Paula Wayne, Wasteland Doctor

By Isabel Stewart Way, ©1962 

With looks and a figure that belied the seriousness of her profession, young Dr. Paula Wayne had come to the California wasteland to take over her ailing Uncle Eric’s practice, and to join his fight against the come-lately faction trying to put up another hospital in the desert. It was a bitter contest, and old Doc’s will to live hung on the outcome. It didn’t help matters when, unwillingly, Paula fell in love with Dr. Joel Leander, who led the opposition—but the real trouble came with Mike Comarra, richest rancher in the desert. An animal of a man, well-aware of his influence, he threatened to switch his support to Joel if Paula rejected his advances. “Life” to Paula had always meant the antiseptic facts and colored illustrations in her medical books. Now, she faced a reality she was ill-equipped to deal with. It took the primitive desert and emotions burned raw by the sun to mature her, to teach her that as long as there was honey, there would always be the taste of vinegar.

GRADE: B+

BEST QUOTES:
“Well, if we have to carry on the fight, I’ve sure got the best of it—with such a gorgeous enemy! No holds barred, I trust?” 

“Fact is, I never did see a woman doctor this close before!”

“Maybe you weren’t an ethical doctor, for those few moments, but you were all woman, and a damned fine one!”

REVIEW:
Dr. Paula Wayne, fresh out of medical school, has come to the desert outside Palm Springs to take over her uncle Eric’s general practice after he is laid low by a heart attack. She’s not exactly excited about the prospect: “There could never be enough challenge for her in the life Uncle Eric lived—managing his small ten-bed hospital and attending his patients who were scattered over a large area of the desert,” she thinks to herself. But she is faced with challenge almost the minute she lands, because the only way she can get out to the small town from the airport is to accept a ride with Dr. Joel Leander, who is her uncle’s arch-nemesis. 

Joel is under the impression that Uncle Eric’s practice and Wayne Hospital are not up to snuff. “The equipment’s out-of-date and it’s inadequate,” he tells her, pointing out that the hospital’s nursing staff is headed by Tori Travis, who has no nursing degree and chronic tuberculosis to boot. Actually, Joel’s explanation seems reasonable, that Eric shouldn’t have complete control of the community’s only medical facility without input from others. Paula thinks so, too—and also that Joel himself is pretty gorgeous. “She had wanted to impress him, she admitted in all honesty, and she had wanted to do it as Paula Wayne, good-looking blonde female, measurements 36-26-34, and not as Paula Wayne, M.D.!” He is impressed, and the pair are soon kissing.

Paula soon finds that Uncle Eric really hasn’t been maintaining a modern practice, when on her first day she meets an old woman with a gallbladder infection and discovers that the woman has few records and fewer tests. “How could her uncle have treated a chronic case like this, over a period of time, without insisting on full GI tests?” It won’t be the last time that she encounters shoddy methods, and slowly she begins to come around to Joel’s way of thinking—until, while reapplying makeup after mussing hers while making out with Joel, she sees a negligee on his bed, and decides this belongs to his nurse, Diane Holsworth, whom he’s also been dating.

This sends Paula into a very peculiar tailspin. “Just what was the matter with her, anyway? Had she suddenly gone neurotic? Or was she what her roommate at General used to prophesy she would eventually become—a frustrated virgin?” Paula “had chosen to remain a virgin, but not strictly from moral reasons,” but because “sexual continence seemed a cleaner, more organized way of life.” But now she thinks if she hadn’t seen someone else’s underthings in Joel’s bedroom she would have slept with him that night, and what seems to be bothering her most is that she “had let him know she was willing and ready to be kissed! So she was a frustrated virgin, after all.” 

Her morality struggle is compounded when she meets rancher Mike Comarra, a commanding presence against whom she is warned by three different women before meeting him, and who immediately make the pass at her despite the fact that he is married and she is only at his house to treat his wife’s migraine, which he attributes to the fact that he wanted to “visit her bedroom.” He asks, “Dr. Paula, just what can you give a man who has a frigid wife?” Well, she can give him a kiss, just six pages after her encounter with Joel. Then things really get interesting, because when Paula tells him it was a mistake, he declares that he is going to throw his support behind Joel Leander’s push for a new hospital if she doesn’t sleep with him. She refuses, and soon Joel is sending out of flyer for a town meeting to discuss building a new hospital, with funding from a real estate pal of Mike’s. It’s not frequently that we encounter such blatant sexual harassment in a VNRN, and this may be the most blatant case I’ve seen to date, actually.

