American physician and radiologist
Stafford Leak Warren
(July 19, 1896 - July 26, 1981) was an American
physician
and
radiologist
who was a pioneer in the field of
nuclear medicine
and best known for his invention of the
mammogram
. Warren developed the technique of producing
stereoscopic
images of the breast with X-rays while working in the Department of
Radiology
at the
University of Rochester School of Medicine
.
Warren was commissioned as a colonel in the
United States Army Medical Corps
in 1943 and appointed Chief of the Medical Section of the
Manhattan Engineering District
. He was responsible for the health and safety of the thousands of personnel involved in the Manhattan Project. He was present at the
Trinity nuclear test
in
Alamogordo, New Mexico
, where he was responsible for the safety aspects of the detonation of the world's first
nuclear weapon
. He led a survey team from the Manhattan Project to assess the effects of the
atomic bombings of Hiroshima and Nagasaki
. In 1946 he was Chief of the Radiological Safety Section of the Joint Task Force for
Operation Crossroads
, the
nuclear test
at
Bikini Atoll
.
In 1947 Warren became the first dean of the
School of Medicine
at the
University of California, Los Angeles
(UCLA). Under his leadership, the new school grew from nothing to a major medical school. Although controversial and opposed by
James Bryant Conant
, Warren would speak out about the dangers of
nuclear fallout
from weapons testing from about 1947 onwards and upon the
Castle Bravo
test in 1954 his views were lent some credence, which informed opinion leading up to the
Partial Nuclear Test Ban Treaty
.
[1]
Warren became Vice Chancellor, Health Services in 1962 at UCLA. From 1963 to 1965 he served as special assistant to President
John F. Kennedy
and later
Lyndon B. Johnson
on
mental retardation
. Returning to UCLA in 1965, he became
professor emeritus
, a position he held until his death in 1981. In 1971, he was awarded the
Enrico Fermi Award
for his contributions to science and medicine.
Early life
[
edit
]
Stafford Leak Warren was born in
Maxwell, New Mexico
, on June 19, 1896. He attended the
University of California, Berkeley
, where he earned his
Bachelor of Arts
degree in 1918. He married Viola Lockhart on May 22, 1920. Their marriage produced two sons and a daughter. He went to medical school at the
University of California, San Francisco
, graduating with his
Doctor of Medicine
degree in 1922. He then did post-doctoral work at
Johns Hopkins School of Medicine
and
Harvard University
.
[2]
University of Rochester
[
edit
]
Warren joined the faculty of the Department of
Radiology
at the
University of Rochester School of Medicine
in 1926,
[2]
becoming an Assistant Professor of Medicine.
[3]
The department was a new one that had only been founded in 1921, based upon the ideals of medical education propounded by
Abraham Flexner
in his 1910
Flexner Report
. The medical school had opened in 1925 and did not graduate its first class until 1929.
[4]
Warren was one of the original group that Dean
George Whipple
assembled to staff the new medical school.
[5]
At Rochester, Warren investigated the effects of
artificial fever
,
[6]
including its possible use for treating
gonococci
infections.
[7]
He was also interested in
radiography
.
[8]
In 1930, Warren became an Associate Professor of Medicine.
[2]
That year he published "A Roentgenologic Study of the Breast".
[9]
X-ray imaging of the breast had first been investigated by
Albert Salomon
at the
University of Berlin
in 1913. He produced images of over 3,000
mastectomy
specimens, and observed different forms and stages of cancer. He was even able to detect an undiagnosed cancer in a breast that had been removed because of a large
cyst
.
[10]
However, Salomon apparently did not appreciate the life saving potential of his observations.
[11]
Warren used
radiology
to track changes in breast tissue as a result of
pregnancy
and
mastitis
.
[11]
He developed a
stereoscopic
technique, using patients rather than specimens and adapting general purpose X-ray equipment to his needs. His method involved having the patient lie on her side with one arm raised while being X-rayed.
[12]
In 119 women who subsequently underwent surgery, he correctly found
breast cancer
in 54 out of 58 cases. This represented a leap forward, as it made diagnosis of breast cancer possible without surgery.
[11]
It also sparked intense interest in the technique around the world.
[10]
Today
mammography
saves thousands of lives.
[13]
Manhattan Project
[
edit
]
In February 1943, Warren met with Dr Albert K. Chapman, the vice president and general manager of
Eastman Kodak
,
Brigadier General
Leslie R. Groves
, the director of the
Manhattan Project
and
Colonel
James C. Marshall
, the commander of the
Manhattan Engineer District
(MED). They asked him about his work with radiation and
isotopes
and asked Warren to become a civilian consultant for the MED.
