access to VA records, but a prolonged slippage in its influence with the Veterans Administration began.70

By the end of 1955, the survival of the Follow-up Agency appeared to be ensured. The budget for fiscal year 1956 totaled $120,000 after overhead. Although the VA continued to be the largest single financial sponsor, the Public Health Service and the Army each contributed almost as much. The budget guaranteed the agency's continuation, but it barely covered the more than 21 individuals whom the agency hoped to retain, including 4 professional statisticians and 17 clerical and technical personnel.71

The core staff found itself pulled in many different directions. Staff members participated actively in designing current projects, including a study of the incidence of cancer in veterans, a follow-up on fractures of the femur that had been treated in the European and Mediterranean theaters of operation, and a study of the mortality rates of World War I veterans exposed to mustard gas or post-influenzal pneumonia. They also collaborated with doctors in universities and the government on final reports for completed projects. In this role, Bernard Cohen worked with Dr. H.F. Smetana of the Armed Forces Institute of Pathology on a report dealing with the course of Hodgkin's disease from onset to death, and Jablon applied the final statistical touches to a report concerning head injuries sustained in World War II (see Box 4). Gilbert Beebe completed a collaborative report on "variations in psychological tolerance to ground combat." Cohen, Jablon, and Beebe were also in the process of reviewing manuscripts on the subjects of prisoners of war and tuberculosis in the Army. Even as they undertook these activities, they also explored the possibility of starting new projects such as creating a roster of twins, which later emerged as a central activity for the agency, and studying the natural history of hypertension.72

As the core staff did more, the Committee on Veterans Medical Problems did less. It still met several times a year and discussed each of the major studies being considered by the Follow-up Agency. The CVMP officially recommended whether Veterans Administration records should be used for a particular study. With a study proposed by Bernard Cohen on coronary heart disease in young adult males, the committee faced a situation in which the project had already been reviewed favorably by the National Advisory Heart Council. This meant that the study would be funded by NIH. Still, the committee found it necessary to review the proposal with an eye toward "the propriety and desirability" of granting the investigators access to VA records.73 The committee also contemplated procedures that had proved troublesome from the very beginning of the program. In June 1956, for example, it responded to a complaint from Dr. Barnes Woodhall about the difficulty in getting patients to come to the hospital to participate in follow-up studies. He argued that the Veterans Administration should use its authority to compel people to appear, but how to do so was unclear. The resulting discussion ended as had many similar discussions. The committee reached no conclusion and took no action.



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