2. Captain Leavitt's Search For Cancer Among The Eskimos

On August 9, 1906, we reached the whalemen's harbor of Herschel Island, just west of the delta of the Mackenzie and in Canadian territory, about 40 miles east of the northeast corner of Alaska. Several New England ships were there, but not at the moment the one that I had been hearing most about, Captain George B. Leavitt's steam whaler Narwhal.

Our own expected Duchess of Bedford was not there either. But in her place, unexpected by me, was another polar expedition ship, the Gjoa, and her later very famous commander, Roald Amundsen. He and the Gjoa were just about to complete the first voyage from the Atlantic to the Pacific around the north of our continent, by the glamorous Northwest Passage. Amundsen invited me to be his guest abroad the Gjoa, against the momentarily expected arrival of our Duchess.

Aboard with Amundsen I heard from all and sundry, but especially from the second-in-command, the Danish naval lieutenant Godfred Hansen, about the relatively admirable results of Danish care for Eskimos of Greenland. I also heard much of the allegedly deplorable results of our hit-and-miss system, or lack of system at that time, in the civilized parts of Alaska and Canada; and about the healthy, happy, and admirable, not yet civilized Eskimos whom the Gjoa had known for two years in and around King William Island. Better than anything I could write up, from memory and records, is to quote on this point from Amundsen's two-volume The Northwest Passage (London and New York, 1908). The following excerpt is from his two-chapter section “The Inhabitants of the Magnetic North Pole”:

“During the three year voyage of the Gjoa we came in contact with ten different Eskimo tribes in all, and we had good opportunities of observing the influence of civilization upon them, as we were able to compare those Eskimos who had come in contact with civilization with those who had not. And I must state it as my firm conviction that the latter, the Eskimos living absolutely isolated from civilization of any kind, are undoubtedly the happiest, healthiest, most honourable and most contented among them ...”

Here and there The Northwest Passage gives instances of modern physical decay, and of the tragic effect of Europeanization on health and longevity. On page 142 of Vol. II Amundsen speaks of the people of the Mackenzie delta, a region in which I was to live Eskimo style off and on during the six years following the Gjoa's voyage. Says Amundsen: “... civilization has had its corrupting influence upon them, so that instead of several hundred families their number was reduced to a handful.”

In Amundsen's book, the last sentence of the final chapter on the people of King William Island is set off by him as a paragraph:

“My sincerest wish for our friends the Nechilli Eskimos is, that civilization may never reach them.”

After the Gjoa had been my hostess for a week, she sailed away to complete the Northwest Passage. Her going left me sad, because of Amundsen's and especially Hansen's confirmation of my fear that I had come north to study a dying, though an admirable, race. The feeling wore off. The Eskimos I met on Herschel Island were the happiest-seeming people of my experience up to then. Clearly they worried no more over becoming extinct as a race than children at play, when they are seven, worry because they may die by the time they are in their seventies.

But I felt I had secured from the Gjoa a pertinent opinion, an interesting though not a decisive vote, on whether civilization is good for the Eskimos.

As summer wore on, the whaling ships, singly or by twos or threes, dropped anchor for a night or two in our Herschel Island harbor and then sailed west, homeward bound for San Francisco. No ship was expected from the west except our Duchess, and she did not come. According to my book, Hunters of the Great North, which is the narrative of my first northern year “August the 28th the Charles Hanson and the Olga set sail, thus cutting off from the world for a year the little arctic colony of Herschel Island.”

On Herschel were Northwest Mounted Police — they were not yet called “Canadian” or “Royal Canadian.” There was a Church of England mission and a Hudson's Bay Company trading post. The island was white man dominated, and I had come to study Eskimos; so I moved east, first 60 miles to Shingle Point and later more than another 100 miles, beyond the Mackenzie delta. Of this I have told a connected story in the above-mentioned Hunters book; here I shall relate only such things as seem to me to have a fairly direct bearing on the search for cancer.

In January 1907 I heard through Eskimos that the Duchess, with all but me of the staff of our expedition, had been held up by ice after rounding Point Barrow from the west, an was in the shelter of Flaxman Island, about halfway from Barrow to Herschel. With a single Eskimo as mentor and companion, and a small team of dogs, I reached the Duchess on April 17, 1907, to find the joint commanders, Leffingwell and Mikkelsen, away searching for possible new land by sledging over the unexplored sea northward from Alaska.

In their absence, the Flaxman Island base of the Anglo-American Polar Expedition was commanded by Dr. George Plummer Howe, the expedition's surgeon. It turned out that he and I had been contemporaries at Harvard, though we had never met — not strange, for the medical school is in Boston, and I had been in the divinity school and then in the graduate school, both of which are in Cambridge. He was A.B. 1900 and M.D. 1904.

