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Project Whitecoat: Human Testing Done with Care

THE BALTIMORE SUN

In the service of his country, Army Pvt. Thomas M. Kopko sat on a platform in the middle of the Utah salt flats, amid cages of noisy, scratching guinea pigs, and waited for a germ cloud to waft through the darkness. Soon, the 20-year-old soldier and the other medical research volunteers from Fort Detrick in Maryland were inhaling infectious Q fever bacteria.

Today, at 59, Mr. Kopko can still remember how he instinctively held his breath as his commanding officers slipped on their gas masks during the 1955 project. He can still recall the bacteria moving like "a soft damp mist" across the desert and the pre-dawn flight home to Fort Detrick, the headquarters of the military's biological warfare research in Frederick County.

For nearly two decades, Seventh-day Adventists like Tom Kopko were volunteers in America's little-known Cold War fight to protect its troops from germ warfare.

They took part in experiments like the secret open-air test in Utah -- one of the few conducted beyond the fenced, barbed-wire perimeter of the Army's research and development center for biological warfare at Fort Detrick. The code name was Project Whitecoat, and 2,200 soldiers were involved between 1954 and 1973. Decades later, the extent of harm done to the soldiers still is not certain -- the Army has done no follow-up on the volunteers.

But now, as a presidential panel and congressional committees investigate government-financed Cold War experiments on humans -- particularly those involving radiation -- Project Whitecoat may well serve as an example of military propriety and care in the area of human testing, according to interviews with more than 30 former participants, seven physicians familiar with the program and a review of military, church and historical documents.

The Adventist soldiers, who served as non-combatants in observance of their religious conviction against bearing arms, were used to help develop vaccines to treat American troops exposed to a biological agent or an infectious disease. By the time the program ceased in 1973 with the end of the draft, Whitecoat volunteers had participated in studies on Q fever, tularemia, Venezuelan encephalomyelitis, typhus, Rocky Mountain spotted fever and other exotic diseases.

"They said you wouldn't die. And I didn't die," Mr. Kopko recalled of his participation in a study on Q fever, a flu-like, body-aching disease that could cripple a platoon. "I figured this was one way to serve my country. That's why I did it."

Mr. Kopko, a former Adventist chaplain now living in Florida, never contracted the fever during Project Whitecoat, one of the few conducted in a mock battlefield setting. But dozens of Project Whitecoat subjects did become ill. Treated with antibiotics, most recovered with no recurring health problems. But a few veterans today worry that White- coat service compromised their health or may yet. Many of those same experiments, however, expanded the world's knowledge of infectious diseases and how to treat them, say specialists in the field.

"A number of vaccines were developed and refined there, and they had terrific civilian applications," said Dr. Frank Cal- ia, vice dean of the University of Maryland medical school and a military physician at Fort Detrick in 1967-1969. "The folks at Detrick at that time were a group of outstanding investigators. It was a very exciting time to be there."

Project Whitecoat flourished during the heyday of the Cold War, it was the legacy of another war that shaped the program's concern for the rights of its volunteers. Detrick's researchers were "very conscious" of the 1947 Nuremberg Code that called for the voluntary, competent and informed consent of subjects in medical experiments, said Dr. Abram S. Beneson, who served as director of experimental medicine at Detrick in 1954-1955.

"And we were very, very careful to stick to it," he said.

The consent forms included a clause warning a volunteer that an outcome of a study, "though an unlikely outcome, could be their death," said Dr. Beneson, 80, a professor emeritus of public health at San Diego State University. Army lawyers told Dr. Beneson that he was wasting his time because the form wouldn't hold up legally if challenged.

"From the legal point of view [it may be a waste of time]," Dr. Beneson said he replied. "But from a moral point of view, I'm not deluding anyone."

The Army's history of properly informing soldiers of the risks associated with military experiments has been a checkered one. Neither the infantrymen who were exposed to mustard gas and other agents in 1940s experiments, nor the soldiers given LSD and other chemicals at Edgewood Arsenal in the 1950s and 1960s, were adequately briefed about the inherent risks.

The same complaint has not been made of the Army Medical Unit's work in Project Whitecoat.

