Book review: Medicine, Unbundled

Maggie Hulbert is a medical student in the Class of 2020 at Queen's University

 

Medicine Unbundled: A Journey through the Minefields of Indigenous Health Care
(Heritage House, 2017)

Imagine working in a hospital where a child is admitted and kept on the wards for seven years without being allowed to see their family. Now imagine being that child, and growing up to be an adult in today’s healthcare system. Would you ever set foot in a hospital again? Would you ever trust a doctor? These are the kind of questions that come to mind while reading Medicine Unbundled: A Journey through the Minefields of Indigenous Health Care, a book written by investigative journalist Gary Geddes. By travelling across Canada and interviewing Indigenous leaders, Elders, and members of a wide variety of First Nations, Geddes provides a powerful account of how Canada’s historic Indian Hospitals and Tuberculosis Sanatoriums directly and intentionally contributed to the genocide of Indigenous people. By using these oral histories in conjunction with current research and historical documents, Geddes provides a human narrative to the starvation and nutritional experiments conducted by physicians at residential schools, as first published in 2013 by historian Ian Mosby.1 The accounts of these experiments ought to be mandatory reading for every physician, for they offer a compelling and disturbing rationale for the high rates of metabolic syndrome in Indigenous people today. They also provide insight into the direct trauma inflicted not only by residential schools, but by physicians themselves; the subjects of their experiments were children, parental consent was never obtained, and the experiments continued after the Nuremberg code of ethics was put forward.

While Geddes’ choice to write Medicine Unbundled from a non-Indigenous first-person perspective was questionable and, at times, slowed the book down, the content of Medicine Unbundled is more than valuable enough to make up for the odd and out-of-place anecdote about Geddes’ donut preferences at Tim Horton’s. One of the most haunting testimonies in Medicine Unbundled is that of Sandy Morris, an Indigenous man whose family spans across the Tsartlip First Nation in British Columbia. At the Nanaimo Indian Hospital in the early 1950s, Sandy was told that his brother had died during surgery and went to see his body in the morgue. There he discovered that his brother was still alive, and had been covered with a sheet and left to die. In the Truth and Reconciliation era, many medical schools are incorporating Indigenous Health issues into their curriculum, including the intergenerational trauma imposed by residential schools. If we as a profession are ever going to provide the culturally competent and adequate care our Indigenous patients deserve, we need to fully confront the intergenerational trauma imposed directly by our healthcare systems — not just the residential schools. Medicine Unbundled is an excellent starting point for understanding the loss of trust between Canadian healthcare institutions and Indigenous people. This understanding is the first of many steps towards health equity for Indigenous people and true reconciliation.

 

References

  1. Mosby I. Administering colonial science: Nutrition research and human biomedical experimentation in Aboriginal communities and residential schools, 1942–1952. Social History. 2013;46:145–72.

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