Doing Good: The Life of Toronto's General Hospital (review)

J. T. H. Connor. Doing Good: The Life of Toronto's General Hospital. Toronto: University of Toronto Press, 2000. xi + 342 pp. Ill. $60.00; £40.00 (0-8020-4774-2).

A reporter called the scene a "carnival of death" (p. 157). The local hospital received injured persons as anxious friends and family descended upon its doors. Many of the unfortunate were burned from "head to foot" and subsequently died. The hospital issued daily reports as to the status of their admitted patients. Local citizens responded to the tragedy by organizing a relief fund for the victims' families.

Although this account might have been drawn from modern newspapers, it actually describes the events following a train crash in Toronto in 1884. The hospital in question was the Toronto General Hospital, the subject of Doing Good, written by the historian J. T. H. Connor. As Connor shows, the recent efforts of hospital workers in New York and Washington, D.C., are in a long tradition of "doing good" for the injured or otherwise sick.

Connor's account is chronological, beginning with the original conceptualization of the hospital in the late eighteenth century and its opening in 1829 as York General Hospital. By 1856, York had become Toronto and the hospital had moved to larger quarters in the eastern portion of the city. When the institution moved again, in 1913, to its current location on the corner of College Street and University Avenue, its 670 beds made it the largest hospital in North America.

The trajectory followed by the Toronto General will be familiar to those well versed in the history of hospitals. The facility began as a "charitable institution for sick immigrants and the indigent poor" (p. 31), functioning less like a hospital than an almshouse. During the mid-nineteenth century, hospital trustees pursued affiliations with local medical schools, seeking to bring the latest scientific developments to the Toronto General. Yet the institution was plagued by inadequate funding, unhygienic facilities, and squabbles between its medical staff and administrators.

By the early twentieth century, due in large part to the efforts of an energetic trustee, Joseph Flavelle, the Toronto General began to assume the characteristics of the modern teaching institution. In 1903, when William Osler visited Toronto, he encouraged the hospital to emulate the Johns Hopkins model, urging that it become a center for clinical education, scientific research, and patient care. In this spirit, an affiliation was forged in 1908 with the faculty of medicine of the adjacent University of Toronto. Within fifteen years, pathbreaking research—most notably the discovery of insulin—would result from the collaboration between these two institutions. As the decades passed, the Toronto General Hospital increasingly attracted renowned physicians, well-educated nurses, and the latest medical technology, leading paying patients to seek care in its well-furnished private wards. Noting that "doing good" now also means "doing well," Connor details the recent history of the hospital, including its mergers with other institutions and its current membership in the University Health Network of Toronto.

In contrast to other histories of hospitals, which are largely hagiographic, Connor has written a balanced account of the Toronto General, warts and all. He has adeptly used available source materials, such as trustees' minutes and the personal papers of Flavelle. Well aware that institutional history can be dry, Connor tries hard to liven his work with patients' stories and descriptions of the often quirky individuals who helped forge the institution. Unfortunately, there were no patient diaries or medical charts for Connor to mine, meaning that much of the book addresses administrative matters.

Connor also does an excellent job of situating his research within the existing historiography of the hospital. For example, echoing Charles Rosenberg, he states that the Toronto General Hospital became medicalized as medicine was becoming hospitalized. He aptly notes how the history of Toronto General, like that of other hospitals, was inextricably...