5
“For Your Six-Month-Old Grandson”

There is one elementary truth, the knowledge of which gives birth to countless ideas and splendid plans: that the moment one definitely commits oneself and acts, then Providence moves too. All sort of things occur to help one that would never otherwise have occurred.... Whatever you can do or dream you can, begin it. Boldness has genius, power and magic in it. Begin it now.
—JOHANN WOLFGANG VON GOETHE

FIVE DAYS A WEEK I trudged to the Peter Bent Brigham Hospital for morning rounds from my cardiovascular research laboratory at the Harvard School of Public Health. I welcomed the brief walk along Binney Street, a tiny private thoroughfare devoid of traffic, cloistered by the somber columned Medical School administration building, the elegant Countway Medical Library, and the rather dilapidated two-story red brick hospital that stretched for a block. It was a brief moment of respite before I plunged into the daily hubbub of medical problems.

One morning is distinctly etched in memory. Jim Muller stopped me as I was entering the hospital. He talked with great urgency about the impending collision between the United States and the Soviet Union. Jim insisted that continuing vilification by both sides made nuclear confrontation inevitable. He had lived in Moscow and was fluent in Russian; his knowledge of the country convinced him that the Soviet Union had no intention to attack us. They were terrified of the United States’ misjudgment of their society, yet felt helpless to ward off our possible provocative actions.

I asked Jim what he intended to do about this. He turned the question into a course of action for me. “You must write to Chazov and help start a joint Soviet-American medical organization. Dr. Chazov respects you and will listen to you.” He continued with passion, saying something to the effect that “if you ever move in that direction, I am ready to carry your bags, to provide whatever help you may need. There is no issue more important.”

I told Jim about the unanswered letter I had sent to Chazov some weeks earlier. We agreed to stay in touch and initiate conversations with a few people that summer to lay some organizational groundwork. When I found another human being who was thinking along parallel lines, it provided a lilt of encouragement for my intellectual meanderings. Over a long life, I have learned that gaining even a single supportive voice provides not an arithmetical addition but rather an exponential multiplier. In a social struggle, one plus one is far more than two. It seemed that I was no longer consulting tarot cards, nor were my efforts a quixotic tilting at windmills.

It was on a hot July afternoon in 1979 that six of us met at my home in Newton, the very same house where we had gathered nearly twenty years earlier to launch the Physicians for Social Responsibility (PSR). The meeting is dim in memory. One participant stands out because I didn’t expect him to attend.

Dr. Herbert Abrams was high on the Harvard Medical School academic roster. When invited, his brusque response was, “The hell with you, Lown. I have never disrupted a Martha’s Vineyard vacation.” I was astonished as well as encouraged when he showed up. Herb was liberal in outlook, level headed, sharp witted, impatient with fools, and stridently outspoken in methodically dismantling a poor idea. I knew then that this crazy notion of mine had struck a chord.

Another participant I remember distinctly is Professor Jerome Frank, a distinguished elder in psychiatry from the Johns Hopkins School of Medicine, who had written sagely and spoken out intensely against the psycho-pathology of the nuclear arms race. Helen Caldicott represented Physicians for Social Responsibility as its president. Of course, Jim Muller was also there.

Though we were an odd mix of doctors, there was a pervading agreement on a number of key points. First and foremost, life on earth was perilously poised at the precipice; if the present confrontational course continued, nuclear war was inevitable. A nuclear war could make the planet uninhabitable.

A second shared view was that the consequences of nuclear war were not fully comprehended by the public or political leaders.

A third area of agreement was that we as physicians were equipped to credibly address the nuclear threat and exert a moderating social impact. After all, physicians combine two diverse tendencies in their daily functioning, a scientific mode of thinking and a clinical commitment to healing. The former requires us to be rigorous, dispassionate, objective, loath to reach conclusions until incontrovertible facts have been assembled. The clinical, or professional, component, on the other hand, compelled by the urgency to assuage suffering and to defend life, demands immediate action even in the absence of complete data. This dual character made doctors uniquely prepared to address the nuclear peril. In addition, few professions are as international in character while sharing age-old traditions, a common pool of knowledge, a single scientific database, and similar methods, terminology, and objectives. The ancient and enduring global association of medical practitioners enables doctors to engage in effective citizen diplomacy.

At a time when complex differences between social systems had been reduced to martial combat between the forces of good and evil, physicians were well equipped by education and background to counteract such simplistic, dehumanizing, and dangerous stereotyping of fellow human beings. Physicians are furthermore trained to devise practical solutions to seemingly insoluble problems. Thus, they constituted a natural constituency—a potentially forceful, nonpolitical pressure group—for the rational control and ultimate elimination of genocidal nuclear weapons.

Our group shared these ideas. It made the next step inexorably logical—namely engaging Soviet physicians as partners in our monumental struggle. The notion of forming an alliance with a group of Soviets had the air of forbidden fruit—it was almost too good not to try. For someone like myself, who had been active in antinuclear struggles for about two decades, an important lesson had been learned. In the West, those working against the nuclear arms race had to address the demonizing of every aspect of life in the USSR, or else remain ineffectual. Regardless of the persuasiveness of one’s facts, they were consistently short-circuited by five words: “You can’t trust the Russians.”