Paula hears that one of the people at the meeting who will speak out against Wayne Hospital is going to bring up Tori’s tuberculosis, so she packs Tori off to Los Angeles for a whirlwind day of tests, which again, Dr. Eric had never bothered to run. At the meeting she steps forward to tell them that Tori doesn’t have active TB, but another lung disease that will eventually require an operation. As fate would have it, Joel is a would-be thoracic surgeon chomping at the bit to establish a dedicated service in the desert for all the folks out there who need pulmonary surgery, which would be likely about five, tops, but what of it? Tori ultimately agrees to have the operation but—and you knew this was coming—only at Wayne Hospital, with Joel as her surgeon! And, at the same time, she calls out Paula for her hypocrisy when Paula wants Tory to tell Eric that she loves him, while holding herself apart from Joel. Tori is a feisty, admirable character who greatly enriches the story.

The book plays out pretty much as expected, but the ending is a sweet twist. The most interesting thing about this book is its discussion of sexual harassment, as much as it’s capable of doing for the time in which it was written. None of the men seem to understand why Mike’s family is no longer a patient of the Waynes, and when Joel makes an inaccurate guess, “A lot you know about it! Paula thought, with a little flare of exasperation. Men didn’t realize all the truth about Mike Comarra.” And when Uncle Eric finds out that Paula has lost Mike’s support, she hints at what had happened, but Eric snaps, “Surely you realized that risk when a female turns doctor! You can hold a man in line, can you? A decent man doesn’t venture past the boundaries a decent woman puts up!” To her credit, Paula thinks, “You certainly are living in the past!” and asks him, “What does Mike Camara know about the rules for a decent man?” Not that it changes anything, because she makes no attempt to out Mike as a sexual predator.

Instead, she tackles the problem from the wrong angle, thinking not about the dynamics of power but instead about sexual desire, her own and other women’s, feeling particularly empathetic when confronted with a Hispanic ranch worker of Mike’s who bears one of his children (stillborn). She also examines her own sexuality, and chastises herself repeatedly for having “betrayed herself as a desire-filled female!” She renews her vows of chastity, deciding that “sleeping around was a careless messy habit,” and then several times she refers to Joel’s nurse as a “hussy” for having apparently slept with Joel. She’s a bit judgmental for a doctor, and her opposing attitudes toward the Hispanic woman and Joel’s nurse are not examined. Unfortunately, Mike is never called out for his behavior, and in the end is reconciled with his wife, though it is doubtful that this is going to improve his behavior. It’s a simplistic attitude, but one that could be understood given that this book predates #metoo by about 55 years.

Ultimately this is the best of the four books of Isabel Stewart Way’s that I have read, with interesting themes and glimpses back on the mores of an earlier time. Paula is a strong, independent woman and an excellent doctor, even though she is “as man-conscious as any pubescent girl!” If the ending is not difficult to foresee, it is also a relief that the male doctors value and lean on Paula’s strength and talents as a doctor, and don’t brush her off as soon as they start to work in partnership with her. Some of the characters are interesting, even if the writing style isn’t especially outstanding. Overall it’s a decent enough book, one worth reading, even if it insists on dismissing the desert as a “wasteland.”

The Nurse’s Dilemma

By Vera Cleaver, ©1966
Cover illustration by Mort Engel

“I’d better warn you, Nurse … I’m going to marry Stephen Templeton—so forget any ideas you may have in that line. I’m not ashamed of my money—I like it and I like what it can buy.” Helen Harrison’s arrogance infuriated Nurse Jean Wheaton, but she was comforted by the memory of the handsome surgeon’s embrace. “I doubt very much if you’ll buy Dr. Templeton. Is that all you wanted to tell me?” “I just thought I’d warn you,” Helen said. “Steve is not the man to settle for … second best.” Burning with fury, Jean went to meet Dr. Stephen Templeton. Second best! Anyway, I have no intention of falling in love with him—or have I …? A beautiful young nurse, a rich society girl, and a handsome surgeon become involved in a triangle that rocks Monroe General Hospital.

