Author: Derek Walde

 

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.

In this week’s readings, the focus was put on pregnancy and how notions of pregnancy are socially constructed.  In all three of the assigned readings, the way pregnancy was viewed and adapted was not solely because of medical and scientific discoveries, but rather had more to do with the social climate.  Science was playing its part in the cases of; physical activity during pregnancy, natural births and thalidomide, however women and the culture did more in defining and contesting ideas of pregnancy.

In the case of the Thalidomide situation, Barbara Clow in ‘An Illness of Nine Months’ Duration’ , explains that doctors and scientist were all playing a part in the rise of pharmaceutical drug use and were shrouded in greed trying to turn a profit.  However, that does not tell the whole story, rather the social climate made thalidomide so popular; as faith in medicine in the postwar years was extremely high, perceptions of pregnancy, acceptance of increased pharmaceutical drug use, and increased gender roles of beauty all contributed heavily to the extreme use of thalidomide.[i]

The medical discoveries of pregnancy in the context of physical activity proves further that pregnancy is socially constructed rather than a prescribed ideal by medical professionals.   Shannon Jette illuminates in Exercising Caution, the morphing notions around exercising while pregnant started and originated within ordinary women rather than with medical studies and professionals.  As she explains the history behind the changes, she shows the many ways that women challenged the norms of limiting physical activity while pregnant. She states “second wave feminism, the fitness boom, and the neo-liberal push for personal responsibility for health” were large factors and “in this context of change and uncertainty that individuals in the field of exercise science began to engage in a careful examination of exercise during pregnancy.”[ii]

In the final stage of pregnancy and child birth, the ideas surrounding a “natural birth” were not defined by doctors with rigid meaning, rather it was individualized from mother to mother. Science once again was not the main motor in defining what a natural birth looks like, rather it was the social atmosphere that determined that outcome.  Each mother had different circumstances for their births, however despite these differences all the mothers that used midwives in order to achieve a “natural birth”, saw the outcome as a natural birth.  Even when a mother ended up in a hospital or took an epidural they still classified their child’s birth as “natural.”  This idea of natural birth was a social construction not a classification made by a medical professional. [iii]

Pregnancy for Hutterite women was declining in the 1970’s due to the increased use of birth control.  The increased use of birth control was not prescribed heavily by their medical professionals, rather, Hutterite women used it to gain more control in their lives within a patriarchal system.  Much like the other articles many notions surrounding pregnancy are socially prescribed, and no different is this situation.  The culture surrounding Hutterites in the rest of Canada was pushing against the Hutterites prescribed gender norms, as it was the social climate that brought the increased use of birth control not ,medical professionals.[iv]

Pregnancy as a social construct is clearly shown throughout all these articles, as many of the perceptions revolving around pregnancy were a direct result of the social atmosphere.  Not to say medical opinions and information was not a mover in perceptions however it was not the core mover. The next couple of weeks the theme is defining and contesting illness, and pregnancy fits in.  Norms around pregnancy were constantly being contested and being re-defined as the cultural environment adapted.

[i] Clow, Barbara, “‘An Illness of Nine Months’ Duration’: Pregnancy and Thalidomide Use in Canada and the United States,” in Feldberg, Ladd-Taylor, Li and McPherson, Women, Health, and Nation, Montreal” McGill-Queen’s University Press, 2003: 45-66.

[ii] Jette, “Exercising Caution: The Production of Medical Knowledge about Physical Exertion during Pregnancy”, Canadian Bulletin of Medical History, 28, 2 (2011): 299.

[iii] MacDonald, Margaret, “Gender Expectations: Natural Bodies and Natural Birth in the New Midwifery in Canada, Medical Anthropology Quarterly, 20, 2 (2006): 235-256.

[iv] Ingoldsby, Bron B., and Max E. Stanton. “The Hutterites and Fertility Control.” Journal Of Comparative Family Studies 19, no. 1 (Spring 1988): 137-142.