Though a medical man by training, Dr. Howe proved to be an anthropologist at heart. What he told me included his having heard in the summer of 1906, almost as soon as the Duchess reached Alaska waters, that “Eskimos never have cancer,” and that Captain Leavitt was credited with originating the local search on which this view rested. One of the first to tell Howe this had been the surgeon on the United States revenue cutter Thetis, whose name I neglected to record; but more extensive detail had been given Howe by the head of the Presbyterian medical mission at Point Barrow, Dr. Horatio Richmond Marsh, a native of Illinois.

In talking with Dr. Howe, both the surgeon of the Thetis and the medical missionary at Barrow had agreed on several points, among these that in northern Alaska Leavitt had originated the local quest; that he had been indefatigable in urging government doctors, medical missionaries, expedition surgeons, everybody, to look for malignant disease; that many of these searchers, including Howe's informants, had expected to find cancer; but that all of those who remained in the Alaskan Arctic had been convinced eventually, that cancer was not to be found among Eskimos who still lived native style.

Dr. Howe agreed with his two main informants on the importance of an additional point which both had emphasized: that Leavitt knew the names and personalities of hundreds of sick people; and that by 1906 he had known many of these for more than two decades; so that any external cancers, if not recognized early, must have had by then plenty of time in which to develop and to become easily recognizable, if not fatal.

Dr. Marsh had himself been in charge of the Presbyterian medical mission at Barrow since 1897, thus nearly a decade; and he too knew hundreds of invalids among the thousands of persons who came under his observation. External cancers, Howe felt, could not possibly exist in the inspected region for decades without being recognized or without resulting in deaths.

So we agreed, Howe and I, that we saw no holes in the curtain of testimony. And we both published our agreement. Howe's was the earlier to be printed, in “Medical Notes on Northern Alaska," which he contributed as an appendix to the narrative of the expedition, Captain Ejnar Mikkelsen's Conquering the Arctic Ice (London and Philadelphia, 1909):

“It has been said that cancer does not exist among the Eskimos. So far as I could find out, this is true ...”

My like summary, of what Howe and I both had been told, was printed five years later. For when I was about to leave on my third polar expedition, the one of 1913-18, I gave permission to Dr. Clark Wissler and Miss Bella Weitzner of the Department of Anthropology of the American Museum to go through all my diaries and notes of the two previous expeditions and to publish anything they found there which they might care to extract. The result appeared as Anthropological Papers of the American Museum of Natural History (New York, 1914). The cancer reference was taken by Miss Weitzner from my diary entry at Flaxman Island for April 13, 1907, the second day of Howe's conference and mine, and is on the museum's page 186: “Cancer is said not to be found among the Eskimos.”

When Howe used the wording “It has been said that cancer does not exist among the Eskimos,” he was reporting the opinion of northwestern and northern Alaska as he found it in 1906-7. When I phrased it that “Cancer is said not to be found among the Eskimos,” I was reporting for the same years on the belief as I had found it a little farther east, on the lower Mackenzie and generally in the western Canadian Arctic. Both Howe and I had in mind our talks with each other and our having compared notes on what we had been told by fur traders, whalers, government doctors, and missionaries.

With the exception of the first few remarks of like nature which I heard on the lower Mackenzie, these beliefs on malignant disease were specifically said by many to be conclusions from a search first begun by Captain Leavitt and later carried forward also by many whom he had enlisted, whether by urging or through example. So now we tell more of George B. Leavitt, a whaling captain from Portland, Maine.

As Leavitt himself told it to me, his search for cancer among the natives of northeastern Siberia, Alaska, and northwestern Canada was basically connected with New England thrift.

There was, it seems, a federal law that if a ship had a crew of fifty, or over, she had to carry a fully licensed doctor; so the owners saw to it that no whaler bound for the Alaska-Canada Arctic had a crew of more than forty-nine. But the feeling was that every whaling ship should have a stopgap doctor; so a high officer, captain or mate, was usually a passable amateur in medicine, good enough to look after a sick man till the next chance to get him to a hospital. This meant that an ambitious young seaman would have better chances of promotion to mate, and eventually to captain, if he showed himself good at lancing boils, setting broken limbs, and doing small amputations.

For this sort of advancement young Leavitt had a better chance than most, for he had a half-brother who was a doctor able to give him first-aid training. As others in the whaling fleet told me the story, Leavitt was in any case a natural for promotion, with charm, health, and muscular prowess; but his own version had it that surgery was his mam avenue to promotion. This view is, to an extent, confirmed by the first story of him which we have found in print.

