Unpacking the black bag: Rural medicine in the Maritime provinces and northern New England states, 1900--1950.

摘要

This dissertation looks at the social transformation of rural medicine in the Maritime provinces of Canada and northern New England states between 1900 and 1950. It begins by examining the history of the country doctor as a cultural archetype in popular fiction, film, and television, and then looks at how rural physicians and their biographers responded to this archetype in life-writing. The response suggests that the archetypal country doctor is a kind of political embodiment of social anxieties about rural health care access in a period which saw the centralization of care, and the rise of specialties.; The dissertation then uses autobiographies and biographies from the north east as a starting point from which to understand the changing contexts and parameters of medical practices in "the periphery." These sources are used alongside a variety of others, including local medical journals, registration statistics, public policy documents and research reports to understand the changes in rural practices in the first half of the century. Many topics are investigated, including the demographic distribution of doctors in rural counties of the north east, the decision-making process involved in selecting a field of practice, and the rural-urban divide on early models to provide health insurance for physician services. I conclude the country doctor archetype was (and may be to this day) an expression of "politicized nostalgia." The ways in which rural physicians used and made sense of their experiences of peripatetic medicine in this period suggest that, beginning in the inter war period, growing scale and shrinking scope of rural general practices did much to undermine the basis of traditional community care.