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?. ~lMC) R„rTDU'' TO: T. V. Hartnett July 13, 1956 rROt:: R. C. Hockett SU3JECT: Visit to Dr. ";"illiari S. h'iddleton, Chief Medical Director, Veterans Administration, 'Nashington, D. C. On Tuesday, July 10, T. V. Hartnett and R. C. Hockett called upon Dr. 14. '. Middleton, Chief 1:!edical Directcr of the Veterans Administration in 7,iashington. ;'!e arrived at his office at 11:00 A.?a. and spent about one hour with him. Dr. Jaiddietcn has held his present position for about seventeen months, having previously been Dean of the University of ',irisconsin Medical School for twenty years. In all, Dr. Middleton spent forty-three years at the University of Wisconsin Medical School graduating from the University of ' Pennsylvania Medical School in 1911. Dr. Middleton's field is'internal medicine. H'e is 66 years old and has a considerable record of service in World tiYari I. Dr. Middleton was very cordial'.' He opened the discussion by expressing'his personal opinion that the possible relationio,f smokingto 'lu.na cancer is an entirely open question, that the "waters are muddy": and that; a great deal of work would be required to clear up the issues. He also 'said that;the whole!pr'oblem appeared to be in a state similar tc that which existed a few years ago when alcohol was believed to "cause" cirrhosis of the live~r. It turn;en nut ' eventually that cirrhosis is caused by certain dietary deficielncies and not by alcohol. Because some alcoholics consume an inadequate diet, there is an "associ ation" between alcoholis~:, and liver cirrhosis, but alcohol will never produce cirrhosis in a person who cets the right food. rur. Middleton volunteered the mention of T.I.R.C.'s Scientif:ic A^visory Board and expressed the h;ghest regard for its membersi,, nearly a''ll ef i whom he knows personally. He repcrted that Dr. Reimann had consulted him irn connection with plans for the :Dazhologic-anatomic study of human lungs and that he had recommended inclusion of Sr. D. Murray Angevine of the University o: "isconsin as a participant. This recommendation was accepted and Dr. Angavine has been a participant since the beginning of the study. Dr. Middleton was still at 'r'lisconsin when negotiations were begun on placing a student summer fellowship at the University. He expressed enthusiastic approval of tnis feliowship program. ~.'r. Hartnett explained in full the set-up of the Tobacco In ustry Research Committee and its relation -c the 'Scientific Advisory Board, the comUlete freedom of the latter to plan and ;c:plement its research program, the policy cf unrestricted publication of grantlee findings in scientific journals, etc. ..e also described the fello',vs'rii piip progra:~~ and its purposes and made clear the lir..itaticns on T.I.R.';. activities under z::e anti-trust laws.

- 2 - T. V. Hartnett July 13, 1956 The matter of :;r. Auerbach's study came up and the Life ;..acazine story on this work. Dr. Middleton expressed vigorous disapproval of this kind o: reporting of medical research and said he would have discouraged the Life publication if he had known about it in advance. The indications seemed to be that the VeterGns Administration does not try to keep a tight rein on physicians in its hospitals in such matters. They are given freedom to publish but any publications express the views of the individual scientists and are not to be construed as expressing official views of the Administration. Dr. M!iddleton expressed confidence in Dr. Jjuerbach' s integrity, competenCe and dedication as a scientist. He said he had read the original reports f or comparison with the Life story and had found Dr. Auerbach's conclusions to be guarded and objective. The Life story was over-simplified and read in implica-,ions that were not in the original report. Dr. Middleton expressed the opinion that Dr. Auerbach did not himself seek the Life publicity but was urged into it by someone else; by whom, he did not know. Mr. Hartnett made it clear that in such cases, the T.I.R.C. has no quarrel with the scientists but is concerned about editorial policies of magazines and makes an effort to find out whether they intend to publish unbiased new;s or to promote some particular viewpoint. If they wish to do unbiased reporting they are urged to check storh.es and repbits with T.I.R.C. , The recent correspondence of Mr. Cullman over the Auerbach story in Life was mentionbd,~and the relationship of Mr. Cullman to the T.I.R.C. was explained. '' D'iscussion was also had over the Veterans Administration study of lung cancer incidence and smoking habits. The great interest of T.I.R.O. in this study was explained and the hope was expressed that S.A.B. scientists or their represent8tives might havei a part in review of the findings and their interpretation. Some fear wa,s expressed that the interpretation might all fall into the hands of a few persons whn already have corrr..it teed themselves to a particular poi I nt-of-view., 5r. Hiddleton :.xplained that the work-up of data in this study' has been put wholly into the hands of the National Cancer Institute and the Veterans Administration personnel :,rould not be participating further. He di.: express the view that in a matter of such importance the 5.A.3. scientists s;ould be consulted in the process of drawing conclusions from the data, and agreed -,., make this suggestion to the National Cancer Institute. The possibility of dra,ri,1g Dr. 3erkson into consultation was mentioned and Dr. F.iiddleton expressed ad^ira--iorn for Berkson and approval of the idea. !e orcmised to send Dr. 1: iddleton inf ormation about the T. I.:..:.. program including a copy of the f crthcomina progress report and to keep him cL7er.vise posted on T.I.:?.C. activities and . rogress. ~.~J..1. cc: . T . Y?oyt ~. :I. Darrow C. ;. ;'ho -:oson