What are the roles for health professionals in addressing the rising threat of the use of nuclear weapons? With particular reference to the activities of the Medical Association for the Prevention of War 1951–1963

Those of us who deal with suspicious individuals do not fill our consulting-rooms with equally abnormal bodyguards. – Alex Comfort (1952, 293)

The question of nuclear weapons is as pressing now as it ever has been in my lifetime. Recent Lancet correspondence argues that ‘the ongoing conflict in Ukraine […] has made clear that nuclear war is closer than ever’ (Bisceglia and Fateh-Moghadam 2022, 159). For similar reasons, the Bulletin’s doomsday clock is 90 seconds to midnight, the closest it has even been set (Spinazze 2023). This is in spite of the 2021 Treaty on the Prohibition of Nuclear Weapons being ratified by the UN, in which participating nations agree to ‘not develop, test, produce, acquire, possess, stockpile, use or threaten to use nuclear weapons’ (UN 2021).

There is a long history of nuclear weapons being framed as a public health issue. Like climate change, many see resistance as a constituent part of medical duty and believe that ‘the medical community must prevent what we cannot cure’ (Helfand, Junkkari, and Onazi 2014, 739). Giorgio Cosmacini, a historian of medicine, argued in reference to the two world wars the shortcomings of a neutral medical community:

The fact that no one— or very few—among the protagonists of medicine […] has posed prevention of one of the deadliest pandemics in the history of human societies should make us reflect on the actual coherence of a medical science that, while professing to be at the service of life, refuses to take sides and declares itself neutral. (1987)

Cosmacini’s call in 1987 was for the prevention of war to become ‘a new province of preventative medicine’ and during the 1980s a new wave of anti-nuclear protest came from writers on public health, communications and feminist theory alike (Cohn 1987, 17; Hook 1985, 68; Medical Campaign Against Nuclear Weapons 1983).

Although most histories of medical protest of nuclear weapons primarily focus on the 1980s, the rich history of the Medical Association for the Prevention of War (MAPW) in the early Cold War is often only mentioned in passing (Helfand, Junkkari, and Onazi 2014, 741; Humphrey 2009, 294; Ike 1984, 68; Barnett et al. 2013, 1). The few dedicated monographs on this subject are either narrative, or lacked access to the MAPW primary sources at the Bradford Special Collections (Hurrell 2015; Lewer 1992). Exploring the organization’s bulletins, conferences, and members’ correspondence can reveal myriad ways this community spoke up to resist, rally, and educate in the face of a new threat to health. In the looming spectre of contemporary nuclear stockpiling, it can be illustrative to consider a time when it was felt that ‘the world’s doctors are at this very moment in a position to make world war impossible’ (Adams 1954, 978).

Chairman Alexander Haddow, in his own words, ‘saw, […] the special responsibility of science and medicine’, which shared an ‘essential internationality not quite to be found in any other human endeavour’ (Haddow 1963, 59). Medicine’s further ‘claims of common humanity’ in the Hippocratic oath, were ‘modernized’ by the MAPW to include nuclear weapons (MAPW GB 0532 MAP, 12/6/1952). MAPW meetings were held on ‘medicine’s unwitting contribution to the preparation of war’ to put these revised codes into actionable plans (MAPW GB 0532 MAP, 26/1/1961). By the end of this period, pamphlets carried the following mission statement: ‘The Association […] was formed to enable doctors to fulfill their professional responsibility in relation to the threat of war’ (Comfort, GB 0532 MAP, 1955, 4). It can be helpful to know that this uniquely medical preventative resistance existed in the early Cold War years, but considering the methods of resistance can offer further reflection.

Methods of resistance

Identification of ‘nukespeak’

A trend in the 1980s historiography is the growth of the ‘nukespeak’ framework: deconstructing language that aims to ‘mystify the Bomb, pretend to neutrality and rationality, and habituate citizens to its continued presence’ (Helwich2011, 21). Sanitized, bureaucratic, or obfuscatory language would encourage the public to ‘keep watching’, rather than resist and ‘participate in the construction of a future’ (Goodnight 1989, 268). Although this linguistic framework originated in the 1980s, the MAPW were already keenly aware of this use of language, not least in ‘How to read the newspapers’, a pamphlet by Alex Comfort distributed to members:

The Association which issues this pamphlet is an association of doctors, not politicians. It is concerned with news and its abuse because it is profoundly worried by the resemblance between the effect of propaganda on public thinking and the kind of thought-processes which characterises lunatics. (Comfort, GB 0532 MAP, 1955, 2)

Comfort directly addresses the sanitation of the bomb by fabricating a ‘News Game’. In the game the reader is encouraged to read an article and spot common words used to describe actions taken by ‘Our Side’ and ‘Their Side’. On ‘Our Side’ is defence, security, and Law and Order. On ‘Their Side’ is atrocity, threat of aggression, and murder (Comfort, GB 0532 MAP, 1955, 4).

