Doctor on Call: Chernobyl Responder, Jewish Refugee, Radiation Expert
Doctor on Call: Chernobyl Responder, Jewish Refugee, Radiation Expert
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Overview
Dr. Alla Shapiro was a first physician-responder to the worst nuclear disaster in history: the explosion at the Chernobyl Nuclear Power Station in Ukraine on April 26, 1986. Information about the explosion was withheld from first responders, who were not given basic supplies, detailed instructions, or protective clothing. Amid an eerie and pervasive silence, Dr. Shapiro treated traumatized children as she tried to protect her family. No protocols were in place because no one had anticipated the consequences of a nuclear accident. From the outset of the disaster, the Soviet government worsened matters by spreading misinformation; and first responders, including Alla, were ordered to partake in the deception of the public.
After years of persistent professional hostility and personal discrimination that she and her family experienced as Jewish citizens of the USSR, four generations of the Shapiro family fled the Soviet Union in the late 1980s. As émigrés, they were each allowed to take no more than 40 pounds of possessions and $90 in cash. Their escape route took them first to Vienna and then to Italy, where they were stranded as stateless persons for six months. Eventually the family received permission to enter the United States.
Motivated by her Chernobyl experiences, Alla Shapiro ultimately became one of the world’s leading experts in the development of medical countermeasures against radiation exposure. From 2003 to 2019, she worked for the FDA on disaster readiness and preparation. Dr. Shapiro issues stern warnings regarding the preparedness—or lack thereof—of America for the current Covid-19 pandemic. Doctor on Call exposes the horrifying truths of Chernobyl and alerts us to the deceptions that undermine our ability to respond to global disasters.
Product Details
| ISBN-13: | 9781942134749 |
|---|---|
| Publisher: | Mandel Vilar Press |
| Publication date: | 01/06/2022 |
| Sold by: | Barnes & Noble |
| Format: | eBook |
| File size: | 12 MB |
| Note: | This product may take a few minutes to download. |
About the Author
Dr. Alla Shapiro is a Medical Officer at the Office of Counterterrorism and Emergency Coordination at the U.S. Food and Drug Administration. Her background is in pediatric hematology and oncology. After her experiences as a doctor who was a first responder to the Chernobyl Nuclear Accident and after years of professional and personal discrimination as a Jewish citizen of the Soviet Union, She and her family emigrated to the United States in the late 1980s. When her medical degree was not recognized by U.S. Authorities, she enrolled in Georgetown University School of Medicine and the interned at Georgetown University Hospital. She became one of the leading medical experts in the world on the effects and treatment of radiation. She has never forgotten her experiences at Chernobyl.
Read an Excerpt
Chapter 1
Nuclear Spring, 1986
I first heard of Chernobyl when my father Yefim called me early on Saturday morning of April 27, 1986 with dire news. A nuclear reactor had exploded near Chernobyl, a city located 80 miles from Kiev. The site was in the small town of Pripyat, just nine miles from Chernobyl. Voice of America (VOA) had broadcast into Ukraine its first reports on of radiation that were detected in Sweden. They suspected that it came from a radioactive leakage at a power plant somewhere in the Soviet Union.
My dad for many years had been getting the real news about what was going on in the Soviet Union from the VOA and the BBC. He had heard this at about 2:00 AM, the only time he could receive unjammed broadcasts. The nuclear blast had not been mentioned in this first report. The world was still unaware that parts of the reactor core had exploded like rockets through the atmosphere. Radioactive fission products of uranium, such as iodine, cesium, strontium and other were catapulted into the atmosphere and spread across vast parts of Europe and the Northern Hemisphere. I didn’t pay much attention to the radio reports or feel concerned about my father’s news at first. Chernobyl was a little-known, nondescript place.
For many years, I had followed Soviet news reports on US testing of nuclear weapons in Nevada. Yet I was completely unaware of this nuclear power plant so close to home that would soon propel my life and my career into a whole new sphere.
