Birth of a local living
history collection / 4
The Atwater Library and Montreal Island seniors construct a living a history collection
By Wanda Potrykus
Children’s stories – Part 2
Once upon a time… for that is how all stories should begin.
The Book of Lost Things, John Connolly
Once upon a time in 1909… in Montreal, the TB Capital of Canada
In those early years of the 20th century, Montreal was Canada’s largest city with the highest tuberculosis (TB) mortality rate of all North American cities. This deplorable situation gave rise to another famed Montreal medical institution, the Royal Edward Institute, now the Montreal Chest Institute.
It began operations, in October 1909, as a TB dispensary in a three-story house with a garden at 47 Belmont Park, a two-block, mixed-use street near the downtown commercial core where Central Station now stands. The institute was a direct result of the work of the Montreal League for the Prevention of Tuberculosis, which had been founded six years earlier on June 1, 1903. Funding for the charitable clinic, “with its bright sun parlours and large roof garden”, came from Lieutenant Colonel Jeffrey Hale Burland (1861–1914), who also oversaw the alterations to his former residence.
‘We do not know that any Imperial episode has made a finer appeal to the imagination.’
London Observer, October 24, 1909
It was opened by King Edward VII by telegraph from Chichester, Sussex in the UK, who simply pressed a switch on one side of the Atlantic that sent a transatlantic electrical current to activate the unlocking mechanism on the front door, switch on the lights and cause a flag to raise up the flagpole in Montreal. It was considered a great feat of technological magnitude of that era.
The dispensary movement was modelled on Edinburgh’s Victoria Dispensary for Consumption (another name for TB) that was inaugurated in 1882, which placed an emphasis and the treatment of early-stage patients in their own homes with rest and exposure to fresh air, sunlight and good food. However, shortly after opening, the Royal Edward also began offering in-house rest therapy, no doubt due to the overcrowding and poverty in so many homes, especially those in the “city below the mountain” i.e. industrialized Montreal that included Little Burgundy, Griffintown, Point St Charles, St-Henri, etc. Thus, in 1911, a “limited number of patients” were treated with the “open air method on the galleries of the Institute” where ten patients received 24-hour treatment, and another sixteen came to the galleries during the day but returned home at night.
Surgical Advances in TB Treatment in Montreal 1911-1940
Thus, it was that Montreal developed into an important pioneering centre for innovative TB medical research and training, especially noteworthy for promoting developments in tuberculosis surgery, in addition to maintaining a strong linkage with the non-invasive, sanatorium “open air” treatment movement, which had been the traditional treatment protocol for TB patients.
For instance, in 1911, noted surgeon, Dr Edward Archibald, performed the first thoracoplasty (the most invasive of what became known as the “collapse” treatment options) in North America at the Royal Edward’s sister institution, the Royal Victoria Hospital (established in 1893), which entailed removing a number of ribs to collapse the lung, allowing it to rest and heal.
‘While primitive, collapsing the lung of the infected patient was a fairly ingenious treatment. Tuberculosis breeds in the space inside the lung, thus less lung volume produces fewer bacteria.’
Tuberculosis Treatments Past and Present by Rebar Niemi, November 4, 2014
Although antimicrobial chemical compounds were already being experimented with at this time, it would take until 1946, after WWII, for the first successful antibiotic treatment to appear (streptomycin) and be used to combat the disease.
One of Archibald’s students, in the late 1920s, was the talented, iconoclastic, charismatic, unconventional, humanitarian surgeon, Dr Norman Bethune, a TB activist and sufferer himself, who due to his medical knowledge was more than aware he might die of the disease, but instead of resigning himself to his fate, read up everything he could on it.
Becoming convinced in the process that an alternative treatment protocol known as pneumothorax surgery, in which the affected lung is collapsed using nitrogen gas rather than the more radical rib removal, was the answer for him, he insisted his doctors in the US treat him with this surgery. Although initially incorrectly performed, resulting in a punctured lung during the process, it eventually proved successful in curing him.
Bethune was a gifted doctor, teacher, inventor and medical pioneer in his own right and even though his life was not long, his work has continue to benefit many around the world, both adults and children, as he was the creator of mobile blood transfusion units, and of a mobile hospital, as well as a range of modern surgical instruments, such as the Bethune Rib Shears, which are still used today.
