Dr. Ian Carr
Professor Emeritus, Faculty of Medicine, University of Manitoba
The Manitoba Medical College was founded in 1883, in the small frontier, boom and bust town of Winnipeg, home of free capitalist competition, and free typhoid. Flooding was regular, housing poor, sanitation rudimentary, and water polluted. Tuberculosis and venereal diseases were rampant, and typhoid, diphtheria and scarlet fever recurrent. The Icelandic colony had recently been devastated by small-pox.
The Medical College set adequate standards from the start; in 1883 thirteen physicians, all graduates of established Canadian or British medical schools, petitioned the government to allow development of a medical school, before some entrepreneur started a low grade proprietary school. The guarantee of quality was that degrees were to be granted by the University of Manitoba. There was strong support from prospective students.
The new school drew on long traditions through the eastern Canadian Universities, Edinburgh and Belfast, to Leiden, and thence through the schools of the Italian renaissance to Galen and Hippocrates. The first Dean was James Kerr, a Belfast trained surgeon, who quickly raised money for a purpose built Medical College; the building still stands as a block of flats. The first twenty-five years of the new school were a struggle; money was short, and skills were acquired from outside. But the professors taught, the students studied, the standards were established, and clinical medicine and surgery advanced.
Urban hygiene was a major problem.
The air is polluted and the nostrils offended by disgusting stenches at every turn; accumulated heaps of refuse together with stagnant pools are to be found everywhere.
The mess had to be cleaned up. It was the heyday of bacteriology, and the bacteriologist physicians Gordon Bell and his successor Fred Cadham set up laboratory and public health services which were in time to control the spread of infectious disease.
The dominant administrative figure over the first seventeen years of the new century was that of Henry Havelock Chown, a skilful surgeon who was appointed Dean in 1900, after having been Professor of Surgery. In the next two decades, hospital care and medical standards gradually improved. Chown appointed an endocrinologist, Swale Vincent, in 1904 as Professor of Physiology. He was the first professional formally trained medical scientist, but external review some years later suggested that more improvement in medical teaching was needed. Medical teaching was to become a profession, the entry qualification for which was research training. Chown saw that the stigma of being a second class educational establishment had to go, and hired Alexander Gibson from Edinburgh in 1911 as Professor of Anatomy.
The First World War drained teachers and students to serve as front-line doctors, and stretcher bearers. Those who returned were deeply affected by their experiences. They returned to deep social and medical problems, notably epidemic infectious disease. The intestinal infections were coming under control, thanks to improved sanitation, but at the end of the war the devastating influenza epidemic which killed thousands of Manitobans, and filled hospital beds, was followed by epidemics of encephalitis lethargica, still not entirely explained. The white plague, tuberculosis, was to come under control only slowly, despite the devotion of those who worked in sanatoria, at Ninette and elsewhere, led by Dr. D. A. Stewart , who had a major influence on the development of medicine in the province.
In 1919, the College became the Faculty of Medicine of the University of Manitoba, and its buildings were expanded. Dr. J. W. Prowse , a surgeon trained in Edinburgh and a veteran of the trenches of Flanders was the new Dean of Medicine. A cohort of professional teachers was being established. Gibson brought two of his Edinburgh friends, William Boyd who became the first whole time Professor of Pathology, and J. C. Boileau Grant who succeeded Gibson as Professor of Anatomy. A. T. Cameron became the first Professor of Biochemistry. The post-war generation made the Manitoba Medical School famous by writing text-books galore. The clinicians were largely home-grown. E. W. Montgomery, the revered Professor of Medicine, spent his latter years developing the provincial public health programmes. Jasper Halpenny, Professor of Surgery led the drive to train surgeons adequately, Gordon Fahrni (still alive in 1995) developed safe thyroid surgery, and William Webster pioneered scientific anaesthesia.
War came again in 1939, and again staff and students responded to the call, leaving a reduced number of overworked doctors providing medical care at home. War changed many things, among them if only gradually the nature of the medical profession. Until 1945, it was male dominated; the ruling group ensured by quotas that only a few Jewish, Eastern European or female applicants were admitted to the medical school. The racist selection procedures did not survive the Second World War, but the war reinforced male bonding, and until recently the school remained dominated by men with a few exceptions, most obviously Elinor Black, Professor of Obstetrics.
A major step toward the present research based institution was the appointment of Joseph Doupe as Director of Clinical Research in 1946 and then in 1949 Professor of Physiology and Medical Research. Lennox Bell became full time Professor of Medicine, and Dean, in 1949, and soon afterwards whole time Heads were appointed to other clinical departments - Surgery, Paediatrics and Psychiatry. The scene was set for the physiologically based clinical sciences to dominate the medical school. Doupe's pupils were to establish important research programmes across North America.
Since 1945, in Canada as in other Western societies medicine has expanded, and advanced clinical medicine has become synonymous with clinical investigation. The medical system had to cope with major emergencies like the poliomyelitis epidemic, but the main part of the story has been exponential expansion, fueled at once by the increasing research drive, and the increasing health needs of a population kept successfully alive to a more advanced age.
The more notable medical activities in Manitoba have included concern with the plight of aboriginal people, symbolized by the Northern Medical Unit, founded by Dr. J.A. Hildes, the successful prevention and treatment of haemolytic disease of the new born, the discovery of prolactin, and the successful evolution of cardiac surgery. As elsewhere medicine became too expensive to be paid for by ordinary people, and prepaid medicare developed.
Of late, growth has been hampered increasingly by financial ischaemia, and now significant ethical decisions on priorities face the community. The position of physicians in society has changed; their pedestals have disappeared. But pedestals were never comfortable.