The political situation in the USSR made this argument difficult to refute. Paranoid Soviet secrecy, the rampant and cruel repression of dissent, barely subsurface antisemitism, the disinclination of intellectuals to deviate even a mite from the official party line, made dealing with the Soviets futile at best; at worst, we would become unwitting purveyors of Communist propaganda. Compounding the problem were the power establishment and the mass media in the West, who highlighted and exaggerated each Soviet misdeed to buttress support for the nuclear arms race. In effect, there existed a symbiotic relationship between Soviet secrecy and the military-industrial establishments in the capitalist world.

A climate of carefully cultivated fear and distrust instilled public antipathy to the Soviet Union and made the threat of Communism more real than the fear of nuclear extinction. If doctors were to engage seriously in this struggle, they had to begin to address the issues of the Cold War. Great erudition and technical know-how regarding missiles, megatonnage, the medical and ecological consequences of nuclear war, its impact on children, the economic issues—all would amount to little unless people in the two superpowers began to take a measure of each other’s humanity. A new human perspective was required—balanced, sober, free of cant and ideological fixations.

For physicians to make substantial contributions in dissipating nuclear madness, they had to lead in promoting cooperation rather than adding to the cacophony of stereotyped formulas for confrontation. If we were to make a difference, it was mandatory that Americans perceive the Soviets as an integral part of the human family. The nuclear threat challenged the medical profession to engage in a new area of social responsibility. The small group assembled had no doubt about this analysis.

At the very first meeting that hot July day, Jim Muller argued cogently for the inclusion of Japanese physicians in our movement, an organization that was still a bare flicker in our collective imagination. Jim felt the Japanese, as the only victims of an atomic bombing, would provide the factual witnesses of the human capability for destruction. They would bring a strong conviction against nuclearism, affirming, “We know the horror. It is up to you two, the Soviets and the Americans, to resolve this issue and to ensure that this tragedy is never repeated.” I had already addressed Japanese participation in my first letter to Chazov. Jim was planning to visit Japan, and we authorized him to explore the possibility of their participation.

The meeting was a tentative step forward. We decided to have a monthly get-together at my home. The sense that we were heading in a sound direction received a strong boost in October, when Eugene Chazov replied to my letter. By then I doubted that a response would ever be forthcoming; many months had elapsed since I had first contacted him. Chazov’s response, written in clear if imperfect English, indicated a sound understanding of the paramount issue.

Chazov’s reply foreshadowed a major theme in IPPNW’s work. While he agreed with my assessment of the danger of nuclear war and its medical consequences, he went even further. The arms race, he said, was already taking a human toll by diverting scarce resources to the military. Continuing the nuclear arms race meant that people were dying right at that moment for a lack of adequate health care and other essential social needs. The neutral political thrust of his letter was impressive. There was no party-line cant, nor an attempt to affix blame. He wrote, “Nobody has measured the real losses which are inflicted to the mankind by the uncertainty in the next day, fear of the thermonuclear disaster, encouragement of the most brutish instincts in man by militarism.” This could be readily interpreted to include Soviet militarism as well as the militarism promoted by capitalist countries. The impartial tone was extraordinary for a public statement by a Soviet official.

Though Chazov did not commit to a personal involvement, he did agree that physicians should speak out on the issue. He wrote: “I completely share your point of view that physicians have no right to stand aloof and remain silent facing a challenge to common sense and moral principles. I think your proposal to hold a conference of Soviet, Japanese and USA physicians to discuss consequences of thermonuclear arms race is urgent and deserves support. We are ready to discuss with the US colleagues the question of arranging this conference either in the USA or in Moscow.”

Our small group was elated and energized by Chazov’s response and began to recruit additional activists. The zeitgeist was right. Many people in diverse walks of life were becoming involved in antinuclear activities. One such person was Dr. Helen Caldicott, an Australian pediatrician who had settled in Boston. She was a tireless campaigner for nuclear disarmament and played a major role in revitalizing PSR. Helen was passionate, intense, and a magnetic crowd rouser. She used fear very effectively as an organizing tool. Her speech had the fervor of a religious evangelist. She said, “We are all about to die unless we challenge the authorities who threaten us with annihilation.”

She had particular appeal among women, whom she saw as the energizing thrust of the peace movement. She lectured, “Women have always been the nurturers. A mother will die to save her child’s life, and disarmament is the ultimate parenting issue. We have to fight to make this world safe for our children.” In the late 1970s, Helen’s preoccupation was with nuclear power, rather than the nuclear arms race, although she held intense views against both.

A remarkable coincidence breathed new life into PSR. As a first step to getting PSR on its feet again, Helen had placed an advertisement in The New England Journal of Medicine warning that an accident at a nuclear power plant was a virtual certainty and that a nuclear meltdown would constitute a public health disaster. The very day the ad appeared, on March 28, 1979, the most serious such accident in the nation’s history unfolded at the Three Mile Island nuclear power plant near Harrisburg, Pennsylvania. Helen’s recognition in the media soared and PSR gained much visibility.

