Thursday, September 23, 2010

Fenwick Operating Theatre: a life-saving surgery in Edwardian Kingston

Bennie Stalker two weeks after surgery,
October 1901, Source: Jim Bremner
Bennie S., age 10, on the 17th of September last was accidentally shot by his brother, a lad about two years his senior . . . The arm was nearly severed from the body . . . The patient’s father ascribes the arrest of the hemorrhage to the fact that there was an old man at the house who had a “charm” for stopping bleeding . . . A doctor was procured who came a distance of twenty-two miles and remained at the house for two days, relieved his suffering and applied dressings of carbolic oil to the wound. The arm speedily became gangrenous and the little sufferer was evidently not expected to survive . . . “seventeen days” after the receipt of the injury he was started on his long journey to the Kingston general hospital. Leaving his home at six in the morning lying on a mattress in a spring waggon he reached Calabogie station on the K&P railroad at noon and arrived at the hospital about 5 p.m.

These events occurred in eastern Ontario in September - October 1901. This account reveals much about the stark realities of rural Canadian health care a century ago, but at the same time, the amazing ability of the human body to survive severe trauma and the abiding human desire to care for the sick.

At the heart of the story is young William Benjamin Stalker, who was born in 1891 and lived on a farm near Plevna. The clinical details of his misadventure and life-saving surgery are preserved in the surgeon’s report detailing the boy’s accident and medical treatment in the January 1902 Kingston Medical Quarterly. For historians, Dr. W.G. Anglin’s case study puts a human face to the ancient hospital spaces and dry administrative reports that remain as historical evidence today.

After Bennie’s all-day journey to Kingston General Hospital, he was admitted to the St. Andrew’s Ward for children in the upper storey of the Watkins Wing. Dr. Anglin describes in detail the severity of the boy’s wounds and the extreme deterioration of his arm and upper extremity. The next day we learn that Bennie was wheeled into the recently constructed Fenwick Operating Theatre. Complete amputation was the only option if the boy was to survive – grim, but effective treatment. News reports of the emergency amputations required to save lives of victims of the January 2010 earthquake in Haiti spring to mind.

Gigli saw for cutting bone, MHC Collection 1976.6.37
In his account, Dr. Anglin references an array of instruments and medications now found at the Museum (Gigli saw, aneurysm needle, pressure forceps, chloroform, hypodermic, strychnine, digitalis). To a curator, these real-life references add invaluable context and relevance to our collections.

The doctor’s description of Bennie’s aftercare says much about social services of the day: “Our readers may be interested to know that having but one parent living, the little fellow has been admitted into that excellent institution the Orphans’ Home in this city.”

Dr. Anglin recorded that Bennie was an interesting patient and always quick and bright with his answers. He recounted the boy’s encounter with Dr. Alan Manby, the physician accompanying the Duke and Duchess of Cornwall and York (King George V and Queen Mary) while on their 1901 cross-Canada tour. During a visit to KGH Dr. Manby told Bennie that he would be unable to visit him again because of the great distance the doctor had come to be there. Bennie’s quick and unexpected response is reported to be, “”Well, I came nearly a hundred miles myself to get here.” How medical journal articles have changed.

After his amazing recovery, Bennie grew up to have a full and productive life, first as a travelling ventriloquist and later an itinerant photographer. He married and had five children. After Bennie’s death in 1940, his wife remarried and had a son named Jim Bremner. I thank Mr. Bremner and his wife Marianne who spent ten years researching Bennie’s fascinating story for bringing it to our attention. This is what helps to make history real and bring museum collections to life.


Paul Robertson
Curator

Tuesday, April 20, 2010

Funding Success for Museum Collection

Iron lung, built at Toronto's Hospital for Sick Children, 1937,
MHC Collection 997.019.003
We are excited to announce that Ontario’s Museums and Technology Fund has granted $15,000 to the Museum of Health Care for the development of a new feature on our website entitled “From the Collection”. To be developed over the next year, this page will include a series of short illustrated profiles for various objects, images, and documents drawn from the MHC collections. The subjects of these profiles will include artefacts, drawings, books, documents, works of art, and photographs representing various collections, themes, historical events, persons, medical disciplines, curiosities, and “treasures” currently held in MHC artefact and archival holdings.

Although most of this material is currently available for viewing on our publicly accessible online collections catalogue, we know that many of our most intriguing items are largely hidden from the average visitor to the Museum’s website, particularly from people who may not feel comfortable navigating a database. Another disadvantage is that the artefacts in the catalogue are not searchable from outside the website. It will now be possible to search for objects featured in the new artefact profiles with Google and other external search engines.

