This is the continuation of an interview with Dr. William "Bill" James on February 1, 2006 by Karen Brewster at his home in Fairbanks, Alaska. In this third part of a three part interview, Bill talks about having limited resources for medical care in rural Alaska, diseases and immunizations, and traveling to villages as a doctor. He also talks about what he is doing in retirement.
Digital Asset Information
Project: Community Health Aide Program Project Jukebox
Date of Interview: Feb 1, 2006
Narrator(s): Dr. William James
Interviewer(s): Karen Brewster
Transcriber: Carol McCue
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Operating with limited resources in emergency situations.
Some funny stories about medical professionals and politicians at work in Alaska.
The impact of immunizations on rates of illness and disease.
His retired life and a little bit of reflection on his career.
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KAREN: Okay. DR. JAMES: They said, well, what did you use? I said, well, I have a suture -- I had two suture kits. And he said, well, what was in the suture kit? And I said, well, there was a couple hemostats and a knife holder and scissors and needle holder. And pick up. Is that all you had? I said, yeah. He said really? Well, how did you sew her up? I said, well, I had a couple sutures. And I said, I did run out of sutures, and there were some nuns there in town, so we sent the -- one of the nurses up to the nun's house and got some thread and needle and soaked it in alcohol and I finished sewing up her skin with that. And she lived. And about a week later was back in Tanana on her way back to -- to Nulato. KAREN: Wow. That's quite amazing. DR. JAMES: But that was my last kitchen table surgery. KAREN: Your first and last? DR. JAMES: First and last. KAREN: Yeah. A lot of times other exciting stories that come up are like you have somebody's first plane crash or first baby delivery and those kinds of things. DR. JAMES: Uh-hum. KAREN: Do you have memories of any of those sort of big crises, any good stories? DR. JAMES: Well, the plane crash. Dr. Dunlap's nurse and his wife. That's the only plane crash I was involved in. And there was an old, old couple in Hughes, and Hughes at the time was a Wien -- a Wien navigational system like. And so they had a White Alice site there. KAREN: At Hughes? DR. JAMES: Outside of Hughes. KAREN: I didn't know that. DR. JAMES: Indian Mountain. And they had this old trader couple who sort of were like benevolent dictators of the town. And I got a call from them once that they had a sick kid there, they wanted me come up right away, and I -- so I flew up to Hughes. And this kid had meningitis. And we flew him right back to Tanana and treated him and he got well. And I had forgotten about one kid from Ruby, came in with meningitis, the mother was a health aide, and she reminded me of this at my retirement, she was at the retirement party. KAREN: And so she brought her kid in and you -- did she recognize -- DR. JAMES: It just happened that Floyd Elterman -- she was not a health aide at the time. But Floyd Elterman just happened to be in the village at the time, and he took one look at the kid and said, get him to town right away. So the mother was at my retirement party, and she told me, reminded me of the story. And told me that he that year was just getting ready to graduate from high school. Doing well. She told me she was always afraid of me. She became a health aide without any training. KAREN: Wow. DR. JAMES: And she called one day about this laceration. And she told this story at my retirement. And she had never sewn anyone up before. So she called me to send him -- wanted to send this patient into town. And I said, gee, it doesn't sound that bad. Why don't you sew him up. And she said, well, I don't know how. And I said, well, you just get a bottle of Novocaine and you shoot it in all around the wound, and that will numb it. And then you sew it up just like you would sew up moose skin. And she said, I don't know how to sew moose skin. Apparently I said, well, what kind of a Native are you? You know. I was so -- I said, well, look in the health aide manual. It will show you how. KAREN: Right. DR. JAMES: So she sewed the person up. She said it came out real well. She was real proud of herself. KAREN: That's funny.