The Three Mile Island publicity convinced Helen that nuclear power plants had to be the thrust of a rejuvenated PSR. I disagreed, arguing that nuclear weapons were a far greater threat and that organizational policy could not be set by the changing tides of media attention. I insisted that a movement of physicians was more likely to affect public policy if it focused on the devastating consequences of the escalating arms race rather than the remote possibility of a repeat nuclear plant accident.

I knew PSR could be a vital player in the planned international organization and was gratified by its new lease on life. At the same time, I had a dilemma. I believed that nuclear power, for all its dangers, was not second fiddle to the nuclear arms race, but no fiddle at all in the orchestra of doom. I wanted PSR, an organization I had helped found, to draw closer to its roots as an innovator in the anti-nuclear-war movement. In an attempt to reorient PSR’s focus, I called a meeting in the late fall of 1979 at my home, inviting both the new and old guard of PSR.

Helen agreed to participate in the searching discussion. She had gathered her gifted young “troops”: Drs. Henry Abraham, Eric Chivian, Ira Helfan, Jennifer Leaning, and others. I invited the old guard who were with me in 1961 when PSR was founded, including Drs. Sidney Alexander, Sanford Gifford, Charles Magraw, and Peter Reich.

At this gathering, each of us laid out contrasting views. The greatest nuclear threat, I argued, was the escalating superpower arms race. I offered a glimpse of PSR’s history, its role in securing passage of the Limited Test Ban Treaty, its success in educating a good number of people on the futility of fallout shelters and in bringing a palpable sense of the unthinkable to a mass audience.

Helen was caught in the crosshairs of an intellectual conflict. She agreed with the analysis, yet she maintained that physicians would not be mobilized by the threat of a nuclear Armageddon, that it lacked the immediacy of nuclear power. Eric Chivian suggested that we test her premise by organizing a symposium devoted to the nuclear arms race and determine the amount of support that existed, if any. Eric offered to organize such an event. This idea was supported by the majority.

The symposium was held in February 1980. Helen was certain the symposium would be a fiasco and refused to have her name appear on the program, although PSR was one of the official sponsors. Even those of us who were convinced the medical community could be roused on the nuclear weapons issue were unprepared for the response. More than seven hundred and fifty doctors crowded into the small hall we had reserved. The speakers were eloquent and the audience was geared for action. We had touched a raw nerve of concern, compassion and, indeed, fear.

I recall my grudging admiration for Helen’s political agility. As the meeting was drawing to a close, without anyone having recommended a specific action plan, she went to the podium. In an eloquent summary of the day’s talks, sensing the mood of those assembled, she spelled out a concrete plan. She urged each of the participants to contribute upfront $25 or more for a full-page ad in the Sunday edition of the New York Times. This would be an appeal to President Carter and General Secretary Brezhnev to stop the nuclear arms race. She collected the thousands of dollars needed for such an advertisement. Once again she had taken command.

The advertisement appeared the following month in the Sunday Times. The appeal to the two superpower leaders made several key points: Nuclear war, even if limited in scope, would cause death and injury on a scale unprecedented in human history; a medical response to cope with the victims would be impossible; and nuclear war would have no winners, only victims, a theme later picked up and popularized by President Reagan. The ad called for a reduction in tensions between the Soviet Union and the United States, and a ban on the use of nuclear weapons. It ended with a plea for both Carter and Brezhnev to discuss these issues with leaders of PSR.

We had no way of knowing whether our message would fall on deaf ears, or whether the concern that filled an auditorium at Harvard that cold February day would reach to the very top.

In March 1980, shortly after the PSR symposium, I headed off to Europe to deliver a series of cardiology lectures in London, to be followed by a vacation in Tuscany with a dear friend and patient, Vittorio de Nora.

It was in London that the roller-coaster ride really began. Prior to the medical lectures, Louise and I spent a weekend visiting our friend Fleur Cowles and her husband, Tom Meyer, at their estate in Sussex. It provided an opportunity to discuss the threatening world situation with some of the elite of British society. Present at the luncheon given in my honor were Harold Macmillan, the former prime minister; author Dame Rebecca West; Bonnie Angelo, the bureau chief of Time-Life in London; author Anthony Sampson, and several others.

McMillan, though in his late eighties, was witty, sharp spoken, and insightful. He despised Margaret Thatcher and made no bones about it. He maintained that she lacked sympathy for, and an understanding of, ordinary British people, represented by those valorous and patriotic “Tommies” who had died in droves “for us” in the trenches of the Somme and Verdun. In regard to Russians, he dismissed their government as a failed system that could do little other than make first-rate caviar.

The splendid weekend was nonetheless marred by the blasé indifference of the highly cultured upper crust to the nuclear sword of Damocles hanging over humankind. It augured a difficult journey ahead.