Arriving in Montreal in 1928, he worked first with Dr Archibald at the Royal Vic, then moved to Hôpital du Sacré-Cœur in Cartierville in 1933 as chief of pulmonary surgery. There he operated and trained new surgeons, introduced innovative surgical techniques, including an improved pneumothorax device that pumped sterile air rather than nitrogen gas into the lung, and published scientific articles, work that garnered him an international reputation.
But as talented a surgeon as he was, he also had an artistic and altruistic side. During the eight years he spent in Montreal, he painted, wrote short stories and poems and organized a Children’s Art Centre in his apartment to teach impoverished children how to paint in watercolours and oils. He even hosted public showings of the children’s and his artwork.
In addition, he was an early proponent of a universal health care system, organizing a study group known as the “Montreal Group for the Security of the People’s Health”, which brought together doctors, nurses, and social workers and that resulted, in 1936, in a four-point plan promoting compulsory health insurance, voluntary health insurance, municipal medicine as well as medical care for the unemployed, and which was met with great hostility from the medical community, in particular.
Disappointed, he left Montreal soon after for the Spanish Civil War and later travelled even further afield to China where he started a wartime medical school, created a model hospital and where he died in November 1939 from septicemia (blood poisoning) contracted while performing surgery during the Second Sino-Japanese war.
A commemorative statue, donated to Montreal by a Chinese government appreciative of his work and sacrifice, stands in Place Norman Bethune, at the junction of Guy and de Maisonneuve. Even today, he is considered a hero in China where schoolchildren learn about him, Mao Zedong (or Mao Tse Tung aka Chairman Mao) wrote an essay eulogizing him and the 2000-bed International Peace hospital in Shijiazhuang bears his name. However, in Canada he’s mostly just a statue in a parkette in Montreal as well as a small museum in the Presbyterian manse in Gravenhurst, Ontario, the place of his birth.
Once upon a time… back at the Children’s Memorial Hospital (CMH)
With an ever-growing reputation, the CMH quickly outgrew its limited, and always considered temporary, space on Guy Street and by 1909 it oversaw a move further up the mountain to Cedar Avenue (then called Cedar Street). There, by grouping a number of houses together, to form what were termed “cottage hospitals”, it was able to increase its capacity to 45 beds and the CMH became a well renowned institution dedicated to helping young people suffering from a range of ailments including TB (tuberculosis), typhoid and polio, as well as a wide variety of congenital diseases along with complications resulting from acute illnesses.
Once upon a time… from 1892 to 1998 at the other Montreal Children’s Hospitals
Although the CMH was the first paediatric specialty hospital, Montreal has been home to other hospitals that had concerned themselves primarily with the care of children, such as the Montreal Foundling and Baby Hospital (1892-1943) that had been set up in 1892 by a group of concerned Protestant women.
Designed for “deserted and sick children under the age of two years”, it supplemented the work of the Protestant Infants’ Home and provided care for foundlings (abandoned babies), who made up about one half of its admissions. A special ward for sick babies was opened in 1897. The hospital was managed by a committee of women, aided by a Medical Board. Located first on Argyle Avenue (south of Dorchester) in the present day Shaughnessy Village area, it moved to St Urbain Street in 1915; however, it also suffered from constant funding issues, and in 1932 at the height of the Great Depression it was struggling, as were most other institutions, from a lack of operating funds.
‘… it (the Montreal Foundling and Baby Hospital) supplemented the work of the Protestant Infants’ Home and provided care for foundlings (abandoned babies), who made up about one half of its admissions.’
In addition, “placing out” (fostering) babies was becoming the recommended option rather than orphanages, so its managing board approached the CMH with a suggestion that the two institutions merge. The CMH agreed since amalgamation would provide expanded facilities, a wider range of services, more opportunities for research into children’s diseases plus additional beds for convalescent children, allowing the CMH to concentrate more on acute care patients. Thus, their offer was accepted. The hospital operated as an annex to the CMH until 1943 when its charter was revoked and its elegant St Urbain Street building was absorbed into the neighbouring Royal Edward Institute (renamed the Montreal Chest Institute in 1971), eventually becoming the Institute’s nurses’ residence.
