Sunday, December 23, 2012

OPERATION DELIRIUM


Edvard Munch’s The Scream by Sebastian Cosor Vimeo
"This Shall Be The Story Of The Fall Of A Human Soul— A Fall Which Is Great."

BY RAFFI KHATCHADOURIAN

Courtesy Of  "The New Yorker"

Colonel James S. Ketchum dreamed of war without killing. He joined the Army in 1956 and left it in 1976, and in that time he did not fight in Vietnam; he did not invade the Bay of Pigs; he did not guard Western Europe with tanks, or help build nuclear launch sites beneath the Arctic ice. Instead, he became the military’s leading expert in a secret Cold War experiment: to fight enemies with clouds of psychochemicals that temporarily incapacitate the mind—causing, in the words of one ranking officer, a “selective malfunctioning of the human machine.” 

For nearly a decade, Ketchum, a psychiatrist, went about his work in the belief that chemicals are more humane instruments of warfare than bullets and shrapnel—or, at least, he told himself such things. To achieve his dream, he worked tirelessly at a secluded Army research facility, testing chemical weapons on hundreds of healthy soldiers, and thinking all along that he was doing good

Within the Army, and in the world of medical research, the secret clinical trials are a faint memory. But for some of the surviving test subjects, and for the doctors who tested them, what happened at Edgewood remains deeply unresolved. Were the human experiments there a Dachau-like horror, or were they sound and necessary science? As veterans of the tests have come forward, their unanswered questions have slowly gathered into a kind of historical undertow, and Ketchum, more than anyone else, has been caught in its pull. In 2006, he self-published a memoir, “Chemical Warfare: Secrets Almost Forgotten,” which defended the research. Next year, a class-action lawsuit brought against the federal government by former test subjects will go to trial, and Ketchum is expected to be the star witness.

The drugs under review ranged from tear gas and LSD to highly lethal nerve agents, like VX, a substance developed at Edgewood. Ketchum’s specialty was a family of molecules that block a key neurotransmitter, causing delirium. The drugs were known mainly by Army codes, with their true formulas classified. The soldiers were never told what they were given, or what the specific effects might be, and the Army made no effort to track how they did afterward. Edgewood’s most extreme critics raise the spectre of mass injury—a hidden American tragedy

Ketchum, an unreconstructed advocate of chemical warfare, believes that people who fear gaseous weapons more than guns and mortars are irrational. He cites approvingly the Russian government’s decision, in 2002, to flood a theatre in Moscow with a potent incapacitating drug when Chechen guerrillas seized the building and took eight hundred theatregoers hostage. The gas debilitated the hostage takers, allowing special forces to sweep in and kill them. But many innocent people died, too. “It’s been looked at by some skeptics as a kind of tragedy,” Ketchum has said. “They say, ‘Look, a hundred and thirty people died.’ Well, I think that a hundred and thirty is better than eight hundred, and it’s also better, as a secondary consideration, not to have to blow up a beautiful theatre.”


Edgewood had been built in a fit of urgency during the First World War, when weaponized gas—chlorine and, later, mustard—was used to devastating effect in the trenches of Europe. Fritz Haber, the German scientist who pioneered the rise of chemical weapons, proclaimed, “In no future war will the military be able to ignore poison gas. It is a higher form of killing.” The U.S. Army took the threat seriously, and launched a program to study the chemicals, building laboratories and gas chambers in order to test human subjects. “We began to hear about the terrors of this place,” a private wrote in 1918. “Everyone we talked to on the way out here said we were coming to the place God forgot! They tell tales about men being gassed and burned.”

After the Second World War, intelligence reports emerged from Germany of chemical weapons far deadlier than mustard or chlorine. The new compounds, which had evolved out of research into insecticides, were called nerve gases, because they created a body-wide overflow of the neurotransmitter acetylcholine, often triggering organ failure and near-sudden death. The Reich had invested primarily in three—tabun, soman, and sarin—and the victorious powers rushed to obtain them. The Soviet Union secretly dismantled an entire nerve-gas plant and relocated the technology behind the Iron Curtain. The American government, for its part, acquired the Nazi chemical formulas—and, in some cases, the scientists who developed them—and brought them to Edgewood.

The Army decided to pursue sarin. The chemical was about twenty-five times as deadly as cyanide, and readily made into an aerosol. It was virtually impossible to handle without casualties; in one year, seven technicians required immediate treatment following accidental exposure. As the vapor was released after tests, birds passing over the flue of the gas chambers fell dead, and had to be cleared off the roof. In experiments that the arsenal contracted at Johns Hopkins University, researchers gave sarin to healthy volunteers in cups of water over three days. Some of the subjects were severely poisoned; they twitched, vomited, and had trouble breathing.

