Historiography

Cultures of Health … Live and Plugged!

Inaugural note from Steven Palmer

The field of history of medicine and health already enjoys excellent electronic journals, list-serves, bulletin boards, conference proceedings, institutional sites and collections. As our ideas for this site developed, we saw a need for a kind of on-line research magazine, one that could accommodate eclectic fragments and work-in-progress presented by researchers of all kinds, and quickly get them up and circulating in a pleasing format. We hope that Cultures of Health fits the bill, and that it will be particularly suited to generating contributions by student researchers.

The site’s main objectives are to generate conversations about research and ideas in the cultural and social history of medicine and health, and to leave in their wake useful and interesting materials for teaching and research. The associated Cultures of Health Collections site will make available larger sets of data for researchers, most of them related to elements featured on the main page.

A warm thanks to all those involved in funding, planning, designing, and otherwise creating the site.

In putting the site together, we discovered some “standard” formats. A wonderful example can be found in “Brasil Imenso Hospital”, a contribution by historians from the Casa Oswaldo Cruz, part of Brazil’s great health research institute, Fiocruz. The piece reproduces an intriguing primary source, the 1916 speech of an important doctor that conjured the rural interior of the country as “a vast hospital”. This iteration would be central to the entire twentieth-century discourse on health and nation-building in Brazil. The speech is contextualized in a pithy introduction by Dominichi Miranda de Sá, a researcher working on the subject who has also included a short bibliography, and it is further brought to life with graphics and photographs from the era that illustrate related dynamics in different media.

The Baby

A senior undergraduate at the University of Windsor, Melissa Valentik, found some delightful pamphlets, billboards, and newspaper articles concerning the pioneering diphtheria immunization programs in Ontario in the 1920s and 1930s. Here’s one of them, The Baby, the most popular public health pamphlet produced by the provincial department of health during the 1930s. Its wonderful back cover, depicting a veritable “Totzilla” rising menacingly from the sea above unsuspecting Canadian children at play, captures something of the search for a eugenic White Superbaby that animated the state discourse on child health. Aside from giving us a lovely feeling for the tenor and style of state puericulture from this era, the sources also point researchers in the direction of the treasure troves from whence they came, in this instance the City of Toronto Archives and the Archives of Ontario, whose rich holdings and generosity are hereby acknowledged. The complete version of Melissa Valentik’s note, and the detailed acknowledgements, are found in a Recent Post.

The site also offers a nice possibility for presenting more crafted work. A short biography of a medical figure, for example, perhaps accompanied by a more elaborate photo or portrait series than is usually allowable in printed dictionaries of medical biography and by a key text produced by the subject.

We will also be posting video and audio, whether primary sources, interviews with practitioners, round-tables with researchers discussing certain topics, or mini-documentaries. Here’s a short clip from a longer interview with Stephen Pender, Director of the Humanities Research Group at the University of Windsor who is currently researching pain in the early modern imagination. His erudite commentary on, and lovely reading of a text by Thomas White, Peripateticall Institutions (London, 1656), introduces us to an intriguing eclectic in the history of medicine.

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The possibilities for Cultures of Health are many and I hope potential contributors will think of all kinds of wondrous hybrid formats for the provocative presentation of their findings. I can envision this site evolving in many directions, and taking many wild turns. We hope that we can find ways for it to dovetail with courses, workshops, seminars, research projects, and what you will.

In trying to imagine how such a disparate series of fragments will come together, I thought of the many other figures in the history of medicine who, like Thomas White, have been able to combine an eclectic assortment of healing roles and ideas into the coherence of a lifetime. The first to come to mind, perhaps because I recently watched Donald Brittain’s fine 1964 documentary film about him, was Norman Bethune, an eclectic twentieth-century healer who practiced many types of medicine, endured a number of different patient roles, and participated in the medical dynamics of a series of world-defining struggles. I don’t want to presume that this modest endeavour in electronic publishing and communication is really comparable to such a momentous life in healing. Instead I invoke Bethune’s life in medicine as a way of suggesting this website’s potential to find coherence as a vessel for the intersection, mixing and conveyance of many histories of medicine and health.

Part of the first generation to graduate from the new “scientific” North American medical schools of the post-Flexner Report era (University of Toronto, 1916), Bethune’s subsequent education and apprenticeship resonated with the long training cycle of the modern specialist: six months of surgical internship at Great Ormond Street Hospital for Sick Children in London, eighteen months as Resident Surgical Officer at the West London Hospital, two months observing at the Mayo Clinic, studies in laboratory research. And he explored the world of general practice, for a time settling down to it in Detroit, just across the river from Windsor, Ontario where this site is served.

