Cover

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Title Page, Copyright Page

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pp. i-x

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Foreword to the First Edition

Helen Caldicott

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pp. xi-xii

This is a fascinating account of the life of an Englishwoman, born into a medical family almost 100 years ago, whose discoveries have brought her into conflict with the powerful nuclear industry and the international regulatory bodies that set radiation safety guidelines. Alice Stewart is a pioneer worthy of a Nobel Prize. Her work has been largely unrecognized by the scientific mainstream because it challenges received wisdom that radiation in small doses poses no threat....

Contents

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pp. xiii-xiv

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Preface to the Second Edition

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pp. xv-xxviii

When I finished The Woman Who Knew Too Much in 1999, Alice Stewart was still alive, and so was her archrival and nemesis, Sir Richard Doll. I had played down his part in her story. Though I knew it was important—he had blocked her career at key points—I was not sure what to make of their relationship. Their lives and work were closely intertwined, yet took opposite directions, she becoming ever more oppositional, while he became “ever more of the establishment,” as he said.1 She testified...

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1. Introduction: Daughter of Time

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pp. 1-16

In 1956, Dr. Alice Stewart discovered that a single exposure to a diagnostic x-ray shortly before birth will double the risk of an early cancer death. Her finding made a revolution in medical practice: on account of it, doctors have become very cautious about x-raying pregnant women. A few decades later, she produced a study showing that the nuclear weapons industry is about twenty times more dangerous than worker safety standards admit, a discovery that put her on a collision course not only...

Part 1. The Making of a Doctor

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pp. 17-18

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2. Dr. Lucy and Daddy Naish

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pp. 19-34

Alice Stewart is daughter to two physicians, Lucy (née Wellburn) and Albert Ernest Naish. Both were pioneers in pediatrics, and both became heroes in Sheffield for their dedication to children’s welfare. He was known far and wide as “Daddy” and she was nicknamed “Granny.”
Alice has qualities of both parents, combining Lucy’s extraordinary intuition and gift for problem solving with Ernest’s keen analytical intelligence and talent for diagnosis. She takes from both an idealism about medicine, a willingness to sacrifice financial gain to devote herself to the...

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3. School Days and Cambridge

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pp. 35-48

The first house Alice remembers is not 5 Clarkehouse Road, but the house in Sheffield’s humbler east end, where she was born. It was built on a hill where a broad avenue split into two narrower roads. Facing the junction was a nursery, a semi-circular room with four windows. In each window was a window seat just right for a child to defend as a military post on the many occasions the Naish children played soldiers. The flat roof of the house was used as a battlement....

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4. Marriage, Motherhood, Medical Practice: Through the War Years

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pp. 49-72

Alice Naish and Ludovick Stewart were married in June 1933 and moved to Manchester, where Ludovick became master at Manchester Grammar School. “It was a very good job—Manchester was said to be the only school in England to rival Eton. So I upped stakes to follow him.”
Alice feared that this move was going to put an end to her career. She found a position as a locum—a stand-in or substitute—for a doctor in Tyldesley, a nearby cotton town. “I can remember waking in the morning...

Part 2. Engendering Epidemiology

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pp. 73-74

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5. Changing Subjects

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pp. 75-85

Social Medicine came into existence as an academic discipline in 1943, with the appointment of Dr. John Ryle as chair of the Institute of Social Medicine at Oxford.1
Ryle had been Regius Professor at Cambridge, senior physician at Guys Hospital in London, and personal physician to the king. “He would have lent luster to any enterprise,” says Alice. He was tall, blond, charismatic, with a presence people described as radiant, luminous. “There was, allied to a first-class brain, unfailing courtesy, sympathy, kindness,...

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6. X-Rays and Childhood Cancer

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pp. 86-101

“I said, ‘well, let’s see if we can’t show the world that this subject is much more important than they think.’ ”
Alice’s situation meant that any funding had to come from outside sources. There was fierce competition for grants, but with the help of Leslie Witts, she got Radcliffe money to hire a statistician. “I got David Hewitt—he’d got a first in statistics; he’s since made quite a name for himself in Canada, working with health statistics. And I got Josephine...

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7. Dr. Doolittle’s Team for the Moon

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pp. 102-126

“We were known as Dr. Doolittle’s Team for the Moon—it was a phrase coined by some children of a friend of mine, and it stuck. A funny little team of misfits with big dreams, like Dr. Doolittle’s team with their spade and their bucket, determined to get to the moon. There we were surveying the whole of England, without even a card sorter.”
There were not many women at Oxford in the fifties, especially not many who headed science departments, even if it was only a “unit,” not a...

Part 3. Through the Looking Glass, onto the International Nuclear Scene . . .