Leavitt received his first notable publicity in a book which, although a government report, was a best seller in at least New England and California, indeed wherever the western Yankee whaling fleet was known. For in 1897-98 the fleet was the victim of a “heroic” rescue, the tale of which is told in The Cruise of the U.S. Revenue Cutter Bear ... for the Relief of the Whalers in the Arctic Ocean ... (Washington, D.C.: Government Printing Office, 1899). This volume contains 12 pages by the Bear's doctor: “Report of Surg. S. J. Call, R. C. S.” Here Dr. Call tells about the amateur surgery performed on members of the whaling fleet as a result of the economy dodge of every captain's being his own ship's doctor. The section of Dr. Calls report that is most pertinent here begins on page 122:

“Before closing this interesting subject, I must speak of some of the amputations by one or two of the captains of the whaling fleet. Their fearlessness and the results are sometimes remarkable, and would call forth the praise of our most expert operators. I mention in this connection Captain George B. Leavitt, who lately commanded the steam whaler Newport.”

Dr. Call had asked Captain Leavitt for a memorandum, and quotes from it:

“I am glad,” says Leavitt in the memo he gave Call, “that I have the dates of most of the amputations since the ships began to winter at Herschel Island [1889]. This first was on a man belonging to the Mary D. Hume, in March 1891 ... Captain Tilton bossing the job ... [Here follow details of this operation and of many others.] From December 28, 1895, all surgical work was done by me, with Captains Bodfish, Cook and McKenna assisting ...”

Reports of this sort, but in greater detail, were among the first things I heard about Leavitt when I began to be guest of the Mounted Police at their barracks on Herschel Island, after Amundsen left. The police said that whenever anybody was seriously ill on any ship of the fleet, or anywhere ashore, they looked for a chance to get in touch with Leavitt's ship, which in my time was the Narwhal, to have him prescribe medicines or other treatment and perform surgery if that seemed required.

The aforementioned idea, of using surgical skill as a means toward promotion in the whaling fleet, was Leavitt's own and that of his half-brother, Dr. Charles S. Knight, who, the only time I met him, in the late autumn of 1907, was living at 316 Woodford Street, Woodford Station, Portland, Maine.

As part of the coaching for the coveted promotion, Dr. Knight had impressed upon his sailor brother, in relation to primitive peoples, that two groups of diseases were of special interest to doctors, those more deadly to natives than to whites, and those less deadly. This second group included some troubles to which the natives seemed wholly immune, either for racial or environmental reasons. In this group (it seemed to me from Leavitt's account) Knight had listed pretty much the same troubles which Bishop Reeve had told me were rare or nonexistent among the Mackenzie River Athapaskans, and one of them was cancer.

Leavitt’s first good chance to carry out his brother's suggested scouting among the Eskimos, for rare or missing diseases, came in the fall of 1884 when he was one of a group selected by owners of New England whaling ships to look after a project of theirs to develop in northwestern Alaska the fleet's own local supply of fuel for steaming and cooking. Outcroppings of promising coal had been found on the north coast, just east of Bering Strait near Cape Lisburne. There were in those years a thousand Eskimos living between Point Hope and Point Barrow; all of these, and some more from farther south in Kotzebue Sound, Leavitt had a chance to see during the summers of 1884 and 1885, and during the winter between. So the amateur student of health had a good deal to work on, even during his first year. After 1889 the ships began to winter farther east, around the Mackenzie delta; and the chances of seeing Eskimos ran to 10,000 a year and some years no doubt 20,000, counting those of the Aleutian Islands and northeastern Siberia.

During the Herschel Island winter, when I was occasionally Leavitt's guest, he kept the officers' mess as interested as he did me with stories which as often as not had some medical or health angle; for after all he was the fleet s foremost surgeon. He brought out that in his early scouting for maladies he had been, among the Eskimos of the coastal prairie, as I had been, among the Athapaskans of the Mackenzie woodlands, less interested at first in the absence of cancer than he was in not finding a decayed tooth or a symptom of scurvy. Everybody is interested in toothache; and in those days every sailor worried over scurvy.

But, said Leavitt, the whaling voyages were seldom longer than three years; and when he returned home to Maine his brother kept getting more and more searching in his questions about how sure the captain was that the Eskimos really never showed signs of cancer; for Dr. Knight's interest was swinging in the direction of malignant disease — an amateur interest, for he was a gynecologist.

At San Francisco, going and coming, Leavitt picked up all the acquaintances he could among doctors. After Dr. Call's praise of Leavitt's surgical skill, in a book that all San Francisco was then reading, the young captain found himself invited to clinics and to homes of doctors, especially surgeons. These chances he used in part to discuss malignant disease, its early detection and correct identification. He used every chance he had to see early and obscure cases.