[14]
In March 1943, Warren met with Major Hymer L. Friedell at the MED's
New York City
headquarters. Friedell had joined the
Metallurgical Laboratory
in August 1942 from the University of California, Berkeley, where he had been involved in radiology research under Dr
Robert S. Stone
. Friedell requested information about safety matters involving radiation. Warren was unable to provide all the information, but agreed to initiate research at Rochester.
[15]
Friedell recommended that in view of the scope of the Manhattan Project, a more senior officer be placed in charge. In October, Groves penned a letter to the
Surgeon General of the United States Army
,
Major General
Norman T. Kirk
, requesting that he cooperate with the Manhattan Project in furnishing medical supplies, providing funds for medical care of military personnel, and directly commissioning Warren and other doctors at specified ranks. This letter was signed by
Lieutenant General
Brehon B. Somervell
and delivered in person by Colonel
Kenneth D. Nichols
, who had replaced Marshall as the district engineer. Kirk was furious at what he saw as usurpation of his statutory responsibilities as Surgeon General. When told that Warren was the man the district had in mind to commission as a colonel, and apparently familiar with Warren's work only from his use of radiation to treat
venereal disease
asked "Why do you want that clap doctor?"
[16]
Warren was duly commissioned as a colonel in the
United States Army Medical Corps
on November 3, 1943. He was appointed as chief of the MED's medical section and medical advisor to the director of the Manhattan Project, with Friedell as his deputy. Warren's office was initially located in New York City but moved to
Oak Ridge, Tennessee
, soon after. Warren's initial task was to staff hospitals at Oak Ridge,
Richland, Washington
, and
Los Alamos, New Mexico
. Civilian workers paid $2.50 per month (single) or $5.00 per month (family) for medical insurance.
[16]
Warren's section was responsible for medical research, and also for the MED's health and safety programs. This presented an enormous challenge, because workers were handling a variety of toxic chemicals, using hazardous liquids and gases under high pressures, working with high voltages used in novel ways, and performing experiments involving explosives, not to mention the largely unknown dangers presented by radioactivity and handling fissile materials.
[17]
Yet in December 1945, the
National Safety Council
presented the Manhattan Project with the Award of Honor for Distinguished Service to Safety in recognition of its safety record. Between January 1943 and June 1945, there were 62 fatalities and 3,879 disabling injuries, which was about 62 percent below that of private industry.
[18]
Warren was personally responsible for the safety aspects of the
Trinity nuclear test
on 16 July 1945 at
Alamogordo, New Mexico
. There was considerable concern about radioactive fallout and a network of
geiger counters
was established to track the fallout cloud. Groves found Warren at the base camp shortly after the explosion and was displeased to discover that Warren had been awake for the previous 48 hours. Groves had
US Navy
Captain
George Lyons take over so Warren could get some rest. Fortunately, no problems arose with the test.
[19]
The
atomic bombings of Hiroshima and Nagasaki
were carried out on 6 and 9 August 1945. On 11 August, Groves phoned Warren and ordered him to organize a survey team and proceed to
Guam
, and thence to Japan to evaluate the effect of the atomic bombs and take measures to insure the safety of Allied troops occupying the cities. Initially the survey team was to accompany the assault troops of the
III Amphibious Corps
and the
V Amphibious Corps
in the
invasion of Japan
, but Japan surrendered on 14 August, the day the survey team departed San Francisco by air. The survey team arrived on Tinian on 17 August, where it was split into two parties, one under Warren and the other under Friedell. Warren's party, equipped with portable geiger counters, arrived in Hiroshima by air on 8 September as part of a group headed by
Brigadier General
Thomas F. Farrell
that also included Brigadier General
James B. Newman Jr
and Japanese Rear Admiral Masao Tsuzuki, who acted as a translator. They remained in Hiroshima until 14 September and then surveyed Nagasaki from 19 September to 8 October. They were impressed by both the damage done by the atomic bombs and the extensive Japanese preparations for an American invasion.
[20]
The detonation of the two atomic bombs in Japan "raised as many military and medicomilitary questions as they answered".
[21]
A series of nuclear tests was planned, codenamed
Operation Crossroads
. Some 42,000 personnel were deployed to
Bikini Atoll
as part of
Admiral
William H. P. Blandy
's Joint Task Force 1 to conduct the test. Their health and safety was Lyons's responsibility, but the specialised job of radiological safety was handled by the Manhattan Project. Warren, as Chief of the Radiological Safety Section (RADSAFE), planned and implemented measures to assess, limit and control the impact of radiation. Teams were given special training at Oak Ridge in the operation of instrumentation to measure radioactivity, and the interpretation of their readings.
