Sunday, October 3, 2021

Between Chernobyl and Covid-19, Dr. Alla Shapiro calls for reflection

Book review for “Doctor on Call: Chernobyl responder, Jewish refugee, radiation expert”, by Dr. Alla Shapiro. Mandel Vilar Press, 2021.

  The cover illustration of the "Doctor on Call: Chernobyl responder, Jewish refugee, radiation expert", includes two distinct images. In the bottom image, we see the 4th reactor of the Chernobyl nuclear station and the abandoned buildings of Pripyat, the closest town to Chernobyl power station that housed its employees before the explosion. The top picture is a peaceful view of the American capital dominated by the iconic Washington Monument. Young pediatrician Alla Shapiro from the Hematology Unit of the Kiev Children Hospital couldn't have imagined on the morning of April 26, 1986, that her life would irreversibly change and the rest of it will revolve around those two places: Washington, D.C. and Chernobyl, Ukraine. Washington will become her second home after she leaves the turbulent Kiev of the 1980s; the Chernobyl chapter of her life will manifest itself throughout her work as a radiation expert, and as a patient of radiation-induced cancer, a sinister reminder from April 1986.

          With breathtaking simplicity and sincerity Dr. Shapiro unfolds her odyssey from her native city, Kiev, which began when she was called to treat the children evacuated from the town of Pripyat in the immediate aftermath of the explosion at the Chernobyl nuclear station. The journey starts more than 30 years ago in the Soviet Union, still a superpower, whose imminent collapse is not being envisaged even by the most audacious Sovietologists. Dr. Shapiro’s scrupulous description of the first days and weeks after the disaster reconstructs the harsh realities of the Soviet Union after the explosion. In the first part of the book, we see dreadful images of the ongoing tragedy, with Chernobyl patients overcrowding Kiev hospitals, and medical personnel’s heroic but all too often hopeless efforts to help them. These pictures are intertwined with the author's own desperate and at times futile struggle to keep her own family safe. The scene of Alla Shapiro detecting radiation on the stuffed toy animals of her daughter, or the story of author’s mother Nelly, a scientist herself, who tried to bring her daughter home-made “radiation clean” food from Kiev to Narodichi, are simply unforgettable.

  But beyond the pictures of the unfolding tragedy in the country caught by an absolute surprise and emergency unpreparedness, Dr. Shapiro makes her vigorous diagnosis on the reasons for the failure of the first response to the Chernobyl disaster. The Kiev pediatrician, who out of necessity became a first responder in the unprecedented nuclear catastrophe, reveals how the Soviet policy of secrecy, deliberate hiding of scientific information and absence of transparent communication with the population severely aggravated the crisis causing it to lose control. This simple but powerful insight will forcefully resonate again in the last part of the book that deals with critical preparedness and handling of the world crisis of our time, the Covid-19 pandemic. 

  One of the more powerful passages about the Soviet “web of lies and deceit” in dealing with the Chernobyl disaster, in my eyes, appears in the chapter named “A Radioactive fallacy”.  During her deployments as the head of the medical team to the radiation-contaminated areas, she became fully aware of the insuperable contradiction between the facts, data, scientific analysis, and the directives of the Soviet government whose interest was to downplay the danger and hide the real situation from its own citizens. As a doctor, she was forced to be part of this mechanism she aptly calls “the ladder of lies'', under the threat of losing her job forever.

  As a result, total disappointment with the Soviet system, even a sense of betrayal, felt by Dr. Shapiro and millions of her fellow citizens was one of the main psychological fallouts of Chernobyl. This fresh trauma coincided for her and her family with another wound inflicted on the Jews of the Soviet Union. The second part of the book opens with Dr. Shapiro’s recollection of her and her family’s experience with the “established fact of life” in the Soviet Union, namely the persecution of the Jewish people. Decades before the Chernobyl disaster, the Jewish population of the USSR had already learnt first-hand about the falsehoods of the Soviet propaganda, the insurmountable gap between the communist slogans of brotherhood of nations and the despairing reality of discrimination and antisemitism in USSR. Dr. Shapiro is not trying to answer the question why this happened. She only describes the facts of the discrimination and its psychological impact. But following this endless story of humiliation and prejudice, we, as readers, cannot resist asking those questions. How did it happen that a country who fought and defeated Nazi Germany ended up with the state-supported antisemitism of its own? Why the Jews were systematically persecuted and discriminated against since Joseph Stalin’s rule and almost till the final collapse of the Soviet Union? And what comparisons and lessons can we draw from the Soviet model of antisemitism today, in the year 2021, when physical violence against Jews and all other types of antisemitism, from conspiracy theories to digitally promulgated slanders, are on the rise in Europe, US and in the Middle East? 

