CONCLUSIONS

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP78-06180A000300230001-9
• Release Decision: RIPPUB
• Original Classification: S
• Document Page Count: 10
• Document Creation Date: December 9, 2016
• Document Release Date: August 7, 2000
• Sequence Number: 1
• Content Type: REPORT

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The development of the Operations Division was not a rapid
one. Inasmuch as there was no precedent anywhere within the free
world for the development of procedures and associations in the
field of medical intelligence and, more specifically, medical
operations, there was a long period of trial and error. The
ideas and concepts for the use of medical knowledge and expertise
to assist in the gathering of intelligence and in the conduct of
covert activities were completely alien, not only to those in the
medical profession, but also to the average layman.
The ideas and concepts existed in the mind of one man - Dr.
- who realized that he had a salable product if
the criticisms and misconceptions could be overcome. With
patience and continued education of the people with whom he came
in contact, he developed acceptance, in the beginning grudgingly,
a medical character, for example, the
routine medical diagnosis and treatment of ailments afflicting
agents or assets; the provision of drugs, textbooks, journals,
and equipment for presentation to target individuals; etc.
Through the contacts occasioned by the performance of the mundane,
there developed a trust of the purposes and intentions of the
one Division, plus an opportunity to proselytize
propagandize the more esoteric possibilities for contributions
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in the field of operations. One of the best selling points of
the Operations Division's efforts was the realization on the part
of the customers that no operation involving Operations Division
personnel was ever taken or conducted lightly by the O}1 personnel
and that every effort was made to satisfy the customer's needs
and to protect his involvement, his assets, and his techniques.
In the same fashion that the customers practiced the need-to-know
principle, OD practiced the need-to-know principle, and none of
the activities was discussed with anyone once it was completed
unless it was first discussed with its originator.
As the scope of the division grew and the number of customers
in the various Clandestine Service disciplines increased, it be-
came evident that there were several categories of medically
related intelligence activities other than those involved with
the routine medical care of employees and their dependents.
These may be classified as clandestine (operational) medicine,
destine medical operation, and medical support to operations.
Clandestine (operational) medicine is a philosophy, an art,
a variety of sciences, and an ability to be professionally effective
in assisting CS operators to be effective in almost any operational,
physical, or geographic environmental situation. It frequently re-
quires the modification or conversion of medical diagnostic and
therapeutic measures to permit the accomplishment of an operation.
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Clandestine medical operations are traditional. CS format
activities, but which, due to certain circumstances, are accom-
plished or managed primarily by medical personnel. An example
would be a medical proprietary.
support to operations is the application of recog-
nized medical diagnostic and therapeutic practices, principles,
and measures to support an operation or an operational
human asset. This support is generally provided in a natural
setting in keeping with the operational security required for the
particular case. Medical examination or evaluations and treating
a sore throat could be examples.
From the beginning, questions of ethics and morality were
raised repeatedly, and each time the questions had been posed
because of mis-conception on the part of the questioner. It
seemed that the majority pictured physicians in intelligence
as individuals who ran around with all sorts of drugs, hellbent
on committing assassinations. Further, there were individuals
in the medical profession who thought, and still think, that it
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is not considered evil if it is done for an insurance company, or
for the preparation of a paper, or for a lawyer. Despite the
warranted criticisms, which in our opinion have always been on
the basis of misunderstanding or ignorance or unfamiliarity with
the novel and the esoteric, the Operations Division prospered,
developed close working ties with CS components, and provided
competent and highly professional medical advice, assistance, and
cooperation for its customers. Even though 01) has developed such
a close relationship with other components, either because of in-
ability to understand or failure to want to understand the work-
ings and purposes of the Division, OD is like a step-child insofar
as the Office of Medical Services is concerned.
In addition to the difficulties posed by criticisms, in the
need to sell a new concept of the use of medical knowledge and
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intelligence, there were and are other problems and frustrations.
Perhaps the greatest of these is finding personnel with the proper
philosophy and motivation to work in operational medicine. By
virtue of his training a physician would appear to be ideally
suited for work in the intelligence field. He has learned or
has been taught to take several bits of information and assorted
findings, put them together, analyze them, and make a diagnosis.
a essentially the same process used in converting infor-
mation into intelligence. Once the doctor has made his diagnosis,
he then proceeds to determine the treatment; and, under some cir-
cumstances., in order to provide the proper form of treatment,
especially in an emergency, it is necessary for him to improvise;
and usually he does quite well. Despite all these factors in a
physician's favor, only about one in one thousand in able to
appreciate the aspects of intelligence and to apply his medical
knowledge in an operational sense, that Is, in away other than
attempting to assist the body in healing. Added to this weakness
in the perception of intelligence functions there is the almost
obsessive compulsion for the "laying on of the hands" or patient
contact. In several instances wherein it was felt that physicians
had the make-up to fit into operational medicine with the aid of
agency training, there was a parting of the ways when the candi-
dates were made aware that almost all of the patient dealings
were by indirect methods rather than doctor to patient direct contact.
