Introduction
You live in a world where modern technology holds the power to erase entire cities in a single flash. Understanding this absolute threat requires looking beyond statistics to witness the human reality of nuclear warfare.
Michihiko Hachiya records this reality as director of the Hiroshima Communications Hospital. He documents his own severe injuries and the struggles of his staff from August 6, 1945, through September 30, 1945. You follow his daily entries detailing the immediate chaos, the mysterious progression of radiation sickness, and the eventual arrival of American occupation forces.
The book is structured into a chronological diary that moves from catastrophic destruction to medical investigation and social rebuilding. How did ordinary citizens survive total physical ruin? What governed the strange and fatal symptoms that emerged weeks after the blast? How did a shattered society rebuild its morale under foreign occupation?
1. The Immediate Aftermath and Hospital Operations
The atomic bombing unleashed an unprecedented wave of human and physical destruction, forcing survivors to adapt through emotional detachment and immediate emergency measures.
Dr. Michihiko Hachiya kept an intimate daily record of the atomic bombing's aftermath while recovering as a patient and director in his own hospital. Severely injured by the blast effects with around 150 scars, Dr. Hachiya began logging his convalescence and observations on August 8, 1945. The record was originally published serially in a small Japanese medical journal without any initial intention of wider book publication.
Iconography of Devastation
The immediate aftermath of the atomic bomb produced a haunting and recognizable iconography of human and physical destruction. Survivors experienced a stunning flash followed by a colossal blast that shattered distant buildings. People walked like automatons with skin peeling off, and the city filled with severe burns, silence, corpses frozen in flight, and clogged rivers.
Dr. Hachiya frequently encountered a nameless beautiful girl who suffered severe burns everywhere except her face, initially lying in a puddle of blood and pus before gradually recovering the ability to stand.
Hospital Setting and Staff Structure
The Hiroshima Communications Hospital served as an essential institutional setting for the diary, operating under specific structural capacities prior to the bombing. The hospital served employees of the Ministry of Communications and was located about 1,500 meters from the hypocenter of the bomb, adjacent to reinforced concrete structures that survived the blast. Dr. Hachiya exercised his own authority to evacuate in-patients to the interior prior to the raid, leaving the hospital practically empty when the bomb fell.
Human psychology under extreme catastrophe adapts rapidly through emotional numbing, allowing survivors to accept horrifying spectacles of death and destruction as routine. Faced with an unprecedented landscape of corpses, mass cremations, and rotting filth, the human mind develops a profound detachment. Dr. Hachiya and other survivors found themselves treating mass death, makeshift cremations beside active bathtubs, and human suffering with clinical indifference and equanimity.
Mr. Kitao operated the hospital crematory with nonchalant expertise, while patients bathed next to funeral pyres without expressing horror. During the first night at the Communications Hospital, 16 patients died, while about 150 patients were packed into every nook and cranny.
The total destruction of urban infrastructure creates severe public health crises, characterized by unmanageable human waste, hordes of flies, and rampant scavenging. Without running water, electricity, or waste management systems, hospitals and shelters were overrun by patients, refugees, and corpses. Human waste accumulated rapidly, breeding massive swarms of flies, while desperate citizens looted military supply dumps for basic survival goods.
The hospital entrance became covered in feces and vomit due to a lack of bedpans, and the surrounding ruins became breeding grounds for enormous swarms of human flies dubbed nimbai.
2. Medical Findings on Radiation Sickness
Medical observation and microscopic analysis uncovered a mysterious secondary scourge of agranulocytosis and platelet failure driven by proximity to the hypocenter.
Patients who initially appeared to be improving suddenly worsened. They showed symptoms like subcutaneous bleeding, hair loss, bloody diarrhea, and vomit. Autopsies revealed massive internal hemorrhages. Blood counts showed critically low white blood cells and destroyed platelets.
Dr. Hachiya and his colleagues identified that all patients dying from these erratic internal hemorrhages were within one kilometer of the bomb's hypocenter.
Symptoms and Blood Suppression
Radiation sickness presents a delayed onset of bizarre and devastating symptoms. These include severe gastrointestinal distress, epilation, and petechiae. They occur independently of initial physical injuries.
Patients who initially seemed to recover later developed alarming problems. They suffered from vomiting, bloody diarrhea, gangrenous tonsillitis, loss of hair, and pinpoint subcutaneous hemorrhages. These symptoms frequently appeared together. They were governed by a sharp drop in white blood cells.
Mrs. Hamada and Miss Kobayashi initially recovered from their wounds and vomiting. They only experienced an acute exacerbation of malaise, widespread petechiae, epilation, and fatal complications later.
With the arrival of a functioning microscope from Tokyo, doctors conducted blood counts. They discovered that patients near the hypocenter had critically suppressed white blood cell counts. These counts often hovered around 1,000 or fewer compared to normal levels of 6,000 to 8,000. This explained their vulnerability to infections and hemorrhages.
