of stem cell therapeutic technologies to all mankind.