Leavitt's activity in scouting for cancer would seem to have been at its peak two or three years after Dr. Call's publicizing made him a California celebrity. For he told me in 1907 that the last three or four years before we talked he had pretty much stopped looking for cases himself, or questioning other frontier doctors, because he was so sure by then that, except among civilized Eskimos, no native cancers would be found in the Arctic. Thereafter, I gathered, he used his diagnostic skill mainly to discover early malignancies among the personnel of the fleet, or ashore among whites, Chinese, Negroes. On such malignancy cases as he found, he seldom operated. Instead he used his friendships with other whaling captains, with miners, traders, and such, to get the suspected case with minimum delay, to a good big-city doctor, usually in San Francisco. Leavitt believed himself to have saved a few lives in this way.

It is my hope that from the reading of this book will spring an interest in consulting people who may still be living, among those who knew Leavitt. Therefore, I want to mention the firm of H. Liebes & Company, Post Street, San Francisco, several of whose members and staff knew Leavitt and who should be able to refer to others who knew him. He was well known in the Hawaiian Islands too; the last I knew he was manager of railway there.

Four things seem more important than others to discuss concerning Leavitt and the northern cancer search: (1) how many and what sort of people did he influence to join his quest; (2) how many non-natives did he see per year, among whom he occasionally found malignancy cases; (3) how many natives were seen by Leavitt, and by those whom he alerted, among whom no malignancy was discovered; and (4) what sorts of opportunities did such frontier investigators have for discovering malignancies?

1. Most important of those whom Leavitt egged on to a persistent cancer search was a group that probably did not need egging, the medical missionaries and their nursing staffs. Of those whom Leavitt knew best, and whom I also knew later, those connected with the Presbyterian medical mission to the Point Barrow district were foremost. Later I shall quote two of the medical heads of this mission, who were there through the years 1897-1912 and 1921-36, and also two of their nurses.

The great importance of the missionary evidence is that through decades they knew thousands of persons by name and by intimate history, so that a failure to detect a malignancy in an early stage would of necessity have been revealed through the progress of the trouble. Of lesser but not of negligible importance were the doctors of government ships and surgeons of exploring expeditions. Certainly many of them had only passing glimpses of native strangers; but at least if there had been conspicuous malignancies — such as, for instance, advanced cases of breast cancer in women — they would have been noticed.

2. The number of non-natives passing under review is important; for it was the occasional finding of malignancies among them that kept the investigators, like Leavitt himself, on their toes. We should have in mind, then, that the average number of whale men per ship was probably around twenty-five, since forty-nine was the top number and crews seldom numbered fewer than fifteen. Most of these were white sailors, but there were Massachusetts Indians, New England “Portugees,” Chinese, Negroes, etc. The ships which wintered at Herschel Island were seldom fewer than five in any one year and there probably were never more than sixteen, even counting those that wintered at Langton Bay and the Baillie Islands. The time span, following the inception of the Leavitt search, was from 1885 to 1907. The non-natives, who were a sort of control on the natives, numbered, then, about 250 a year for twenty-two years.

3. The natives, among whom no malignancies were detected during the same period, were about twice as numerous before the measles epidemic of 1900 as they were thereafter. Before the epidemic there were under Leavitt's view perhaps 50,000 natives each year for fifteen years. After 1900 there were, say, 25,000 a year for six years.

4. As for the opportunities which whaling captains, medical missionaries, and other frontier doctors had for detecting malignancies, two main points should be remembered; first, that the Eskimos always had great faith in doctors, their own and later the Europeans', and consulted them on all occasions about real, fancied, pretended, or anticipated troubles. Second, and no less significant, was the native Eskimo practice, not discontinued till after 1910, for both men and women to sit around, in the winter houses, naked from the waist up and from the knees down, sometimes with only breechclouts (as shown, for instance, in John Murdoch's illustrations of his 1881-83 Point Barrow report to the Smithsonian Institution). All whites, and especially missionaries visited around freely under these conditions; and if they were scouting for cancer, as Captain Leavitt and Dr. Marsh were always doing, external evidence of it would have been readily noticed.

To sum up: the non-natives, among whom cancer was occasionally recognized, were much fewer than the natives, among whom cancers were never detected. Among the natives, the chance for detection of a malignancy was better than among the non-natives; for Eskimos liked to consult doctors and they went around naked, especially in winter; but sailors try to avoid doctors, and in any case are clothed usually. Those who think of cancer as chiefly an affliction of middle and old age should note that longevity was high among the natives in the early “cancer free” time, almost certainly as high as among the non-natives. (For a general discussion of Eskimo longevity, before and after the Europeanization of their way of life, see Chapter 14.)

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