Go Ask Alice

Once, when the world and I were a great deal younger, it was my journalistic prerogative to be seated next to the British physician Alice Stewart at an anti-nuke fundraising breakfast where she was the honored guest. Awestruck, I hazarded a question: “Dr. Stewart, what do you consider your most important scientific accomplishment?” to which she replied, between bites of toast, “I invented epidemiology.” I didn’t dare ask her what that meant, but Gayle Greene, bless her, did. What might be called “basic epidemiology” was invented by Dr. John Snow, who traced an outbreak of cholera to a contaminated well. What Stewart meant was that she had refined, enlarged–one could say transformed–the science. Along the way she revolutionized medical practice. And in the words of The New York Times she also became the nuclear establishment’s “most influential and feared scientific critic.”

Most books that treat of atomic catastrophe are a hard sell, the reason being, of course, that scarcely anybody can bear to read them. But The Woman Who Knew Too Much is something of an exception; a lot of it is grim beyond belief, but a lot of it isn’t. Once word gets around about the un-grim part, it should have a new audience, one outside Dr. Stewart’s disciples in the anti-nuclear movement. That new audience will be made up of (of all things) English majors! Also, English teachers, English lit profs, fans of Merchant Ivory/E.M. Forster movies, reciters of Ezra Pound, W.H. Auden and “the Oracle” (critic William Empson’s irreverent nickname for T.S. Eliot), and on and on–the whole band of nostalgic Anglophiles who still pine for that golden phase between the two wars when Empson, at the hub of it all, was making and breaking reputations and writing his own difficult poetry.

But, you ask, what’s all this stuff about Empson doing in a review of a book on the life of Alice Stewart? What was he to Stewart or she to Empson? Greene deliciously reveals–to the amazement of many of Stewart’s admirers in the anti-nuclear movement–that all the while their heroine was carrying out her world-shaking studies, all that long while when she was establishing that even very low levels of radiation kill, that there is no threshold for radiation effects, she was simultaneously carrying on a sizzling love affair with the dashing, iconoclastic, and married poet/critic. The two had met as undergraduates at Cambridge where Stewart, at once ostracized and bored by the male medical students, chose to run exclusively with the literati. But Empson soon scooted off to adventures in the Far East accompanied by his recent bride–not Stewart, who later drifted desultorily into a less than happy marriage to a master at an elite private school. Many years later, when Empson came home, he ran into her at a party, and asked her to dance. After that, she told Greene, “we went right on dancing, as it were.”

“The years between the wars,” he once wrote, “were like a circus with a thrill in every turn. But the post-war scene turned flat and dull.” Perhaps, he added, striking a note of uncharacteristic pessimism, “the atomic bombs have rabbitted our heads.” When he died of a cancer-which, like all post-World War II malignancies may well have been caused by atomic radiation-Stewart’s closest companions became fellow researcher George Kneale and the scientists, activists and writers of the anti-nuclear movement, who now include Gayle Greene.

Now for the grim part of the story. In 1956 Stewart produced the first of her two celebrated studies, the Oxford Childhood Cancer Survey, which demonstrated that a single diagnostic x-ray received in utero doubles a child’s risk of early cancer. Greene communicates the drama of how Stewart arrived at this finding by first visiting every one of England’s 203 county health offices and then tracking down the mothers of children who had died of cancer (an accomplishment that is all the more remarkable since Stewart was working before the time of computerized databases). She persuaded the women to fill out a uniquely exhaustive questionnaire concerning their children’s lifestyles going back to birth as well to events that had occurred during the fetal stage beginning with conception. As Greene makes clear, a conventional epidemiologist would have stopped the investigation at birth. The x-ray-cancer correlation leapt out at Stewart and Kneale, the brilliant, eccentric statistician who has been her lifelong research collaborator. This accumulating of great masses of data and letting it speak to her, this “letting in the noise” as Stewart calls it, is part of what she meant when she told me that she had invented epidemiology.