Enema Syringe, circa 1800, MHC Collection 002.050.006 a-d
Another goal of “From the Collection” is an “added value” component for each object. For each artefact and image profiled, we want to provide a more complete interpretation of what those items are and how they fit into broader themes. The new artefact profiles will also provide links to other similar objects in the collection, thus making searching on a health care subject even easier than before.

We want to involve the public more with our collection. “From the Collection” will include a link to a newly created online forum included with each profile. In this way we hope to provide an opportunity for user-generated content through community contribution, discussion, and interaction.

Watch this site for further information as the project gets under way!

Paul Robertson
Curator

Friday, February 19, 2010

Early Penicillin Sample Comes to Collection

Curators are always excited when they make a “find”, especially when that find more or less just arrives at our doorstep: an ampoule containing some of the first experimental penicillin produced in Canada!

Ampoule of penicillin, MHC Collection
How did it come to the Museum of Health Care? In the late 1990s the Museum received a transfer of artefacts and archival documents from Queen’s University (Kingston, Canada), known as the Faculty of Medicine Collection. Most of the objects were shifted to the Museum at that time, but a few remained on display in the medical school on campus. Recently it was decided to move the remaining pieces to the Museum for processing and preservation. Among the Victorian surgeon’s kits, textbooks, and medical student graduation programmes was a nine centimetre glass vial holding a white powder and a typewritten file card:

“The last of twelve ampoules containing the first batch of PENICILLIN (10,000 units) made experimentally by Ayerst, McKenna, Harrison of Montreal. The untried, unproved drug was used successfully (but unofficially) to save the life of a 16 year old boy, critically ill with septicemia following a ruptured appendix in the summer of 1940.”

According to the card, the sample was given to Queen’s by one of its grads, Dr. C.W. Kelley (1928), former chief of surgery, Ottawa Civic Hospital.

The anti-bacterial function of penicillin was first discovered in 1928 by English bacteriologist Alexander Fleming, but its clinical potential was not realised until 1940 when pathologist Howard Florey and biochemist Ernst Chain were able to extract, purify, and produce the drug in their laboratory. This short video explains the discovery of penicillin:


Watch Penicillin at EncycloMedia.com

What makes our penicillin sample particularly rare is that the isolation of the antibiotic’s active ingredient in England appears to have taken place only a short while before this ampoule was produced. Founded in 1925, Ayerst, McKenna and Harrison was a young Canadian pharmaceutical firm – in 1931 it set up the first commercial biological laboratory in the country. Penicillin was still an experimental drug and clearly its use on a teenager in 1940 was a gamble, but fortunately one with a happy outcome, given how unauthorised was its administration.

During the Second World War pharmaceutical companies in several countries rushed to produce penicillin for soldiers – the antibiotic’s ability to greatly reduce mortality rates resulting from infected wounds, unclean surgery, and infectious diseases was a clear advantage on the battlefield. The war galvanised the mass production of many drugs and penicillin became available on a wide scale to the general public between 1944 and 1946. This 20th –century “magic bullet” has long been an effective weapon against pneumonia, anthrax, tetanus, syphilis, and diphtheria. The little penicillin ampoule buried in a university exhibit showcase – what has turned out to be an important treasure highlighting a significant development in Canadian healthcare history.

Paul Robertson
Curator

Tuesday, February 9, 2010

The Book of a Life

MHC Collection
While doing a long overdue sorting and clean-up of the Museum’s small research library recently, I came across a fascinating little publication entitled The Book of a Life, From Generation to Generation by James C. Connell, M.D., published in 1935 by the Ryerson Press. This slim volume is a form of medical diary, where an individual writes down his or her health history from birth until old age (presumably, the book would be started by the parent!). It’s sort of the “full life” version of those baby books where parents record their child’s early development and paste in photos and locks of hair.

Dr. J.C. Connell, portrait by Kenneth Forbes, Queen's University collection

The author was once an influential player in medical circles here in Kingston where the Museum is located. Dr. Connell (1863-1947) was long a prominent figure in medicine, education, and administration at Queen’s University and at Kingston General Hospital. A Queen’s graduate and an early specialist in surgery of the eye, ear, nose, and throat, in 1891 he was appointed the first director of the university’s ophthalmology department and later wrote a textbook on the subject that was used by students for many years. Dean of the faculty of medicine from 1903-1929, Dr. Connell was instrumental in improving the profile and quality of medical education at the university and departmental and clinical expansion at the hospital. He was also briefly the principal of Queen’s. In retirement, he produced The Book of a Life, no doubt fueled by his decades of medical experience and his personal criteria for wise and healthy living.