Early nerve-gas experiments focussed on the extreme lethality of the chemicals, and on antidotes, but researchers at Edgewood also began to take note of the chemicals’ cognitive side effects. Subjects often felt giddy at first, then deeply anxious. Some had nightmares or lost sleep and became depressed. A secret 1948 study on the poisoned Edgewood technicians noted that “the outstanding feature of these cases appears to be the psychological reactions,” and its author wondered how “young men having no experience or knowledge” of the chemicals would react. A senior official at the arsenal had observed that men exposed to highly diluted tabun “were partially disabled for from one to three weeks with fatigue, lassitude, complete loss of initiative and interest, and apathy.”

I spoke to a former Edgewood test subject who was given the nerve agent VX, which, when applied to the skin, is a hundred times as deadly as sarin. An officer came to his bedside to draw a small circle on his arm, and then a doctor with a syringe squirted on a drop of liquid. The effect was rapid. The subject heard other people groaning—one man said, “Oh, shit”—but he felt only a calm disassociation from his environment. There was a radio on in the room, but the words made little sense. When he was given food, he didn’t know what to do with his utensils. “I was not in control,” he told me. “It was incredible. This tiny drop had rendered me helpless.” As the test continued, he was seized by an agonizing wave of tension, as if each nerve ending were being crushed in a vise. “It was intense,” he told me. “My body was clenched. All of my nerves were tight, physically and mentally.”

In 1949, L. Wilson Greene, Edge wood’s scientific director, typed up a classified report, “Psychochemical Warfare: A New Concept of War,” that called for a search for compounds that would create the same debilitating mental side effects as nerve gas, but without the lethality. “Throughout recorded history, wars have been characterized by death, human misery, and the destruction of property; each major conflict being more catastrophic than the one preceding it,” Greene argued. “I am convinced that it is possible, by means of the techniques of psychochemical warfare, to conquer an enemy without the wholesale killing of his people or the mass destruction of his property.”

In its broad strokes, “Psychochemical Warfare” fit within the evolving ethos at Edgewood: better fighting through chemistry. The first commanding general of the Army’s Chemical Warfare Service had extolled the “effectiveness and humaneness” of gases: they killed quickly, and kept infrastructure intact. Psychochemical warfare certainly promised a form of conflict less deadly than clouds of sarin—even more humane, in that sense, perhaps. But Greene did not want to elevate consciousness; he wanted to debilitate, in ways that would inspire terror. As he put it, “The symptoms which are considered to be of value in strategic and tactical operations include the following: fits or seizures, dizziness, fear, panic, hysteria, hallucinations, migraine, delirium, extreme depression, notions of hopelessness, lack of initiative to do even simple things, suicidal mania.”

Greene drew up a list of chemicals to investigate, ranging from barbiturates to carbon monoxide, and he urged a deeper inquiry into the psychological effects of nerve gas. Enoch Callaway, a Navy psychiatrist who arrived at Edgewood in 1950, recalled, “I was told that I needed to measure ‘nervousness,’ because nerve gas was supposed to make you nervous.” So he designed a test: people given sarin were blasted with noise to measure how much they jumped. “We figured out that nerve gas actually reduced anxiety in doses that did not cause convulsions.” The work, he insisted, was conducted responsibly, with a sense of urgency now hard to understand: “We didn’t know that chemical warfare was going to disappear so thoroughly.”

In the mid-nineteen-fifties, psychochemical warfare was formally added to Edgewood’s clinical research, and approval was granted to recruit soldiers from around the country for the experiments, in a systematic effort called the Medical Research Volunteer Program. The Army assured Congress that the chemicals were “perfectly safe” and offered “a new vista of controlling people without any deaths”—even though early efforts to make weapons from mescaline and LSD were dropped, because the drugs were too unsafe or too unpredictable. Congressional overseers, terrified of Soviet military superiority, were ready to lend support. The Red Army had an extensive chemical-warfare program, and evidence suggested that it had an interest in “psychic poisons,” used to trigger mental illness. “Some foreign enemy could already be subjecting us in the United States to such things,” one panicky legislator proclaimed during a hearing. “Are we the ones receiving it now? Are we the rabbits and guinea pigs?”