GRADE: A

BEST QUOTES:
“I was talking to a guy this afternoon who drives a truck for a living. He told me he makes four dollars an hour. We could live on four dollars an hour, couldn’t we?”

“I’m going to wear my new white sweater and my new black pants, and when you see how handsome and virile I look whizzing around on my new silver skates with the wind in my hair and a song on my lips, you’ll fall to your knees and entreat me to marry you immediately. 

REVIEW:
It is with great sorrow that I tell you that The Nurse’s Dilemma is the only nurse novel that Vera Cleaver ever wrote. It was her first, written when she was 47, and thereafter she turned her focus to books for young adults, mostly written in partnership with her husband Bill Cleaver; you may have heard of their third book together, Where the Lillies Bloom, which was written in 1969 and was a National Book Award finalist.

But here we have a truly remarkable story, of Nurse Jean Wheaton, who is an excellent surgical nurse. “If you’re just routinely good, you wait for the surgeon to ask for the instruments. If you’re more than good—if you’re standing there moving, breathing, feeling with him—you anticipate. You know ahead of time and you act … You are trained and, more than that, there is a built-in intuition in you, so you don’t wait for him to ask. You give. It’s a little like dancing with a stranger.” She’s the preferred scrub of Dr. Stephen Templeton, who likes everything just so, and who has carefully plotted out his life. “Dr. Templeton wants prestige in his life,” she tells her roommate Willow. “You can tell that from the way he speaks and dresses and acts. He graduated from one of the best schools in the East. He’s not going to throw all that away now.” His plans to obtain nothing but the classiest mean, Jean suspects, that she isn’t high on his list of suitable dates.

Nonetheless, he accepts Jean’s invitation to visit her raucous family in the hills for Christmas, and upon seeing him in her messy home, she realizes that she’s blown it. “When we all trooped in and took our places, and I saw Stephen Templeton look at it, I knew that the table covering should have been white cloth, that I should have somehow managed matching napkins, that the thick restaurant china my father had bought at an auction should never have been considered for such an occasion ... that it and all of us were in our element, but not in Dr. Templeton’s.” But he’s still human underneath his armor of plans, and he falls in love with Jean anyway. He’s announced his engagement to Helen Harrison, a society snob, but tells Jean he’s going to break it off with her. Unfortunately, Helen beats him to the punch and tells him that she has tuberculosis, so now we have the slightly stale situation of a couple staying together because of tragic illness. “We have to be sensible. And we have to do the honorable thing,” Stephen tells Jean, and she agrees. She packs off to a new job 600 miles away while Helen packs off to a sanitorium.

Months pass, and then there’s a knock at the door: Helen has hired a detective to find Jean, and sends a summons. She’s going to die, she tells Jean, and though Jean the trained nurse determinedly denies the truth, Helen refuses to have it, and frankly acknowledges, “My marriage to Stephen wouldn’t have been successful. It would have flopped because Stephen is in love with you.”

From here the story is fairly predictable, but what I couldn’t have predicted was how fine and how truly original the writing, how honest the emotions, how lovely the characters. The story has an actual heart. The characters are admittedly flawed, but in the end, they realize their failings and promise genuine growth, together, as a real honest love should. The medicine is detailed and mostly accurate, showing that Vera Cleaver put in a lot of time at the library for this one. This book demands a special niche on your VNRN bookshelf as a rare story that actually deserves to be read a second time, with a tear that it has no sisters, but a relieved smile that we have the remarkable gift of this one.

High Country Nurse

By Virginia Smiley, ©1970

Lovely young Cass Fleming wanted nothing more than to be a good nurse. But suddenly her work at City Hospital, the suffering of small helpless children and kind elderly people, seemed too much for her. To make matters worse, her fiancé, Dr. Dan Driscoll, could not understand her feelings. Could she marry a man who was that cold-hearted? Cass decided she needed to get away from it all—to sort out her bruised and mixed-up emotions. The remote Navajo Reservation, where her Aunt Norma taught school, seemed the perfect refuge. But “getting away” wasn’t quite that easy. There were the Navajo people whom she quickly learned to love, and who needed her help. And there was the tall, self-assured young flyer, Sandy Russell, whose playful mockery suddenly turned into something much more serious. Cass realized there was no escape from life and its decisions … and the most important decision of all still lay in wait for her.