On Monday afternoon, March 24, I was to lecture at London’s Hammersmith Hospital in a symposium honoring the newly appointed chief of cardiology, the outstanding Italian research physician, Aldo Masseri. Sitting in the front row, increasingly embarrassed by the profuse praise for presumed accomplishments, I was startled as the moderator summoned me to the podium with the statement, “Shortly after this lecture Dr. Lown is traveling to Moscow to meet with President Brezhnev” or words to that effect. I was dismayed, since that was sheer invention. I had no such plans. I was traveling to France and Italy, not to Russia. My first bewildered stuttering words were that Moscow was not on my itinerary. The moderator, unfazed by the denial, assured the audience that notwithstanding my diplomacy and modesty, the fact was that I was on my way to the USSR.

Confronting an audience of physicians expecting me to lecture on the role of psychological stress and neural imbalance as contributors to heart attacks, I could not at the same time preoccupy my brain with this invented hokum. But it was not to be smooth sailing. I noticed in the audience both my wife, Louise, and Fleur Cowles, who had not planned to attend my talk. More distracting was that Fleur was waving a newspaper at me. Baffled, I struggled through the talk wondering what the Moscow business was all about.

As soon as the lecture concluded, Louise came rushing up with a copy of the International Herald Tribune, and sure enough, there was a story about Dr. Bernard Lown heading to Moscow for a possible meeting with Brezhnev. Unbeknownst to me while en route to London, Leonid Brezhnev had responded to the physicians’ appeal that had appeared in the New York Times. Eric Chivian, Jim Muller, and Helen Caldicott traveled to Washington to receive Brezhnev’s response from Anatoly Dobrynin, Moscow’s longtime ambassador to Washington. Brezhnev’s message was a warm and supportive one, welcoming the involvement of physicians and stating that nuclear war would be a disaster for humankind.

Helen, Eric, and Jim, each highly media savvy, had organized a press conference in Washington to gain the widest publicity from Brezhnev’s response to the physicians’ appeal. When asked if the PSR leaders planned to travel to Moscow to meet with Brezhnev, they improvised, “One of our group, Dr. Bernard Lown, is already in London on his way to Moscow.” Through the pages of the International Herald Tribune I was first informed of my upcoming “trip” to Moscow.

I had no such plans. Going to Moscow on short notice seemed out of the question. Even if my schedule could be changed, Soviet visas often took weeks to obtain, and what about flight reservations, hotel accommodations, meeting arrangements? The whole idea seemed preposterous. Brezhnev’s reply said nothing about a meeting.

Why would I travel to Moscow? As I reflected a bit on what had transpired, I had to admire the chutzpah of my three co-conspirators who, without consulting me, were arranging my travel schedule if not my life. Yet, on another level, we were trying to gain some visibility in a world that denies visibility to do-gooders, especially to peaceniks. What we were trying to accomplish was no small matter. The creation of a Soviet-American physicians’ organization opposed to nuclear war was itself far-fetched and required innovative improvisation exploiting every scintilla of opportunity. So why not travel to Moscow? What were the minuses and plusses?

A major minus in my mind was a possible meeting with the Communist Party general secretary, Leonid Brezhnev. My exposure to the Soviet system convinced me that from their weakened economic, political, and military stance they would welcome additional peace groups; indeed, they were promoting such groups all over the world. A Soviet embrace at any time would be throttling; a bear hug at this early incubation period would probably be life extinguishing. To be labeled a Communist stooge was something to avoid at all costs.

From my perspective, the struggle was not to gain support from the Russians but to communicate with democratic public opinion in the West. It was vital to educate the American people on the issues. This was compelled by a hidden reality, namely, that the Cold War was invented and largely fueled by the United States. Of course, there was plenty of assistance from the Soviet military-industrial complex, but it was not setting the trajectory; it was merely responding.

So what were the possible plusses? A trip to Moscow was a necessary follow-up on our appeal to Brezhnev and Carter. It would help promote organizational capital, open up media venues, and promote public visibility in the West. Most important, a visit could help bring Chazov aboard, not as a voyeur, but as an active participant and hopefully as one of the leaders of the doctors’ antinuclear movement. Chazov’s letter did not indicate that he would become personally involved. There was no certainty that he was ready to undertake any effort in the USSR similar to our own.

The letter from Brezhnev would no doubt legitimize us in Chazov’s eyes. For Brezhnev did write: “You may rest assured that your humane and noble activities aimed at preventing nuclear war will meet with understanding and support from the Soviet Union.” In my mind, Brezhnev’s response provided an opportunity to energize Chazov to organize a counterpart Soviet physicians’ movement. The major personality for the new movement was Chazov, not Brezhnev. I concluded that travel to Moscow was the next step if we were to advance beyond square one.

When Vittorio de Nora, who met us in London, offered his private Falcon jet for the flight to Moscow, the improbable began to take on the aura of the attainable. We set our sights on the Soviet Embassy in London, with the goal of obtaining entry visas to the Soviet Union.