The original Montreal Children’s Hospital in Little Burgundy 1920-1940
Meanwhile, in the mid 1920s, the CMH, also struggling for funding, had also been approached to merge by the Montreal Children’s Hospital (also called the Vipond Hospital after two of the founding doctors, Albert and Charles Vipond, who along with Dr Duncan Anderson had first opened the hospital in 1920 on St-Antoine Street in Little Burgundy); however, at that time the CMH Board of Trustees had denied the request. Until 1940 that is, when yet another approach was made that was finally accepted and the CMH took over its building and services to the community but not its debts or its staff.
Over its 20-year history the Montreal Children’s Hospital had operated from two different locations on St-Antoine. After the first CMH refusal, it had moved to the Rodier Mansion at 360 St Antoine, on the southwest corner of Guy and St-Antoine, the former home of one of Montreal’s more colourful mayors. It remained there until its amalgamation with the CMH in 1940, when the building became a busy outpatient department for the MCH.
The Alexandra Hospital for Contagious Diseases “not in my backyard” 1906-1988
“Anyone seeing the hospital for the first time (…) might be tempted to exclaim, ‘What a place for a hospital!’ The land upon which it is built is quite low; it is in the very thick of railway traffic and, apparently, directly in the path of the city smoke.”
The Montreal Standard, June 19, 1909
Meanwhile, the Alexandra Hospital was opened in 1906 at the southern edge of Pointe-Saint-Charles, near the border of Verdun. It was the infectious diseases institution for the west-end English speaking community. Its equivalent in Montreal’s francophone community was St Paul’s hospital on Sherbrooke Street East (now part of Hôpital Notre-Dame).
According to the medical principles of that time, contagious diseases were controlled by isolating patients in dedicated wards, minimizing access to them while providing sun and fresh air, clean water and good food. Somewhat ironic in the case of the Alexandra, as it was built in one of most polluted parts of Montreal, in a low-lying area next to the Grand Trunk railway lines and yards, as well as near the mists from the St Lawrence river.
‘… even in Point St-Charles its construction was not initially well received, since its closest neighbour across a field was a school.’
One of the original sites proposed in 1900 had been much further north, in Fletcher’s Field (now Jeanne-Mance Park), but it seems, no one wanted a hospital with “contagious diseases” as part of its name, located right next to their house, and even in Point St-Charles its construction was not initially well received, since its closest neighbour across a field was a school.
“… about the Alexandra Hospital in the Pointe. On August 16, 1966 our 5-week-old daughter had to be hospitalized there for whooping cough. They took very good care of her, and she was able to come home on October 8, 1966… I’d like to know more… My only memory of it was that I was allowed to visit her once a week for an hour, but when I got there the first week, a nurse was holding her behind a rope barrier and I was not allowed to touch her. Not an easy situation.”
When the hospital first opened in 1906, its clientele was, for the most part, children and one of its attending physicians was Dr John McCrae, the author of In Flanders Field, who also worked as a pathologist at the Montreal Foundling and Baby hospital.
Its priorities were the treatment of whooping cough (pertussis) along with scarlet fever, measles, and diphtheria (croup). It would also take in children with a variety of other diseases that included chickenpox, polio and rheumatic fever but not TB. Not until later that is, as the institution opened a tuberculosis isolation unit in 1948, specializing in the treatment of, and research into, tuberculosis meningitis, and which operated for 20 years until 1968 (which is also when the hospital stopped taking contagious disease cases altogether) and that appellation was dropped from its name. It became the Alexandra Pavilion of the Montreal Children’s and the Montreal General. Its new mandate was long-term care for children with chronic mental and physical illnesses. It was permanently closed in 1988 as part of the provincial government major shifts in how healthcare is delivered in Quebec and as part of the de-institutionalization of mental healthcare in favour of group home care.
Watch for Part 3 of Children’s Stories coming soon in WestmountMag.ca
Further updates and the public access launch date
The Atwater Library Seniors’ group will have some of the collection available for access by the public as of mid-2018 but do check back over the coming months in the WestmountMag.ca and/or the Atwater Library website for more snapshots and updates on this vibrant Living History Collection project.
For further info on the background and rationale of the Living History Collection see: Birth of a Local Living History Collection – Part 1 and Part 2
Feature image: “Only a memory”, postcard of nurses standing outside the Montreal Children’s Memorial Hospital on Cedar Street, August 1912 – BANQ
Wanda Potrykus is a writer, editor, translator and poet. A graduate of McGill, she has spent most of her career in marketing communications, PR, event and media relations specializing in international aviation, telecommunications, education and the marketing of the arts.