Graham, Effie, Jackie Pflaum and Elfrida Nord, editors and authors of the introduction, and commentary, With a Dauntless Spirit: Alaska Nursing in Dog-Team Days. University of Alaska Press. Hardbound $45.00. Softbound. $21.95. Black-and-white photographs.

After the purchase of Alaska in 1867 the United States did not exactly lavish attention on its new acquisition. Not until 1912 did the territory receive autonomy, and even then it was highly restricted. Missionaries, the American Red Cross, and finally the territorial and federal governments supplied health care limited by funds and the size and harsh conditions of Alaska.

These personal stories of six nurses serving are taken from their letters and diaries. R. N. De Armond once observed that he had given up on diaries since most he had seen had "Snowed again today" as the main news. There is some of that in these accounts, but the editors have done a fine job of winnowing and the result is an excellent picture of the lives of these women and their surroundings, in all covering the years between 1904 and 1947.

Although of different temperament, they had certain things in common. They were stationed in various parts of rural Alaska and were limited by their training, which was to be completely subservient to (male) doctors. Nurses were to diagnose only in order to assist the physician. In the field they often found the doctor was elsewhere and they had to make the life-or-death decisions. One nurse, who saved the life of a child with appendicitis by installing a drain, had a doctor demand her license be revoked. It wasnít, but that summed up the belief of the day.

Medicine itself was primitive by our post-antibiotic and x-ray standards; the chief reason doctors made house calls was because they could offer little besides sympathy.

In addition, a public health nurse was expected to organize activities like soap-making and sewing, teach sanitation, and in general work all the time. Her housing and food ranged from pathetic to marginal, and she was, of course, expected to be cheerful, sympathetic, and good-natured at all times.

Of the six, while all portrayed women devoted to their work, the most appealing is Mildred Huffman Keaton. She served in Southeast Alaska from 1923 to 1932, then moved to Kotzebue for a year. She seems more modern to us because she was closer to the people; when she left Kake "...all the people came down to the beach to bid me goodbye and Iíll admit to a lump in my throat."

The paternalistic approach was common in those racist days; the white people, even the kind and caring ones, considered themselves superior to the natives. The medical workers and educators, off-hours, stayed with their own kind, and while they learned a few words of the language, saw no reason to actually become friends with the villagers. Today we mourn the lost opportunities on both sides, but we have to place them in the context of their time. The editors, nurses all, point this out in their introduction, but also conclude "...a quality of mental toughness and endurance emerges from [the nursesí] letters and memoirs. In later life, their memories of the rural Alaska experience were keen and fresh, and recalled with pride." Fair enough.

There is a glossary in the back that explains medical terms both current and obsolete. There is a bibliography and the appendix gives the duties and qualifications necessary for a government nurse in Alaska in 1938.

Overall, recommended for all former and current health workers in Alaska.

D. L