Dr. Hachiya and his colleagues tested themselves and patients. They found that white blood counts directly correlated with radial distance from the hypocenter. Those further away showed normal counts.
Autopsy Discoveries and Statistical Correlation
Autopsies reveal that internal organs suffer widespread hemorrhaging and loss of blood coagulating power. This clarifies the internal mechanisms of radiation death.
An autopsy performed on a deceased patient showed that petechiae and hemorrhages were not limited to the skin. They penetrated nearly all internal organs, including the stomach, intestines, liver, and abdominal cavity. This occurred alongside a total loss of blood coagulation.
Dr. Hachiya and Dr. Katsube performed an autopsy on Miss Kobayashi. They discovered her abdominal cavity filled with uncoagulated bloody fluid and petechial spots covering her internal organs.
Through systematic autopsies and blood examinations, medical staff discovered that blood clotting failure was due to a complete disappearance of blood platelets. While initial observations focused solely on low white blood cell counts, researchers realized that petechiae and fatal hemorrhages resulted directly from platelet failure.
Miss Nishii, a sixteen-year-old girl exposed 500 meters from the hypocenter, developed severe epilation and petechiae. She died of suffocation and internal bleeding on August 29. Autopsies on patients like Mr. Onomi and Mrs. Chodo revealed extensive hemorrhages in critical organs such as the heart wall and abdominal cavity.
By conducting statistical analyses of over two hundred patient records, Dr. Hachiya concluded that victims exposed within 500 meters outdoors died almost instantly or within days. Those within 500 to 1,000 meters suffered delayed yet severe symptoms and a high mortality rate. Patients shielded by heavy reinforced concrete buildings experienced minimal symptoms even close to the center.
Dr. Hachiya mapped patient positions onto circles drawn at 500, 1000, 1500, and 2000 meters from the Hiroshima post office. He noted that unshielded individuals within 1,000 meters suffered the highest rates of fatal blood dyscrasia and epilation.
The arrival of outside medical teams and emergency relief supplies restores operational capacity and morale to devastated hospital staffs.
As local medical resources exhausted themselves, teams of doctors, nurses, and supplies dispatched from other cities provided vital reinforcement. Their competence, optimism, and concrete material aid helped stabilize the chaotic hospital environment.
Dr. R. Norioka arrived from the Osaka Communications Hospital with a team of assistants and supplies. He acted like a merciful rain during a drought and lifted the spirits of the weary staff.
Operational recovery depended on structured emergency measures:
- Sort and prepare meager supplies of drugs under strict supervision.
- Organize ambulatory patients, clerks, and janitors into working support teams.
- Establish crude outdoor isolation wards using straw mats to contain suspected dysentery outbreaks.
3. Public Panic, Rumors, and Treatment Remedies
Destruction bred panic-inducing rumors of a seventy-five-year curse, which doctors successfully combated through physical examinations and simple nutritional home remedies.
The complete absence of communication channels, books, and radios led to widespread rumors. Citizens panicked over claims that Hiroshima would be uninhabitable for seventy-five years or that a lingering poison gas was killing healthy people who entered the city after the blast. Chief Kitajima and other officials repeated the ominous claim that no one could live in Hiroshima for the next seventy-five years, causing widespread desertion among workers until Dr. Hachiya posted corrective notices.
You can counter such fear with systematic verification. To combat widespread panic, the hospital staff began examining individuals who entered the city from the suburbs after the blast. Finding normal white blood cell counts between 5,000 and 7,000 in these late arrivals, the doctors successfully disproved the presence of lingering poison and published their findings in local newspapers. Dr. Hachiya and Professor Tsuzuki independently announced their findings to the public and staff in late August and early September.
Combatting Rumors
- Post clear notices based on verified blood counts to dispel panic and rumors.
- Instruct healthy workers who were not present during the blast to continue their duties without fear.
- Advise persons with low white blood cell counts to avoid injury, exertion, and infection.
Dietary Remedies and Economic Conditions
Drawing on the ancient Chinese proverb that patients with an appetite will not die, Dr. Hachiya observed that ten critically ill patients given ample food without heavy injections experienced a smoother recovery. Dr. Hachiya applied this dietary rule to a group of ten patients, ensuring they received maximum care for wounds alongside generous food portions, resulting in faster convalescence compared to heavily medicated patients.
- If the white blood count is low or radiation symptoms are present, remain quiet and eat plenty of good food.
- Even those showing no trouble should eat more than usual.
- Sick individuals should try to eat as much as possible.
Due to severe shortages and hyperinflation, standard currency lost its purchasing power, causing the value of cigarettes to soar exponentially. A pack of Kinshi cigarettes that originally cost thirty-five sen at the end of the war escalated to trade between three hundred and five hundred sen in the ruins of Hiroshima.
