The Left Atrium ship style was anything but MBA- esque, and might best be described as Sir Charles Tupper: From Fighting Doctor high-mindedness yoked to an ornery to Father of Confederation ox. He led his party and constituency Jock Murray and Janet Murray down potentially explosive avenues and Toronto: Fitzhenry and Whiteside; 1999 survived. For example, he instituted a 153 pp $18.99 ISBN 1-55041-183-7 system of free primary education in Nova Scotia long admired by opposi- anadian history is widely recog- fied the audience, and word soon tion politicians but cynically thought to C nized to be a neglected subject of spread from that little gathering that be political suicide because of the requi- modern curricula; students are taxed to Charles Tupper was a doctor with skills site increase in taxation. His paternal- recall basic facts such as the year applicable beyond the bedside. The ism would not be much in favour these women were given the vote, or when Conservative party quickly came to days, in politics or in medicine. He was public hospital insurance became the capitalize on this. a man who, after winning the popular status quo in Canada. This general Tupper set a trend in Nova Scotian vote, failed to take opinion polls among weakness is perhaps a poor defence for politics. As the first physician–premier the electorate or his own party; he sim- my own ignorance of Canadian medical of Nova Scotia, he introduced the pop- ply evaluated the situation and decided history. So I sheepishly admit that be- ulace to the concept of having an obsti- on the right course of action without fore I came across this book I knew nate man of medicine as their leader. equivocation. This is the chief paradox nothing about Sir Charles Tupper, de- This trend continues to the present of his political career: lacking the savvy spite his status as one of the most im- day, especially with the mid-1990’s of the usual successful politician, Tup- portant figures in Canadian medical reign of the ejected per is described by the authors as history and one of the founders of Dal- Dr. John Savage (like possessing a “no-nonsense, hu- housie Medical School, my alma mater. Tupper in single- mourless, demanding, [and] As Jock Murray and Janet Murray make minded determina- dominating manner.” As a clear in the 23rd instalment of the Han- tion, but not in abil- political ramrod, Tup- nah Institute’s Canadian Medical Lives ity to persuade) and per could institute series, Tupper had a most interesting current premier of measures that, in and eminent medical life. the province, Dr. the hands of more sil- The first few chapters lay out the ba- John Hamm. ver-tongued politicians, sic biography. Born in East Amherst, Provincial politics would have meant doom Nova Scotia, in 1821 as the son of a was not the sole on the hustings. dull but capable Presbyterian minister, arena for the dour Focusing primarily on he grew to affiliate himself with the but marketable Tup- the role of medicine in town’s local medical man, gaining the per. As a Father of Tupper’s life, this concise experience necessary to be admitted to Confederation, he volume only whets the Edinburgh University in 1840, at the briefly served as reader’s appetite with its in- time recognized to be the world’s pre- prime minister of troduction to Tupper’s ma- mier medical training facility. His re- Canada, the first of jor rival, Joseph Howe. turn to Nova Scotia was to a typical our ilk to do so. He The authors hint at bat- country doctor’s life: he had a thriving also played an instru- tles of cataclysmic pro- practice that featured its share of bad- mental role in found- portion, on a par with weather house calls, charity cases and ing the Canadian Fred Sebastian Trudeau and Lévesque appreciative patients. Medical Association in modern times, and I A career among the rural inhabitants in 1867. Not only did he agitate for the wish more attention had been paid to of his birthplace seemed his ultimate creation of this national advocacy body, the relationship between these two calling until the young Dr. Tupper but he also sat as its first president and seminal figures in Nova Scotian poli- took the stage at a local political meet- was elected for three consecutive terms. tics. However, since they are writing ing. Being a respected figure in the Tupper’s political success stands in for a biographical series whose focus is community, he was asked to introduce opposition to his nature. Although he trained on the medical aspects of a sub- a candidate. His forceful speech electri- was elected democratically, his leader- ject’s life, the authors can hardly be CMAJ • FEB. 18, 2003; 168 (4) 463 © 2003 Canadian Medical Association or its licensors De l’oreille gauche faulted. Imagine, though, a hostile rela- his early advocacy on their behalf. Vis- bookends representing a voluble doc- tionship of mutual regard, in which re- itors to Ottawa can make a pilgrim- tor who fought for his principles — spect for ability is undercut by a disdain mage to the bronze bust of Tupper sit- health care for the poor, free and non- for each other’s policies. Sharing the ting atop a pedestal at the CMA’s sectarian education — and usually credit for the creation of Dalhousie offices; but a more economical option won. An old lion on the front cover Medical School must have been a bit- is to seek out this book. On the front and a young lion on the back, Tupper tersweet moment of common purpose. cover, Tupper is mature and fear- shouldn’t just rest on a pedestal. He Maritimers and their Dalhousie- somely jowled, grey sideburns cover- should be read about. trained physicians owe Tupper a great ing a great swath of his side profile, debt; he forged for them a locus from head slightly inclined. The younger Shane Neilson which they could obtain their health man on the back sits erect over an offi- Emergency Medicine Resident care and their training. Canadians and cial desk, holding a quill at the ready. Dalhousie University Canadian physicians owe Tupper for Both versions of the man are perfect Halifax, NS Room for a view My first house call he date was May I had a beautiful wife and a one- most immediately I would see ahead of T 30, 1946. I was year-old son. My wife, pregnant at term me a narrow, tunnel-like underpass un- twenty-five years of with our second child, was to be de- der a railroad. The road would then go age, embarking on my livered in the private hospital. sharply upward, and in about 100 feet medical career. Then two events occurred would turn abruptly to the right, where Two years earlier I simultaneously. My wife I would find a cluster of unpainted had been granted suffered sudden pain and houses. These were the company the degree of Doc- began to bleed. And houses of a small mining firm. They tor of Medicine, my employer re- would be lit only by kerosene lamps which qualified me ceived a phone and would be hard to spot. to practise medicine, Off I went, full of trepidation, in an surgery and obstetrics. My experience unfamiliar car of pre-war vintage, since was fairly slim: less than a year as a ju- new cars had not yet appeared on the nior intern in a children’s hospital, and market. But I followed my directions. just over a year as a regimental medical call from a Sure enough, they took me to the little officer in the Canadian army, mainly remote loca- cluster of houses. treating young soldiers with colds, tion: a man was I knew I had found the right place rashes and the clap. Then I was retired dying, and a as soon as I turned off the ig- into civilian life. I had paid my fees to doctor must come nition. I could hear the the Ontario college and obtained my li- immediately. loud keening of women. cence to practise. What to do? My doc- But which house? I My first job was as assistant to a tor-employer admitted picked up my medical general practitioner who ran a private my wife to hospital, bag, hitherto un- hospital and office in a large town 40 where he would need to used, and followed miles from Toronto. His practice attend her constantly. I, the sound of the served about 10 000 people, and there who had never yet made a lament to the was only one other doctor in town. I’d night call into a remote re- middle house. been on the job for about a week, dur- gion of the countryside, As I entered ing which my employer saw me must attend the dying man. an incredible through several office and hospital vis- It was 1 a.m., pitch dark sight met my its and obstetrical deliveries. I under- and raining. The circuitous eyes. A man stood the fee schedule: one dollar for route, as my employer de- of about 35 an office call, three dollars for a house scribed it, was this: four miles years was lying call. A bottle of medicine must always west, then a right turn onto a on the kitchen Fred Sebastian be included. dirt road, then a left turn — and al- floor. He was sur- 464 JAMC • 18 FÉVR. 2003; 168 (4).