over fuel for the Tehran Nuclear Reactor means Iran will soon be unable to produce medical isotopes used by many Iranian cancer patients. This does not mean these patients are destined to die. But it does mean Iran will have to import the medical isotopes, something it obviously does not want to do while boasting about how it is producing almost all its medicines. Of course, the boast is hollow when much of what it imports from the United States is pharmaceuticals and medical technology. Iran says fuel for the Tehran reactor that produces the isotopes will run out in September next year. A deal for the West to provide fuel for the reactor has all but fallen apart in the deadlock over Iran’s broader nuclear program. Iran says it will produce the fuel itself by next September. Most analysts seem to believe Iran is capable of producing the fuel—albeit at vast expense and not by next September. At the nuclear medicine ward in Tehran’s Shariati Hospital, Ghodratollah Ghalavand fears the standoff could eventually leave him without his lifeline. Every week, he comes in for treatment of his thyroid cancer with iodine-131 isotopes produced by the reactor. “I’m not familiar with politics. I’m a rural person. I only know that not giving fuel is wrong. It will endanger my life. Humanitarian issues are different from politics,” Ghalavand, a man in his 50s from a village in southwest Iran, told an Associated Press reporter visiting the hospital. Ghalavand appeared not to believe his own government’s assurances that it would have all the fuel needed to produce his medication on time. The Tehran reactor is fueled by uranium that has been enriched to 19.75 percent. It has been running on fuel that Iran imported from Argentina more than a decade ago to produce medical isotopes like iodine-131, used to treat thyroid cancer. Iran doesn’t produce all the medical isotopes it needs. It already imports some ready-made isotopes. But it has faced problems under UN sanctions and has to pay higher prices to get them. Sanctions do not directly ban the sale to Iran of medical equipment, but the Associated Press said, “They make foreign producers more reluctant to provide it, and those who will sell it do so at inflated prices.” Mohammad Reza Ramezani, an official at Shariati Hospital, said, “We are paying twice the value of this product to import it from Turkey.” He pointed to a cargo of technetium-99, the most common radioisotope used in diagnosis, that arrived from Turkey at day earlier. Last year, the United States proposed a UN-backed deal that it hoped would provide a confidence- building measure and leave Iran at least temporarily unable to produce a bomb. It suggested that Iran ship abroad most of its stock of low-enriched uranium, which would be further purified to 19.75 percent and turned into fuel rods, which would then be sent back to Iran to power the Tehran medical reactor. Doing so would leave Tehran’s uranium stocks too low, for a brief while, to produce enough high-enriched uranium for a bomb. But Iran balked, arguing that the deal did not provide enough guarantees that the West would actually deliver the fuel plates and not just pocket Iran’s uranium. US officials have recently said Washington could agree to a new version of the fuel swap deal—but it wants Iran to ship out a larger amount of low-enriched uranium so its stock on hand will be less than needed for a bomb, at least for several months. Iran has 120 nuclear medicine centers around the country, with some 200 patients a week getting iodine-131 treatments for thyroid cancer, according to Mohammad Ghannadi, a top nuclear official. At the Shariati ward, 50- year-old Manijeh Shahri coughs as she describes the radiotherapy treatment for her thyroid cancer. “I’m not familiar with politics nor with nuclear issues,” she said. “But I need radioisotopes to remain alive.”