Changes in personnel also occurred at this time. As expected, Gilbert Beebe took a leave of absence to serve as chief of biostatistics for the Atomic Bomb Casualty Commission. In February 1959, Bernard Cohen suffered a heart attack, and he did not return to work until September 1960. To compensate for this loss, the agency hired two new professional staff members, the most significant additions since Jablon and Cohen had joined the agency a decade before. Dean Nefzger, who had a Ph.D. in psychology and statistics, came to the agency from the University of Buffalo. Robert Keehn left his job as director of the Bureau of Vital Statistics for the State of Connecticut to work for the MFUA.81

This transition in personnel slowed the agency's progress. When Gilbert Beebe went to Japan, he had to put aside three manuscripts on subjects related to acute viral hepatitis, cold injuries, and arterial injuries. When Bernard Cohen got sick, it stopped his work on monographs related to Hodgkin's disease and Buerger's disease. Michael DeBakey, Cohen's collaborator on the second study, was overwhelmed with other work and unable to attend to the Medical Follow-up Agency's projects.82 Then, once Beebe returned to Washington, Jablon left for Japan, a pattern that would be repeated in the years ahead as staff members shuttled back and forth.

In Beebe's absence, the staff concentrated on five major projects during fiscal year 1959. The first involved a follow-up of about 2,200 cases of coronary heart disease that had been diagnosed in the Army during World War II. The second study, which had a similar design, centered on the natural progression of multiple sclerosis in 850 soldiers diagnosed during the war. The third study consisted of the clinical trial of chemotherapy as an adjuvant to surgery in the treatment of cancer, and the fourth was a study of men admitted to Army hospitals during World War II with ulcerative colitis or regional ileitis.83

The fifth study, which proved to be the most time-consuming, concerned twins. The agency began the the cross-country search of birth records to obtain the names of live, white, male twins born between 1917 and 1927. During the first year of the project, the agency enlisted the participation of 44 of the 48 (soon to be 50) states and obtained information from 29 states, yielding 45,000 pairs of twin births and 170 sets of all-male triplets. Using the VA Master Index, project staff identified 6,000 pairs of twins who had both joined the military. Simultaneously, work began at the FBI to find the induction fingerprints of eligible twins. Even at this preliminary stage the project went over budget, since there were more twins than investigators had anticipated and the state offices charged more for their services than the investigators had expected.84 The VA, which financed the project along with the National Institutes of Health, agreed to make up the difference. Additionally, the project began to encounter delays, particularly in the FBI phase of the work. This in turn slowed progress in the next phase of the project—testing the effectiveness of using fingerprints to predict zygosity by comparing fingerprints with clinical observations. 85

Even as work on the twins and other major projects continued, and despite

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