Unless one has had personal experience with Soviet bureaucracy, it’s almost impossible to appreciate its lethargy, passivity, and obstructionism. It was a world in which “yes” meant “no,” “tomorrow” meant “never,” and “no problem” meant “impossible.” Furthermore, Russian officials learned that if one did nothing, a small pension was a certainty by the time of retirement. If one tried to be innovative, there was always the chance of a glitch; or if a higher-up found it not to his liking, one then paid a heavy penalty. So why gamble?

At the Soviet Embassy in London I was met with the expected indifference. I was informed that a visa would require six weeks. I gave an impulsive shout, “But I need a visa immediately!”

“Why so urgent?” the insouciant young man inquired with a half yawn.

“Because President Brezhnev has invited me,” I fabricated.

The embassy officer looked at me as though I were daft. Totally carried away with the fantasy of the moment and overstepping the boundaries of sanity, I made matters worse by also requesting clearance for de Nora’s private jet to land in Moscow. The embassy clerk surely thought he was confronting lunatic escapees of an asylum. It all sounded so absurd and unreal that I had to back off, assuring the embassy official that the plane was not the issue, only that my wife and I get visas.

I pulled out three documents and urged the embassy clerk to examine them. One was my passport identifying me as the person I was claiming to be; the second was a Harvard University faculty card, establishing that I was a professor at a major American academic institution; the third was the current edition of the International Herald Tribune with the banner headline, BREZHNEV LAUDS PEACE EFFORT and a subhead, “U.S. Doctors, Soviet Envoy Discuss Nuclear War Peril.” I had underlined in red in the body of the article, “Dr. Bernard Lown, a professor at the Harvard School of Public Health and a major figure in the organization, is in Europe now, and Mr. Dobrynin reportedly said a visa would be arranged for him to go to Moscow.”

The officer excused himself, apparently to read the article. When he returned, he seemed puzzled. The article had persuaded him that I was serious, but he had no instructions for a visa for Lown. Here we were stuck. I knew he was not about to freelance and stick his neck out for some odd foreigner. I was now consumed by the urgency of getting to Moscow.

The danger of feeling compelled by a higher mission is that we permit sound ends to justify unprincipled means.

I brought my face close to the embassy official, riveting on his eyes. In a quiet, deliberate voice I stated that if he liked the London job, he had better facilitate my obtaining a visa and make sure I got it in Paris, where I would be the next day. I repeated that this mission was so urgent that his position would be jeopardized if he did not move heaven and earth to expedite our travel to Moscow on Thursday, two days hence. He gulped hard, didn’t seem to know what to say, but finally managed, “I’ll do my best, Doctor.”

That evening Louise and I flew to Paris on Vittorio’s jet. Vittorio permitted me to take the pilot’s seat and make believe that I was guiding the plane for a landing at La Bourget airport. Fortunately for the passengers the plane was equipped with the latest electronic gear, including a robotic autopilot preprogrammed to make a perfect landing. A quarter of a century later, recalling the fairy tale view of Paris and the approaching runways at the busy airport still brings waves of excitement. Whatever one’s age, the young child is hovering below the surface.

That evening Vittorio had us for dinner at the three-star restaurant Lasserre. He invited some interesting friends; his intent was to beseech me before reliable witnesses to mend my wayward behavior. Vittorio was a good friend, a man whose counsel I valued, so I listened carefully. He thought the whole trip was sheer madness.

Vittorio’s words were approximately the following: “Bernard, I am an experienced man, and you are a gifted cardiologist who has made many significant contributions. What you are doing now will end your professional life because you are getting involved with evil people who will use you. I am opposed to what you are doing. My sound intuition tells me that this matter will turn out badly.” I had heard similar words before—that the Soviets had no interest in peace, that they would exploit our good intentions for their own nefarious ends, that they couldn’t be trusted. Again, that five-word mantra neutralized any effort to bridge the Soviet-American divide: “You can’t trust the Russians.” But I had moved far beyond a futile mindset.

Vittorio had made his great fortune as a gifted chemist. I therefore appealed to him as a scientist, spelling out in minute detail what would happen if only a single megaton bomb were detonated on Paris. The more nuclear weapons that were stockpiled, the greater the risk of accident, mistake, or misjudgment that could lead to a holocaust, wrongly mislabeled as war. I knew that the Russians suffered a national epidemic of alcoholism and suspected that 30 percent of the military officers sitting that very moment in a Soviet nuclear missile silo were probably drunk. As the missiles grew faster and were positioned ever closer, less than half an hour would be needed for a nuclear warhead to traverse the globe and deliver its devastating payload. Time for intelligent decision making would be impossible. Human deliberation, being far too slow and hesitant, would sooner rather than later be eliminated from the response loop. Robots would then address robots. The world was living on borrowed time.