[22]
Training was also conducted aboard
USS
Haven
en route to
Bikini Atoll
, where it arrived on 12 June 1946. In all, some 3,500 personnel were assigned to RADSAFE.
[23]
Warren was appalled by the effects of radioactive contamination on the environment. "The deadly range of radioactive products from the atomic bomb has been clearly demonstrated under controlled conditions..." he wrote, "the only defense against atomic bombs still lies outside the scope of science. It is the prevention of atomic war."
[24]
Warren left the Army on 6 November 1946. He temporarily became the Chief of the Medical Section of the
Atomic Energy Commission
, the civilian agency which succeeded the Manhattan Project. In February 1947, he was replaced by Dr
Shields Warren
.
[25]
For his services with the Manhattan Engineer District. Warren was awarded the
Army Distinguished Service Medal
[3]
and the
Legion of Merit
.
[2]
University of California
[
edit
]
Toward the end of World War II, a group of physicians proposed that the University of California should establish a medical school in Southern California. One of them was the
urologist
Elmer Belt
, whose patients included the
Governor of California
,
Earl Warren
. The University of California Board of Regents voted to establish a medical school as part of the University of California at Los Angeles (UCLA) on October 19, 1945. In 1946 the
California State Legislature
unanimously voted $7 million to establish the new school, and Earl Warren signed it into law.
[26]
In 1947, Warren was appointed the
new school
's first dean. Once again he found himself involved in creating a new medical school.
[5]
His first appointments were three former associates in Rochester: Dr
Charles Carpenter
as the first professor of infectious disease;
Dr. Andrew H. Dowdy
as the first professor of radiology; and Dr
John S. Lawrence
, who had pioneered the use of
phosphorus-32
as a radioactive tracer, as professor of medicine.
[26]
[27]
With Dr
William P. Longmire Jr
, a 34-year-old plastic surgeon from Johns Hopkins University recruited by Lawrence as professor of surgery,
[28]
they became the "Founding Five" of the new school. Initially, the new school was accommodated in wartime
Quonset huts
scattered about the UCLA campus.
[26]
Warren was still wearing his army fatigues.
[2]
Construction of permanent accommodation commenced in 1949. By 1951 when the first students, 26 men and two women, arrived there were 15 faculty members. By the time the first class graduated in 1955 there were 43 faculty members. The
UCLA Medical Center
opened in 1955.
[26]
Under Warren's leadership, the school grew steadily, adding schools of dentistry, nursing, and public health. Against some influential opposition, Warren established his medical school on the UCLA campus rather than in another part of the city. He strove to integrate not only the structures but the faculty with other departments of the university. He fostered the development of a major biomedical library as both a tangible and intellectual link between the life sciences and the health sciences.
[2]
Warren became the vice chancellor for health services in 1962. From 1963 to 1965 he served as special assistant to President
John F. Kennedy
and later
Lyndon B. Johnson
on
mental retardation
. Returning to UCLA in 1965, he became
professor emeritus
, a position he held until his death in 1981.
[3]
His first wife Viola died in 1963 and on July 18, 1970, he married Gertrude Turner Hubberty.
[2]
In 1971, Warren was awarded the
Enrico Fermi Award
. His citation read:
For the imaginative, prescient, and vigorous efforts which made possible the early development of atomic energy so as to assure the protection of man and the environment, and for the establishment of a biomedical research program which has resulted in many substantial applications of ionizing radiation to diagnosis and treatment of disease and to the general welfare.
[29]
He died on July 26, 1981, in
Pacific Palisades, Los Angeles
. He was survived by his wife and three children.
[2]
His papers are in the UCLA Library, Department of Special Collections.
[3]
The Stafford L. Warren Medal is named in his honor and is awarded to the top graduating medical student from the
David Geffen School of Medicine at UCLA
each year.
Notes
[
edit
]
- ^
Greene, Benjamin (2006). Eisenhower, Science Advice, and the Nuclear Test-Ban Debate, 1945?1963. Stanford, CA: Stanford University Press. page 10-11
- ^
a
b
c
d
e
f
g
h
"University of California: In Memoriam, 1985"
.
University of California
. Retrieved
March 12,
2011
.
- ^
a
b
c
d
"Finding Aid for the Stafford Leak Warren papers, 1917-1980 bulk 1943-1980"
.
University of California
. Retrieved
March 12,
2011
.
- ^
"History of the University of Rochester Medical Center"
.
