Negotiating Disease: Power and Cancer Care, 1900-1950

Cynthia R. Comacchio is an associate professor of history at Wilfrid
Laurier University. She is the author of Nations Are Built of Babies:
Saving Ontario’s Mothers and Children.

Focusing on the experience of cancer and its treatment in Ontario during
the first half of the 20th century, this book makes a significant
contribution to the social history of Canadian medicine. The author
details both mainstream and alternative medical theories and approaches
to cancer, but she is also concerned with the experiences of patients
and the relations between patients, the medical profession, and the
developing modern state. At the core of these entwined experiences is
the vital issue of power.

One of the most interesting aspects of Clow’s analysis is her
depiction of the ways in which the authority of science was not only
socially constructed, but also socially contested as patients, far from
bowing to the authority of the medical experts, sought out and became
committed to a number of alternative treatments. Paradoxically, even
treatment outside of conventional medicine was imbued with the assumed
legitimacy of scientific authority, so that the present-day emphasis on
a patient’s “empowerment” clearly does not apply to early forms of
alternative medicine beyond allowing scope for more patient choice.

Clow’s detailed case studies of three of the key alternative
practitioners—the Kingston-based Dr. Hendry Connell, Dr. John Hett
from Berlin [Kitchener], and nurse Rene Caisse, operating out of
Bracebridge, Muskoka—reveal much about the haziness that surrounds
what is “scientific” and what appears to be efficacious but cannot
be scientifically “proven.” The limitations of the author’s
sources here lead to some repetition, as is also the case with her
references to patient experiences—most notably that of Beatrice
Leacock, wife of the renowned McGill political economist and humorist
Stephen Leacock. It would be worthwhile, as well, to learn how
accessible were both mainstream and alternative medical procedures to
patients outside the largely urban middle class that Clow discusses,
especially at a time when medical care was paid for out of pocket. When
discussed in terms of class, power and authority become all the clearer.


In the end, Clow has produced an intrinsically interesting and
provocative study of the varied “negotiations” surrounding cancer
during the first half of “Canada’s century.” Negotiating Disease
raises the kinds of questions that social historians, historians of
medicine and health care, and those concerned with the contemporary
politics of health and care will find compelling.