Vittorio shifted the conversation. Who was Chazov—and why the importance of this particular trip to Moscow? As far as I knew, Chazov was highly placed in the Soviet hierarchy. He was a member of the USSR Supreme Soviet, the personal physician to Soviet leader Leonid Brezhnev, and doctor to other members of the Politburo, most of whom were aged and afflicted with heart disease. I had known him for more than ten years, and my respect for his abilities and integrity had grown. He was powerful and widely respected throughout the USSR. Whenever I asked a Russian doctor a question, or wanted to get something done there, the invariable answer was “talk to Chazov.” Later, when I befriended Anatoly Dobrynin, the influential Soviet ambassador in Washington, he commonly counseled when requesting something from the Soviet government, “You are more likely to succeed if you ask your friend Chazov.”

The source of Chazov’s power was more than his position as Brezhnev’s personal physician. He was in charge of a special directorate of the Ministry of Health that took care of the entire Soviet political elite. I told Vittorio that I had recently received a call from the State Department inquiring why Chazov was so important in the Soviet pecking order. Curiosity was raised, the official told me, because Ambassador Dobrynin was not an early-morning riser. When Foreign Minister Andrei Gromyko visited Washington and had to catch a morning flight, someone else drove him to the airport. The ambassador had been seen, however, accompanying Chazov to Dulles Airport as early as 6 A.M. Chazov was probably his doctor, I conjectured. This turned out to be the case. What mattered much more to me was that he was an unpretentious, decent human being.

I indicated to Vittorio that if the Russians were, as their propaganda made clear, a peace-loving society, our initiative to organize the medical profession would put pressure on Chazov to create a counterpart organization. We could gain credibility by demonstrating that our colleagues in Russia were addressing their own public on the mortal threat that confronted humankind. In our crazy world, if we were to succeed, there had to be exact symmetry in the Russian and American movements. The Brezhnev letter was a moment of truth that challenged our Soviet colleagues to respond creatively.

I pointed out that one can draw hope from facts on the ground. Even in the darkest days of the Cold War, cooperation between doctors of the two rival ideological camps had never ceased. At the very time when missiles were multiplied in readiness for preemptive nuclear strikes, American and Soviet physicians struggled shoulder to shoulder in a global campaign to eradicate smallpox. Such acts of camaraderie were persuasive models for the antinuclear struggle.

Vittorio regarded much of what I was saying as romantic twaddle. If our aim was to win support in the West, he asked, would having Chazov aboard not undermine this very effort? After all, Chazov would be seen as a mouthpiece for Soviet propaganda. His purpose would be to manipulate well-meaning American doctors into the service of the Soviet cause. I agreed that, indeed, from here on we would be engaged in a tightrope act on a dangerous high wire. However, being able to speak not only in Washington and London, but also in Moscow as well as in Prague and Budapest, would render our message more persuasive. It would help sunder the prevailing paradigm of good versus evil. We and the Russians were together in an impossible and deadly fix. The way out was through cooperation, not confrontation.

We needed a Soviet ally with influence, one who would be permitted to engage openly in an international movement, one who could take a message about nuclear war and its consequences to his countrymen, a message that hitherto had been denied the Soviet people. No dissident would be able to do that. Symmetry would give us traction in both societies. We needed an ally high in the hierarchy of power, a person of character who would, incrementally, be able to speak truths that others in the Soviet establishment might wish to censor. Chazov met the bill of particulars. Along with some strategic thinking that went as far as it could given our knowledge base, the journey to Moscow was propelled on a wing and a prayer of wistful hopes and perhaps wishful thinking.

Our discussion went on until about 3 A.M. At the end Vittorio was not persuaded, but he offered to help regardless. He volunteered his chief of staff, Emil de Jekelfalussi, who would provide us with French currency, take us for passport photographs in a kiosk along the Champs-Élysées, and drive us at 10 A.M. for the fateful visit at the Soviet Embassy. Vittorio seemed to delight in the certainty that no visa would be forthcoming, thereby preventing an ill-fated journey for his friend.

Emil de Jekelfalussi was a Romanian émigré. His father, who had been chief of the Romanian general staff under King Carol II, may have been executed by the Soviets for collaborating with the Nazis. Emil himself was a gentle, kindly man who followed Vittorio’s directions with consummate efficiency. He told us that while he would do everything to facilitate our journey to Moscow, he would stay out of the Soviet Embassy since they were likely to abduct him and send him to a Siberian gulag. When we showed up at the embassy, they seemed to be waiting for us with the necessary visas. Since then I counsel friends, “Don’t slight miracles; I rely on them.”

Back at the hotel, Vittorio surprised us by having purchased first-class Aeroflot round-trip tickets to Moscow. In the many years thereafter he never again questioned the logic of collaborating with the Soviets. On the contrary, he became a persuasive advocate of our cause.

A new issue now loomed: namely, who was aware of our Moscow arrival? Unexpected visits to the USSR are a nightmare to be avoided. Russians are not adept at dealing with the unexpected. Who would meet us at Sheremetyevo airport? How would we navigate passport and customs control? What about hotel reservations? Who would arrange short-notice meetings with Soviet doctors? Who would promote in-depth publicity of this visit? Having had so much luck this far, I expected the streak to be unending, the very thought process and undoing of the inveterate gambler. But I had a proverbial ace in the hole, the indispensable Vittorio. He promised to connect with someone in Moscow while we were airborne.