Edgewood began reviewing hundreds of chemicals, many provided by pharmaceutical companies. One officer remarked, “The characteristics we are looking for in these agents are in general exactly opposite to what the pharmaceutical firms want in drugs, that is the undesirable side effects.” Starting in 1959, the arsenal aggressively pursued phencyclidine—or PCP—which Parke, Davis & Company had marketed as an anesthetic but abandoned because patients were having hallucinations and delusions. Edgewood doctors tested it as an aerosol and surreptitiously gave it to soldiers to see if they could then “maintain physical security over simulated classified material.” One subject—who had been exposed to sarin gas a week earlier—was handed a glass of whiskey laced with twenty milligrams of PCP. “Manic reaction and much hostility,” a doctor observed. The subject passed out, and began breathing in a pattern associated with neurological trauma or cardiac stress.

Rioch told Ketchum that another volunteer had ended up in the hospital for six weeks. “He had a paranoid reaction that didn’t go away after the drug wore off,” Ketchum recalled. The trials with PCP were eventually dropped, but stories of other problem cases circulated. A military advisory council decided that the arsenal was ill equipped for the newer line of research. “It seems important to undertake immediately a program to develop sound, fundamental techniques of assessing abnormal behavior,” its members noted. “The services of people trained in this field, such as psychologists, psychiatrists and neuro-physiologists should be obtained.” Edgewood, in other words, needed young doctors just like Jim Ketchum.

The psychochemical-warfare program was a small part of the over-all research, and in many respects it was the strangest. Once, Ketchum walked into his office and found a barrel the size of an oil drum standing in a corner. No one explained why it was in his office, or who had put it there. After a couple of days, he waited until evening and opened it. Inside, he found dozens of small glass vials, each containing a precisely measured amount of pure LSD; he figured there was enough to make several hundred million people go bonkers—and later calculated the street value of the barrel to be roughly a billion dollars. At the end of the week, the barrel vanished just as mysteriously as it had appeared. No one spoke about it. He never learned what it was for.

After receiving a security clearance, Ketchum was told that EA 2277 was 3-quinuclidinyl benzilate, or BZ—a pharmaceutical, intended as an ulcer therapy, that was rejected after tests found it unsuitable. Infinitesimal amounts could send people into total mental disorder. BZ is an anticholinergic, similar to atropine or scopolamine, which are used in medicine today. At high doses, such drugs trigger delirium—a dreamlike insanity usually forgotten after it subsides. Sim, one of the first doctors to try BZ, later proclaimed that it “zonked” him for three days. “I kept falling down,” he said. “The people at the lab assigned someone to follow me around with a mattress.”

For years, Sim had been overseeing secret intelligence experiments at Edgewood. At one point, he did research for the C.I.A. on a BZ-type drug, called the Boomer, that causes delirium for as long as two weeks. The agency wanted to know if it could be administered through the skin. Could a Soviet agent brush some on silverware at a diplomatic party and cause an American official to go crazy? Could an operative dose an adversary with a handshake? Sim initiated trials at the arsenal and at Holmesburg Prison, in Pennsylvania, with which Edgewood had contracted to conduct experiments on inmates.

Testing psychochemicals for intelligence purposes, Sim appeared to believe, required a uniquely loose protocol: the goal was to control the mind, and the subject’s expectations of the drug’s effect mattered. He often gave LSD to people without warning.

Not long after arriving at Edgewood, Ketchum took to playing tennis with a commanding officer at the arsenal, who, after a match one day, described how Sim had spiked his morning coffee with LSD. “He was pissed off as hell,” Ketchum told me. LSD had been mixed into cocktails at a party, and into an Army unit’s water supply. Some men handled it fine; some went berserk. A test subject in 1957 exhibited “euphoria followed by severe depression, anxiety, and panic—feeling he was going to die,” according to his chart. Another test involved intelligence specialists who were blindfolded and placed in an isolation chamber. “Only one subject was in a condition to undergo extended interrogation,” a report concluded. “A second subject fled from interrogation in panic.”

Ketchum later wrote of Sim’s “hare-brained experiments” and his “lack of scientific (and ethical) judgment.” The Army had apparently reached the same conclusion. In 1959, responsibility for the volunteers was taken from Sim—who was eventually given the new title of chief scientist—and transferred to Lindsey, a more capable leader, though not immune to bouts of recklessness himself. To demonstrate the effects of VX, he was known to dip his finger in a beaker containing the lethal agent, then rub it on the back of a shaved rabbit; as the animal convulsed and died, he would casually walk across the room and bathe his finger in a Martini to wash off the VX. “I thought they were crazy,” a doctor who served under him told me. “I was going to New York, and Colonel Lindsey tells me, ‘How about taking a vial of nerve gas to New York to make a demonstration.’ And I am looking at the guy and thinking, If I have an accident on the Thruway, I could kill thousands of people—thousands of people. I said, ‘No. It’s that simple.’ ”

Sim appeared to believe that personally sampling every chemical agent made him free to circumvent conventional standards; “I have to live with myself,” he once said. Lindsey had an officer’s protectiveness for the enlisted men. Many of the Army doctors—draftees, like the volunteers—who worked under both men strove to reconcile their military obligations with their medical commitments. “As doctors, we are used to treating people who are sick, not making them sick,” one told me. “I did not like the idea of what I was doing with individual human beings. But I understood what I was doing in the context of the defense of this country.”