Back on that sunny day of April 26, the day of the catastrophic event, people went about their daily lives. They were enjoying an early and welcome warm Saturday morning and in the surrounding Chernobyl area families mingled outdoors; many of them headed to the woods to pick the spring’s first wild strawberries and mushrooms.
After the explosion at Chernobyl the Soviet and Ukrainian governments issued no warnings and repeatedly insisted over public broadcasts that life should continue normally in the shadow of the powerful nuclear disaster. The pervasive official response was to deny and mislead the public. This approach was embraced by those in the highest positions down to the lowliest bureaucrats.
On April 29, three days after the disaster a friend of my dad called to share some unprecedented events he had witnessed. His friend Vladimir, a retired airplane pilot who still worked at a large airport in Kiev, had noticed something disturbing during the night shift: Airport workers had been ordered to handle a frantic scramble for flights out of the city, even as the government news media repeated that the nuclear explosion near the city of three million people posed no threat. The passengers on these night flights, Vladimir said, were “special and distinguished.” They were Communist Party leaders and their families.
For days, Soviet officials were mute about the accident and its rapid deterioration into a severe catastrophe. Yet while local Communist Party bosses evacuated their own families, hundreds of thousands of ordinary people and their children were encouraged to attend a May Day parade in Kiev, where radiation had soared above safe levels. On the following Monday, April 28, and in the weeks after the Chernobyl tragedy, life at the largest hospital in Kiev changed dramatically for the medical personnel in the Pediatric Hematology Unit. We were all on high alert, but at the same time it was a vague alert. It seems incongruous to use both “high” and “vague” to describe such vigilance, yet this is the most fitting way to portray the pervasive chaos of the days and weeks that followed the night of April 26, 1986.
I shared a medium-sized office with six colleagues (also pediatricians). Our boss, the Professor, had a private office and only rushed into our room whenever he heard rumors pertaining to Chernobyl and the surrounding areas. One day he barged into our cramped room, slammed the door and stared for a moment, not knowing where to begin. His face was red, his eyes scanning each corner of the room, as if looking for a hiding space.
“I just got a call that hundreds of children have been evacuated from the 30-km zone around Pripyat where unit No. 4 of the nuclear reactor exploded and are coming to our hospital.”
“Could you please provide some instructions on what we are supposed to do when the children arrive?” I asked our boss.
“We do not have any instructions or guidance,” he replied. “Just exercise common sense. Thousands more children from the surrounding highly contaminated areas are already waiting in long lines for us to admit them,” the Professor added.
For a few minutes, we remained stunned as we tried to absorb the news. During this silence, the telephone rang. I was the closest to it, and therefore the first to hear the “request” that followed. It was non-negotiable, since it came from the top. I immediately recognized our Director’s voice and was gripped by anxiety and fear. I covered the microphone of the receiver and whispered into the air: “It’s Nick.” He was the Director of the National Institute of Hematology and Blood Diseases. Our hospital came under his umbrella. The silence grew heavier as a wave of panic spread through the room.
“Who is responsible for covering hematology cases in Ukraine this month?” the Director asked me. “It’s my turn,” I responded. Why was he calling us? Usually it was a clerk who asked this question and then directed the consultant to a place where our medical expertise was needed the most.
“Listen,” the Director continued. “In one hour, an ambulance will pick you up from work and take you to a place not too far from here.”
“Of course,” I replied. “Just one question. Should I let my family know that I won’t be coming home tonight?”
“I don’t know,” he answered. “You must decide on the spot.” He hung up.
My colleagues remained silent as they processed the brief one-sided conversation they had overheard. Nobody asked me anything. Everyone chose to assume that the Director was giving me one of our regular assignments. As usual, that would include going as a specialist hematologist consultant to areas of Ukraine to help solve tough diagnostic cases, or to offer treatment options when other therapeutic approaches had failed.
