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Historical Perspectives on Rural Medicine HISTORICAL PERSPECTIVES ON RURAL MEDICINE The proceedings of two Witness Seminars held by the History of Modern Biomedicine Research Group, Queen Mary University of London, on 29 January 2010 and 3 September 2015 Edited by C Overy and E M Tansey Volume 61 2017 ©The Trustee of the Wellcome Trust, London, 2017 First published by Queen Mary University of London, 2017 The History of Modern Biomedicine Research Group is funded by the Wellcome Trust, which is a registered charity, no. 210183. ISBN 978 1 91019 5222 All volumes are freely available online at www.histmodbiomed.org Please cite as: Overy C, Tansey E M. (eds) (2017) Historical Perspectives on Rural Medicine. The Proceedings of Two Witness Seminars. Wellcome Witnesses to Contemporary Medicine, vol. 61. London: Queen Mary University of London. CONTENTS What is a Witness Seminar? v Acknowledgements E M Tansey and C Overy vii Illustrations and credits ix Abbreviations xiii Introduction Professor Geoffrey Hudson xv Transcripts Edited by C Overy and E M Tansey The Development of Rural Medicine c.1970–c.2000 3 The History of Rural Medicine and Rural Medical Education 83 Biographical notes 155 References 169 Index 183 Witness Seminars: Meetings and publications 191 WHAT IS A WITNESS SEMINAR? The Witness Seminar is a specialized form of oral history, where several individuals associated with a particular set of circumstances or events are invited to meet together to discuss, debate, and agree or disagree about their memories. The meeting is recorded, transcribed, and edited for publication. This format was first devised and used by the Wellcome Trust’s History of Twentieth Century Medicine Group in 1993 to address issues associated with the discovery of monoclonal antibodies. We developed this approach after holding a conventional seminar, given by a medical historian, on the discovery of interferon. Many members of the invited audience were scientists or others involved in that work, and the detailed and revealing discussion session afterwards alerted us to the importance of recording ‘communal’ eyewitness testimonies. We learned that the Institute for Contemporary British History held meetings to examine modern political, diplomatic, and economic history, which they called Witness Seminars, and this seemed a suitable title for us to use also. The unexpected success of our first Witness Seminar, as assessed by the willingness of the participants to attend, speak frankly, agree and disagree, and also by many requests for its transcript, encouraged us to develop the Witness Seminar model into a full programme, and since then more than 65 meetings have been held and published on a wide array of biomedical topics.1 These seminars have proved an ideal way to bring together clinicians, scientists, and others interested in contemporary medical history to share their memories. We are not seeking a consensus, but are providing the opportunity to hear an array of voices, many little known, of individuals who were ‘there at the time’ and thus able to question, ratify, or disagree with others’ accounts – a form of open peer-review. The material records of the meeting also create archival sources for present and future use. The History of Twentieth Century Medicine Group became a part of the Wellcome Trust’s Centre for the History of Medicine at UCL in October 2000 and remained so until September 2010. It has been part of the School of History, Queen Mary University of London, since October 2010, as the History of Modern Biomedicine Research Group, which the Wellcome Trust 1 See pages 191–7 for a full list of Witness Seminars held, details of the published volumes and other related publications. v funds principally under a Strategic Award entitled ‘The Makers of Modern Biomedicine’. The Witness Seminar format continues to be a major part of that programme, although now the subjects are largely focused on areas of strategic importance to the Wellcome Trust, including the neurosciences, clinical genetics, and medical technology.2 Once an appropriate topic has been agreed, usually after discussion with a specialist adviser, suitable participants are identified and invited. As the organization of the Seminar progresses and the participants’ list is compiled, a flexible outline plan for the meeting is devised, with assistance from the meeting’s designated chairman/moderator. Each participant is sent an attendance list and a copy of this programme before the meeting. Seminars last for about four hours; occasionally full-day meetings have been held. After each meeting the raw transcript is sent to every participant, each of whom is asked to check his or her own contribution and to provide brief biographical details for an appendix. The editors incorporate participants’ minor corrections and turn the transcript into readable text, with footnotes, appendices, and a bibliography. Extensive research and liaison with the participants is conducted to produce the final script, which is then sent to every contributor for approval and to assign copyright to the