The Volunteers

The freshman and the sophomore from Antioch College who share a room in a huge federal building in Bethesda, Md., are free men, but their routine last week was as rigid as a prisoner's. Almost as confining as leg irons were the polyethylene tubes and electric cord that hooked each of them up to a trolley loaded with complicated apparatus. Peter Schmidt, 18, and Lawrence Baldwin, 20, got out of their room only once a day, to walk a few steps down the hall and be weighed on a scale that is accurate to a fraction of an ounce. Even then, the trolley and tubes went with them.

Each of the seven days that the hookup lasted, Schmidt and Baldwin divided their time equally between sitting up in bed and lying down. They could sleep as much as they wanted. Schmidt, who comes from Levittown. L.I., broke the monotony of reading and card playing by strumming his banjo and singing folk songs. Baldwin, who comes from Ithaca, N.Y., was eagerly looking forward to a steak dinner at experiment's end after meals that were identical every day.

What Is Normal? Schmidt, Baldwin and 50 other people are volunteers for research projects at the Clinical Center of the National Institutes of Health. Some of the most fundamental questions in medicine--how man ages, what stress does to him, how hormones interact, how physical changes may cause or be caused by emotional illness--cannot be answered until doctors learn more precisely what is normal and how the system reacts to a single change in its economy.

The transfusion-type apparatus to which Schmidt and Baldwin were hooked up last week provides such a change. A pump sends a continuous infusion into an artery in each subject's left arm. In the infused fluid is an infinitesimal amount--1/90,000 oz. per day--of a mysterious and immensely potent substance called angiotensin. Explained Dr. Frederic C. Bartter, head of NIH's hormone studies: "We know that a lot of angiotensin raises the blood pressure and causes salt retention. What we need to know is whether an increase so small that it does not raise the blood pressure will nonetheless cause salt retention, and therefore help to account for edema--'dropsy.' It looks that way, from our work with volunteers like Schmidt and Baldwin. This may be important in treating patients with heart failure."

Colds from Monkeys. The angiotensin study is one of about 100 projects, under the center's associate director, Dr. Clifton K. Himmelsbach, employing volunteers in normal health. The center also has a list of 300 projects for the study of various diseases. Because the 14-story Clinical Center is designed for research, less than half its sprawling space goes for patients' rooms, while more than half of it goes for laboratories.

The center does not sign up individual volunteers directly, but gets them only through sponsoring agencies. It has contracts with five colleges. In years past, for example, it got a winter invasion of Bennington-girl volunteers for its studies of psychosomatic ills. Other volunteers come from conscientious-objector groups such as the Mennonites and the Church of the Brethren, and from the U.S. Bureau of Prisons. A 19-man squad of car thieves, tax evaders and embezzlers is now at the center, volunteers all and watched by special guards, to see whether they will catch colds from monkey viruses. The pay is $5 a day.

Stress & Hormones. Most medical studies of stress are physical and highly artificial--a man running on a treadmill or being deprived of sleep. Doctors cannot induce genuine emotional stress without violating their medical ethics. But the Clinical Center has a unique group of eight volunteers under severe stress: five mothers and three fathers of children whom the center is treating for acute leukemia.

One is Mrs. Joel Stevens, 32, from Bossier City, La., who has taken turns with her husband in staying at the center with a daughter under treatment. Says Roberta Stevens: "Being able to stay here, two floors away from her, and see her a large part of the day, was the best thing that could have happened to us under the circumstances." Mrs. Stevens and the other parents are not being treated psychiatrically, but are being studied. "Our focus," says Dr. Stanford Friedman, ''is how these people react to their situation, not only their perceptions and ideas about it, but also in possible physical changes such as hormone balance." Their situations are harrowing: all the parents know that the acute leukemia of childhood is invariably fatal.

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