Their findings were initially received with enthusiasm and predictions of a Nobel Prize. Then the radiological community, which consists of radiologists, x-ray-happy M.D.’s , makers of x-ray equipment et al., who panicked at the potential loss of income, weighed in against her. Finally, after stormy, dramatic Congressional hearings, the American, followed by the British, medical profession reluctantly capitulated and recommended against the x-raying of pregnant women. As Stewart explains to Greene, when she started out, she had no idea that her Oxford Survey would eventually range far beyond the medical x-ray issue, even challenging the sacred cows of nuclear war and nuclear war’s handmaiden, nuclear power. (Nuclear power reactors produce plutonium, which, after suitable reprocessing, is transmuted into the raw material of atomic bombs.) She began to get the picture in 1974 after she received a call for assistance from Dr. Thomas Mancuso at the University of Pittsburgh Medical School, one of the world’s most respected occupational health researchers. It seemed that the U.S. Atomic Energy Commission had commissioned him to see whether workplace exposure had had any deleterious effect on the health of workers at the gargantuan Hanford complex in Washington State, which produced plutonium for nuclear weapons.

The sponsors of the research assumed that Mancuso would confirm the results of the Atomic Bomb Casualty Commission, which was created to study the health effects of the atomic bombs dropped over Hiroshima and Nagasaki. (In 1974 the ABCC was renamed the Radiation Effects Research Foundation in order to dissociate it from the atomic bomb.) The Commission, or Foundation, is set on Hiyama Hill, looking out over the Hiroshima River delta. As the Japanese bomb survivors who were summoned to Hiyama Hill found out, it is not so much a hospital as a research institution with the survivors as its subjects. Instead of doctors the ABCC/RERF staff consists largely of persons who have no clinical knowledge of the human body and its workings–“number crunchers,” says Stewart disdainfully. Persons whose knowledge comes from textbooks. This sinister group decreed that Hiroshima caused no health effects beyond those of the high-level bomb explosion radiation; their findings formed the basis for international radiation standards.

“For years and years our prenatal study had been the only evidence that there was anything dangerous with low-dose radiation,” Stewart explained. “At Hanford we were looking at people being exposed day in and day out over a period of time to doses only a fraction higher than background radiation, and we were finding a cancer effect… This meant there was a serious health hazard not only to workers in the atomic energy industry, but to the general public as well… We were challenging the official story that says, if the dose rate is reduced and given over time, you’ll get less cancer–and if you lower it enough, you’ll get no effect… Now we were saying, lower doses received over time might actually produce more cancer per unit of exposure than a single large dose.” (The general public would have even higher rates of cancer than the Hanford workers since it contained old folks and children, known to be more susceptible to radiation insults than healthy primetime workers.) For his efforts, Mancuso lost his funding and was not allowed to publish his findings; Stewart and Kneale went back to England and continued to work on the project independently. It takes Greene more than a chapter to describe the ordeal by bureaucratic fire through which Stewart, Kneale and Mancuso had to pass in order to regain access to health records of the workers; it took them a decade. “Everyone in America who took our side in the years subsequent to the Mancuso incident lost their funding,” she told Greene. “They don’t burn you at the stake anymore, but they do the equivalent, in terms of cutting you off from your means to work.”

Greene first laid eyes on her subject-to-be a decade or so ago during an interview that literary-scholar-turned health writer Greene was doing for a book ambitiously entitled Cancer, co-authored with Dr. Vicki Ratner. At first acquaintance Greene saw the great scientist as a sweet, somewhat doddering grandmother type until she shot Greene a couple of those piercing “I-do-not-suffer-fools-gladly” looks of hers and displayed flashes of her barbed wit. Greene was hooked. An overextended Scripps College professor of women’s studies and literature with a big book in progress, she nevertheless knew she had to do the bio. It is likely that she considered that while Stewart might live to 100, she might not. At this writing Stewart is 95; that is to say there was an urgent need for a record of her actual living words. For who but Alice Stewart could speak for Alice Stewart?

Like Empson, Greene is a literary scholar, but she had more courage than he and took on the challenge of making Stewart’s work accessible. Greene’s book takes its place along with Robert J. Lifton’s Death in Hiroshima, Harvey Wasserman’s Killing One’s Own and Carol Gallagher’s magnificent Ground Zero, as a book that unflinchingly describes the contemporary human situation (where it’s at, in all its horror, so to speak). May it be made into a film as soon as possible-Tim Robbins could do it-and by some miracle may it reach the hearts and minds of those who call the shots in the global nuclear economy.

Anna Mayo was a Village Voice staff writer and columnist for over 20 years. She has written on nuclear issues since 1979.