Contesting Medical Authority

Heading into the sixth reading log, History 4250 has entered a new theme, Authority and Ideals.  Authority and Ideals for this week’s reading revolve around medical professionals and their ability to use their elevated status and expertise to inform the public on healthy decisions, procedures and programs, influencing popular culture’s norms of health.   However, the reception of these expectations are not always unanimous, as debates and a challenging of the medical professionals and the poplar culture norms is common throughout Canada’s history.  In each of the articles there is a dichotomy created between whether or not to accept medical practices.  Hence, doctors have great power over citizens and prescribe ideals, however these are not always received by the public wholesomely.

Doctor’s elevated position in society is apparent, as their developments in research often push citizens towards the new practices or ideals of health. Doctor’s fascination in adolescence, as a life stage, eventually forced society into accepting this new stage of life.  The research and the encouraged implementation of the school medical programs for this age group, produced the acceptance in popular culture of the adolescence age group.[i]  Another example of doctors clear authority and ability to prescribe ideals is that doctors were used an assimilative tool.  In order for a doctor to have the ability to be assimilative there had to be a certain level of respect and authority in order for the people to accept new ways of medicine. In the case of doctors in Aboriginal communities, they often were used as a tool of assimilating the Aboriginals into European medical norms, thus superseding Aboriginal’s old ways of living.  Doctor’s impact on society was clearly felt amongst society, as there opinions were held in high regard and influenced wider ideals.[ii]

The debate on adding fluoride into the water in many municipalities helps illuminate the clear dichotomy between acceptance and rejection of medical ideals.  Having both the Canadian Dental Association and Canadian Medical Association’s backing, there was still a considerable split amongst residents to add fluoride to the water.  Advocates from the pro-fluoride side always respected and were mindful of the recommendations made by the doctors.  On the other side people were less accepting of the doctors recommendations, which degraded the status of doctors in society.  The split between these two sides show the struggle between accepting doctors higher status in regards to health or using personal knowledge and doctor’s knowledge together. Doctors as being absolute, was always questioned, people often took doctors advice but used their own interpretation and experiences in conjunction with doctor’s recommendations, in order to create or accept health standards.[iii]

In the case of Hutterites, prescribed ideals of health are not always followed by the colonies.  The way in which Hutterites viewed death was very different then the popular culture ideas. In Hutterite colonies surrounding death, an increased social cohesion and group identity sparked to help a person deal with death, unlike mainstream culture where social cohesion was not stressed. Therefore, Hutterite’s cultural normalities create a much different notion of death, compared to other Canadians.  The prescribed ideals of mainstream culture are not uniformly accepted by Hutterites, rather their ideas of death revolve around Hutterite’s culture and experience. Much like the dichotomy of accepting medical practices amongst Canadians, the Hutterites are similar interpreting notions of health by their own ideals and cultural normality’s.[iv]

[i] Comacchio, Cynthia, “‘The Rising Generation’: Laying Claim to the Health of Adolescents in English Canada, 1920-70,” Canadian Bulletin of Medical History, 19 (2002): 139-178.

[ii] Kelm, Mary Ellen, “Doctors, Hospitals, and Field Matrons.” In Colonizing Bodies: Aboriginal Health and Healing in British Columbia, 1900-1950, Vancouver: UBC Press, 1998:

[iii] Carstairs, Catherine, “Expertise, Health, and Popular Opinion: Debating Water Fluoridation, 1945- 1980,” Canadian Historical Review, 89 (2008): 345-371.

[iv] Cacciatore, Joanne and Kara Thieleman. “We Rise Out of the Cradle and Into the Grave: An Ethnographic Exploration of Ritual, Mourning and Death on a Hutterite Colony.” Omega: Journal of Death and Dying 69, no.4 (June 2014): 357-379.

