Dr. Sasaki and his colleagues at the Red Cross Hospital watched the unprecedented disease unfold and at last evolved a theory about its nature. It had, they decided, three stages. The first stage had been all over before the doctors even knew they were dealing with a new sickness; it was the direct reaction to the bombardment of the body, at the moment when the bomb went off, by neutrons, beta particles, and gamma rays. The apparently uninjured people who had died so mysteriously in the first few hours or days had succumbed in this first stage. It killed ninety-five per cent of the people within a half mile of the center, and many thousands who were farther away. The doctors realized in retrospect that even though most of these dead had also suffered from burns and blast effects, they had absorbed enough radiation to kill them. The rays simply destroyed body cells—caused their nuclei to degenerate and broke their walls. Many people who did not die right away came down with nausea, headache, diarrhea, malaise, and fever, which lasted several days. Doctors could not be certain whether some of these symptoms were the result of radiation or nervous shock. The second stage set in ten or fifteen days after the bombing. The main symptom was falling hair. Diarrhea and fever, which in some cases went as high as 106, came next. Twenty-five to thirty days after the explosion, blood disorders appeared: gums bled, the white-blood-cell count dropped sharply, and petechiae appeared on the skin and mucous membranes. The drop in the number of white blood corpuscles reduced the patient’s capacity to resist infection, so open wounds were unusually slow in healing and many of the sick developed sore throats and mouths. The two key symptoms, on which the doctors came to base their prognosis, were fever and the lowered white-corpuscle count. If fever remained steady and high, the patient’s chances for survival were poor. The white count almost always dropped below four thousand; a patient whose count fell below one thousand had little hope of living. Toward the end of the second stage, if the patient survived, anemia, or a drop in the red blood count, also set in. The third stage was the reaction that came when the body struggled to compensate for its ills—when, for instance, the white count not only returned to normal but increased to much higher than normal levels. In this stage, many patients died of complications, such as infections in the chest cavity. Most burns healed with deep layers of pink, rubbery scar tissue, known as keloid tumors. The duration of the disease varied, depending on the patient’s constitution and the amount of radiation he had received. Some victims recovered in a week; with others the disease dragged on for months.

As the symptoms revealed themselves, it became clear that many of them resembled the effects of overdoses of X-ray, and the doctors based their therapy on that likeness. They gave victims liver extract, blood transfusions, and vitamins, especially B1. The shortage of supplies and instruments hampered them. Allied doctors who came in after the surrender found plasma and penicillin very effective. Since the blood disorders were, in the long run, the predominant factor in the disease, some of the Japanese doctors evolved a theory as to the seat of the delayed sickness. They thought that perhaps gamma rays, entering the body at the time of the explosion, made the phosphorus in the victims’ bones radioactive, and that they in turn emitted beta particles, which, though they could not penetrate far through flesh, could enter the bone marrow, where blood is manufactured, and gradually tear it down. Whatever its source, the disease had some baffling quirks. Not all the patients exhibited all the main symptoms. People who suffered flash burns were protected, to a considerable extent, from radiation sickness. Those who had lain quietly for days or even hours after the bombing were much less liable to get sick than those who had been active. Gray hair seldom fell out. And, as if nature were protecting man against his own ingenuity, the reproductive processes were affected for a time; men became sterile, women had miscarriages, menstruation stopped.

For ten days after the flood, Dr. Fujii lived in the peasant’s house on the mountain above the Ota. Then he heard about a vacant private clinic in Kaitaichi, a suburb to the east of Hiroshima. He bought it at once, moved there, and hung out a sign inscribed in English, in honor of the conquerors:

M. FUJII, M.D. MEDICAL & VENEREAL

Quite recovered from his wounds, he soon built up a strong practice, and he was delighted, in the evenings, to receive members of the occupying forces, on whom he lavished whiskey and practiced English.

