Many international events were built around or grew out of Seven Countries Study surveys. These were often new and stimulating undertakings in the fledgling science and organization of cardiovascular disease epidemiology. Here are a few anecdotes among myriad adventures.
The Healing Power of Jazz
At Makarska's Hotel Jadran on the Dalmatian coast, in late September, 1963, some sixty cardiologist investigators from sixteen nations had worked for five long days in separate workshops for the Research Committee of the International Society of Cardiology. On the final work day we had summarized findings and read them to one another in plenary session. The next morning we were to convene and vote approval of broad new recommendations for cardiovascular research needed worldwide.
As the evening Adriatic breeze freshened so did our spirits. We had worked well together and produced a solid document that we believed could affect the course of researches for a decade. The workshop occurred at the peak of the international cardiological enterprise of Ancel Keys and Paul Dudley White. Their worldwide "network" had effectively stimulated collaborative studies and launched the fields of cardiovascular disease epidemiology and preventive cardiology. We, the "younger generation" of investigators, were caught up in the excitement. Our group had worked particularly hard and borne a large measure of responsibility for the actual writing of workshop reports.
We all eagerly looked forward to the final gala dinner, its poetic toasts, and its climactic address by a Wall Street banker. Let's call him Mr. X. He was representing Albert Baer, the industrialist-philanthropist who was then President of the International Cardiology Foundation, the major source of funding for the Research Committee.
Starched, dark-suited men and radiant women in long dresses swept down the balustraded stairways to the restaurant where they were seated at long white tables. The pinkish wine of the region was splashed in all glasses and these were quickly emptied. The hum of conversation rose.
Eventually, the marvelous local giant fish, called a Dental, was picked clean, and the last drops of wine quaffed in a final, convivial toast. As the Yugoslavian version of a Baked Alaska was brought in, flaming, the guest of honor rose to deliver his message. Those at the head table, Paul Dudley White of Boston, Ancel and Margaret Keys of Minneapolis, Professor Akmetaly from Moscow, Vittorio Puddu from Rome, Bozdiar Djordjevic from Belgrade, and Sir Kempson Maddox from Sydney, turned, as did everyone, toward Mr. X, who began his address as follows:
"Some might think that the greatest enemy of mankind is Nikita Krushchev; others might think it Madame Nhu. Some might even say it is John F. Kennedy! But we all know that the greatest enemy of mankind is --- "
The hush was complete. Not a fork lifted, not a glass clinked. We couldn't believe our ears. This "fat cat" from Wall Street, apparently thinking himself at the Waldorf-Astoria talking to the Board of the American Heart Association, appeared unconscious of the fact he was addressing representatives of sixteen nations, six of them socialist. He was even the guest of a Communist country!
All these thoughts went flashing by, but before the speaker could continue, we heard a guttural exclamation, followed abruptly by the scraping of a chair pushed back brusquely from the table. We saw only the back of Akmetaly's head as he left, storming out of the dining room, slamming shut the huge French doors. Almost instantly he was followed by all the Eastern Bloc representatives and their companions.
Weakly, the lecturer continued: "But we all know that the greatest enemy of mankind is - heart disease!"
Having finished what he had thought would be a clever introduction, he paled and broke out in a glistening sweat. It seemed, too, that all the men remaining in the room suddenly aged a decade, and that the ladies, buoyant a few moments before, now sagged. Obviously, this Manhattan businessman had never visited an Eastern or socialist country. His talk went on about approaching "big business" and soliciting the support of "substantial people" for international research efforts in cardiovascular disease. The entire message was as inappropriately worded as had been his introduction. Even in Western countries, most cardiovascular research is supported by government, not by private solicitations of voluntary contributions. The man apparently had some experience in capitalist philanthropy, but clearly no tradition of international diplomacy or of science.
We sat stunned. We had arrived at the dinner exhilarated by the intellectual activity of the workshop, buoyed by the admiration and camaraderie that had developed among us, proud of the work we all had done to produce the research report. It seemed to us that the International Society of Cardiology would surely, in the future, become much more than an exclusive club of prominent cardiologists. Many others would find rich opportunities, stimulated by the Society's international research activities. We had been primed to celebrate. Instead, the success of the entire workshop was threatened.
