It was at this point that Safford himself entered the history of Guam. He was a navy lieutenant at the time, an aide to Captain Richard Leary, the first American governor – but Leary, for reasons of his own, elected not to leave his ship, which was moored in the harbor, and sent Safford to act in his stead. Safford soon ‘gained a working knowledge of the Chamorro language and customs, and his respect for the people, his courtesy, his curiosity, made him an essential bridgehead between the islanders and their new masters.[61] The new American administration, though not quite as out of touch as the Spanish one it replaced, did not institute too many changes in Guam. It did, however, open schools and English classes – the first of which were conducted by Safford in 1899 – and greatly improved medical observation and care. The first medical reports of ‘hereditary paralysis’ and its unusual incidence date from 1900; the more specific term, ‘ALS,’ was used as early as 1904.
Life in Guam remained much the same as it had been for the past two centuries. The population had gradually increased since the genocide of 1670-1700; a census in 1901 found 9,676 people, of whom all but forty-six considered themselves to be Chamorros. Nearly 7,000 of them lived in the capital of Agana or its adjaacent villages. Roads were very poor, and the villages in the south, like Umatac, were almost inaccessible in the rainy parts of the year, and could only reliably be reached by sea.
Nevertheless, Guam was deemed important from a military point of view, because of its size and crucial position in the Pacific. During the First World War, Japan was one of America’s allies, and Guam was not drawn into the conflict. But there was great tension on December 8, 1941, as Guam got news of the attack on Pearl Harbor; within hours, it too found itself under attack as Mitsubishis from Saipan, just a hundred miles to the north, suddenly appeared in the sky above Agana, spitting machine-gun fire. Two days later, Japanese infantry, which had been massing on Rota, landed, and Guam could offer little resistance.
The Japanese occupation was a time of great cruelty and hardship, reminiscent of the conquistadores. Many Chamorros were killed, many were tortured or enslaved for war work, and others fled their villages and farms to live out the occupation, as best they could, in the hills and jungle. Families and villages were broken up, fields and food supplies were taken over, and famine ensued. Cycad seeds had been an important part of their diet for two hundred years at least; now they became a near-exclusive diet for some. Many more Chamorros were brutally murdered near the end of the war, especially when it became clear that the Japanese days were numbered, and that the island would soon be ‘liberated’ by the Americans. The Chamorros had suffered appallingly during the war, and welcomed the American soldiers, when they came, with jubilation.
The real Americanization of Guam came after 1945. Agana, which had housed half of Guam’s population before the war, had been levelled in the recapture of the island and had to be totally rebuilt; the rebuilding transformed it from a small town of low, traditional houses to an American city with concrete roads, gas stations, supermarkets, and ever-higher high-rise apartments. There was massive immigration, mostly of servicemen and their dependents, and the population of the island swelled from its prewar 22,000 to more than 100,000.
Guam remained closed to visitors and immigrants, under military restriction, until 1960. The entire north and north-eastern portions, which contained the best beaches on the island, and the beautiful and ancient village of Sumay (taken over by the Japanese in 1941, and finally flattened by the Americans in 1944), were appropriated for new military bases, and closed even to the Chamorros who had once lived there. Since the 1960s, huge numbers of tourists and immigrants have arrived – Filipino workers by the tens of thousands, and Japanese tourists by the million, requiring ever vaster golf courses and luxury hotels.
The traditional Chamorro ways of life are dwindling and vanishing, receding to pockets in the remotest southern villages, like Umatac.[62]
John normally goes on his rounds with Phil Roberto, a young Chamorro man who has had some medical training, and who acts also as his interpreter and assistant. Like Greg Dever in Pohnpei, John feels strongly that Micronesia has been far too dominated by America and American doctors, imposing their own attitudes and values, and that it is crucial to train indigenous people – doctors, nurses, paramedics, technicians – to have an autonomous health-care system. John hopes that Phil will succeed him, completing his medical degree and taking over his practice when John retires, for Phil, as a Chamorro himself, will be an integral part of the community in a way that John can never fully be.
Over the years there has been increasing resentment among the Chamorros in regard to Western doctors. The Chamorros have given their stories, their time, their blood, and finally their brains – often feeling that they themselves are no more than specimens or subjects, and that the doctors who visit and test them are not concerned with them. ‘For people to admit that their family has this disease is a big step,’ Phil said. ‘And then to let medical people come into their homes is another big step. Yet in terms of treatment or care, health care, home care, they’re really not given enough assistance. Visiting doctors come and go, with their forms and research protocols, but they don’t know the people. John and I go into people’s houses regularly, and we come to know the families, their histories, and how they’ve come to this point in their lives. John has known many of his patients for ten or twelve years. We have videotaped hundreds of hours of interviews with patients. They have come to trust us, and are more open in terms of calling for assistance – saying, ‘So-and-so is looking rather pale, what should I do?’ They know we are here for them.
‘We are the ones who go back to their homes weeks after the researchers have been here and taken their samples back to the States. The patients ask us, ‘So what happened to those tests performed on us?’ But we have no answers for them, because they’re not our tests.’
The next morning John and Phil picked me up early. ‘You saw a little of the parkinsonism and dementia – the bodig – yesterday,’ he said. ‘Kurland felt this form of the disease was replacing ALS in the 1970s – but you must not imagine the ALS is extinct. I have lytico patients I have been following for years, and new cases as well – we’ll see some today.’ He paused, and added, ‘There is something unbearable about ALS; I’m sure you have felt it, Oliver – every neurologist does. To see the strength go and the muscles wasting, people unable to move their mouths to speak, people who choke to death because they can’t swallow…to see all this and feel you can do nothing, absolutely nothing, to help them. Sometimes it seems especially horrible because their minds remain absolutely clear until the end – they know what is happening to them.’
We were on our way to see Tomasa, whom John has known ever since he came to Guam. She had already had lytico for fifteen years when he met her; it has advanced steadily since, paralyzing not only her limbs but the muscles of breathing, speech, and swallowing. She is now near the end, but has continued to bear it with fortitude, to tolerate a nasogastric tube, frequent choking and aspiration, total dependence, with a calm, unfright-ened fatalism. Indeed a fatality hangs over her entire family – her father suffered from lytico, as did two of her sisters, while two of her brothers have parkinsonism and dementia. Out of eight children in her generation, five have been afflicted by the lytico-bodig.