After a few minutes of silence, Natasha, one of the doctors who was listening to my conversation with the Director, took me aside.
“Do you really want to go there?” she asked.
I decided that answering her question with another question would be less rude than responding, “No.” So I posed my question:
“Do I have a choice?”
Natasha looked away from me:
“Well, I think that you do.” She went on, “This morning I had a fight with my husband and I don’t want to go home and face him tonight, so I could go for you today instead. When it is my turn to do the out-of-town consult, you can switch with me.” This sounded like a very decent proposal, and I agreed without hesitation, as I had already planned something for that evening.
It was a hot spring day. Natasha was dressed in a short sleeve blue blouse, skirt and sandals. Her pretty, blue eyes looked grey; they reflected sadness and emotional pain. Her golden hair was hanging down her back. As required by hospital etiquette she was wearing a white robe. One hour later the ambulance arrived. Natasha waved to us and left. The rest of the medical staff stayed at the hospital awaiting the busloads of evacuees from Pripyat and villages surrounding Chernobyl to arrive.
Earlier that day, thirty-six hours after the explosion the population of Pripyat received a false “assurance” from the calm voice of a female announcer. “Attention! Attention! In connection with the accident at the Chernobyl atomic power station, unfavorable radiation conditions are developing in the city of Pripyat. To ensure complete safety for residents, children first and foremost, it has become necessary to carry out a temporary evacuation of the city’s residents to nearby settlements of Kiev oblast [province].
For that purpose, buses will be provided to every residence today, April 27, beginning at 14:00 hours, under the supervision of police officers and representatives of the city executive committee. It is recommended that people take documents, necessary items and food products to meet immediate needs.
“Comrades, on leaving your dwellings, please do not forget to close the windows, switch off electrical and gas appliances and turn off water taps. Please remain calm, organized and orderly.”
Over 1,000 buses from Kiev went to Pripyat, people boarded them and the exodus began. Some of the buses arrived in Kiev in the early afternoon as expected. However, some did not arrive until late at night. Families with children waited outdoors for many hours. As the day died out and it became dark, the last buses finally arrived and carried the exhausted people away from the 30-kilometre Exclusion Zone.
For some of them it was too late. Two years later I treated a four-year-old girl with acute leukemia. Her mother told me their evacuation story. She and her daughter, the girl was two years old then, were waiting in Pripyat for the buses when evacuation was announced. Her baby, along with other children had played in the radioactive sand under the shower of nuclear fallout, breathing the air filled with dense radioactive particles. The evacuees had packed only the essentials; they were prepared to be away for three days only. The Soviet government preferred to keep up this “temporary evacuation” lie in the permanent string of other betrayals.
In our unit at the hospital the next three days seemed endless. As more buses with evacuees arrived at Kiev, scared passengers from Pripyat and surrounding villages were unloaded at different this, the empty vehicles were moved to the center of the city.
Bus drivers rushed to the public baths to shower. They dropped their highly contaminated clothes on the floor, chairs, and shelves of the public bath. The emptied buses were blocking one of the main streets, right where my family lived. Teams of workers washed highly radioactive contaminated buses with hoses. Muddy water poured off the buses, streamed down the street, forming large and deep ponds in the populated areas of Kiev. Toddlers and older children splashed in the contaminated water.
Hundreds of families who were evacuated from the 30-km exclusion zone around Pripyat finally arrived at the hospital. In the absence of instructions or medical guidance, each of us did the best we could with courage and creativity. No one complained that the doctors did not spend enough time with each patient. Time itself became meaningless.
For three straight days and three nights my colleagues and I didn’t leave the hospital. We lived and worked on the Pediatric floor. Our family members brought us food and clean clothes. The few existing hospital showers were filled with the incoming children and adults. For most of them home had become a place of no return. Evacuees also crowded into the hospital registration area. Doctors and nurses waited to gather the medical history on each child and to perform a physical exam. No -one cried. No -one talked. There was a pervasive sound of coughing among the incoming patients. This red flag put all the medical staff on high alert.