Giving Miss Sasaki a local anaesthetic of procaine, Dr. Sasaki made an incision in her leg on October 23rd, to drain the infection, which still lingered on eleven weeks after the injury. In the following days, so much pus formed that he had to dress the opening each morning and evening. A week later, she complained of great pain, so he made another incision; he cut still a third, on November 9th, and enlarged it on the twenty-sixth. All this time, Miss Sasaki grew weaker and weaker, and her spirits fell low. One day, the young man who had lent her his translation of de Maupassant at Hatsukaichi came to visit her; he told her that he was going to Kyushu but that when he came back, he would like to see her again. She didn’t care. Her leg had been so swollen and painful all along that the doctor had not even tried to set the fractures, and though an X-ray taken in November showed that the bones were mending, she could see under the sheet that her left leg was nearly three inches shorter than her right and that her left foot was turning inward. She thought often of the man to whom she had been engaged. Someone told her he was back from overseas. She wondered what he had heard about her injuries that made him stay away.

Father Kleinsorge was discharged from the hospital in Tokyo on December 19th and took a train home. On the way, two days later, at Yokogawa, a stop just before Hiroshima, Dr. Fujii boarded the train. It was the first time the two men had met since before the bombing. They sat together. Dr. Fujii said he was going to the annual gathering of his family, on the anniversary of his father’s death. When they started talking about their experiences, the Doctor was quite entertaining as he told how his places of residence kept falling into rivers. Then he asked Father Kleinsorge how he was, and the Jesuit talked about his stay in the hospital. “The doctors told me to be cautious,” he said. “They ordered me to have a two-hour nap every afternoon.”

Dr. Fujii said, “It’s hard to be cautious in Hiroshima these days. Everyone seems to be so busy.”

A new municipal government, set up under Allied Military Government direction, had gone to work at last in the city hall. Citizens who had recovered from various degrees of radiation sickness were coming back by the thousand—by November 1st, the population, mostly crowded into the outskirts, was already 137,000, more than a third of the wartime peak—and the government set in motion all kinds of projects to put them to work rebuilding the city. It hired men to clear the streets, and others to gather scrap iron, which they sorted and piled in mountains opposite the city hall. Some returning residents were putting up their own shanties and huts, and planting small squares of winter wheat beside them, but the city also authorized and built four hundred one-family “barracks.” Utilities were repaired—electric lights shone again, trams started running, and employees of the waterworks fixed seventy thousand leaks in mains and plumbing. A Planning Conference, with an enthusiastic young Military Government officer, Lieutenant John D. Montgomery, of Kalamazoo, as its adviser, began to consider what sort of city the new Hiroshima should be. The ruined city had flourished—and had been an inviting target—mainly because it had been one of the most important military-command and communications centers in Japan, and would have become the Imperial headquarters had the islands been invaded and Tokyo been captured. Now there would be no huge military establishments to help revive the city. The Planning Conference, at a loss as to just what importance Hiroshima could have, fell back on rather vague cultural and paving projects. It drew maps with avenues a hundred yards wide and thought seriously of preserving the half-ruined Museum of Science and Industry more or less as it was, as a monument to the disaster, and naming it the Institute of International Amity. Statistical workers gathered what figures they could on the effects of the bomb. They reported that 78,150 people had been killed, 13,983 were missing, and 37,425 had been injured. No one in the city government pretended that these figures were accurate—though the Americans accepted them as official—and as the months went by and more and more hundreds of corpses were dug up from the ruins, and as the number of unclaimed urns of ashes at the Zempoji Temple in Koi rose into the thousands, the statisticians began to say that at least a hundred thousand people had lost their lives in the bombing. Since many people died of a combination of causes, it was impossible to figure exactly how many were killed by each cause, but the statisticians calculated that about twenty-five per cent had died of direct burns from the bomb, about fifty per cent from other injuries, and about twenty per cent as a result of radiation effects. The statistician’ figures on property damage were more reliable: sixty-two thousand out of ninety thousand buildings destroyed, and six thousand more damaged beyond repair. In the heart of the city, they found only five modern buildings that could be used again without major repairs. This small number was by no means the fault of flimsy Japanese construction. In fact, since the 1923 earthquake, Japanese building regulations had required that the roof of each large building be able to bear a minimum load of seventy pounds per square foot, whereas American regulations do not normally specify more than forty pounds per square foot.