A rumor spread quickly that the Soviet delegate was not only enraged, but was packing his bags and requesting space on the next flight to Belgrade. That would mean that the Soviets and Eastern Bloc representatives would not ratify the working paper, and that the truly international import of our assembly and its work would not be realized. It was also rumored that the international dean of cardiology, Paul Dudley White, had gone directly to the Russian's quarters in an attempt to mollify him. That encounter apparently was so unpleasant, he, too, had retired to his quarters. The calamity rolled on with tragic momentum.
On cue, the wretched little hotel orchestra, in an alcove off the Grand Terrace, started its doleful baying at the Adriatic moon. The musicians, with mixed Western and Eastern instruments, played mainly out of tune, under-inspired and over-drunk. It was the final week of their long summer engagement on the Dalmatian resort coast. I had already decided that this would not be an occasion to exercise my newly acquired passion - the soprano saxophone. But our conference now required desperate measures.
I appeared at the rear of the alcove and beckoned to the band leader. We talked, I, in pidgin Croatian, he, in pidgin English. I learned that he and one or two others possibly knew some jazz tunes that sounded something like, "Sweet Georgia Brown," and "Margie," and "My Blue Heaven," and they welcomed me to join them. These banal tunes would have to suffice.
I dashed up the stairs in bounds, and dove under my bed to retrieve the precious old Conn, turning to hurry out of the room. Suddenly, I stopped to take stock. I carefully opened the case, found the best reed, tested it, wrote down the three tunes and thought about the tempos, and analyzed how it would be best to kick off each tune and how to lead the motley orchestra without offending them. From my balcony, I could see our group mounting heavily the long spiral staircase from the restaurant to the terrace. The Adriatic air itself was languid, matching the mood. Participants gathered in tiny knots. There was no closeness, and no one danced.
I picked my way carefully down the stairs and arrived at the back of the musical alcove. The musicians greeted me with broad smiles. I had not played with them before, but they had heard me "diddling" on my horn in my room all week long and had an idea of what to expect in traditional jazz. We agreed in spirit that a radical cure was needed for the evening's malaise. I beat out the tempo for the first tune with a rhythmic lilt, called out the key to assure we would all start together, and then, with a one and a two, let go with the old sawhorse, Sweet Georgia Brown. Thankfully, it came out at just the right lilting bounce, not so fast that the musicians or dancers would be out of control, yet fast enough, I hoped, to get pulses going.
Faithful Ivica Mohacek, cardiologist colleague from Zagreb, stood up first and raced across the terrace to grab Anna Brodarec, the blonde Partizanka, and escort her to the dance floor. They lurched merrily around the terrace, infectiously enthusiastic. Others rose, one pair after another. The maitre d' then turned on a brilliant bulb above the musical alcove, forming a circle of light extending some meters about us and attracting the dancers toward the bandstand, like insects to the flame. The non-dancers brought up chairs or stood behind their companions, swaying and clapping their hands. The breeze picked up freshly from the mountains. Soon a throng of a hundred or so of our scientific set were twirling, and laughing.
Looking upward, following the gaze of front-row colleagues, I could see on the second floor balcony, beaming down on our happily lighted circle, the effusive figure of Comrade Akmetaly, now arm-in-arm with the dignified Paul Dudley White! They held their glasses high, toasting the multitude below with broad smiles and bows. Soon, all eyes were turned upward toward the two symbolic leaders. The tune ended, the dancing stopped, and hurrahs burst from all our throats.
The wound was healed, the evening, and the meeting - with its report - were saved. The joint report was later signed by all participants and forwarded to the International Society of Cardiology, and on to the World Health Organization for publication and circulation. Cardiovascular research communications would expand and be enriched. And the Wall Street banker would be forgotten.
As the music and dancing resumed, gazes were attracted to the sky, where we could see the American balloon satellite, Echo, flaming across the zenith. Our cardiological balloon, too, was floating high. Such is the healing power of Jazz!