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The feeling among these physicians was that without direct patient
contact their knowledge of medicine and their ability to perform
medically would suffer. We, on the other hand, have found that
in dealing with people in an indirect fashion our knowledge of
medicine and perception of symptomatic complexes denoting specific
syndromes have increased, and we have become more aware of the
little things that are of significance, With respect to the medical
service officers, we have not experienced, on the whole, the same
difficulty in the matter of motivation and comprehension of operational
techniques. We have not been able to determine why it is this way, but
we feel that it is probably the result of the parochial and intense
training that a physician receives - so much so that he is totally
immersed, at least from the professional viewpoint, in the diseases
of man. We refer to this as gun-barrel vision. There have been
several physicians who applied to the Agency specifically in order.
to become involved in the intelligence profession rather than in
clinical medicine. Almost all of these, it eventuated, had romantic
ideas of the intelligence process and did not realize that there
would be the aforementioned giving up of the "laying on of the
hands." We have noticed that the more hobbies a physician has
the more apt will he be to appreciate operational medicine. Ideally,
for operational and intelligence purposes, a physician, in addition
to his degree in medicine, should have a background or interest in
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some other field such as engineering, chemistry, pbysica, or elec-
tronics; have hobbies that are not related to medicine; and have
a foreign language in addition to good English. He should be a
man who is not satisfied with the ordinary, but has a thirst for
additional ktzowiedge and experience. Although it in not necessary,
a military background is an asset.
Another source of minor difficulty has been, and continues
to be,, the location of the Operations Division within the Deputy
Directorate for Support. The chauvinism of the DDP has been such
that there is a distrust of components outside of the DDP. This
has resulted in hesitancy on the part of operators to approach
Operations Division and failure to consider that a component
another directorate could be of assistance to the Clandes-
tine Service. Personnel in the Operations Division have overcome
this difficulty to a degree through personal contacts and a bit
of subtle proselytizing. Wherever possible, an effort is made
to inforan Clandestine Service personnel of the assistance that
can be provided them by OD personnel. However, we do not see
the day when this difficulty will cease to exist since the re-
assignment rate within the Clandestine Service is such that there
will be need for continuous propagandizing.
Despite the seeming disadvantage of being located in the
Support Directorate, from the professional and the pragmatic
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viewpoint, it is felt that the Division should remain in the
Deputy Directorate for Support within the office of Medical
Services as OD personnel contribute to the medical functions.
The proximity to other physicians with expertise in varying
fields is an advantage for quick consultation and assistance
in arranging consultations. Further, since many requests have
to do with the procurement or the provision of drugs and medical
supplies and equipment, day to day association with the medical
supply office enhances the assistance that can be given the re-
quester. Finally, if an operator is confronted with what appears
to be a medical problem, he or she would automatically think in
terms of the Medical Staff to seek assistance.
In the category of frustrations, one has to place near the
top of the list the matter of duplication of effort when such
duplication of effort results in conflicting opinion. This was
most highly manifested when Life Sciences Division of the Office
of Scientific Intelligence began to publish its assessments of
the health of people of interest, its so-called VIP Program. As
is obvious, its program was copied from Operations Division and
occurred shortly after a physician and a medical service officer
had been assigned to the Life Sciences Division from the Office
of Medical Services. Inasmuch as the Operations Division does
not publish its findings and opinions but provides these directly
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to the customer, there is a broader range of more sensitive material
on which to base Judgments. LSD/08I., on the other hand, since it
publishes, is limited to those reports that can be disseminated
within the intelligence community. The discrepancy posed by this
different grouping of reports has at time resulted in divergent
opinions, with the result that it was necessary for the OD phy-
sicians to refute the opinions set forth in the L8D/051 publications.
This has at times necessitated return to Headquarters after work
hours and on week-ends to assist the Clandestine Service with a
proper judgment.
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It has become obvious over the years that
in order to provide an accurate assessment a physician should be
a clinician who had had experience in treating patients and has
had training within the Agency in order to understand the intel-
ligence, political, and operational implications of what is or is
not reported, bow it is reported, and by whom it is reported.
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When it comes to speaking of achievements, perhaps the greatest
achievement of all is that Operations Division was developed. From
experience and desire on the part of the personnel associated with
the Division has been developed to the point where it is capable
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of giving a rapid response in operational matters in all categories
and pertaining to any geographical area. The Division has developed
and managed. successful proprietaries which have never been compromised
and has developed a high level of accuracy in providing medical M
been learned. Much of OD ' s actions continue to be the result of
taking advantage of targets of opportunity. With increasing tech-
nology and sophistication throughout the world, Operations Division,
in turn, must develop new techniques and ideas to continue to be able
to assist the operators
M Operations Division has not reached that point where
be said that it has total capability and that everything has
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