None of us could diagnose the cause of the cough; therefore, no one knew the proper treatment. It became a high priority for us to crack the “cough code.” This proved to be very challenging. The “happiest” moments occurred when one of us caught a child whose cough was accompanied by fever or shortness of breath. In such cases, the proud doctor placed an order for drugs to treat fever and bronchial spasm.
Unexpectedly, one of the pediatricians from our group blurted out:
“Guys! The kids and their family members are coughing because they have inhaled radioactive particles! Who knows what should be done?”
There was a long moment of silence. No one knew what to do. The answer was not to be found in any of the medical books. This reality forced us to be innovative. We improvised treatment, using whatever materials were readily available. One colleague took the initiative and tensely directed, “Go and grab a blanket,” he instructed me. I immediately obeyed. While observing my actions, my colleague snatched the belts from a few white robes. Then we placed as many kids as possible on the beds to allow them to be under the blanket “tent”.
“Get an oxygen tank!” he commanded. His voice gained strength and confidence. We brought in a few oxygen tanks, turned them on, and the treatment commenced. The oxygen helped to reduce coughing in most of our patients. The kids did not even cry or whine because, if they did, the caregiver would remove them from the tent –- not a desirable outcome. Although we never claimed ownership of this invention, it did fit some 18th or perhaps 19th century standards of care.
Another intuitive move was to talk to the children about something funny and calming. Many of them were in shock, most were anxious, and some were clearly depressed. We did not have any advice on how to decrease their stress and spare them from the related health effects of Chernobyl such as psychological damage. Therefore, we did what we could to brighten up their days by telling them funny stories to make them laugh.
Days after the disaster the medical community still remained unprepared. Medical personnel all desperately needed whatever information could be found in literature to help them. The head of Pediatric Hematology at Children’s Hospital asked me to stop by the National Medical Library in Kiev to pick up books about the human health effects of radiation exposure. This premier library had the best current sources of medical literature in Ukraine.
I set off in search of information for a presentation that my boss wanted me to make the following day to health care providers. As I walked into the library I stared in disbelief at rows of empty shelves and display windows. A librarian explained that the library staff had followed an order from “above” to pull from the shelves all the books and scientific journals that contained the word “radiation.”
The Soviet government’s default strategy was: No information means no panic. Consequently, the population of Kiev and its vicinity learned about protection from radiation through rumors, which spread like wildfire. Many people, including my family, started thinking of evacuating their children. We wanted to send our 3-year Olga to a “clean” area, but I didn’t know where such a safe place might exist.
Very soon after the explosion, some scientists managed to gain access to the true numbers reflecting the degree of radioactive contamination of different areas. They put together a color-coded map with each color representing levels of radioactive contamination in a respective area. It varied from angry red to soothing green. One of the neighbors in our apartment building in Kiev was a scientist with a PhD in physics who worked at the Institute of Physics in Kiev. His affiliation enabled him to “smuggle” from his workplace a map showing contaminated areas in Ukraine, Belarus and Western Russia. We finally had a chance to see where the hottest radiation spots were.
A few close friends gathered at our apartment. Growing up in the Soviet Union, everyone feared that authorities would follow them, listen to their conversations, or even put them in jail. We pulled down the drapes on the windows and unplugged our landline phone. From watching spy movies, we thought that these precautions would spare us from the KGB agents whose job was to catch people who showed too much interest in uncovering the truth. We stood at the table and pored over the smuggled map—and realized instantly that the city of Kiev was in a hotspot. Alarmed by this news, I borrowed a Geiger counter—a device for measuring radioactivity—from a friend. During the 10-day information blackout I could check levels of radiation at home, on furniture, Olga’s toys, and potted plants on the balcony. Two hours later, after crawling between the two rooms and the kitchen with the Geiger counter, I forbade my daughter from playing with her toys.