GRADE: C

REVIEW:
Nurse Cass Fleming, apparently just a few years out of nursing school, is already burned out. Working at City Hospital in Phoenix, she has witnessed both children dying of cancer and elderly people dying of old people diseases, and she just can’t take it! Plus she had a fight with her fiancé, Dr. Dan Driscoll! So she decides to take a four-week vacation—can you imagine such a thing?—and heads off into the desert to visit her aunt Norma, who is a schoolteacher on the Navajo Reservation. 

OK, I know, you’re already bracing for the racist attitudes of the Great White Woman descending into sandy poverty to bring holy healing to the unwashed, and I will in fact be making reparations in the form of a donation to the American Indian College Fund, a truly inspiring organization that has already benefitted from another horrific book I’ve read (Peace Corps Nurse) and, unfortunately, is likely to be hearing from my checking account in the future as well. On the whole, however, High Country Nurse is less appalling than other VNRNs I’ve read, in that our heroine Cass actually seems to respect and admire the Navajo people she meets. She does, however, feel that their lifestyle is backward—never mind that they were forced out of their homelands and marched on the Long Walk to a prison camp, and then to a piece of land no one else wanted, not exactly prime farmland. Can you blame the Navajo for not trusting anything white people brought them?

Initially Cass is reluctant to get involved in the community clinic, run by an aging Dr. Barton, who begs her repeatedly to help out even for a few hours, but she is on vacation, she insists, and still struggling to get over her heartbreak from witnessing bad outcomes in patients she had cared for. But before long a crisis forces her to get involved, helping to ferry a man with appendicitis to the hospital on the local medical rescue helicopter piloted by heartthrob Sandy Russell. The patient sleeps the whole way, but that’s all it takes for Cass to overcome her reluctance, and now she’s showing up at the clinic in a pale green shift because she neglected to bring any nursing uniforms with her on the trip.

She’s also hanging out with Sandy, and increasingly musing over fiancé Dan’s shortcomings in classic VNRN style. “Dan would want a large, well-staffed office in the best section of the city, with patients in the upper-income bracket.” “Dan had always been so very serious, almost to the point of being stuffy.” “Sometimes lately, when she thought of Dan, he seemed shallow and a bit selfish.” So naturally, when Sandy asks her why she doesn’t wear her engagement ring on her hand—she keeps it on a chain tucked into her blouse—she jams it back on her finger, snaps angrily at Sandy, and, when he coolly says goodbye, she decides, “She would return home to repair her relationship with Dan—and just as soon as possible, they would  be married.” Because marriage will fix everything!

Central to the story is a young girl, Daisy, who wants to attend school but is prevented from going by her grandmother. This is one of Cass’s biggest obsessions during her stay, and she tries again and again to befriend Daisy as well as win over Grandmother Many Blankets—who may recall the compulsory boarding schools for Native Americans that attempted to wipe out Navajo and other Indian Nations’ culture, but no one ever bothers to ask Grandmother about her objections.

Cass’s vacation winds down, and with Sandy now a bit more cool, she heads back to Phoenix to her job, but soon finds it—and her betrothed—a bit dull. “Cass did her work efficiently, but it was always the same—assisting the doctors on rounds, routine work, taking orders, endless orders. More and more often, in spite of her intentions to push it aside, she thought of Dr. B. and his clinic. There, she had shouldered responsibility—there she had felt alive.” Furthermore, Dan has not turned out to be all that great, surprise! Furthermore “since you came back, our dates have been a bit on the dull side,” Dan says. So she decides to return his ring, because “the butte country had changed her. There was no use in trying to force him out of her mind any longer,” she says, and then, out of nowhere, “She was in love with the young flyer.” Now she’s mooning over Sandy, but can’t possibly tell him how she feels.

Eventually Daisy, now ill with tuberculosis, runs away from home and collapses on Cass’s doorstep. Sandy’s helicopter, coming to carry her to the hospital, frightens Grandmother, who is hot on Daisy’s heels. Grandmother believes the helicopter and its radio to be “magic,” though it’s inconceivable that she hasn’t seen the ubiquitous chopper before. Suddenly Grandmother is on board with white man’s medicine and education as well: “You take Daisy to place in city to make her well. Then she will go to the school like other boys and girls.” This shockingly sudden about face sweeps Grandmother’s years of resistance away with the backwash from the helicopter rotors, delegitimizing her feelings without even informing the reader what they even were.