Exposed soldiers exhibited bizarre symptoms: rapid mumbling, or picking obsessively at bedclothes and other objects, real or imaginary. “Subjects sometimes display something approaching wit, not in the form of word-play, but as a kind of sarcasm or unexpected frankness,” he wrote in a report for Sim. The drug’s effect lasted for days. At its peak, volunteers were totally cut off in their own minds, jolting from one fragmented existence to the next. They saw visions: Lilliputian baseball players competing on a tabletop diamond; animals or people or objects that materialized and vanished. “I had a great urge to smoke and, when I thought about it, a lit cigarette appeared in my hand,” a volunteer given a drug similar to BZ recalled shortly after the experiment. “I could actually smoke the cigarette.”

Soldiers on BZ could remember only fragments of the experience afterward. As the drug wore off, and the subjects had trouble discerning what was real, many experienced anxiety, aggression, even terror. Ketchum built padded cells to prevent injuries, but at times the subjects couldn’t be contained. One escaped, running from imagined murderers. Another, on a drug similar to BZ, saw “bugs, worms, one snake, a monkey and numerous rats,” and thought his skin was covered in blood. “Subject broke a wooden chair and smashed a hole in the wall after tearing down a 4-by-7-ft panel of padding,” his chart noted. Ketchum and three assistants piled on top of the soldier to subdue him. “He was clearly terrified and convinced we were intending to kill him,” his chart said.

“These soldiers are not really informed at all,” he told Malcolm Bowers, an Edgewood medical officer who later became a professor at Yale. Little was known about the long-term effects of the experiments, and yet the volunteers, after a stay at the arsenal, were blindly pushed back into the Army at large, with no follow-up care. In a self-published memoir, “Men and Poisons,” Bowers recalls Lindsey wondering if the lack of follow-up stemmed from the Army’s fear that such a program would disclose concern about lasting health effects. Sim later offered a more mundane reason: insufficient funding

The Medical Research Volunteer Program initially had difficulty attracting volunteers, so monthly quotas were established to insure a steady supply of research subjects. Recruiters fanned out to Army facilities across the country; some commanders even ordered men to attend the sessions. People who attended the sessions came away with an uncertain sense of what they were being asked to do. 

A number of them told me that recruiters advertised the program in vague terms, as human behavioral studies, or equipment testing, or medical research. Inducements were offered, too. Soldiers could spend time near several large East Coast cities, and would be given three-day weekend passes to explore them. There would be extra pay, and few responsibilities, aside from showing up at a test. Many men spent much of their stay playing Ping-Pong and watching movies. When it came time for volunteers to leave—at first, they were asked to serve for a month, later two months—a letter of commendation would enter their file. In the sixties, the arsenal offered an even more powerful incentive: time away from Vietnam.


Once the volunteers arrived at Edgewood, they were given medical and psychological examinations, and were divided into four groups. The least healthy would be used to test equipment. The top twenty-five per cent—the Astronaut Class, as Ketchum once called them—would typically be prepared for the most dangerous chemicals. Doctors informed the volunteers in generalities and asked them to sign a consent form—usually long before any specific test was announced. The forms were designed to offer few details; as one version was drafted, the words “mental disturbance or unconsciousness” were replaced with “discomfiture.” Sometimes a little more information would be provided just before the test began, but not always. Van Sim later confessed that researchers testing nerve gas would tell volunteers that the drug might give them a “runny nose” or a “slight tightness of the chest.” In 1961, a volunteer from Kansas, named John Ross, was given soman, a highly persistent nerve agent. Only when the needle was in his arm did he overhear the doctors saying that he had been given something lethal. “I started having convulsions,” he told me. “I started vomiting. One of the guys standing over me said, ‘We gave you a little too much.’ They told me to walk it off. I started to panic. I thought I was going to die.” Ross became rigid and was rushed to Walter Reed. For years afterward, he suffered from insomnia and depression.

Test subjects had a right to decline an experiment—assuming that they knew they were part of one—but they almost never did. “There was no question that they would participate,” Bowers recalled. Withdrawing from a test required backing down from a commitment to one’s superior, which was anathema in the Army. “In the military, if you don’t do something you will be ostracized,” a soldier given LSD in 1958 told me. “I believe they did give us the option to leave, at first, but you didn’t really have a choice once you were in.”


