Behind the Book with Maureen Lux

Lux_SeparateBeds

Maureen Lux gives even more depth to her striking new title Separate Beds: A History of Indian Hospitals in Canada, 1920s-1980s:

How did you become involved in your area of research?

In a sense Separate Beds emerged out of the research from my previous book, Medicine That Walks (2001).  In that book I examined the nascent Canadian state’s expansion westward and the impact on Aboriginal bodies and societies.  Indigenous communities, once valuable and respected partners in trade, exploration, and commerce, came to be seen as impediments to settlement and agricultural progress.  The impact of dispossession and colonization on individual and collective wellbeing was immediate.  Rationalized at the time by reference to an inevitable struggle with the challenges of civilization, health disparities were accepted by state and society (bolstered by medical opinion), as the last gasp of a ‘dying race’.

That book ended with what I thought at the time was a somewhat positive note.  Following years of neglect and blame, the government had, by the 1940s, finally begun to devote some resources and attention to Indigenous peoples’ health care. But as I got further into the research on the Indian Health Service and their Indian Hospitals, my optimism quickly faded.

After the Second World War, Indigenous peoples’ continued economic, social, and political difference, or what was called the “Indian problem,” captured Canadians’ attention.  In particular, the discourse of a ‘dying race’ no longer held; disease in First Nations and Inuit communities came to be characterised as a threat to national health and hygiene.  Intended to isolate that threat, Indian hospitals also served to ensure that Aboriginal people would not take up beds in increasingly modern and expensive community hospitals.  While Canada invested millions in hospital infrastructure and programs of hospital and health insurance that became Medicare, Indian hospitals operated on the premise and promise that they would operate at half the cost of community hospitals.  Separate Beds examines the mid-twentieth century state’s response to continued health disparities.  Institutionalised health care, Indian Hospitals, emerged as Canada was actively defining something called ‘national health’ in the 1940s and 1950s.

Underfunded by design and situated in redundant military barracks and residential schools, Indian hospitals would never draw personnel and resources from modernizing Canadian hospitals.  Aboriginal patients were characterized as careless in their own health and therefore subjected to prolonged institutional treatment, and increasingly invasive surgery, for tuberculosis at a time when most non-Aboriginal patients were treated at home.  Separate Beds exposes an abiding mid-century faith in medicine’s promise to treat those made ill by reserve poverty, only to return them to it.  Health disparities continued to widen.

What do you find most interesting about your area of research?

In talking to archivists, librarians, and other historians about my research on Indian Hospitals, I was constantly surprised by the almost complete lack of knowledge that such institutions ever existed in Canada.   I was intrigued by their reactions: “Canada didn’t have racially segregated health care!”  Yet, when I spoke with people in Indigenous communities, everyone had either personally experienced the institutions, or knew someone in their immediate family that had.

How to explain this apparent erasure of Indigenous experience from public memory?  The hundreds of banker’s boxes of documents – though restricted and difficult to access - were there in front of me.  The bureaucratic record of the Hospitals was mostly intact (though many patient files were destroyed in the 1950s).   Yet twentieth century health care history told a progressive story of the ‘road to Medicare’ that embraced all Canadians.   It took me probably far too long to finally understand that the isolation and segregation of Indigenous people in Indian Hospitals was integral to the dominant project of modernizing health care for non-Indigenous Canadians. On the rare occasion that Indian Hospitals intruded into this story of progress, it was to congratulate Canadians on their humanitarianism.

What do you wish other people knew about your area of research?

I think most thoughtful Canadians understand that health disparities in (some) First Nations and Inuit communities have deep economic and political roots in colonialism.  Yet there remains a sort of ideological shorthand that equates Indigenous communities with ill-health; that despite every effort, health disparities are seemingly inevitable.  Some even dredge up the old ‘biological invasion theory’ that Indigenous people somehow lack immunity to diseases brought by settlers.  Perhaps that notion had some purchase in very early contact situations, but it certainly does not apply to health history since the early nineteenth century.

Canadians have only very recently begun a serious dialogue about the destructive role of the century-old Residential School program in our shared history.  Like the schools, Indian Hospitals and Health Services might be seen as nodes in the broader web of policies and relations that sought to undermine and isolate First Nations and Inuit communities in the interests of non-Indigenous Canada.

What’s the most surprising thing you discovered during the course of your research?

As I researched, I was always taken aback by the overwhelming paternalism of the physician-bureaucrats that designed and operated the Indian Health Service and its hospitals.  This surprisingly small group of men tied significant state power to medicine’s soaring twentieth century reputation that only grew with announcements of new drug treatments, daring surgeries, and the seeming ‘conquest’’ of another infectious disease.  Despite evidence to the contrary, they claimed success for their Hospitals project while blaming Indigenous people and their supposed cultural (racial) shortcomings for any failures.  The bureaucrats rarely, if ever, questioned that they alone knew what was best for Aboriginal communities.

It was not until the 1970s and 1980s that Indigenous communities and their leadership were finally able to force some recognition that they might have insight into health problems and their solutions.  And it was not until the new century that communities were allowed a measure of decision making in the Health Transfer Agreements.  Given that history, it should not come as a great surprise that health disparities continued into the 21th century.

What are your current/future projects?

I am currently collaborating with Professor Erika Dyck on a history of reproductive politics in the 1960s and 1970s.  Taking our cue from the elder Prime Minister Trudeau’s famous quip that the state has no place in the bedrooms of the nation, we examine the politics of reproduction in the wake of liberalizing Criminal Code amendments that legalized birth control and abortion.  Some middle class white Canadians achieved a measure of reproductive autonomy, yet others, defined by their disabilities and their race, found that the state had become even more interested in what went on in their bedrooms.   This project is nearing completion.

What do you like to read for pleasure?  What are you currently reading?

I just finished Rosemary Sullivan’s fascinating narrative Stalin’s Daughter.  Right now I am re-reading (again) Alice Munro’s Open Secrets.  Her short stories are delicious; she makes every word do so much work.  Who else could describe snow drifts that “curled like waves stopped, like huge lappings of cream.”  Her writing dazzles.

If you weren’t working in academia, what would you be doing instead?

I honestly couldn’t imagine working at a more fulfilling and exciting career!