Others similarly deconstructed illogical nukespeak in MAPW conferences. Nigel Calder notes the paradox that ‘the deterrent is designed to avoid a nuclear war but the deterrent threat must allow the possibility of a nuclear war’ (Calder 1963, 48). Gene Sharp at the same conference points out that ‘missiles and hydrogen bombs’ provide ‘no defence of anything but extermination of almost everything’ (Sharp 1963, 78). These manifested into action when the MAPW encouraged members not to respond to a questionnaire circulated to all doctors asking advice in a hypothetical ‘fresh state of emergency’, regarded as a euphemism for nuclear war (Lewer 1992, 68).

Threat construction and ‘negative nukespeak’

Edward Schiappa coined a hypothetical ‘negative nukespeak’ to refer to ‘language used to condemn or negatively portray nuclear weapons, strategy, and war’ (Schiappa 1989, 255). Negative nukespeak is therefore language that demystifies, derationalizes, and denaturalizes the bomb. Others have used this analytical framework under different names to examine film or the press, but it is incredibly useful in this context (Bingham 2012, 624; Sylvest 2015, 105–106). One way the MAPW engaged in negative nukespeak was by satirically or sarcastically pointing to the absurdity of what historian Peter Kuznick referred to as the ‘quantum leap in destructive capability’ of nuclear weapons (Kuznick 2007, 411):

The generally accepted propaganda about the deterrence is – that our H bomb is to deter the Russians from using theirs, and presumably their deterrent H bomb is to deter us from bombing them. So our present idyllic state is due to existence of plenty H bombs on each side. We live under a rosy mushroom cloud of nuclear peace – very restful. (Brown 1963, 50)

At this point, the legality or illegality of these weapons ceases to matter; for, in such an eventuality, both sides are resolved on employing these weapons of mass destruction and prepared to expose themselves and their foes to co-extermination in a final orgy of mechanised barbarism. (Schwarzenberger 1963, 51)

Being a ‘voice of sanity’ that made the threat of nuclear weapons explicit was a founding value of the MAPW (Montuschi 1951, 116). This language works to precisely counter the naturalization of nuclear weapons’ continued presence, to point out the specific horror and destruction it leads to, and to argue that ‘even if you think conflict is inevitable, it need not be in terms of an exchange of nuclear bombardments’ (Storr 1963, 75). Andrew Bingham, referring to the press, argued that they ‘made the bomb meaningful’ with emotional appeals and the MAPW took a similar angle, visible in their founding letter: ‘each pound spent on bombs means … more dead babies now’ (Bingham 2012, 616; Doll et al. 1951, 170).

The organization was also keen to construct the threat outside its own circles by circulating pamphlets. Most offered gruesome, horrifying details, like ‘Facts on Fall-Out’ distributed in 1959 (MAPW GB 0532 MAP, 1959). One in particular from the late 1950s uses a particularly striking visual language, placing a circular radius the size of the Hiroshima blast over London and reminding the reader that ‘people in Japan are still dying from leukaemia as a result of this bomb’. Accompanying the image is a direct comparison between Japan, where ‘this already happened’ and London, where ‘this might happen’ (MAPW GB 0532 MAP, c1958). This was a common visual used to ‘make the bomb meaningful’ and examples from others place the radii over Manchester, New York, and London (‘If an Atomic Bomb Hit Manchester’, 1947, Feinberg 1960, frontispiece). Andrew Bingham notes the way these visuals in particular contribute to a nuclear intertextuality, becoming larger and ‘all the more troubling’ as new weapons are developed (Bingham, 2011, 617).

Pathogenesis of war

Pathogenesis is the study of how a disease is maintained within a system, as opposed to aetiology, which focusses on the causes (Witthöft, Gellman, and Turner 2013). During the early 1960s, the MAPW held three ‘Pathogenesis of War’ conferences which are only substantially considered in the secondary literature by Marinoff (2019) despite being an incredibly rich, prognostic discourse. In the introductory address, Duncan Leys mentions that, although ‘the conference on the pathogenesis of war is the first of its kind’, ‘to think of war as we think of disease and for a medical society to have war prevention as its single aim is nothing extraordinary’ (Leys 1963, 6–7).

Though metaphors of war in diagnosis are commonly deployed and commonly analysed – notably by Sontag (1989, 16) – metaphors of diagnosing war in prevention discourse have received only recent and sparse attention, particularly from Rodehau-Noack (2021, 1). These conferences used this analogy to prompt writers to ‘diagnose’ the reproduction of war from many perspectives. For example, psychologist Davis (1963, 33) wrote about maladaptive habit formation, asking whether it was ‘worthwhile going on trying to get nations to abandon the old habits of building up armaments against each other? Does not more hope lie in seeking to develop new habits, which will eventually supersede the old?’ He does not offer advice outside of psychology, but applies his own knowledge to prevention discourse, hoping to synthesize new ideas. Similarly, Lionel Penrose writes on both game theory and crowd theory, using both to critique deterrents (Uzunova 2021). The writers saw that the ‘complexity and extent’ of the problem necessitated the engagement of ‘many different disciplines’ (MacDonald 1963, 2). These conferences can be a striking example of interdisciplinary cooperation in peace studies, which is now far more common.