Another side story is Navajo Louise Beh, who wants to go to nursing school, but whose father, a medicine man, is against it. Cass visits Louise in Louise’s home, and “there was, Cass noted, nothing in the room to show that an Indian family loved here.” Louise says, “White man’s school has taught me much better ways,” and my heart broke for poor misguided Louise.

This book is fairly simplistic and formulaic, with cardboard characters and perfunctory writing that yielded nothing for the Best Quotes section. While the thinly veiled racism will make you wince, there’s not much else here to either upset you--or interest you, either. If we hear a lot about sand, we really don’t have much description of the southern Arizona landscape.  Like the other two Virginia Smiley books I’ve read (Nurse Kate’s Mercy Flight and Nurse of the Grand Canyon), this book is not the worst I’ve reviewed, but it certainly is a flat and arid desert.

My Love an Altar

By Joan Sargent
(pseud. Sara Jenkins Cunningham), ©1963

To Roxanne Collier, Dr. Vance Collier had become a shadow-husband keeping up the façade of an empty marriage, so when Dr. Fritz Bascomb showed her that she was still a beautiful, desirable woman, she was grateful and flattered. Then tragedy struck in the form of an epidemic that threatened the lives of the town’s children. It was a time for some quick and deep soul-searching, for Vance and Roxanne faced not only the break-up of their marriage but the loss of their child.

GRADE: B+

BEST QUOTES:
“What’s he doing to Pomeroy that the rest of us wouldn’t if we got the chance?”

“He’s going to get better. He assures me that he won’t stay in such a place as this and that he hates me. You can’t down a man like that.”

“Miss Skipper, completely won over, was quite willing to try anything that went with that smile.”

“How do you like being an incurable disease, Beautiful?”

REVIEW:

I’ve been on a roll lately, finding myself in some of the more interesting VNRNs I’ve met to date. My Love an Altar continues in this vein: The main characters are a decade older than most, are already married (even if only to each other), and are attracted to other people. Roxanne Collier is the perfect doctor’s wife, beautiful, stylish, a brilliant hostess—and she hates every minute of it. On the inside she is insecure, lonely, and contemplating a major change in life. Her husband, chief of staff Vince Collier, admittedly married young Roxanne for her money, and has built a successful career as the head of a major sanatorium for tuberculosis treatment. He’s not happy, either, however, because he is overwhelmingly guilt-ridden, feeling he has been handed everything on a silver platter belonging to his father-in-law, who has funded Vince’s education and the hospital itself.

Then, at a dinner party during which Roxanne is suffering a major migraine, she is seated next to psychiatrist Fritz Bascomb, who recognizes Roxanne’s ailment as springing from the deep-seated dissatisfaction in her life. He rescues her from the party, takes her home, gives her medication, and days later is taking her out for pie at the truck stop on the edge of town. He’s an incorrigible flirt and knows how to use his powers, and soon his attentions perk up the wilting Roxanne, giving her a confidence she had lacked when she felt overlooked and unappreciated. She secretly begins taking classes at the local university and plots a trip to Reno when the couple’s daughter, Susan, goes off to college next year.

Vance, meanwhile, has an office nurse, Mary Pendleton, who has long been in love with the doctor and with whom he shares a not entirely professional relationship. Nothing untoward happens, of course, but his demeanor toward her is more possessive and involved than it should be. After several years of this, Mary has decided she needs to put an end to the chaste affair and submits her resignation. Vance has a better idea, however, and offers her a post working for the new doctor in town, Tom Hazard. Soon Mary is looking at Tom with the same adoring eyes she once cast on Vance, and for some inexplicable reason Vance despises young Tom and his new-fangled ways of treating tuberculosis.