Dr. Connell’s goals for his little book were clear: he wanted a means to document an individual’s complete personal record, more than the usual birth, marriage, and death information collected by the state. His vision was a volume that captured someone’s ancestry, physical characteristics and development, mental growth, education, attainments, ailments and accidents, and important incidents of life. Dr. Connell designed his book as a way to educate the public on the value of personal record keeping and to expose them to information about standards of healthy living. Coupled with this, he saw it as a useful summary record for the family physician who he recommended should examine the diary periodically and “write out the result and the admonition or advice he thinks necessary to assist development, to ward off unhealthy tendencies and, later on, to prevent the many disorders and diseases of advancing life.” Foreshadowing our modern permanent electronic integrated health record perhaps? It also gives patients a real role in their own health care.

MHC Collection

Interspersed between the pages recording the details of an individual’s health and wellbeing over the course of a lifetime, The Book of a Life contains helpful information about the body and its functions and advice on healthy living, the sort of stuff one expects to find in a guide for parents or other health service pamphlets. A wide assortment of topics cover such subjects as average growth rates in children, hygiene, healthy eating, the value of sleep, recommended body weights, details of common diseases, the desired frequency of regular physical examinations, and mental health.

What I found interesting but a little eerie were the life expectancy statistics and rates of mortality included at the top of each diary entry for a particular age. Even on the page where the book’s owner writes down particulars of his birth and parentage Dr. Connell notes “Expectancy of life is 65 years at the time of birth, if advantage is take of all the benefits of modern medicine. Without these it may be only 47 years.” This statement is revealing: it shows the change in the average lifespan from 1935 to our own time (80.4 years) but also describes an era where living standards for many Canadians were lower and professional health care was often infrequent or unavailable. Clearly, the introduction of universal Medicare has had a major impact on the lives of Canadians.

I was excited to see that our copy of The Book of a Life has been filled in by its former owner, a woman born in the Kingston area in 1896 who had received it as a gift from Dr. Connell himself. True to the doctor’s design, reading the pages of the diary I can pull together a reasonably good picture of the diarist, her health, her career, her activities and achievements, her family history, and some of her hopes and aspirations over the course of her life.


MHC Collection

For example, I learned that she was the daughter of a farmer and that her mother was assisted by a midwife at her birth -- typical of the late 1800s. She was ninth child of 12 children, six boys and six girls and she had brown hair and blue eyes. Because she didn’t receive the book until she was 38, those early pages reveal little else about her early years. Her first few entries record only scant information, but I did lean that she was a trained nurse and in good health. As directed by the book, she updated her height, weight, and measurements annually. I later learned that she was a graduate of the Kingston General Hospital School of Nursing in 1921 and that she did private duty nursing after graduation. She eventually returned to KGH where she remained until retirement at age 65.

A longstanding member of Zonta, the professional women’s organisation, our nurse travelled to annual conferences in addition to trips with her sisters to various places in Ontario, Quebec, and New York State. She sometimes recorded world events that had occurred, items she’d bought, and houses she lived in. I was delighted to read of her purchase shared with her sister of a Pontiac Coupe in 1937 when she was 40. Other entries leave one begging for more. In one case she has clipped out the entry that fell under the words “Very unhappy summer” (age 43) – what was it that she wanted no one ever to see? In another instance she provided no details about the circumstances or subsequent events connected with the diamond ring she received a gentlemen when she was 49. From what I can tell, she never married.

She often recorded her annual salary with the attached notations “good”, “fair”, or “strained” dependent upon her circumstances at the time. In addition to her changing health and medical and dental procedures, she recorded details of operations of family members, their life changes, and eventual deaths. She included the death of Dr. Connell himself in 1947 when she was 51 with the annotation ““Author” of this book.” Did she anticipate that some future researcher would eventually be pouring thorough the diary’s pages? I love the routine quality of some entries: under “Friends” she often answered tersely, “As usual”.

Our nurse was a faithful diarist: she continued to make annual entries into her book until she was 88 years old in 1984, but by then it was clear that she was having difficulty writing. From other nursing school records we have on file, I believe she died four years later around the age of 92. There is so much more one can do with a document like this – it pages are full of questions as much as there are details. We know of several copies of the book in libraries – have they been filled in by their former owners? Have other copies survived elsewhere?

This is truly the “book of a life” – a marvelous record and a rare and valuable research resource. We are now adding it to the Museum’s permanent collection.

Paul Robertson
Curator

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The Museum of Health Care shows how Canadians have preserved health and managed disease, pain and suffering. The Museum strives to connect visitors of all ages with the experience of people in past times and provide context and perspective on today's health issues.