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pp. 127-128

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8. Up Against the Department of Energy

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pp. 129-143

Leaving Oxford, Alice arrived in Birmingham, “with no plan, really, but to wind up the Oxford survey.” But within three months she’d received a phone call from America. Dr. Thomas Mancuso, who had been commissioned by the Atomic Energy Commission (AEC) to study the “biological effects, if any, of low-level ionizing radiation among workers employed in atomic energy facilities,”1 had turned up something peculiar in his study of Hanford workers....

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9. Taking on the International Nuclear Regulatory System

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pp. 144-162

“It was simply unacceptable,” says Alice. “We were turning up effects ten to twenty times higher than those claimed by the A-bomb studies.” Naturally, she found this troubling, for these are the studies that set radiation safety standards for the entire world. They determine international guidelines for licensing new nuclear facilities, for deciding risks and benefits, and for settling the claims of veterans, workers, and downwinders. Who were Alice Stewart and George Kneale to go up against this Goliath?...

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10. Rogue Scientists

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pp. 163-177

After the Mancuso affair the Department of Energy split the study of the workers’ records into groups, assigning them to government contractors in Hanford, Oak Ridge, and Los Alamos. From now on, research on nuclear health was to be performed solely by labs under contract to the DOE.
“Divide and conquer—in this case, literally,” says Alice. “The government determined never again to let the records fall into the hands of one person. And it determined not to allow any researchers from outside...

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11. Alice in Blunderland: Back in Britain

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pp. 178-192

“When we returned to England with the Hanford data, there was an inquiry about whether they should be expanding the Windscale facilities. I remember telling George, ‘we must be prepared now to let the world know what we’ve found.’ ” Alice assumed the nuclear industry would be in touch immediately, eager to know what the Mancuso/Stewart/Kneale team had turned up about the Hanford workers, but she was wrong. “They were sending out refutations of MSK behind our backs, but never once did they consult us directly.1...

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12. Fallout

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pp. 193-208

Meanwhile, back in the United States, the Mancuso affair had opened a can of worms that continued to spill out in embarrassing places.
The 1978 congressional investigations had blown the cover off the secrecy that had shielded DOE operations for decades. An accident in 1979, near Harrisburg, Pennsylvania, followed by revelations in the mid- 1980s of scandalous conditions at DOE facilities, blew other covers....

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13. The Invisibilizing of Alice

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pp. 209-226

There are a lot of people wishing that Alice would go away, since her findings imply that there are risks to nuclear workers and residents around facilities, risks that are, at best, embarrassing to the industry and, at worst, financially ruinous.
The reason the nuclear industry continues to get away with its claims that it is a clean, safe industry is that there is, as yet, no way of proving beyond a shadow of a doubt that illnesses associated with radiation have actually been caused by working with radiation or living near nuclear...

Part 4. A Message to the Planet

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pp. 227-228

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14. Epidemiology and Alice Stewart

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pp. 229-247

“The reason people don’t believe in radiation is, it’s out of sight, out of mind—then, twenty or thirty years later, someone drops dead. We are dealing with something so imperceptible to the senses and with such late effects—sometimes third and fourth generation effects—that we are very far from solving the mystery.”
Alice Stewart sees herself as a kind of medical detective, practicing a Sherlock Holmes type of medicine....

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15. The Good Doctor

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pp. 248-263

The whole of this remarkable woman’s work, since the Oxford Survey turned up its revolutionary discovery about fetal x-rays and childhood cancer, has been a search for the cause of cancer. “This is the mystery, and it’s kept me busy my entire life. To me the whole thing has been an effort to tease the story out, to understand the etiology of childhood cancer.”
From the start she felt that their discovery about fetal x-rays had put them on to something momentous. “I regarded it as very important, a fixed point to steer by, like the polar star from which the science of...

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16. Pioneer and Pariah

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pp. 264-281

“It is very difficult for the Alice Stewarts of the world to survive,” says Sheldon Samuels, health consultant to the AFL-CIO, one of the speakers who presented Alice Stewart with the Ramazzini Prize. “All people are creatures of their institutions, especially scientists, who must generate resources for computers, labs, staff, equipment, publication, in order to function. Any scientist who doesn’t follow the mainstream has difficulty. She has a struggle not only to be independent but to find the support— social, intellectual, and material—that a scientist needs.”1...

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17. Endings

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pp. 282-286

Alice Stewart’s story is that of a woman scientist whose unpopular positions cost her standing, salary, access to funding. It’s also the story of a woman who’s had “a marvelous time,” enjoyed a full and interesting personal and professional life, and had the satisfaction of seeing her work shape a critical scientific debate. It’s the story of a physician and researcher who has put her expertise to the service of the global community, a story that holds out hope for those who are striving for a more inclusive...

Notes

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pp. 287-316

Selected Bibliography

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pp. 317-320

Index

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pp. 321-338