I reacted to the discovery with emotional numbness, my way of protecting my conscious mind from the devastating distress and shock of detecting significant radiation in the safest place on earth: our family home. I had to accept the direness of the predicament, and then my frightened thoughts focused on one of Olga’s favorite stuffed toy animals, which my daughter was gently hugging and kissing. I slowly moved the Geiger counter along the fuzzy body to detect the extent of radiation pollution on the surface of the toy. The negative results thrilled both of us and Olga pulled the toy from my hands and kissed it on the nose.
“Wait!” I shouted, “Let me check the nose too!” The next moment felt like another explosion as we heard the dreaded click, click, click. The radiation level found on the tip of the nose far exceeded the safe limit to which a child could be exposed in an entire year. I buried the toy in the trash, along with some sofa pillows and flowerpots from the balcony.
Common sense prevailed after my initial emotional reaction. I couldn’t totally rid the apartment of radiation. My family would end up sleeping on the floor without pillows or blankets, eating without dishes or silverware. It didn’t take long for me to realize that we could not live that way.
I returned household objects to where they belonged and announced, “Business as usual,” with a bravado I did not feel. I cuddled the inconsolable Olga, who hugged a pillow in lieu of her toy. Business as usual became part of everyday life for the people of Kiev and surrounding areas. The winds of life are sometimes unpredictable and rough. I just tried to adjust my sails.
A few days after the explosion I was called in to a Kiev clinic to consult on a pediatric hematology case. I was to see a sick child and meet with the radiologist to discuss the patient’s X-ray results.
I had never been to this clinic before and so asked an employee, “Where is your radiology department?”
“Everywhere,” he replied nervously, with a wry attempt at humor.
I wasn’t upset by this answer. I shared his deep perception of danger as I prepared to battle this great unknown enemy, invisible and in many other ways undetectable. In the face of the worst nuclear disaster the world had known, nothing appeared “as usual,” and were not prepared.
On occasion, some physicians refused to see patients who came to a clinic or ER with diseases or conditions unrelated to exposure to radiation. Their standard response was: “What’s the point of treating you, if we are all going to die tomorrow?”
Many of my colleagues and I traveled to the most radioactively contaminated areas of Ukraine without protective clothing or any specific instruction. Physicians and so-called “liquidators,” teams of civilian and military personnel, entered contaminated areas to triage and help with the clean-up after the radioactive fallout of the explosion.
Between my deployments to contaminated areas, I continued to work at the Children’s Hospital in Kiev. Medical personnel there evaluated and treated hundreds of children of different ages who were evacuated from Pripyat. As is the standard everywhere else, each patient’s chart was enclosed in a hard “jacket” (cover). Diagnoses were always written on the cover.
Patients who came from Pripyat and surrounding areas were treated for a range of different diseases. However, for most of them the diagnosis was Acute Radiation Sickness (ARS). Several weeks after the explosion the staff were told that a high-level commission from the Ukrainian Ministry of Health would be visiting their hospital.
The order from above was straightforward: Rip off the covers of all charts showing a diagnosis of ARS. Put a new jacket on the corresponding chart along with a new “benign” diagnosis. In this case creativity was not allowed. We were ordered to change the diagnosis to Vegetative Vascular Dystonia. People with this condition of the autonomic nervous system have symptoms of weakness, sleepiness and depressed mood. Nobody dared to question or argue.
Like many of my colleagues, I felt betrayed. Why should the doctors remain silent after the “father of glasnost,” Gorbachev, had preached openness in his nation’s affairs? How could revealing the truth be a deadlier killer than actual radiation? Why was there such a need to conceal the Soviet Union’s biggest failure? I asked myself this repeatedly. Answers never came.
