Cancer

In 1896 a man destined to become the territory's most famous doctor reached southwestern Alaska fresh from medical school; he was Kansas-born, Austrian-descended Joseph Herman Romig. His observations and views on cancer, in relation to Alaska natives, were soon to become well known locally. They do not appear to have reached international circulation until 1939, through the publication of the widely noticed Nutrition and Physical Degeneration by Dr. Weston A. Price (New York and London). In regard to an interview between these two in 1933, I quote the cited book from the fourth American edition (1945), pages 90-91:

“Anchorage ... has an excellent government hospital which has been built around the life of one man who, many people told us, was the most beloved man in all Alaska. He is Dr. Josef [Joseph] Romig, a surgeon of great skill with experience among the Eskimos and Indians, both the primitive and the modernized ... He stated that in his thirty-six years of contact with these people he had never seen a case of malignant disease among the truly primitive Eskimos and Indians, although it frequently occurs when they become modernized.”

Dr. Greist's reply to my letter was to the effect that the man I asked about had not died in hospital, that there had been no post mortem, and that the cause of death was unknown. Thus it was not until 1957, some twenty-two years later, that I discovered I had failed to get the information I needed, because I had asked a loaded question and the doctor had answered me literally. I had asked whether a certain specified man had died of cancer and the answer I got was that, in this specified case, the cause of death was unknown. Meantime it was known to Dr. Greist that another Eskimo had died of cancer. From the records of his hospital it is apparent that a cancer patient died there of the disease on July 27, 1933.

Because this was the first known malignancy death in northern Alaska, occurring forty-nine years after Leavitt began his search on the north coast, I shall set down all the details of which I feel sure.

When I took up again those inquiries which led to the writing of this book, an early step was to attempt to revive my correspondence with Dr. Greist, who had resigned his medical missionary position in 1936 and retired to his Indiana home at 318 North Bluff Street, Monticello. The reply came from Mrs. Greist, for her husband had died two years before.

In a letter dated February 19, 1957, Mrs. Greist explains that she remembers nothing of a disagreement between her husband and Mr. Brower on the cause of anybody's death, and suggests that if there was such a dispute it would be outside her sphere unless the man died in hospital or unless for some reason there was s post mortem, at which, in her capacity as head nurse, she would have assisted or at least have been told about it. Then Mrs. Greist continues:

“... I do remember nursing a case of cancer of the liver of an old man who came to Barrow from far to the eastward. After a week or two he died and Dr. Greist and I held a post mortem. We were then satisfied it was cancer ...”

This was all Mrs. Greist was able to say from memory, except that northern Alaska's first identified cancer illness and death came during some year early in the 1930's. But when she learned that her testimony was intended for publication, along with other testimonies, she instituted a search and finally discovered precise dates for this case. She wrote me on August 30, 1958:

“After three days and late nights reading through three years of my diary that I kept in the North, I found what you wish to know about the cancer case. On July 27, 1933, at 7:45 A.M. Jobe passed. I have recorded the fact that Lee, Helen and I helped Dr. Greist with the autopsy. [We found] an immense cancer of the liver; we guessed the weight at 25 or 30 pounds ... Helen is dead; Lee should remember [the cancer victim's] full [Eskimo] name... Lee is head of the native store at Barrow now.”

Mrs. Greist followed up this second letter by lending me a handwritten diary dating from January 1, 1933, to December 31 of that year. Into this she has freshly written, opposite the entry for July 5: “The day Jobe came in.” The entry says: “Jobe came in with obstruction of the bowels; very bad shape.”

The diary for July 17 says: “Old Jobe much worse; going to die ... Up on duty till 4:00 A.M., did not sleep till 4:30.”

In a further recent entry Mrs. Greist indicates on the margin for July 27 that here is the crucial passage of her informal, private diary. Insofar as applicable the passage reads:

“Helen came and called me at 3:00 A.M. as she thought Jobe was passing ... but he did not die until 7:45 A.M. Both girls were very sleepy so we let them sleep ... Worked all day; cleaned some in the operating room and clinic. Helped Dr. with the autopsy on Jobe (Helen, Lee and I). An immense cancer of the liver ... it must have weighed 25 to 30 pounds. Helen and I washed and dressed Jobe for burial."

Apart from assuring me that this was the first case known to herself, or to Dr. Greist, of death from cancer by an Eskimo native from the north coast of Alaska, Mrs. Greist had little pertinent information on the case of Jobe. He was an elderly man. Whether he had worked on shipboard (thus living a good deal European style) she cannot say.

Dr. L. A. White of 642 Eugene Medical Center, Eugene, Oregon, wrote me on February 21, 1958:

“... It has been almost 17 years since I practiced in Alaska. I was at Unalaska [Aleutian Islands] 1934-48, having previously spent 17 months at Metlakatla [Alaska Panhandle], then several months in '39 at Klawock [Panhandle]; finally one and a half years at Bethel [Lower Kuskokwim]. My work led me to these conclusions: (1) hypertensive and arteriosclerotic diseases were practically nonexistent among the native peoples; (2) diabetes was extremely rare; (3) malignant disease was extremely rare — in fact, I had only one proven case (Bethel, 1940). I saw no strokes nor coronary heart disease ...”

 A health survey made in 1935, with cancer as one of its focal points is described in an article by the senior investigator of the survey, Dr. I. N. Rabinowitch of Montreal, appearing in the May 1935 issue of The Canadian Medical Association Journal (Toronto).

“Two different interests prompted this investigation. The purpose of the Canadian Government was to determine the general health of the Eskimos; whether contact with civilization is causing their deterioration; and, if so, the causes. Quite frankly, this was not the writer's interest ... His interest was primarily in the alleged absence of diabetes, cancer, and arteriosclerosis, and the possible relationship between such absence and the peculiar dietary habits of the people.”

Dr. Rabinowitch found in 1935 that the Eskimos of the northern coastal section of the Canadian eastern Arctic were still living substantially on their native foods, although they were in some places eating enough carbohydrates to materially affect their previously good teeth. Of diabetes and arteriosclerosis he found only slight indication. Of cancer he says on page 493:

“In the western Arctic [from Alaska to Coronation Gulf] Dr. Urquhart has not yet met with a single case of cancer in the seven years of his practice. Cancer must be very rare in the eastern Arctic also. I saw one suspicious case ...” [Dr. Rabinowitch thought it was probably not cancer.]

Cancer among Labrador Europeans was, of course, well known to the Moravian mission, both from their own experience and that of the Grenfell mission to the south of them. In his letter of November 20, 1957, Superintendent Peacock says, “Previous to my coming to Labrador, Robert Ford [a Scot who may have had some Eskimo blood] ... died from a diagnosed cancer ...”

In the aforementioned letter of November 20, Superintendent Peacock reports what he believes to have been the first death of a Labrador Eskimo from a recognized cancer:

“When I first came to Labrador, in 1935, I was told [by the Reverend W. Perrett] that cancer never occurred among Eskimos. However, during the winter of 1935-36 an Eskimo, Michael Nochasak, became ill with abdominal trouble ... This man suffered intense pain and was removed to a hospital when navigation opened, and died of cancer.