KAREN: Any other things you want to talk about that I haven't asked you about, or stories that come to mind? I'm sure you must have a full repertoire. DR. JAMES: You know, it just seemed like everyday sort of things. Everyday sort of things. I went to Barrow, temporary duty, about, you know, probably -- I don't know, in '60, 1960 or so. And there was a -- it was a one-doctor hospital. And the plane went in Monday, Wednesday, and Friday, the planes went to Barrow. And so I got off the plane and the doctor that had been in Barrow got on the plane was going on vacation, so I was going to be in Barrow for a couple weeks. And I walked into the hospital, the head nurse came running, oh, Dr. James, I'm so glad to see you. We have a woman here with appendicitis. I said, well, why -- she said he had been here since yesterday. And I said, well, why didn't Dr. So-and-So operate on her? Well, he was afraid to. And I said, well, why didn't he take her to Anchorage with him when he went? Well, he was afraid to tell them that he was afraid to operate on her. So I went in and I checked her. Sure enough, she had appendicitis. And I looked at her name and it was Brower. And I had just read "Forty Years Below Zero" or something like that. KAREN: "Fifty Years Below Zero." DR. JAMES: "Fifty Years Below Zero." So I knew that Brower was an important name. And I said, well, there's not another plane for two days, so we better do it. So I did a spinal on her and -- spinal anesthesia. Took her appendix out and had no trouble at all. And the nurse thought I was God. You know, she was so relieved and everything. And then when I went to Tanana the second time, she was then head nurse of Tanana. So we got along very well. She was -- she had been an old Army nurse and she had been stationed out on the Aleutians in the Second World War. She decided that there wasn't always a doctor there, you know, he was on field trips at times, and so she thought that every nurse should deliver a baby. So I was standing right by the nurse and the baby was born, and it had a cleft lip and pallet. And just joking, I said, gosh, you pulled too hard. And the nurse went -- she just fainted. I had to grab the kid. We had one nurse, it was -- she had come from New York and she was a big nurse, she was tall and she was heavy, powerful nurse. And she had been in Tanana a week and she knew more about Alaska, knew more about Tanana than any of the Natives or me or anyone. And she was sort of obnoxious about her knowledge. And she got a little husky pup. And she wanted to name it a Native name. So I said, "Okay. Why don't you call it Anaq. That's an Eskimo name. Call it Anaq." And she thought that was a good name. So she called the dog Anaq. And she'd walk through town, "Here Anaq. Here Anaq." And oh, everyone was just kind of snickering at her and so forth. But after a couple weeks she found out that Anaq meant "shit." And when she found that out, she came running towards me. I -- I thought she was going to clobber me. Oh, how could you do something like that? You made me -- It was so funny. That she wasn't quite as smart as she thought she was. KAREN: You played the local trick. DR. JAMES: But she really made an ass out of herself walking through town with this little dog. Going, "Anaq, Anaq, Anaq." KAREN: And this is in Tanana? DR. JAMES: Uh-hum. KAREN: And they knew what Anaq meant, even though it was an Eskimo word? DR. JAMES: Oh, I think most everyone in town knew what it meant. KAREN: Yeah. DR. JAMES: On a -- on a routine field trip to Anaktuvuk Pass, one of my first ones up there, I noticed there were no kids under a year old. And I asked them, well, has it -- haven't you had any kids born in the last year? And they had some but they had all died. And I just put that in my report that I sent on to Anchorage. And several months later, I got a letter from the Surgeon General saying this is terrible, all the babies are dying in Anaktuvuk Pass. They had had some sort of an epidemic come through and killed all the babies. And they said, from hence on, all pregnant women from Anaktuvuk Pass should deliver in the hospital and we'll pay their transportation and so forth. So okay. We'll do that. And the first woman that came in didn't speak English. And she only spoke Eskimo. And we had an Eskimo cook at the -- at the hospital, but she was from out on the coast, West Coast somewhere. And she could -- they could communicate a little but not really too well. And tried to tell her that if she started having labor pains, to tell the nurse. And explain to her that we would deliver her in the delivery room and so forth. And this nurse was sort of suspicious that maybe she was in labor. And she'd go in and see her, the lady just would smile, you know. And the cook wasn't available. But the nurse was somewhat concerned. And she'd go in every once in awhile and check her. And then once the bell rang, the nurse showed her this bell, to ring the bell. And the bell rang, so the nurse went running in there, and there she was sitting on her knee, you know, like this, holding the baby with the umbilical cord still on and the placenta still inside. So they called me over right away. So it just kind of went to prove that maybe they didn't all have to come to the hospital for delivery, that they knew what they were doing. KAREN: Right. DR. JAMES: And that it was her fourth or fifth kid, and but we still kept bringing them all in. KAREN: It shows that Washington doesn't always know what's going on in the communities.