Volunteers were briefed on the nature of the experiments, asked to sign consent forms and given the chance to back out of a project. A few volunteers never participated in a study. And those who did say they received excellent care from the Detrick medical staff.

"If they were pulling the wool over anybody's eyes, I don't think it was in the Whitecoat program, because there were too many civilians involved who had no allegiance to the Army," said W. Jay Nixon, a 46-year-old Washington businessman and Whitecoat volunteer who served from 1969 to 1971. "To a man, we didn't want to be there but we owed allegiance to our country."

Noncombatant volunteers

Although Adventists refused to carry weapons, they did not refuse to serve in the military. As non-combatant draftees, they routinely were sent to Fort Sam Houston in San Antonio, Texas, the home of the Army's medical training center. There, they received basic and advanced training and, beginning in 1954, an introduction to Project Whitecoat.

By then, America's biological warfare program was well under way, fueled by concerns of a Soviet threat. At an arsenal in Arkansas, the Army was already producing a biological agent that causes undulant fever. And Fort Detrick, the Army's research and development center for biological warfare since 1949, had been refitted with more than $10 million worth of new laboratory facilities, among the most sophisticated in the world.

Twice a year, the commanding officer of the Army Medical Unit at Fort Detrick and a leader of the Adventist Church arrived at Fort Sam Houston to explain the Whitecoat program to potential recruits. They were briefed as a group, interviewed individually, given a chance to ask questions and required to sign a consent form before joining a medical project.

The Adventist Church "did not see or believe the project to be either unethical or immoral, but as a way for obligatory military service to produce good for humanity," the late Robert L. Mole, an Adventist chaplain, wrote in a history of the Whitecoat program. To be selected for the program, a volunteer had to be in good health. Once accepted, volunteers worked as laboratory technicians, typists or medical supply clerks at Fort Detrick or nearby Walter Reed Army Medical Center. They lived in Army housing, or in off-base apartments with their wives.

Soldiers were asked to participate in at least one research project, which was approved by a board of civilian infectious disease specialists. They received no extra pay, just several weeks' additional leave and a future assignment of their choice anywhere in the world.

For many Adventists, the opportunity to remain in the States made the program attractive -- especially to a soldier drafted during the height of the Vietnam War. Robert F. Cooke arrived at Fort Sam Houston in 1968, the year of the Tet offensive in South Vietnam.

"By the time I got out of the Army, I lost four friends -- three of them from my hometown -- in Vietnam," said Mr. Cooke, an accountant with the Adventist church conference in Silver Spring who lives in Western Maryland. "If I came down with something 35 years later, that's still 35 more years I had than they did."

While at Detrick, Mr. Cooke participated in a vaccine study for Western equine encephalomyelitis, an inflammation of the brain and spinal cord. He never came down with the disease and learned later that he had been a control subject and never exposed to it.

A Project Whitecoat volunteer could live off base with his wife, play on the post softball team or hold down a second job -- as did one soldier who worked as a newspaper printer in Washington. With an Adventist school in Takoma Park, a small woman's college in Frederick and active Adventist church communities in the area, volunteers led busy social lives.

But, not every volunteer had an easy time of it.

The dangers

Participating in a 6-week Project Whitecoat study usually meant exposure, however small, to an infectious disease. In the early years of the program, soldiers were taken to the "Eight Ball," a one-of-a-kind, spherical test chamber -- about the size of a hot air balloon -- in which concentrations of infectious agents were mixed and measured. Sitting at a porthole-like station on the exterior of the chamber, a soldier slipped on a face mask and inhaled. The Army stopped using the Eight Ball in 1969; it now is on the National Register of Historic Places.

"I remember how long it took me to get sick," recalled Dan Zacharias, a Texas businessman who served in a 1964 Whitecoat study on tularemia, a debilitating respiratory disease the Army believed was a potential biological agent. "It seemed like three to four days. I started running fevers, 104, 105. I just lay there in a pair of shorts because I was burning up. I knew who I was but didn't care whether I lived or died."

By the fourth or fifth day, Mr. Zacharias and others in the study began receiving antibiotics.

"Individuals were never exposed to a microorganism where there was no available way to appropriately and effectively treat the patients," said Dr. Leighton Cluff, an infectious disease specialist who worked with Fort Detrick researchers while serving as a military consultant from 1955 to 1966.