The climax of the book comes when Vance’s daughter—along with a good number of other children in town—becomes desperately ill with a tuberculosis-like disease that no one can diagnose, and it’s all hands on deck to save her life. The ending is exactly what you know it will be—even the mystery epidemic is foretold in the book’s opening chapter (and this is by no means a spoiler). We couldn’t actually have a VNRN solve its romantic dilemmas with divorce, but this book is unique in that it gives us characters who are preparing to take that ignoble route. The writing is quietly more than competent and honestly sincere, and I must confess I even shed a tear at one point. Though it lacks the camp I hope for in a VNRN, we do, however, have some sass in the Collier’s daughter, Susan, who is full of quips like, “I know the book says an adolescent gets a crush on a man much older, but don’t worry about me and Dr. Bascomb. I’m thinking of having my crush on Mr. Bates, who teaches physics at school. He’s more my type. Sort of plain and helpless.” If its ending is not as revolutionary as it hints it could be, this book has a lot more to offer than most of the herd. 

Arctic Nurse

By Rose Dana (pseud. William E. Daniel Ross), ©1966

Following in her missionary father’s footsteps, Nurse Grace gave up her comfortable city job to work in the small Arctic hospital. But she hadn’t counted on the young surgeon—and her hopeless love for him. Or on the violence that suddenly erupted in the tiny community. Or on the plane crash that brought a vital young stranger into her life. The Arctic winter was torn by violence—and she was shaken by a whirlwind in her heart.

GRADE: B+

BEST QUOTES:
“The past was as real to him as the scar on his cheek.”

“He had a strong, distinguished-looking face, even with half of it lacerated and bloodstained.”

“When I first landed here you all annoyed me. Since then I’ve changed. I’ve grown to hate you.”

“You’re a pleasant change from these little brown-skinned gals.”

REVIEW:
Not many vintage nurse romance novels have as much going on as Arctic Nurse. This book actually makes use of its setting, allowing us to experience (in an admittedly limited way) what the Arctic is like. We get a fair amount of racism toward the native Eskimos, but it’s not your standard, straightforward prejudice; the white population is there primarily to assist the natives, and the interface between cultures of different technological levels is a complicated question with no real answer. So this book actually gives you something to think about, a rarity in the VNRN. (The only other VNRN that attempts a discussion on colonialism I’ve seen is Congo Nurse.)

Grace Barrow is on her third year in the Arctic at the hospital on Kovik Island, somewhere in way northern Canada. She’s doing this because she feels like she is helping her father, who was killed when she was five years old doing similar work. Dr. Mark Windsor came to the Arctic after he lost his fiancée in a car accident: He’d been driving them home from a party at which he had been drinking, and now he never touches the stuff, “refusing to join them even in a festive glass of wine at Christmas and New Year’s, because he blamed his drinking for the accident.” This is the first time I’ve ever seen the risks of drunk driving mentioned in any VNRN, though the characters certainly do it on a regular basis. Of course, Mark, who “could have had a brilliant future in any great hospital had come to bury his talent in this sixty-bed Arctic outpost hospital.” This is a more popular theme, that the genius doctor would better serve humanity in a city hospital. Because, as everyone knows, rural and non-white populations only rate sub-par physicians. Though the idea that general practice doctors can’t possibly be brilliant, that the best minds must specialize, lives on today. But I shouldn’t get started on that little diatribe.

There is “quite a sizable native village” on the island, and at one point 50 natives gather to hear news of a comrade who is sick in the hospital. They are balanced, or maybe outweighed, by six white characters: two doctors, two shopkeepers, a Mountie, and Grace. We are repeatedly given the white characters’ fondness for their brown neighbors: “Grace had come to understand and love the amiable, broad-faced people in their colorful woolen and fur jackets.” The two races even intermingle on occasion, though with mostly limited success, such as in the case of the two male Eskimo hospital attendants: “Even though they were well trained and had been educated at the mission schools this place still spoke of magic to them.”

Then there’s Konala, an Eskimo woman who has trained as a nurse in Toronto, where she was jilted by a white doctor. She is a perfect means to introduce paternalistic attitudes about Eskimos, such as, “Konala was living proof that the natives could adapt themselves to the twentieth century.” When Konala says her half-brother seems “filled with a wicked spirit,” Dr. Mark chides, “We don’t believe in wicked spirits do we, Konala? I mean, after all we’re much too well educated for that.” Grace warns the Mountie, Bert, about his growing closeness to Konala, saying he should be careful not to break her heart. “The natives don’t always understand the subtleness of our relationships,” she tells him. Konala is different from the other natives, “but only to the degree she’s absorbed our culture. She’s really typical of her own race in every other way. And I find the Eskimos a wonderful people.”