DR. JAMES: The immunizations have made a big, big difference for, like, measles. KAREN: And the health aides were doing -- were giving those immunizations? DR. JAMES: They had a -- the Public Health nurse, a state Public Health nurse. Yeah. The flu vaccine for meningitis has made a tremendous difference. And the meningitis and hepatitis shots. You know, measles, mumps, Rubella. H-flu. Pneumococcus vaccines. They've all made a -- there's not many doctors ever saw a kid die of measles, you know. KAREN: Yeah. DR. JAMES: Whooping cough. Whooping -- you know, the DPT, the diptheria, whooping cough, DPT, was the kids were getting immunized for that. The only whooping cough I saw was during my residency, my internship in Denver where some of the Native kids were not getting their shots. So up here, they were getting their DPTs. Polio was just coming out. I don't remember seeing any polio in -- up here. The meningitis in infants was -- MMR, measles, mumps, Rubella. KAREN: What's -- what's the -- how do you get meningitis? DR. JAMES: Oh, it's probably a respiratory, coming in through a respiratory system. It seemed like we were -- just have one kid with meningitis and get over it, and we'd get another one in. KAREN: But meningitis is now no longer such a problem? DR. JAMES: No, because of the -- in infants, the main cause is hemophilus influenza bacteria. And so the kids are immunized for that. KAREN: Right.
KAREN: Now what have you been doing with yourself since you retired? Keeping yourself busy? DR. JAMES: Pretty much so. I go to the gym every morning. And so that's shoots my morning. And then I come home, have lunch, maybe take a nap. I've been doing a lot of skiing up until the last month. I've been -- I usually go downhill on the weekends and cross-country during the week. KAREN: So you're completely out of the medical -- DR. JAMES: Uh-hum. KAREN: -- world? DR. JAMES: I'm skiing four or five days a week until cold weather came. KAREN: Right. DR. JAMES: And we went to Houston, my stepson lives in Houston, we visited him for about 10 days this month. He's getting married next month, so we're going to his wedding, and go. KAREN: Do you miss work? DR. JAMES: I miss the people but I don't miss the work. It is stressful. And I think I'm a lot less stressed out than I used to be. But I miss the coworkers, you know and the patients. I still see a lot of them when I go in Fred Meyer's or somewhere. KAREN: Yeah. And is it work you're glad that you did? DR. JAMES: What's that? KAREN: Is it work that you're glad that you did? DR. JAMES: Yeah. KAREN: You made a contribution? DR. JAMES: I worked until 70 years old. I thought that was long enough. And I had leukemia -- I have leukemia and I have prostate cancer. And so that kind of decided it. I don't have the pep and energy I used to have. I read a lot. Always before I felt if I had time to read and I wasn't reading medical stuff, I felt guilty. But I like to read a lot. My wife retired just before I did, and then she went back to work. So I do some housework. Go to things that I haven't had -- didn't feel like I had time. Like last night we went to a lecture on the Aurora that the science puts on, science foundation. I don't know. I haven't had a bored minute. I have a garden in the summer. My wife plants a lot of flowers. It's terrible mowing this lawn. You know, it's so steep. KAREN: Steep hill. Yeah. DR. JAMES: But mowing the lawn. Get out in my boat some. KAREN: So when you look back on your career, experiences around Alaska, lessons that you've learned, things that you would do differently in hindsight? DR. JAMES: I don't know what I would do differently. I've enjoyed what I've done the whole time. I could have gone into a different specialty and made more money, but I don't regret not -- I don't regret working, having a long career in the Public Health Service. I never had any desires to be a big shot in the Public Health Service and have an office in Washington or anything. I thought that was -- I felt when they wanted me to move to a bigger place and more administrative duties, I said, gee, I'm not even 30 yet and I worked hard to become a doctor, I don't want to be an administrator. KAREN: Right. DR. JAMES: And that's why I quit the Public Health Service the first time. But I was lucky to be able to stay in one place, I think, for a long time. Sometimes I kind of wish that maybe I'd traveled around more and maybe worked down in the Navajo area and so forth. But I don't know that I would have liked it any better than here. I don't know if it was -- I tell people, I don't know if I put down roots or if I was just in a rut. But I have no regrets for career. KAREN: So now -- you're 73 now? DR. JAMES: Uh-hum. KAREN: Okay. All right. Well, those -- that's all of my questions. DR. JAMES: Okay. KAREN: Is there anything else you want to say or wrap up with? DR. JAMES: No. That's -- it's been fun. KAREN: Good. Well, thank you very much. I appreciate the time.