University of Rochester
. Archived from
the original
on 28 December 2009
. Retrieved
27 March
2011
.
- ^
a
b
"News and Notes"
.
California Medicine
.
66
(3): 145?147. March 1947.
PMC
1642869
.
- ^
Cohen, Peter; Warren, Stafford L. (July 1935).
"A Study of the Leukocytosis Produced in Man by Artificial Fever"
.
Journal of Clinical Investigation
.
14
(4): 423?433.
doi
:
10.1172/JCI100693
.
PMC
424697
.
PMID
16694316
.
- ^
Warren, Stafford L. (1937). "Artificially Induced Fever for the Treatment of Gonococcic Infections in the Male".
Journal of the American Medical Association
.
109
(18): 1430?1435.
doi
:
10.1001/jama.1937.02780440020006
.
- ^
Shouse, Samuel S.; Warren, Stafford L.; Whipple, George H. (28 February 1931).
"Aplasia of Marrow and Fatal Intoxication in Dogs Produced by Roentgen Radiation of All Bones"
.
The Journal of Experimental Medicine
.
53
(3): 421?435.
doi
:
10.1084/jem.53.3.421
.
PMC
2131967
.
PMID
19869855
.
- ^
Warren, S.L. (1930). "A Roentgenologic Study of the Breast".
The American Journal of Roentgenology and Radium Therapy
.
24
: 113?124.
- ^
a
b
Gershon-Cohen, J.; Forman, Myron (September 1964).
"Mammography of Cancer"
.
Bulletin of the New York Academy of Medicine
.
40
(9): 674?689.
PMC
1750642
.
PMID
14172056
.
- ^
a
b
c
Gold 2005
, p. 3
- ^
"History of Cancer Detection 1851-1995"
.
Emory University
. Retrieved
March 12,
2011
.
- ^
"Mammography - Mammography Saves Lives"
. American College of Radiology
. Retrieved
March 18,
2011
.
- ^
Warren 1966
, pp. 848?849
- ^
Nichols 1987
, p. 122
- ^
a
b
Nichols 1987
, p. 123
- ^
Jones 1985
, p. 410
- ^
Jones 1985
, p. 430
- ^
Groves 1962
, pp. 298?299
- ^
Warren 1966
, pp. 886?889
- ^
Warren 1966
, p. 901
- ^
Groves 1962
, pp. 384?385
- ^
Warren 1966
, pp. 902?905
- ^
Warren, Stafford L. (August 11, 1947).
"Conclusions: Tests Proved Irresistible Spread of Radioactivity"
.
Life
. Vol. 23, no. 16. New York. p. 88
. Retrieved
2009-12-05
.
- ^
Warren 1966
, p. 915
- ^
a
b
c
d
"About the David Geffen School of Medicine at UCLA"
.
University of California, Los Angeles
. Archived from
the original
on March 10, 2011
. Retrieved
March 12,
2011
.
- ^
Warren 1966
, pp. 834?836
- ^
"William P. Longmire, Jr"
. williamlongmire.org. Archived from
the original
on May 9, 2010
. Retrieved
March 12,
2011
.
- ^
"The Enrico Fermi Award - Stafford L. Warren, 1971"
.
US Department of Energy
. Archived from
the original
on July 21, 2011
. Retrieved
March 12,
2011
.
Bibliography
[
edit
]
- Gold, Richard H. (2005). "History of Breast Imaging". In Bassett, Lawrence Wayne; Jackson, Valerie P.; Fu, Karin L.; et al. (eds.).
Diagnosis of Diseases of the Breast
. Philadelphia, Pennsylvania: Saunders.
ISBN
978-0-7216-9563-1
.
OCLC
488959603
.
- Groves, Leslie
(1962).
Now it Can be Told: The Story of the Manhattan Project
.
New York, New York
:
Harper & Row
.
ISBN
978-0-306-70738-4
.
OCLC
537684
.
- Jones, Vincent (1985).
Manhattan: The Army and the Atomic Bomb
. Washington, D.C.:
United States Army Center of Military History
.
OCLC
10913875
.
- Nichols, Kenneth David
(1987).
The Road to Trinity: A Personal Account of How America's Nuclear Policies Were Made
.
New York, New York
:
William Morrow and Company
.
ISBN
978-0-688-06910-0
.
OCLC
15223648
.
- Warren, Stafford L. (1966). "The Role of Radiology in the Development of the Atomic Bomb". In Ahnfeldt, Arnold Lorentz (ed.).
Radiology in World War II
. Washington, D.C.:
Office of the Surgeon General
,
Department of the Army
.
OCLC
630225
.
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