Wellcome Trust. Copies of the original, and edited, transcripts and additional correspondence generated by the editorial process are all deposited with the records of each meeting in the Wellcome Library, London (archival reference GC/253) and are available for study. For all our volumes, we hope that, even if the precise details of the more technical sections are not clear to the non-specialist, the sense and significance of the events will be understandable to all readers. Our aim is that the volumes inform those with a general interest in the history of modern medicine and medical science; provide historians with new insights, fresh material for study, and further themes for research; and emphasize to the participants that their own working lives are of proper and necessary concern to historians. 2 See our group’s website at www.histmodbiomed.org vi ACKNOWLEDGEMENTS A Witness Seminar on rural medicine was suggested in 2009 by Professor Roger Strasser and Professor John Hamilton, and planned for later that year. Transport difficulties meant the original meeting was postponed, and eventually a smaller, more focused seminar than was originally intended was held in January 2010. This served as a useful introduction to the topic, and we envisioned holding an additional, more substantial, meeting to add more comprehensive and international dimensions to the published proceedings. Administrative changes and physical relocations delayed further organization until mid-2013, at which point the plan was resurrected, with the additional help of Professor Geoffrey Hudson, medical historian at Northern Ontario School of Medicine. To overcome the logistics of arranging such an international discussion it was decided to hold the second meeting with the majority of overseas participants contributing via video links; this was held in September 2015. We are very grateful to Roger Strasser, John Hamilton, Geoffrey Hudson, and also Dr John Wynn-Jones for their help in planning these meetings, and to Roger and Professor Sir Denis Pereira Gray for chairing the Witness Seminars. The initial intention was to meld the proceedings of the two meetings into one published account. However, after reviewing both transcripts, it became apparent to the editors that the two volumes could not only be read independently but they also complemented each other. Thus we are publishing them together but organized in reverse order to that in which they were held. We thank Geoffrey Hudson for writing an introduction that includes both meetings. Our thanks also goes to the participants for providing many of the images used, and to the Wellcome Library, London, for permission to use photographs taken at the meeting. As with all our meetings, we depend a great deal on Wellcome Trust staff to ensure their smooth running: Audiovisual, Catering, Reception, Security, and Wellcome Images. We are also grateful to Mr Akio Morishima for the design and production of this volume; the indexer Ms Cath Topliff; Mrs Sarah Beanland and Ms Fiona Plowman for proofreading; Ms Dee Briston and Mrs Debra Gee for transcribing the seminars; and Mrs Wendy Kutner, Mrs Lois Reynolds, and Dr Carole Reeves, who assisted in the organization and running of the meetings as did Mr Adam Wilkinson who also managed the complex video link arrangements of the second meeting. Finally, we thank the Wellcome Trust for supporting this programme. Tilli Tansey and Caroline Overy School of History, Queen Mary University of London vii ILLUSTRATIONS AND CREDITS* Figure A Professor Geoffrey Hudson. Photograph supplied by and reproduced with permission of Professor Geoffrey Hudson xxvii Figure 1 Professor Tilli Tansey 5 Figure 2 Professor Roger Strasser 6 Figure 3 Witness Seminar screen 9 Figure 4 Dr John Wynn-Jones. Photograph supplied by and reproduced with permission of Dr John Wynn-Jones 10 Figure 5 Professor Ian Couper. Photograph supplied and reproduced with permission of Professor Ian Couper 12 Figure 6 Manguzi Hospital. Photograph taken by Dr Colin Pfaff and supplied by and reproduced with permission of Professor Ian Couper 13 Figure 7 Manguzi Nursing School. Photograph supplied and reproduced with permission of Professor Ian Couper 13 Figure 8 Professor James Rourke 14 Figure 9 The Rourke family farm. Photograph supplied by and reproduced with permission of Professor James Rourke 15 Figure 10 Leslie Rourke in front of Drs James and Leslie Rourke’s medical office in Goderich (Ontario). Photograph supplied by and reproduced with permission of Professor James Rourke 16 Figure 11 Professor James Rourke in Haiti. Photograph supplied by and reproduced with permission of Professor James Rourke 17 * Unless otherwise stated, all photographs were taken by David Bishop, Wellcome Trust, and reproduced courtesy of the Wellcome Library, London. Photographs from the 2010 Witness Seminar (Figures 28–36) were taken by a member of the History of Twentieth Century Medicine Group. ix Figure 12 Dr Jo Scott-Jones. Photograph supplied by and reproduced with permission of Dr Jo Scott-Jones 18 Figure 13 Professor Ivar Aaraas.
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