 

Healthism and Popular Culture

In the final week of the topic, defining and contesting illness, the focus was put on natural approaches and healthism.  Despite this, one of the other major intersections that became apparent through the three assigned readings was popular culture and its effect on health.   We define the term healthism “as the preoccupation with personal health….a goal which is to be attained primarily through the modification of life styles, with or without therapeutic help.”[i] Not only are the readings illuminating the changing of lifestyles for personal health, but how those lifestyle changes can be affected by the wider popular culture. As our History 4250 class heads into our next section “Authority and Ideals,” it will be diving deeper into this very idea. In the Introduction of Bodily Subjects, this third theme discusses “the ways in which health, identity, and morality are closely linked in Western society and how they infuse popular culture.”[ii]  Therefore healthism and popular culture intersect as the achievement of healthism is based on the popular culture norms of health.

In both the readings they get at this very idea of how popular culture can influence notions of health and the reciprocation of that, where popular culture is impacted by health. Marketing experts noticed this relationship many years and exploited it for monetary gain. Advertisements displayed in the magazines Playboy and Esquire, were intentionally created to manipulate the popular culture norms of the time into a form in which they could sell hygiene products.  For example, in a time of hyper heterosexuality in the years during the Cold War, cologne was advertised in such a way that it pandered to this overreaching ideal.  Associating the cologne with the sport and sexual prowess around women, allowed the company to gain a strong footing amongst the readers because both were heavily associated with displaying heterosexuality. Using the popular culture ideals, a company twisted that in a way that allowed them to sell more product.[iii]

In another case, the Large as Life action group used their new lifestyle of “fat acceptance” in order to better participate in popular culture unlike before.  Where “fat-acceptance gave these women permission to participate in health and popular culture” that was not available to them before.  Having the ability to see themselves as healthy and having a fashion line designed for their aerobic needs, increased inclusion for those that embraced their bodies as they were. In this case, the women’s notions of health created a new popular culture surrounding the Large as Life action group.  The reciprocation is found, where health is affecting popular culture, instead of the other way around.[iv]

The Hutterites, a people attempting to reduce outside influence as much as possible, was not inept to the wave of healthism.  Many of the women were increasing their labor force participation, higher education and desiring more control over their lives, which lead to the increased use of birth control methods and a declining population growth.  Influenced during the 1950’s to 1970’s by the Second wave women’s movement, Hutterite women followed popular culture trends and adapted tier lifestyles in achievement for better well-being, which is a facet of healthism.  Health and popular culture were intertwined and even affected those most cut-off from society like the Hutterites.[v]

 

[i] Crawford, Robert., “Healthism and the Medicalization of Everyday Life,” International Journal of Health Services, 10,3 (1980): 368.

[ii] Penny Light, et.al, “Introduction,” in Bodily Subjects: Essays on Gender and Health, 1800-2000, Montreal: McGill-Queen’s University Press, 2015: 16.

[iii] Wendelboe, Thomas, “The Heterosexual Nature of Health and Hygiene Advertisements” in Penny Light et.al (Ed), Bodily Subjects: Essays on Gender and Health, 1800-2000, Montreal: McGill-Queen’s University Press, 2015:

[iv] Ellison, Jenny, “‘Let Me Hear Your Body Talk’: Aerobics for Fat Women Only, 1981-1985,” in Cheryl Krasnick Warsh (Ed), Gender, Health and Popular Culture: Historical Perspectives, Waterloo: Wilfrid Laurier University Press, 2011: 193-214.

[v] Laing, L. M. “Declining Fertility in a Religious Isolate: The Hutterite Population of Alberta, Canada, 1951-1971.” Human Biology 52, no. 2 (1980): 289-310.

Cancer and Medicalization

 

Cancer in the context of contesting and redefining illness, presents an interesting intersection between cancer and the role of medicalization.  In the 1970’s, according to Metzl and Herzig, medicalization was “the expansion of medical authority into the domains of everyday existence, which was promoted by doctors.”[i]  Having cancer being viewed as a deadly illness, where the body was waging a war, was advanced in such a way that doctors authority and knowledge was seen to be absolute.  All the readings explained the promotion of doctors and their authority through cancer to keep the patients healthy and prevent future complications.   Between screenings and the treatments of cancer, popular magazines, publicly funded programs and doctors themselves reproduced the discourse that doctors were the only way to preventative and safe lives, free of cancer

Many people turned to self-examination and self-diagnosis instead of going for an embarrassing screening test done by a physician.  In the National Film Board video Cancer in Women, guided one through a basic breast self-examination test.[ii]  While others just avoided the test all together, with only 54% of women Saskatchewan getting a pelvic examination in 1939,[iii]  many avoided the screenings out of embarrassment or lack of symptoms.[iv]  Despite all these attempts to avoid the tests, doctors, media, and the government worked hard to display the necessity in seeing a doctor.

