. . . . . . .. . The follo~’-up care of patients with total ablation Scme had stopped of the thyroid also appears inadeqate. their medicine because of side reactions and appear hypothyroid to my eyes. NO regular follow-up has been pursued to allow change of thyroid medication, or increase or A general feeling of distrust of the decrease of dosage. Treaty Trust and Atomic Energy Commission physicians is The people of the wide-spread among the Marshallese. Marshall Islands I spoke to have no great faith in these physicians, do not consider them de~~oted to their interests, but instead representing the interests of the Atomic Ene~gy Commission or the Trust Treaty authorities, and were reluctant to place their health in tlieir hands, --although they finally did so for want of any other ade~ate facilities supplied by the Treaty Trust Organi1 an also impressed with the failure of the zation. physicians to comnunicste findings and prcgnosis to the Each patient is entitled to people of these islands. He should be told the nature have his q~estions answered. of the lesion discovered, and, if he asks-for it) a Pro5The doctor should, ~hen he can, nosis should be given. . infor,m the patient of the cause of his illr,ess- These basic rights of a patient have been in large part ignored in the lfarshall Islands, and I found very few Harshallese who were acqu~inted with the nature of their pathology. I reject firmly the thought that the people vere too primitive or uneducated, TO absorb s:lch inforrr,ation, 4UTiOFg them are since I have fol~nd this not to be true. educated and intelligent leaders who,yould be able to digest s’~ch information and form their ctin c~nclusions about ~;hat the islands, its vegetation, its people, and its culture has suffered. I have planned conversations with A..mericansin this area of various expertise who would be useful in underspending the course of focal-chain radiation and its injuries, Some as well as the complex picture of fallout injury. of these conversations have been sta~-ted, and scme of the “ correspondence is already under way. .. I am writing to you instead of delivering an Oral report so that you may use this h’ritten report to demon.. . -11-