The same day Elbin was given BZ, Ketchum gave the drug to Teddie Osborne, who had been stationed at the Yuma Test Center, in Arizona, where he was using a crude detector and a caged rabbit to look for chemical leaks. Osborne thought that his work would not change much at Edgewood. “It wasn’t really explained,” he told me. At the arsenal, he was assigned to help manage the recruits; he liked the work and volunteered again.

The second time, he was told that he was going to be a subject. He felt tricked. “I could not have said no,” he told me. “You are dealing with professionals. We were very gullible.” One Wednesday, Osborne was injected with BZ, and ushered into a padded room. He had no idea what the drug was or what it would do. “I don’t remember anything until Saturday,” he told me. “That was so disturbing. Later, it still haunted me.”

By this time, the Army was running a “crash program” to turn BZ into an operational weapon.

Even as it became reasonable to suspect that BZ could cause serious injury on the battlefield, the military was pushing to put it into use. In November, 1964, an Army major travelled to Edgewood on an urgent mission from Lieutenant General William Dick, the chief of Army research. Soviet trawlers had been spotted off the coast of Alaska, and Dick wanted to know if a projected cloud of BZ could disable the crew. Senior officers at the arsenal told the major that such a thing was out of the question—the chemical had not even been field-tested. Eventually, the major came to see Ketchum, who was leading a newly created group called the Psychopharmacology Branch. “The plan didn’t make a whole lot of sense, and it offended me on a rational level,” he wrote in his memoir. “On the other hand, the challenge ruthlessly tickled my imagination.

The Soviets were not ignorant of BZ, after all. Vil Mirzayanov, a chemist who conducted secret weapons research for the Soviet Union, told me that Moscow never had more than a halfhearted interest in LSD, and that its interest in BZ was strictly to keep up with Ketchum’s program. “We knew the West had developed this weapon, and we were trying to copy it,” he said. Soviet scientists, who called the formula Substance 78, conducted their own clinical trials with it and manufactured tons of the drug at a plant in Volsk. 

By the late sixties, the high point of the Cold War had sloped into a murkier geopolitical condition; half a million Americans were in Vietnam, and though the Army had freely used defoliants and tear gas there, it decided not to use BZ. Popular sentiment was turning against the idea of deploying psychochemicals in war. “There are moral imponderables, such as whether insanity, temporary or permanent, is a more ‘humane’ military threat than the usual afflictions of war,” E. James Lieberman, a psychiatric resident at Harvard, wrote in The Bulletin of the Atomic Scientists. In 1965, Sidney Cohen, a well-regarded LSD researcher, argued that “such degradation of a person’s mind is worse than his physical death and can hardly be considered humane warfare.”
A physician named Mark Needle told me that he thought Ketchum’s human experiments were run like the Keystone Kops. “There was nobody qualified,” he said. “And the fact that they were allowed to do it without people who knew what they were doing was very, very scary. There was no humanity in it. There was no morality in it. If anything happened to the volunteers, we could say, ‘You were offered an out,’ but then we were also telling them, ‘Listen, this is the Army, and we are at war.’ Our view was that this was a terrible thing to do to these kids, because who the hell knew what could happen?”

When Ketchum sought to orchestrate a field test with a new version of BZ, four doctors wrote in dissent. He overruled them. Another version, called EA 3834, appeared to cause microscopic hematuria—tiny amounts of blood in urine—and other renal problems. One soldier was sent to Walter Reed. “This is a dangerous drug,” a psychiatrist named George Leib insisted. Leib, who worked on the arsenal’s annual budget, had come to think that tests of a baroque nature and questionable design were being funded merely to sustain the program. His office was across from the toxic-aid station, and he was sure that records were being manipulated to disguise problem cases.

In April, Matthew Meselson, a Harvard biologist, argued in congressional testimony that non-lethal chemical weapons would only make war more savage, because armies would use them to flush out enemies and then slaughter them. 

The lasting health effects of the research were difficult to judge. Records were either messy or incomplete, and no experiment had collected data to determine how a drug might affect lives in the long term
.

The Nuremberg Code established an ethical framework for medical experiments. The code begins with a clear premise: 
“The voluntary consent of the human subject is absolutely essential.” That consent must flow from an “enlightened decision,” shaped by a true understanding of the test’s medical risks. Moreover, human experiments must be preceded by animal studies, and conducted in pursuit of a greater social good—with risks never exceeding “the humanitarian importance of the problem.” If a subject is unable to endure the experiment, or if a researcher believes there is a probability of injury, the test must end.





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