Table of Contents
Table of ContentsIntroduction
Prologue - The Future Looks Different from the Past
PART I Chernobyl: Doctor on Call
Chapter 1- Nuclear Spring, 1986
Chapter 2 - Rx For Radiation: Take as Directed
Chapter 3 – Olga Leaves and Natasha Returns
Chapter 4 - The Human Toll of Displacement
Chapter 5- A Radioactive Fallacy
Chapter 6- Doctors on Call
Chapter 7 - Red Wine Improves Doctor-Patient Communications
PART II An Extraordinary Journey
Chapter 8- We Left Behind Years of Prejudice and Lies
Chapter 9 -Citizens Without the Country
Chapter 10- Fear and Fortitude
Chapter 11- An Immigrant’s Guide
Chapter 12 - The Tale of the Wandering Jew
Chapter 13 – Prequel the “Trans-Siberian” Express
Chapter 14 - This Was No “Roman Holiday”
Chapter 15 - Live Hard, Sell Hard: The Americana Flea Market in Rome
Chapter 16 – The Pretty Woman Guide to Hitchhiking
Chapter 17 – Global Historic Events Unite Us
Chapter 18 – Barbie Also Wears a Stethoscope
Chapter 19 - My Medical Residency, Take Two
Chapter 20 – A Highway Legend
Chapter 21 –Taking Root in America
PART III Looking Back to Protect the Future
Chapter 22 – Recipient of the Order of the Nervous Neutron
Chapter 23 – Children of Chernobyl
Chapter 24 - At the Roots of a New Drug Discovery
Chapter 25 – The Pursuit of One Gram of Indralin
Chapter 26 – Chernobyl: Twenty Years After
Chapter 27 – On the Shoulders of Giants
Chapter 28 – Who Will Live and Who Will Die?
Chapter 29 - Chernobyl: Thirty Years After
Chapter 30- Wisdom Comes with Experience
Chapter 31- Converging Catastrophes: Chernobyl and COVID-19
Chapter 32- A Disaster will Strike Again: Are We Prepared?
Epilogue
References
What People are Saying About This
“This story is an intimate, first-hand, personal account of Alla Shapiro, MD., Ph.D. as she endures the trials and tribulations caused by the lies, deceptions, and harsh policies of the socialist regime in the USSR before, during, and after the 1986 Chernobyl radiation disaster….Few would be able to endure the same hardships that Alla experienced along her journey, but her passion and love for medicine and family gave her the strength and persistence. I wonder what she will tackle next?”
“A wonderful story of human resilience in the face of tremendous adversity….In our current world of so much uncertainty this memoir gives strength to the human spirit and brings important lessons to keep in mind as we face potential untold consequences from other disasters to come.”—
“Dr. Shapiro’s firsthand experience caring for victims of the Chernobyl disaster to her distinguished academic and regulatory career in the USA gives her a truly unique perspective on the intersection between public health and politics. These lessons are as timely for us today America as they were in 1986 during the Chernobyl disaster.”
“Dr. Shapiro chronicles her life in a country that discriminated against women and Jews and yet rises above it to be a hero, a physician, a scientist and a wonderful mother. From the worst nuclear disaster to a pandemic, Dr. Shapiro reveals that governments that were not prepared and lessons were not learned. Her story is emotional, inspiring and thought provoking. It is a must read for everyone.”
"This ground level, personal account of the Chernobyl catastrophe by a Ukrainian pediatrician is a riveting, fast read…the reader gains a keen understanding of the ethical dilemma of conscripted physicians who were forced to endure, as they worked tirelessly to understand and treat a unique spectrum of radiation-associated injuries that they had never before encountered. The relevance of Dr. Shapiro's story to today's COVID-19 pandemic and to potential future radiation accidents, malicious use of radioactive materials and nuclear war, is highlighted in the last chapters of the book…this is a must read.”
“Alla Shapiro took me along on her odyssey, from the Soviet Union to the streets of Washington, DC, from the Chernobyl nuclear disaster to the COVID-19 pandemic, all the while filling me with emotion and having me marvel at the human capacity to resettle and build a better life."