Eventually he secured major appointments as a thoracic surgeon: at Montreal’s Royal Victoria Hospital (where, I am happy to say, I was born), at the Herman Kieffer Hospital in Detroit, and at another classic type of modern hospital, the Catholic Hopital Sacré-Coeur near Montreal. Bethune was a firebrand in the rapidly transforming field of thoracic surgery, distinguished for his speed and technical capacity, and for inventing and patenting surgical tools like “Dr. Bethune’s Rib Shears” that were marketed across the continent by Pilling and Co. of Philadelphia. He bubbled near the surface of the professional and scientific world of biomedicine, giving papers at conferences and publishing in medical journals advocating new techniques in pulmonary intervention. Iconoclastic, he was also a virtual stereotype of the patriarchal, privileged surgeon of professionalized Western medical lore, famous for his arrogance and his authoritarian tyrannizing of nurses.

But he was still capable of radical metamorphosis. Moved by the poverty he saw around him in Depression-era Montreal, he toyed with medical philanthropy, establishing “Dr. Bethune’s Sick Parade” at the Verdun YMCA, treating free all comers for all ailments, from tooth ache to tummy ache. More formally, he became a catalyst in the Group for the Security of the People’s Health, a circle that was promoting socialized medicine, and he led the presentation of briefs to government, political parties, and the media.

Bethune was also a patient. When TB took the wind from his sails in 1926 he became a sanitorium inmate at Saranac Lake in upstate New York. Thus “excluded from the living world,” as he put it, his talent as a medical artist flowered. On his cottage walls a Chagall-like mural appeared – “The TB’s Progress,” he entitled the series: episodes of his own life entangled with visions of the human battle with disease. Even his kicking against the routines, hierarchies and dogmas of incarceration grew boring. He finally insisted on receiving the experimental pneumothorax operation, suffering a punctured lung that almost killed him.

I invoke Bethune’s life in medicine as a way of suggesting this website’s potential to find coherence as a vessel for the intersection, mixing and conveyance of many histories of medicine and health…

Bethune’s most famous mark on the history of medicine would be his highly original stints in military medicine. In 1936 he volunteered for the Republican internationalists in Spain, where he was a witness to the horrific aerial bombardment of civilians by the fascists in Madrid and Almería. The inventive and indefatigable surgeon pioneered the mobile blood transfusion unit, and his Servicio canadiense de transfusión de sangre became a fixture of the hospital system formed during the fierce fighting of the winter of 1936-37.

Finally, of course, he went to China in January 1938, made contact with Mao, and co-ordinated the creation of a front-line surgical field hospital system for the Communist soldiers fighting the Japanese. Operating in precarious conditions and with the most limited supplies on “roads watered with tears and blood,” Bethune married high biomedicine with mass empiricism. He trained hundreds of “barefoot surgeons” and other health workers, discovered methods for making medicines out of available ingredients, and worked himself to death performing surgery in the dim light of peasant homes and Buddhist temples. Often operating without anaesthesia after running out of chloroform, his speed (speed having been, according to the eminent historian of medicine, Guenther Risse, the most critical aspect of successful surgery in the pre-anaesthetic era) would have stood him in good stead. In the end he cut himself during an operation and succumbed to blood poisoning after a withering illness in the cold hills of northern China.

Bethune was quickly mythologized by the Chinese Communist leadership, and he would become a minor symbol in Canadian nationalist discourse, the subject of a number of biographies, a play, a television series and a film (both starring the great Donald Sutherland), and Brittain’s fine National Film Board documentary, Bethune.

All of these themes, condensed in the life of Bethune, could and should appear in the pages of this website during its lifetime. Born in Canada, connected to the world, Cultures of Health is capable of accommodating the eclectic and international character of contemporary historical research on medicine and health: medical education, traditional healing, gender and professionalism, the politics of medicine, the medic in politics, technologies and commercialism, the hospital, patient narratives, military surgery, empiricism, the role of religious in healing, missionary medicine, the international circulation of medical practitioners, modern warfare and civilian casualties, the mythification of doctors and other health practitioners, medicine and literature, the emergence of socialized health care, and medicine and artistic representation (to name just a few).

We’re still getting our feet wet, but the Cultures of Health site is ready to grow. Please look around, post your comments, subscribe to our RSS feed, send suggestions for Asides and Related Sites, and think about contributing now or some time in the future.

Steven Palmer
Canada Research Chair in History of International Health
Department of History
University of Windsor

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