Undercover for the CIA
November 4, 1958
Dear Dr. Blackburn:
Thanks very much for allowing me to read your journal or diary of your field work in Yugoslavia. I enjoyed it tremendously. It was just like taking the trip and enduring some of the hardships as well as sharing some of the pleasures.
You are an excellent observer and a very graphic writer. If you have similar documentation of your more recent trip, I would appreciate very much the opportunity of perusing it. This one is full of very useful bits of information as I am sure others will be.
I will try to contact you soon after you return.
Paul F. Austin
354 Midland Bank Bldg
Federal 5-7853
Paul Austin, it turned out, was the Minneapolis bureau chief for the CIA, his office located in that somber, old-fashioned, Midland Bank Building in downtown Minneapolis.
Before I figured it out, I wondered how he had obtained my name, and how he had such uncanny knowledge of my recent trips behind the Iron Curtain. Mr. Austin didn't actually tell me for whom he worked. It was simply clear, from his modest, quiet demeanor, that it was for a government agency that I should not ask him about.
More curious than anything else, I had agreed to an interview upon my return from a prolonged trip to Yugoslavia after the first formal survey of the Seven Countries Study in the fall of 1958. Since it was clear that I was not to ask him questions, I assumed that my passport and visa application had somehow been the source of Mr. Austin's knowledge of my whereabouts.
It all started so innocently with this bland little man, a harmless functionary if ever there was one, assuring me that his function and that of his agency were only gathering information, and that every bit of information was important. That it was all gathered together, sifted and stirred, and boiled down to a useful source. And, he went on to say, my small part would fit along with a thousand other small parts, eventually painting an accurate picture of life behind the Iron Curtain. That, he said, was the ultimate goal of his bureau.
"May I now just ask you a few questions about your trip, Dr. Blackburn?"
"Shoot," I said.
He assiduously took notes and occasionally asked a question about such things as the director of the public health institute in Zagreb, and his wife, one of our field team. He always expressed interest in specific names, specific places, and specific functions in specific institutions. Finally, it seemed to me that I would be better off simply giving him my journal to read. This led to his later note of thanks, written on unmarked typing paper.
In those days, I was out of town eighty to a hundred days a year as Project Officer of the Seven Countries Study - for the U.S. Railroad Study as well as for the overseas operation. And for a while, these quiet visits from Mr. Austin became routine.
Then, just as in the spy thrillers, Mr. Austin began to turn the screws on the unquestioning, compliant Dr. Blackburn. He flattered me as a "sharp observer and graphic writer." We were quite comfortable with each other by this time. He breezed in cheerily one day after I had returned from a trip to Prague, asking me directly, "How was your trip to Prague?"
A little bell went off in my head. Before this day, he had always asked me, "How was your trip, Dr. Blackburn? What countries did you visit this time?"
Now I replied, "So, Mr. Austin, where else did I go beside Prague?"
He rattled away: "Well, after Prague you touched down in Budapest and Vienna and in Geneva for WHO meetings, and then came home via London and the School of Hygiene."
I suddenly realized that it wasn't a visa application or a plane ticket that was the source of his information. He was repeating my destinations and purposes of my journey almost word for word as I had written them on my University travel request. Then it dawned on me that, of course, our Dean, or someone in his office, was photocopying my travel requests and sending them to Mr. Austin's CIA office!
I had always regarded Dean Gaylord Anderson as a liberal-thinking, fair-minded person, and here I was learning that he was in cahoots with the CIA. Without my knowledge or consent, he had allowed them to determine the dates, purpose, and destination of my overseas trips as a private citizen and university faculty member.
That day I asked nothing further of Mr. Austin, and went ahead with the detailed interview about my latest trip to Prague and beyond.
The next call from Mr. Austin came some months later, and exceptionally, it was prior to, rather than after, an extensive trip I was to take that included Iron Curtain countries. In his usual clipped manner on the phone, he asked if he might stop by. I gave him an appointment for the following day.
On arrival, he said he thought he would just stop by and leave me a list of things his bureau would be interested in my observing on my next trip to the Dalmatian coast and to the interior of Yugoslavia. I regret now that I didn't keep that list. As I recall, they were interested in such details as the availability and price of a vial of penicillin.