A team of nurses and doctors constantly monitored the volunteers, taking blood, urine and stool samples to determine the onset of symptoms, the pace of infection, the rate of recovery.

With this information, they would be able to devise the most effective vaccine therapies for troops.

"Fort Detrick did more to basically get an understanding of airborne infections than any other unit in the world," said Dr. Cluff, the retired president of the Princeton-based Robert Wood Johnson Foundation, which finances many health-related projects.

At the outset, Adventist Church leaders lauded Project Whitecoat. But they noted that "there are some in the church, and elsewhere, who question the basis of the project," according to the Whitecoat history written by Chaplain Mole.

Those questions were provoked by the other type of research going on at Fort Detrick: the secret buildup of America's biological warfare arsenal. It was, after all, the 1960s, an era of social unrest. In some sectors of the country, attitudes toward the government and its military ranged from suspicion to distrust.

During that decade, the focus of America's biological warfare program significantly changed from "retaliation only" to "preparedness for use at the discretion of the President," according to an Army report.

While about 15 percent of the 138 Whitecoat studies were classified, Army officials insist that the soldier volunteers participated almost exclusively in efforts to defend against a biological attack.

But advancements in one arena clearly influenced progress in the other. "The development of vaccines for Q fever and tularemia enabled development work on Q fever and tularemia to proceed to standardization as BW agents," an Army report to Congress noted.

With pressure mounting in Congress and the United Nations to ban biological weapons production, President Richard M. Nixon in 1969 ordered an end to the United States' offensive work.

The country would follow a defensive strategy only -- a course pursued today at Fort Detrick.

Lingering suspicions

Glenn A. Meekma and Robert M. Kline have more basic concerns. Both men have health problems they suspect stem from Whitecoat studies from 30 years ago.

Since Project Whitecoat ended, the Army has received few health complaints from program veterans, according to a Fort Detrick spokesman. The base maintains the soldiers' Whitecoat files and makes them available upon request. Nearly all of the Whitecoat volunteers interviewed for this story were reported to be in generally good health and said they have had no recurring illnesses. The Army acknowledges, however, that no medical follow-ups have been performed on the soldiers.

Mr. Meekma, 54, says he was forced to quit his job as an auto body painter in 1986 because of respiratory problems that have plagued him since he joined a 1964 Whitecoat study on 'f tularemia, the disabling respiratory illness. During the project, he inhaled the tularemia germ, came down with the flu-like symptoms, and later recovered.

"I've got a severe case of asthma, and I'm sitting on the edge of going into emphysema," said Mr. Meekma, a nonsmoker who lives in Newfolden, Minn. Jobless, he and his wife Joyce live off her $4.48-an-hour job as an aide for the handicapped and the couple's 100-acre sheep farm.

Several years ago, Mr. Meekma applied for a military disability pension. It's still pending. He knows the struggle he faces. "I did [auto] body work for a goodly number of years. It's a line of work that does have a lot of dust and fumes, too, you know," he said. "How do you prove or disprove where you got this problem from?"

Bob Kline wasn't out of the military a year before he had what he believed was a relapse of Q fever, the flu-like illness he contracted as part of a Whitecoat study in 1955. For several years after his 1956 discharge, Mr. Kline tried to get a disability pension from the Army, citing an inflammation of the liver. But the commanding officer of the Whitecoat program, then-Col. W. D. Tigertt, disputed Mr. Kline's contention.

In 1963, Mr. Kline gave up. "The VA. said there was not enough positive proof that it was Q-fever related," said the 59-year-old draftsman from Burtonsville. "But nobody could say what it was related to, and there is no history of liver problems in my family."

So Mr. Kline "just decided to live with it." But he has never stopped wondering.

In the file he keeps on his Whitecoat experience, amid the letters from Army and civilian doctors, a former Maryland congressman and the widows of Whitecoat colleagues, he has a 1981 bulletin on Q fever from the California Division of Occupational Safety and Health.

The pamphlet cites the disease's symptoms: fever, chills, severe headaches and malaise. It goes on to note that, "About half of Q Fever patients experience loss of appetite and vomiting. Pneumonitis occurs in most cases. The liver may be affected."

Ann LoLordo is a reporter for The Baltimore Sun.

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