About 74,000 people in Nagasaki died instantaneously or within five months of the bombing. Only 150 were military personnel. Another 75,000 people were injured, and these numbers do not count those who fell ill and died from radiation-related conditions in the decades to come.

Initially, purple spots appeared on their bodies, their hair fell out, and they developed high fevers, infections, and swollen and bleeding gums. Later, cancer rates surged. The survivors, known as hibakusha, lived in constant fear of illness and death.

The United States suppressed this part of the story. In the fall of 1945, high-level American officials rebutted news reports of deaths from radiation exposure. For years to come, the occupation authorities censored news accounts, photographs, scientific research and personal testimonies about the attacks.

To counter growing criticism of the bombings, American leaders established a narrative that the bombings had ended the war and saved up to 1 million American lives by preventing an invasion of Japan. (These postwar casualty estimates were far higher than pre-bomb calculations.) Most Americans accepted this narrative.