Review By Megan J. Davies

April 30, 2016

BC Studies no. 191 Autumn 2016  | p. 151-154

This small stack of books reviewed here are all doctors’ memoirs of practice centred primarily in remote or rural regions of British Columbia in the 1960s through the 1970s. Clearly, they are not academic works, but are they of use to the medical historian or to the BC historian? And what value are they as pieces of public history?

Shared themes regarding rural and remote medicine will be appreciated by those with scholarly or experiential knowledge of health delivery in such locations, particularly in earlier times when communication was limited. Each author describes the challenges of reaching the injured or ill, the difficulties of transporting the very sick to hospital, and the recourse to improvisation when the appropriate medicine or equipment was unavailable. They recount a fluidity in professional roles as rural doctor becomes dentist and then veterinarian. Stories of catastrophic injury are also common. In House Calls by Float Plane, Alan Swan interweaves horrific details of the 1956 death of two loggers working with defective equipment on a steep slope near Jervis Inlet with memories of his logging party antics with one of the deceased men and a description of the emotional intensity of his packed memorial service. I cannot think of a better illustration of what a good local history can deliver than that passage (53-56).

These books recount medical practice in the early years of Medicare, enacted by three men who were educated in post-Second World War urban medical institutions, but who worked in locales where medical conditions fell far short of what their training had led them to understand was required. One amusing story from Sterling Haynes’s book relates the story of an iron lung sent to the Cariboo region’s tiny Alexis Creek Hospital by English philanthropist Lord Nuffield. The town had no electricity, and so the machine became a handy repository for misplaced mittens, boots, and long underwear (57-58). Motifs of backwoods masculinity and the “good woman” (nurse, mother, teacher) are indelibly imprinted on the pages of these books, though we catch only glimpses of their often-truncated lives and the emotional and logistical obstacles they faced.

These topics should make each of these books an interesting read, but Haynes’s Wake-Up Call, which covers the Cariboo, Kamloops, and Vancouver, along with some non-BC locales, is poorly written and ill-conceived. Indeed it is the kind of quickly composed lay history that relies on stereotypes and gives such books a bad reputation. I cannot recommend it. However, Swan and Paetkau are talented storytellers, and because they shared a congenial Sunshine Coast practice for key decades of change, their books stand as good popular histories that are also fascinating to read as a pair. For instance, both men describe their promising practice model that allowed them to spend every fifth year upgrading their skills, a move that simultaneously fostered a higher level of local professional expertise and allowed for a break from the rigours of rural medicine. Given Swan’s evident difficulties managing the emotional stress of work — which is sensitively covered in both books, and which is another feature of practicing medicine in remote regions — these five-year breaks seem a particularly sensible way of balancing the hardships of rural medical practice.

As a BC health historian with an interest in remote regions, I appreciated how the conjoined narratives of the two doctors allowed the reader to understand the local and the particular as part of broad socio-economic shifts that coastal areas faced in these post-war decades. For example, the difficult mid-1960s political decision to abandon the old Columbia Coast Mission hospital at Garden Bay, which had been built and sustained by local citizens for thirty-five years, for a modern hospital forty-five kilometers south in Sechelt, was both a response to higher medical expectations and a reflection of a shifting settler population and the vanishing world of logging camp life and up-coast communities. Paetkau’s chapter on the complex finances of running a remote medical practice in the early 1960s would be useful reading for any medical historian or health policy analyst interested in physicians and the transition to Medicare. This is a rare and important missive from the front lines of medical change.

While I am critical of Haynes’ effort, I consider Paetkau’s and Swan’s books to be engaging reading for the general public and valuable volumes of local history. However, there is an important “public” element of remote regions of the province that is either misrepresented or absent in these three books: Indigenous peoples. As a keen knitter, I noticed that Swan, in his well-illustrated volume, worked his way through a couple of generations of Cowichan sweaters, yet I searched in vain for stories about the First Nations citizens of the many Indigenous communities with whom he worked. Recounting his first arrival on the Sunshine Coast in 1959, Paetkau mentions driving past St. Augustine’s Indian Residential School; he tells us that he received $25 from the federal government for delivering a First Nation’s baby, and that the Sechelt Band donated eleven acres of land for the new hospital in 1961. But I could find only one reference to a specific Indigenous person in his narrative. Haynes’s liberal use of the word “Indian” is particularly egregious in 2016. Despite the plethora of character sketches littered throughout these books, Indigenous peoples are rarely given individual identities or personal characteristics. Instead, they are presented as entities with a collective character: stoic, untrustworthy, indifferent parents or neglected children (Wake-Up Call); wise grandmothers, intuitive, unsophisticated, uneducated, stoic, generous, kind (House Calls); poor money managers (The Doc’s Side).

Ours is a storied world, and when the doctors of the Sunshine Coast and some of their books’ male characters met each week for lunch post-retirement, as depicted in a delightful image in The Doc’s Side (169), their retrospective conversations would have given meaning and order to their working lives. But when Swan and Paetkau’s life stories became books, they also became public history, and the casual racism they exhibit is now open to a wide readership and public scrutiny. For me, reviewing these two interesting books became a reflection on how we might, and must in the wake of the Truth and Reconciliation Commission, craft local histories that do not privilege the perspectives of certain residents and obscure and “other” discordant or different narratives. My second-year university lecture on Indigenous Health includes a tale of cross-cultural collaboration shared by an old friend, RN Moira Coady, whose youthful face shines out from page 171 of Swan’s narrative of his work in Telegraph Creek and other northern BC communities in the late 1970s. Before Coady came to the coast, she worked in Snowdrift (now Lutselk’e), Northwest Territories. New to the challenges of northern nursing, and faced with a complicated birth in the middle of an April snowstorm, Coady used the nursing station oven as an incubator and called on the community for assistance: baby and mother were saved with help from, “an old lady whose parka was covered in blood [she had been skinning an animal], who put down the cigarette she was smoking and started to puff into the baby” (Personal Communication, Moira Coady, 2005).

This is a classic tale of medical improvisation in a remote locale, and students love the “baby in the oven” piece, but I tell it because this oral history disrupts established narratives about medical knowledge and professional practice. We need to be doing the same with BC local histories, revisiting and revising our stories to add new meanings, holding memories that no longer make sense up to the light and looking at them without flinching, accepting the kind of non-linear chaotic narratives that leave local heroes and stereotypes in the dust, and always building toward a history that is not just about our past, but also about our present and our future. And “our” needs to be about everyone.

Wake-Up Call: Tales From a Frontier Doctor
Sterling Haynes
Halfmoon Bay: Caitlin Press, 2010. 160 pp. $19.95 paper

The Doc’s Side: Tales of a Sunshine Coast Doctor
Eric J. Paetkau
Madeira Park: Harbour Publishing, 2011. 224 pp. $19.95 paper

House Calls by Float Plane: Stories of a West Coast Doctor
Alan Swan
Madeira Park, Harbour Publishing, 2013. 224 pp. $24.95