Popular magazines were in the forefront of reproducing medicalization through cancer. Most articles in these magazines supported and encouraged testing by licensed physicians, as one of the only ways to ensure complete health.  Whether it was the Toronto Star, Maclean’s Magazine, or Chatelaine, they all promoted the expertise of doctors and the preventability of cancer when tested often by a doctor.  Stating that there was an increased rate of success when cancer was caught in the early stages by doctors.  Not only was basic information on cancer displayed in these articles but they used fear as a tactic to influence Canadians to engage in medicalization, otherwise they ran the risk of losing their life.[v]

Public programs were put into place to increase the percentage of people getting screened, removing some of the socio-economic barriers.  The creation of the National Cancer Institute of Canada (NCIC), was one of the attempts to increase research through government grants, which eventually increased discussions about nationalizing screening programs for all of Canada.  Governmental support increased endorsement of doctors and their authority in people’s lives to end cancer.  The increased lobbying of the government through these public programs cemented the status of doctors in Canadian society by getting backing from the public sphere in order to further doctor’s authority over citizens.[vi]

Finally doctors themselves reinforced medicalization in Canadian society, as they promoted their techniques and practices as the best way to curb potential problems.  Many doctors stressed the importance of being screened often and that treatment for cancer should be done promptly.[vii] Doctors and their recommendations always revolved around returning to your physician for check-ups and for using the physician as their sole proprietor for health.

Mennonites, who have similar ideology to the Hutterites, took a step back from medicalization and instituted their own mental health institute called the Rosthern Mennonite Youth Farm, where current medical practices were not stressed, rather a form of spiritual health care was their solution to those with mental health problems. Eventually in the 1950’s, they received aid for their institute from the provincial government.  The Mennonite Youth Farm was an organization that worked against the experience of medicalization by the rest of society, through cancer.[viii]

[i] Metzl, Jonathan & Rebecca Herzog, “Medicalization in the 21st Century: Introduction,” Lancet, 369 (2007): 97.

[ii] Hadenko, Mandy, “The Challenge of Developing and Publicizing Cervical Screening Programs: A Canadian Perspective,” in Cheryl Krasnick Warsh (Ed), Gender, Health and Popular Culture: Historical Perspectives, Waterloo: Wilfrid Laurier University Press, 2011: 144.

[iii] Mitchinson, Wendy, “The Womanly Body: A Cancer Threat,” in Body Failure: Medical Views of Women, 1900-1950, Toronto: University of Toronto Press, 2013: 222.

[iv] Miele, Richelle and Juanne Clarke, “‘We Remain Very Much the Second Sex’: The Constructions of Prostate Cancer in Popular News Magazines, 2000-2010,” American Journal of Men’s Health, 8, 1 (2014): 16.

[v] Hadenko, “The Challenge of Developing and Publicizing Cervical Screening Programs”: 133-142; Miele, and Clarke, “We Remain Very Much the Second Sex’.”

[vi] Hadenko, “The Challenge of Developing and Publicizing Cervical Screening Programs”: 129-136; Mitchinson, “The Womanly Body”; Jasen, Patricia, “Malignant Histories: Psychosomatic Medicine and the Female Cancer Patient in the Postwar Era,” Canadian Bulletin of Medical History, 20, 2 (2003): 285-286.

[vii] Ibid.,232, 233.

[viii] Dyck, Erika. “Mennonites, Healthcare Institutions, and Modernity: The Mennonite Youth Farm in Rosthern, Saskatchewan.” Journal Of Mennonite Studies 29, (January 2011): 91-104.