regularly stnéeduiea, céntraii1zea \/ wasnington, v.L.)planningsessionsww
coordinate and clarify the various interrelationships and responsiblities for
all concerned.

The agenda should be circulated months in advance by the coordin-

ating agency, asking for additional items for discussion prior to the meeting.
The field representatives should include some representative from the Trust
Territories, if possible, to anticipate or preclude misunderstandings with this
vital administrative link.

Such meetings would bring a sense of "common purpose"

to all of the participants and allow each unit to clarify its role in relationship
to the total effort.

One of the most vexing problems I encountered was the absence of medical
records.

We had comparative lab data from previous reports but the clinical data

was rudimentary or not available at all.

I realize this field trip was dedicated

to a review of the thyroid problems, but unfortunately each patient had other
problems that may have interacted with, or actually taken precedence over the
thyroid problems.

I found it very difficult to play with half a deck.

My clinical

judgement must be based on an evaluation of all of the available data - not just
a few sentences describing the previous physical examination of the thyroid.

The

patients seemed confused by the fact that we were "only interested in their thyroids”

and that Dr. Knudsen and John Iaman would take care of the rest of their complaints.
I was fortunate enough to see some of the general sick call patients and there was
a plethora of serious medical problems.
nutritional.

In my opinion, the principal problems were

In fact, when we landed on Rongelap, the first thing we were told

was, "We are starving."

That was really the community's "chief complaint".

afraid the medical team did little to deal with that problem.

I am

Select target paragraph3