This love of the Eskimos is more than a little syrupy, not only to the reader but also to Grace’s single white patient, a crusty reporter who crashes his plane near the hospital. He tells off the whole gang, shouting that he’s sick of hearing them “saying how wonderful it is that you’ve come up here and dedicated your lives to the poor Eskimos! … As I see it you’re all failures. Covering your failure by running away from civilization and pretending to be heroes.” To Grace, he adds, “You’re in the Arctic because you think it would please dear old Dad who was a missionary. Your neurosis is you’re trying to live your father’s life rather than discover one of your own. … What really makes me rage is your mealy-mouthed way of pretending it’s because you love the Eskimos.” It’s an excellent point.

The question of whether the white people are a help to the Eskimos is raised repeatedly through the book. Grace “felt that civilization had come as a mixed blessing to them and it was up to those who cared to try and balance the scale in the Eskimo’s favor. To date it didn’t look too hopeful.” For starters, they brought the scourge of alcohol. The trading post owner “carefully guarded against large amounts of liquor getting into native hands,” because of course the poor devils just have no self-control; if great white doctor Mark could forswear the stuff, how hard can it be?

Dr. Mark believes that “another bad thing we white, and so-called civilized people, have brought to your country” is greed, “the white man’s curse.” He and Grace have a conversation in which they decide that “it brings people closer together when they have to struggle against nature. That’s why these Eskimos are so unselfish. … We had the same generosity in America during the frontier days. It still exists to a degree in small towns and villages. But we’ve lost it completely in our cities … So even civilization has its failings.” I’m frankly puzzled by their idea that frontier America was all sweetness and light; from what I have read, it was pretty rough and ragged—was the gold rush really known for its unselfish behavior?

So it’s not surprising that Dr. Mark sometimes gets discouraged: “I wonder if we’re getting anywhere after all. Maybe we should abandon these people to their own devices.” But Grace reminds him, “Civilization always brings drawbacks with its benefits.” That’s about as heavy as the discussion gets, but at least it raises the point that technology, modern education, and fancy hospitals aren’t the answer to every problem.

They’re certainly not the answer to disease. Tuberculosis is a particular scourge in the Arctic, and the barbaric treatments the natives get include thoracoplasty, which means “all of the upper ribs were removed over the region of the afflicted lung. This caused a partial collapse of the underlying lung and so permitted prolonged rest.” (In Ski Resort Nurse, they just poked the patient in the lung with a scalpel under local anesthesia, collapsing the lung in a far less invasive procedure.) Then there’s the phrenic nerve crush, in which a small incision is made in the neck above the collar bone, and the phrenic nerve supplying the diaphragm is grasped and crushed, paralyzing the diaphragm on one side. “And as a result the paralyzed diaphragm would rise up in the chest and cause a limitation of the lung’s expansion. Such a limitation took the place of a thoracoplasty in giving the lung a prolonged rest and it had the advantage of not being so drastic for the patient.” I’m going to have to do some research to see what the evidence-based medicine has to say as to which is the superior of these treatments. The sad thing is that some TB patients at the Kovik Island Hospital were receiving streptomycin, which actually worked.

As far as the story goes, the descriptions of life in the Arctic are interesting: The houses are built on piles of rock, because if the foundation rested on the frozen ground, the earth would melt and sink, throwing the house into crazy contortions. The supply ship comes to the settlement in the spring, after the harbor has cleared of ice, and the “balmy” summers bring temperatures as high as 50º, while the winter storms drop to -50º. Sometimes the references are a bit gratuitous, such as the time Grace recalls, “The afternoon I took my first dogsled trip and we passed that immense polar bear on the ice I knew I wasn’t in Boston!”

The writing carries you easily along; it’s more the numerous controversial issues that bring you up short now and then. While it’s easy to see the racism, you can’t avoid the fact that the white folks mean well, and sometimes they even recognize their narrow point of view, such as when we are told that though Konala’s romance with the white doctor fell apart, “it was hardly fair to blame this failure in love on her racial background; it could have happened to any young nurse.” (They still think of her race first, but at least they try to knock it to the background.) And when Konala worries about whether she should wed Bert even though they are different races, Grace gives her some very sound advice: “If you marry Bert do it with the feeling that you’re bringing as much to him as he is to you.” Now if only they weren’t so parsimonious with commas!