Much to our delight, both Chazov and Venediktov were at the airport to greet us. That meant VIP treatment, neither passport nor customs control, and nothing to worry about except the big agenda item that had brought us to Moscow. They had arranged for Louise and me to stay at the Sovietskaya Hotel on the outskirts of Moscow. I had stayed there seven years before during the “emergency” medical consultation. The suite was extravagantly spacious; the refrigerator this time was well stocked with caviar, sturgeon, and vodka; the television sets worked; and the grand piano was tuned.

The next day’s agenda was remarkably filled, primarily with meetings with Russian co-workers in Task Force 5: Sudden Cardiac Death. The evening was given over to a ballet, Tolstoy’s Anna Karenina. The fabled Maya Plisetskaya danced the title role in a work she had choreographed; the music had been composed by her husband, the conductor Rodion Shchedrin. Merely writing the above brings goose bumps. Nothing we had ever before witnessed measured up to that artistic experience. At Anna’s tragic death, Louise and I wept.

The next night, Friday, was the long-awaited meeting with Eugene Chazov. I immediately launched into the concept of a Soviet-American physicians’ organization. He seemed taken aback. While my mind had been racing for months with these ideas, he had not gone beyond some inchoate intellectual interest in the general concept. I needed to slow down and learn why he hesitated. I didn’t have to wait long. Chazov stopped me dead in my tracks with words to the effect that there was no way he would become involved in an antinuclear organization. His dogmatic outpouring seemed like tumbling boulders that would permanently block any forward movement. I was tooting my imaginary locomotive, but there were no railway cars following, not even an attached caboose.

Chazov had his own ambitions. Over a period of many years, he had engaged in a complex struggle on numerous fronts to have the government grant him millions of rubles to build a cardiology center in Moscow, a showplace for Soviet medicine. From this hub, he would oversee spokes that radiated to cardiology centers throughout the Soviet republics. He was consumed by the idea of creating a medical facility equivalent to our National Institutes of Health. Any activity that detracted from this goal was to be avoided. Above all, he must not alienate such an important political constituency as the military. Becoming involved in a project such as I was proposing threatened to derail these ambitions. He was not about to jeopardize the major undertaking of his life’s work. Indeed, two years later the envisioned cardiology center was built.

During our discussion, Chazov downplayed his obvious personal ambition. He expressed surprise at my naiveté. Surely I was aware of the pervasive power of the Pentagon in America. He reminded me of President Eisenhower’s warning, some twenty years earlier, about the US military-industrial complex. The success of the doctors’ organization depended on media exposure; yet mass channels of communication were controlled by the very corporations who bedded down with the Pentagon. How did I expect to develop a countervailing force against such entrenched power? Chazov warned that with America swinging to the right in the forthcoming election I might jeopardize more than my career. It could be far worse.

He was speaking about me, but I believe he was really addressing his own peril. For Chazov to pursue the agenda I had in mind, he would have to take big risks. We were out to expose the folly of the nuclear policies of both countries, debunk the myth of civil defense, show how alcoholism and drug abuse in both militaries could cause an accidental nuclear war, and prove that genocidal weapons undermined the survival of both our societies. The fact was that the USSR, with all its nuclear throw weight, was incapable of protecting the Motherland from devastation far worse than that suffered in World War II. We were about to proclaim that the emperors had no clothes. These were extraordinarily sensitive subjects and were not discussed publicly in the Soviet Union.

Chazov was unmoved by Brezhnev’s letter stating that we would find “understanding and support in the Soviet Union.” The Soviets had many spokespersons traveling the world to preach peace while government policies helped stoke the arms race. Chazov knew that even with all of the “peace loving” rhetoric, the Soviet Union was not about to reduce its nuclear stockpiles. It wanted parity with the United States—partly for military reasons, but more, I think, for reasons of national pride as one of the world’s two superpowers.

For the Russians, it was supremely important to be seen as equal, and yet they were, technologically and economically, far behind. The Soviet national treasury had been ransacked in pursuit of military parity. Though they could ill afford it, the government was determined to play catch-up, forever if need be. Chazov was too bright, had too much integrity, to lead a charade movement of this kind. My feeling was that he especially craved the respect of international colleagues for the high quality of his medical work. Being labeled a government mouthpiece would undermine that goal.

As the evening wore on, I exhausted all cogent arguments, yet I was unwilling to let go. Without Chazov we would never get the organization I had in mind off the ground. I felt increasingly like a weak swimmer in water far over my head. I had misinterpreted Chazov’s friendly letter in order to give sanction to my dreams. This misinterpretation had misled friends and colleagues—and, above all, had resulted in self-deception. We had no powerful partner ensconced in the Kremlin. Chazov, no doubt, wished us well. Perhaps he could be swayed to participate in a onetime conference.

