Mr. Brian Farley - 2 - October 13, 1972 Majuro also treatment was recommended on some of the people examined to the local medical officers. In the interest of trying to promote a better communication between the examining doctors and the Marshallese examined, an attempt was made at the completion of each examination to explain to the person through an interpreter the general results of the examination and possible treatment recommended. , At each island clinical conferences were held by the physicians, including the medical observers, Dr. Riklon and the health aide, to evaluate all cases examined and to recommend treatment and disposition. In some cases, the health aide was advised as to further treatment. In other cases, Dr. Knudsenjiwas asked to see certain cases on his return visit to the islands. In other cases transfer to the Majuro hospital were recommended for further evaluation and treatment. At Rongelap there were two hospital cases and at Utirik five cases. We took them with us on the Militobi to Majuro. None of these people appeared to have conditions related to radiation exposure. When we left Majuro at the end of the survey, the two Rongelap women were being further examined. Four of the five Utirik cases were found to have conditions that could be treated on their home island and they were to be returned. The other case from Utirik needed further consultation. There were important findings in three exposed people who lived at Majuro. Two young exposed girls had developed thyroid nodules since last examined in 1971. They were Billiam Jabwe (female, age 19) who had been exposed at one year of age at Ailingnae. The other girl was Rokko Iso (female, 29) who had been exposed on Rongelap at age 12. Surgical removal of these nodules is of course necessary. Dr. Brown Dobyns at the Cleveland Metropolitan General Hospital, who operated on many of the other Marshallese thyroid cases, has agreed to operate on these as soon as it is possible to arrange transportation of the patients to Cleveland. Preliminary arrangements have already been started for this. The third case is more serious. Lekoj Anjain, male, age 19, who was exposed at one year of age on Rongelap was found to have a low white blood cell count during the survey. A repeat count later in the survey was even-lower. This boy had previously had thyroid surgery for removal of benign nodules of that gland in 1968 and when last examined in March 1971 he was found to be healthy. In view of the alarmingly low blood count and after consultation withhts father, we took Leko} with us to Tripler Army Hospital in Honolulu. They were unable, however, to get a successful bone marrow examination and we decided to take him back to Brookhaven National Laboratory. I am sorry to report that the diagnosis of acute myelogenous leukemia was 233 emg 0503