Unceasing autumn rains and a violent typhoon in early September destroyed temporary shacks, flooded hospital rooms, and saturated bedding. During the typhoon on September 17, high winds tore down improvised window screens, flooding the rooms and forcing patients and refugees to hug the walls in knee-deep water while lighting failed completely. Dr. Hachiya himself contracted acute dysentery characterized by severe tenesmus, bloody mucus, and prostration.
- Isolate patients suffering from acute gastrointestinal distress.
- Administer sulfaguanidine and codeine to control infection and tenesmus.
- Restrict dietary intake strictly to rice gruel and hot sugar water during recovery.
4. Surrender, Loyalty, and the Occupation
The Emperor's surrender broadcast shattered national morale into kyodatsu, while initial fear of Allied occupation troops gave way to surprisingly amicable relations.
The Surrender Shock
The Imperial Proclamation of Surrender on August 15 produced a psychological shock that rivaled the atomic bomb itself. You watched as the announcement of unconditional surrender, framed by the Emperor's injunction to bear the unbearable, stunned staff and patients into silence. Intense outrage erupted against the military leadership who had concealed losses, abused power, and forced the nation into defeat.
Chief Okamoto relayed the news in the Communications Bureau, and angry denunciations of the military immediately followed. Acquaintances of Dr. Hachiya risked walking through the dead and dying to rescue the Emperor's sacred photograph from the hospital to a safer place.
Mr. Ushio, Mr. Yasuda, and Mr. Oishi formed an escort team that carried the Emperor's picture through burning debris to the dikes of Asano Sentei Park. Cheering and saluting crowds opened a path for them while soldiers and civilians viewed the preservation of the portrait as a sacred duty.
Defeat ushered in kyodatsu, a national state of psychological prostration, exhaustion, demoralization, and rampant corruption. Cities filled with aimless wanderers, demobilized soldiers, and beggars amidst widespread inflation, looting, burglary, and inept local officials profiting from misery.
Dr. Hachiya observed a poor woman walking through the rubble near Hiroshima station wearing her wedding kimono and carrying a sack of sweet potatoes, serving as an emblem of the kyodatsu state on September 15.
Wartime Loyalty and Encountering Occupiers
Initial severe apprehension and fear regarding the arriving Allied occupation forces quickly dissolved into surprisingly amicable relations. While local women and staff initially fled or feared atrocities due to projections of how Japanese soldiers had behaved in occupied lands, the American occupation troops behaved with restraint, friendliness, and generosity.
When two American officers visited the hospital on September 29, Dr. Hachiya conducted a tour despite his weakness. The officers parted by smilingly saying konnichi wa instead of sayonara, prompting laughter and relief among the staff.
Old Mrs. Saeki, despite losing her husband and three sons in the war, concluded after a visit from young American officers that they were kind and very nice.
American medical investigating committees arrived in Hiroshima by mid-October to study radiation sickness. Professor Sasa of Tokyo University brought an investigating committee of Americans toward the middle of October, and they remained in Hiroshima for about a month.
Doctors J. Philip Loge and Calvin O. Koch, along with pathologist Dr. Averill A. Liebow, visited the hospital. Dr. Loge came to the hospital every day and spent all his spare time examining patients, bridging the language gap through shared feelings.
Colonel John R. Hall, Jr., operated from his headquarters in Kure as chief surgeon and frequently visited the hospital. Colonel Hall brought high officials from various countries and introduced patients with radiation sickness, including the author, to General Patterson.
The author noted on 10 April 1952 that recalling the kindness of these people allows one to overlook thoughts of revenge and feel warmth in the heart. Compassionate interactions with former adversaries removed fear and hostility, replacing them with hope for the harsh winter ahead.
10 Key Ideas
- Dr. Michihiko Hachiya recorded his intimate daily convalescence and medical observations as director and patient of the Hiroshima Communications Hospital starting August 8, 1945.
- The immediate atomic aftermath produced a haunting iconography of devastation featuring survivors walking like automatons, severe burns, mass cremations, and rotting filth.
- Extreme catastrophe induced rapid psychological numbing, allowing survivors and staff to treat mass death and rotting filth with clinical indifference.
- Medical investigations and autopsies linked delayed radiation sickness to proximity to the hypocenter, white blood cell suppression, and fatal platelet failure.
- Outside medical teams and relief supplies provided vital reinforcement that lifted the spirits of the weary hospital staff and stabilized operations.
- Hospital staff combated panic-inducing rumors about a seventy-five-year curse by examining late arrivals and publishing verified normal white blood cell counts.
- Dr. Hachiya observed that critically ill patients given ample food and care without heavy medical injections experienced a smoother recovery.
- The Imperial Proclamation of Surrender on August 15 shattered national morale, causing intense outrage against military leadership and sparking efforts to save the Emperor's sacred photograph.
- Japan's defeat ushered in kyodatsu, a national state of psychological prostration, exhaustion, and rampant corruption symbolized by aimless wanderers and beggars.
- Initial fear of Allied occupation forces gave way to surprisingly amicable relations as American doctors and officers showed kindness, generosity, and compassion.