I was tired, jet-lagged, and more frustrated and disheartened than I had been in a long time. Perhaps the many years of frustration and anger in the Soviet-American cardiovascular project now conflated with Chazov’s rejection. Sitting with a reluctant Chazov, I wondered what had possessed me to try to undertake this venture in the first place. With all the odds against such an endeavor, no one in his right mind would believe that even if launched, it had the most remote chance of success.

The tension proved too much for me, and I lashed out at Chazov. I remember my harsh words clearly: “Eugene, you’re not the person I thought you were. I presumed you were an honest, deeply committed physician, not a political opportunist!” With that, Chazov grew red in the face and stormed out. Our relationship had been sundered. I was certain that I would never see him again, at least as a friend. Louise, who witnessed it all, was aghast. Rarely angry, she bristled, “What possessed you to indulge in such an improper accusation? Why the tantrum and the display of such poor manners so devoid of good sense? You took a lot of pains to inflate this balloon, then punctured it. Why?” I had no answer. The feeling of paralyzing fatigue and bottomless despair made me yearn to get out of that place, and the sooner the better. I planned to return to Boston as quickly as we could obtain flights.

Saturday morning at 9 the phone rang; to my astonishment, it was Chazov. His voice was friendly, as though we had had a congenial discussion the night before. “I have given a lot of thought to what you’ve said,” he told me. “Let’s get together and talk specifics.” We agreed to meet at the Myasnikov Institute, the very place we had begun discussions about sudden cardiac death seven years earlier.

How was this unexpected turnabout to be explained? My American mind was conditioned to think conspiratorially whenever it involved the “evil empire.” I imagined that Chazov had stormed out of my hotel suite and phoned Brezhnev, who counseled, “We can use Lown and the organization he proposes as a conduit to the West for advancing the party line on nuclear weapons.” Until that moment, I had prided myself on being impervious to the drumbeat of American propaganda about the Russians. But even I had succumbed.

As I headed for the Myasnikov Institute, I could not imagine what had really changed Chazov’s mind. In Geneva some seven months later at a party for Russian and American doctors sponsored by Vittorio de Nora, another explanation emerged. All of us, including Chazov, were quite drunk. I asked him what had led to the change of mind that Friday night. Chazov, quite voluble and unrestrained, offered an explanation.

He related that he was deeply troubled by what had transpired. His daughter, who was a young physician, seeing that he looked very stressed, commented that he was killing himself with hard work. Indeed, he was one of the hardest-working persons I had known, a remarkable exception in a society known for its sloth. He often labored an eighteen-hour day for weeks on end. He once told me that he had worked for twelve consecutive years without taking a vacation. Chazov was one of those individuals who grow uneasy and restless when not working.

He responded to his daughter’s question with the comment that he had just met a crazy American who did not think he was working hard enough. She asked what that was all about, and he gave her a verbatim account of our conversation. She reflected a long while and then responded that the crazy American was probably right, not on his account, not on her account, but on account of “your six-month-old grandson.”

He indicated that that was a moment of truth. In fact, he had been left no moral choice as a doctor and human being but to address the greatest threat to life.

When we met on Saturday morning at the Myasnikov Institute, Chazov brought Dimitri Venediktov along with him. Although Venediktov was silent throughout, Chazov was the supreme organizational man who began immediately seeding allies in key sectors. At this meeting Chazov insisted that I lay out my ideas about the nuclear threat and the structure, scope, function, and governance of the organization I envisioned.

I spoke for about four hours, and Chazov, like a dutiful student, took copious notes. We agreed that, this being a Soviet-American undertaking, it should have a Soviet-American co-presidency to symbolize the cooperation necessary for human survival in the nuclear age. I emphasized, above all, the apolitical nature of a physicians’ movement. Prophetically, Chazov warned me about numerous provocateurs who would try in the most well-reasoned ways to distract us from our mission.

When our conversation ended, Chazov indicated that he had arranged for me to meet two important people: one, the president of the Academy of Medical Sciences, professor Nikolai Blokhin, and the other, Leonid Zamyatin, head of the International Affairs Department of the Central Committee of the Communist Party. Both conversations were contentious and uncomfortable. They did not see the merit in a physicians’ antinuclear organization. Both were anti-American party hardliners. The journey had begun.

I said earlier that miracles happen. In the launching of IPPNW they were numerous—if not miracles, certainly unexpected alignments of stars. To begin with, the concoction that I was on the way to meet Brezhnev launched my trip to Moscow; I got the Soviet entry visa within twenty-four hours; Vittorio, staunchly reactionary politically and a rabid anti-Communist, facilitated radical events and became a firm supporter of Soviet-American cooperation; Chazov made an amazing twenty-four-hour turnaround. There were many more miracles on the long road ahead.

At the time of the Nobel Prize award in 1985, Thomas Power wrote, “The friendship and collaboration of these two men is one of the small miracles of the age.... In 1914, the soldiers of Europe, acting on no authority but their own, suspended the First World War for a day to celebrate Christmas. This was a gesture that should have been heeded. In their own way, Lown and Chazov have declared a small truce in the war we call cold.”