By chance he mistook me for someone else. I was just at the point of giving a neighbor a bookmark celebrating, Jolt: a rural noir. A slender, alert man in his seventies, I thought, with well-cared for teeth, a ready smile, a perky cap, and a leather-like jacket with the logo of his place of work on it.

I told him he was just in time to receive a bookmark. He accepted it graciously and commented on Jolt, adding, "I was there, you know. Walked all over it. Hiroshima. Nakasaki."

My sister, W. was with me and I mentioned my interest in radiation sickness. I told him I wanted to include it in my next book.

We talked a bit, and then he said, "I got it you know. They didn't tell us anything. We just walked over everywhere. Terrible sights. Charred bodies all around. I still can't get over it. It's not a sickness. It's a disease."

Asked if he would talk about it, meaning the radiation sickness, he understood me to mean the scene. He said I was the second to ask him to do so. He wouldn't then. He wouldn't now. Too painful.

No, I told him. I meant the sickness. Like, how did he feel?

Well, there were times like now when he felt great. But then every month or so he had to go for chemotherapy. After that it was not so great.

He continued. "I have a lethal form of cancer," he stated. "I'll live about two more years . . . I wouldn't tell everyone that. But since you're writing."

So this was radiation sickness. In its aftermath. Its latermath.

I admired the man's courage. I admired his style. I took him for much younger, but as it turned out he was eighty-two year; he read the writing on the wall yet knew how to whistle.

I thought of the timing of the second World War. 1945. He would have been seventeen at the time. Probably had jumped up, signed up, and gone off to the save the world at sixteen. Perhaps his father signed for him. Or his mom.

Maybe he was one of the young sailors my dad brought home during that time to whom my mom fed hamburgers and fruit cake and coffee. Strangers they were. But my mom said they were really just kids and my dad brought them home to lessen their homesickness. And here was one of them. A Hiroshima survivor with radiation sickness turned lethal cancer and a few more years left and smiling.

It had not occurred to me that among the Hiroshima survivors were young Americans in the military, how many I couldn't guess. And probably nobody really knows. Or tells.

Later, in the Mall, walking along, we saw a young woman soldier in desert camoflage. Probably just back from Iraq on a visit.

Like an endless continuum it proceeds. Only the faces change.

RMR

In preparation to write my next novel, Too Close, I am researching the potential effects of nuclear power plant criticality accidents such as might result in someone being irradiated. To understand what would occur in such rare instances, I am reading, A Slow Death: 83 Days of Radiation Sickness, NHK-TV "Tokaimura Criticality Accident" Crew, Translated by Maho Harada. It discusses the events in the life and care of Ouchi, a critically irradiated man, injured in a probably preventable accident that occurred on September 30, 1999, at a nuclear fuel processing plant in Tokaimura, Ibaraki, Japan. It was the first of its kind in that country.

The first concept I needed to understand was that criticality occurs when fission chain reactions occur continuously. When it happens, a blue light known as the Cherenkov light is generated at the site of the fission when criticality is reached. At that moment neutron beams, the most powerful form of radioactive energy, are released that convert the sodium in a nearby person's body into radioactive substance Sodium-24.

The second concept I had to understand is that while the substance Sodium-24 irradiates the cells of the affected person's body, it does not irradiate those who come in close proximity to or touch the person. This contrasts with what one finds when a person is covered with nuclear fallout. Nuclear fallout is made of substances such as Strontium-90 and Cesium-137. They do give off radiation causing the risk of radiation exposure when those attending them touch or breathe in the radioactive materials from a patient's body or clothes.

Were the irradiation to have been caused by fallout therefore, before unprotected treatment could begin, the person so affected would have to be decontaminated by a thorough washing with soap and water. But in Ouchi's instance, this strong, healthy-looking man who was, so to speak, dying from the inside out, from the first was safely both approachable and touchable. The fact there was no risk was a reality many of the staff had to struggle to accept. Nonetheless, they did, and Ouchi's care was relentlessly of the highest medical and personal quality. 

As the criticality accident was the first of its kind in Japan, no one in the country had other than a theoretical knowledge of the best treatment protocol for Ouchi. Because of this, an enormous team composed of all kinds of medical specialists was gathered to collect data on Oushi's condition daily and to determine the best course of treatment. This they did out of a combination of disbelief, untried hope based on what they knew theoretically, and humanism facing the edge of life with inadequate experience. 

The case had had no precedent on which to build a protocol. They did what they could with what they knew. But from the beginning, the odds were against them.

From previous study I know that the most important information in treating radiation sickness is the exposure level experienced by the patient. According to this book, radiation levels of above 8 sieverts (8 Sv) result in a mortality rate of one hundred per cent. Ouchi's exposure level was estimated as being at about 20 Sv, approximately 20,000 times the amount of exposure we can individually tolerate in a year. The telltale symptom of almost immediate vomiting and passing out following Ouchi's exposure would have been a first alert to any informed doctor. 

Well, I shall continue reading the story of Ouchi and his treatment for the purpose of better understanding the most severe effects of radiation sickness. However, as the numbers of persons likely to be so affected in a nuclear meltdown would be small, I have decided to write about one or more persons who are irradiated less and to an extent that permits them to survive. In that way, I hope to tell not only a more gentle story, but also an informative one that might help the reader understand what he or she might do in the way of home care for a loved one less severely affected were the necessity ever to present itself. I want to do this because were there ever a larger, real event in which radiation from any cause--meltdown criticality, dirty bombs, or other--it would be likely the hospitals would be overrun and those who survived and were in need of help would best be tended to at home.

RMR