Resisting silencing

Rather than simply countering the dominant ‘nukespeak’ narrative with a counternarrative, the MAPW also resisted direct attempts to disempower their organization. In 1963, Aiden Crawley published ‘The Friendly Face of Communism’, which accused the MAPW and other organizations ‘whose objects appear to be the promotion of democracy […] and peace’ of being fronts for Communist activities (Debbs 1962). Many of these organizations became ‘ineligible for affiliation’ with the Labour Party later that year (Labour Party 1962). According to Greta Jones, the Labour Party would only usually ‘hold the line’ with nuclear weapons protest, but not take radical action of their own. This relationship between Crawley’s article and the list of organizations ineligible for affiliation, which the MAPW argued were directly connected, certainly deserves further study.

Although others on the list were self-identified communists, the MAPW vehemently disagreed (McIlroy 2017, 31). Member Phyllis Debbs wrote to Haddow that the conflation of peace organizations and communism within Crawley’s article could very well mean ‘England would be well on its way to McCarthyism’ (Debbs 1962). Haddow and Doll were incredibly concerned by these events and wrote many times to Crawley (Uzunova 2021). When he refused to compromise, Haddow threatened to make copies of the correspondence and mail it to all Labour executive committee members to prove his lack of evidence. This succeeded and the MAPW was reaffiliated the same year (Haddow 1962). In the third Pathogenesis of War conference, Haddow reminds attendants of the need to defend their beliefs ‘only a few years since doubts were cast on the need for the very existence of our Association’ (Haddow, 1963.b, 54).

Collaborating

Another key method of resistance attempted by the MAPW was collaborations between disciplines, to other activist organizations, and globally. Interdisciplinary collaboration has been touched on in terms of the Pathogenesis of War conferences, and many of the speakers felt their duties intersectionally, not least Katherine Lonsdale whose alliances were felt as a medical professional, a Quaker and as a global citizen (Lonsdale 1952, 222). Alexander Haddow’s duties were also multifaceted, he acted as part of multiple other nuclear research groups with different aims and policies, which allowed for contact with many collaborators (Laucht 2016, 237).

The MAPW’s global collaboration was their most contentious, being the motivation behind Crawley’s article. This can be historied as part of a wider movement to develop global health and human rights after the horrors of the second world war proliferated, using the ‘essential internationality’ of medicine as a springboard (Haddow 1963b, 59). To Haddow, the MAPW could be part of an eventual ‘supranational’ ‘concilium of world science’. (‘The Bombs’, 1954, 815). To enact this, the MAPW retained newspaper cuttings about similar anti-war, anti-nuclear organizations in Brussels, France, and China; they sent letters of friendship to both American and Russian organizations; and they considered ‘making an active contribution to medical relief work in Korea’ (‘Overture to Moscow’, 1951, 744). The group also sent members to observe other conferences. Dr Sawdon attended the Britain China Friendship Association (China being part of a group whose isolationism Haddow found particularly ‘serious’) and Alex Comfort was voted to attend the Authors’ World Peace Appeal (MAPW, 1952, Haddow, 1963.b, 63, MAPW, 1951). Appealing to global medical sensibilities of nations on both sides of a conflict is an idea that can certainly be reflected on in present circumstances.

Conclusions

Although it is important not to anachronize the early Cold War in terms of contemporary issues, we may still draw lessons from the similarities and differences of past actors. One might be an awareness of the unique link between medical science, conflict prevention, and nuclear disarmament. If we are unable to take at least some ‘responsibility in relation to the threat of war’, we cannot always expect politicians or military strategists to fulfill their own duties in similar ways (Comfort n.d., 4). This is especially true where nukespeak is still used by political actors Russia, the US, and the UK (Egeland 2022, 1).

The MAPW felt they could overcome this language in many ways, not only by spreading the truth, but also through language deconstruction like Alex Comfort’s News Game, or their use of analogy. Other threat construction symbols of this period, like the Doomsday clock, are still used today which speaks to their potential longevity. Even Medact’s Holdstock-Piachaud student essay competition has a comparable precedent back in 1956, when the MAPW ran the J. A. Ryle memorial prize for the best student essay on a ‘world approach to human survival and health’ (‘J. A. Ryle Memorial Prize’, 44). Perhaps, the most surprising aspect is the false-start of the Pathogenesis of War conferences. Perhaps this interdisciplinary, collaborative diagnosis of war could be one method to revise in the current day.

Disclosure statement

No potential conflict of interest was reported by the authors.