          The Chernobyl tragedy and the trauma of antisemitism would be a sufficiently hard life experience for one person, but in 1989 Alla Shapiro was up for another challenge: immigration. The hardships of her family exodus from the Soviet Union, the time they spent in the temporary refugee camp in Italy and the pains of adapting to a new life in the United States will be familiar to any person who underwent immigration. Those of us who had this experience would agree that the life of an immigrant oscillates between periods of despair and uncertainty with time of accomplishments and success, mingled with amusing moments of confusion and silly mistakes. Alla Shapiro eagerly shares with us such comic and incredible situations, like hitchhiking in the car of the Italian movie star Michele Placido or her unsuccessful “escape” from the highway police on Wisconsin Avenue. The immigrant life, with all its ups and downs, looks suddenly less stressful, less tragic, more manageable experience; it also has a logic of gradual adjustment, of settling down, of taking root, particularly in the country that is built on immigration ethos. It is by all accounts a more bearable challenge than a nuclear disaster or antisemitism. 

  With determination and resolve, Alla Shapiro had succeeded to overcome the language barrier, to pass recertification exams and to establish her medical credentials in America, opening for her a career path in pediatric oncology. But very soon her Chernobyl experience was required by the United States government and U.S. defense agencies involved in research on anti-radiation drugs. She joined a fellowship at the National Health Institute, was invited to speak at scientific conferences, and at the same time volunteered to work with children of Chernobyl suffering from different types of cancer.  Subsequently Dr. Shapiro became deeply involved in research and development of drugs to be used in radiological or nuclear incidents. And one day she went to Kiev, as representative of the FDA’s Office of Counterterrorism, to speak at the international conference dedicated to the 20th anniversary of the Chernobyl disaster. During her flight she heard from another passenger about the new “hot” tourist destination in Ukraine, the ghost town of Pripyat... But enough with spoilers, I will leave it for you to discover if Alla Shapiro eventually came back to Chernobyl. 

  This visit to Kiev, 20 years after the Chernobyl disaster, could probably be an ideal ending for a book of fiction. But the life of Alla Shapiro had one more dramatic twist of fate. A sinister personal reminder from Chernobyl. While working on the development of the medications that can help fight radiation, she was herself diagnosed with cancer - radiation-induced cancer. 25 years after the explosion she was again in the oncological department, this time as a patient. After her first chemotherapy treatment session she starts to write this book. 

  The readers will like “Doctor on call” for different reasons. First and foremost, it is a truly incredible personal story of a courageous woman, as we say in Hebrew “Eishet Chayil”, the Women of Valor. The eyewitness authentic accounts of the Chernobyl tragedy and of the antisemitism in the Soviet Union are a valuable contribution to our understanding of those phenomena, both for professional and ordinary audiences. No doubt, many people will enjoy the cultural and historical references abundant in the book and will smile while reading about the adventures of Alla Shapiro the immigrant. But in my eyes, the greatest value of the book is the inducement to reflect on the current realities through the prism of past experiences. I believe this is the book’s major message, that is why the author shares her concerns, assessments, and recommendations on the best response to the Covid19 pandemics, which she argues must be based on data, science, and transparency. 

As an American citizen, Dr. Shapiro is primarily concerned with US critical preparedness, and I am sure the readers will appreciate her thoughts on how the government should better tackle the pandemic in the country. However, the topics raised in the book have global implications, far beyond the United States. The Chernobyl tragedy demonstrated that by hiding information from its own population any government will run the risk of a crisis that gets out of control. Was this lesson learned when coping with the Covid-19 pandemic? Definitely not. Just look at the phenomenon of “infodemics” around the coronavirus. At the anti-vax conspiracy theories spread on social media. Or the fact that in this age of information, a year and a half after the outbreak of the pandemic, we still don’t have a clear picture about the origins of the virus.  

  Dr. Shapiro tells how back in 1986, scientists from neighboring countries alerted the international community about the nuclear explosion in the Soviet Union. 35 years later, we see global campaigns destined to undermine the vaccination efforts, to spread false information and to deliberately discredit efforts of rival countries to struggle with pandemics. Be it the “prestige” of the superpower, as was the case in the USSR, or some obscure geopolitical calculations as might be the case today, the lesson of transparency was not learned. The Chernobyl crisis management by the Soviet leadership revealed how the policies of information manipulation could backfire and be self-destructive. When it comes to the Covid-19 pandemic, democratic countries might have difficulty in resorting to lockdowns and other harsh measures, but they could swiftly accommodate social and political pressures and change leadership to cope with the crisis. The story is different for authoritarian regimes. The Chernobyl disaster overwhelmed the people in the Soviet Union and led to the USSR's inevitable collapse 5 years later, a result of a pervasive and insurmountable loss of trust in the system. As to the Covid-19 pandemic, it is too early to say what would be its long-term political fallout but judging by the past events it is unavoidable.

Those are my first personal reflections after reading “Doctor on call”. At heart, this is a book of reflection, not just a memoir, and a significant dose of reflection is what we all need today. No less than an effective vaccine.