IN CONFIDENCE to be removable. l(b). Present examination methods appeared to me to be extensive, detailed and careful. In particular, the clinical examination of the thyroid was ordinarily done by one of the team and one observer, with two others of the team and two other observers also in any case of doubt. The laboratory tests used highly sensitive modern methods of detecting any threatened, as well as any actual, depression of thyroid function (by measuring the blood concentration of the thyroid stimulating hormone as well as of the thyroid hormone itself). They are in general of the same type and range as those that I use in my own work in excluding depression of thyroid activity. Apart from additional tests that were made occasionally of the reserve of thyroid function (by injection of thyroid stimulating hormone in a few cases), these are the orthodox routine tests ordinarily done in sound advanced thyroid clinics - given that thyroid scans need to be specially arranged outside the Trust Territories if shown to be required. I therefore do not see other thyroid tests which should be added, Or any present ones deleted. Nor do I see any tests for radiation effects which should be added or deleted. It is a matter of opinion whether any tests carried out as part of general medical care and surveillance, and presumably irrelevant to radiation effects, for example by electrocardiograms or tests on the urine, should be deleted. If an expert team with the necessary facilities is on these islands in any case, and if these tests detect treatable disease that had not otherwise been detected, I think it would not be appropriate to delete them, even though from the narrower point of view their deletion would probably not impair the necessary care of these peoples in regard to purely radiation induced effects. Unless equally detailed medical examination is available to these (and other) islanders from other sources, therefore, it would seem to me wrong to diminish this general health protection, even though the size of the team could be reduced if its work were confined to radiation effects alone and if "sick calls" and general surveillance were excluded. As it stands, I think it could in fact even be held that the exposed islanders may actually have had better health than other islanders - by virtue of non-radiation diseases detected and treated and despite the radiation induced thyroid conditions that have required treatment. l(c). With so little common language between most members of the team and the people examined, an impression of brusqueness could easily be created, but I did not consider that the many examinations that I saw were inconsiderate. It was particularly obvious that Dr. Conard was being greeted as an old friend, and Dr. Sutow's gentleness and charm in dealing with children and young people were very evident. In general the difficulties seemed to be only those that, for example, I find in London in examining a patient with whom I have no common language: namely that one cannot verbally express reassurance, cannot indicate in detail [014833 eek / continued...