By this time I was mildly exercised; first that my Dean was working with the CIA without informing his faculty, but mainly that the CIA was now sufficiently emboldened by my past cooperation to call me before rather than after a trip, and even to present me with information they would like me to seek out and collect for them!
Still attempting to stay "cool," I said to Mr. Austin, "What do we pay our scientific attaché at the Belgrade embassy for, if it's not for this sort of routine information?"
Again, I heard his litany about, "every little piece of information, from every little piece of geography, collated and compared with every other little bit, all contributing to a whole fabric."
I accepted Mr. Austin's question form, but jettisoned it shortly after his departure. Needless to say, I didn't collect the details he asked me to provide. I had no intention of deliberately gathering information on my Yugoslavian colleagues, their lives, or their society.
I decided that very day that I had had enough of being a "CIA informant," and after returning from the trip, when I again gave Mr. Austin an appointment, I notified my office-mate, Burt Hamrell, of my intentions. My strategy was that I would carry out the interview with Mr. Austin in Burt's's presence, and would not inform the CIA beforehand. Also, I would keep my Dictaphone running on my desk, since Austin had now begun to tape my interviews. I thought it would be a lark to tape him taping me.
When our secretary escorted Austin into my cubicle, Burt Hamrell, sitting at the desk opposite, made as if he were busy. Austin seemed uncomfortable, cleared his throat several times, and finally blurted: "As you know, Dr. Blackburn, it has been our custom in the past to conduct these interviews in privacy. Who is this with you?"
"Oh, Mr. Austin I thought you knew my office-mate, Burt Hamrell."
Burt said, "Oh, hello, Mr. Austin. I assumed that you already knew all about me - for example, that my father was an immigrant to this country, and that my Polish grandfather was a notorious horse thief!"
Mr. Austin did not crack a smile at our prank. Rather, he turned on his tape recorder and, looking squarely at Hamrell, inquired, "Now, Dr. Hamrell, please tell me your full name and title and what you do in this laboratory."
Burt gave me a wide-eyed look as if to say, "What gives? I don't want any part of this."
My subsequent interview with Mr. Austin that day was short. He realized that we were having fun with him. After my next overseas trip, he left a message for me that another agent from the bureau would be stopping in to see me.
By this time, I wanted nothing more to do with the CIA. They continued to request me to serve as their information-gathering agent, with lists of specific questions to explore. Moreover, the bureau continued to be concerned, foolishly I thought, with maintaining the secrecy of our interviews.
When the agent replacing Mr. Austin was ushered in, I started my tape recorder, admittedly continuing a puerile prank - taping ,the CIA taping me! The new agent was as boorish as Mr. Austin had been correct. As he came into my office he saw me hanging up a new raincoat and remarked, "Boy, that's a good-looking coat. What would you take for it?"
I laughed as if it were a joke. He went on to indicate that he was seriously interested in making me an offer for my coat!
For some reason that day, I had little recollection of anything I had observed on my last trip, which had been to Moscow. This interview, too, terminated early. My days with the CIA were over.
I have thought of asking for my FBI files, using the Freedom of Information Act, to see whether I am considered an uncooperative citizen, but I have resisted the temptation. I did take up the issue with Dean Anderson later, when examining him in our annual businessman's study. He did not admit directly to forwarding my travel requests to the CIA, but he indicated that he felt there was nothing wrong with the CIA knowing when members of the faculty were going to interesting areas. He was unresponsive when I said, " Then it might be nice if it were publicly announced that faculty travel requests were released in this fashion. It is disconcerting to have a gentleman request a secret interview and then walk into one's office and list off the places where one has been - and for what reason!"
Years later, on an airplane returning from a day in Washington, I was seated next to a former colleague from the Medicine service of the Minneapolis Veteran's Hospital. I recounted the story about my "victimization" by the CIA and the pranks I had played on the agents in return. I was brought up short when he terminated our conversation on the CIA by asking, "Whose side are you on, anyway, Henry?"
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