Body Failure: Medical Views of Women, 1900–1950 by Wendy Mitchinson (review)

Wendy Mitchinson, recently retired professor and Canada Research Chair in Gender and Medical History at the University of Waterloo, has treated us with Body Failure, the third in a series of studies on women’s health, which include The Nature of Their Bodies (University of Toronto Press, 1991) and Giving Birth in Canada (University of Toronto Press, 2002). The present volume is the logical companion to the first, because it covers an equally wide range of topics, including the nature of womanhood; puberty, menstruation, and menopause; sexuality and marriage; motherhood, infertility, and birth control; gynecology; and mental illness. An excellent chapter on cancer represents a more recent research interest. Mitchinson improves upon The Nature of Their Bodies by referencing an ever-growing historiography in the field of Canadian women’s health history, and through ethnic, racial, and class inclusion. She also incorporates welcomed reminiscences from patients/interviewees.

In Body Failure, Mitchinson chooses as her chronological limits the period from 1900 to the end of the Second World War. In so doing, she notes the Victorian perceptions of women in the pre–Great War period, and how the catastrophic losses of the war, and resulting transformations in socio-cultural values, affected those perceptions. Other chronological guideposts for changing attitudes to women’s biology included the isolation of the hormone estrogen in the late 1920s, which gave the Canadian medical profession “more confidence” (4) in their knowledge of women’s health, and the impact of the Second World War in accelerating the institution and acceptance of more varied social and economic roles for women. Mitchinson’s conclusion is that advancements in surgery, endocrinology, pharmacology, etc. did not trump persistent traditional attitudes toward women; rather, traditionalists were able to interpret those advancements in ways that would uphold often centuries-old views about the differences between men and women.

The book’s themes, clearly delineated in the detailed introduction as well as that of each chapter, include the power of medicine “to define a social problem and how it should be discussed” (11); the physician’s power vis-à-vis the vulnerable patient; patients’ agency and its limits; and constraints on the medical profession. However, the last theme at times diminishes the impact of the others, occasionally lending to Body Failure an equivocal tone that was not present in The Nature of Their Bodies. Mitchinson takes pains to remind us that most male physicians were just trying to do the right thing, that they faced their own professional challenges and pressure from insistent and desperate patients and family, and that the misogynistic medical attitudes of some simply reflected the larger community. But most people in that community didn’t have the opportunity to cut out body parts without asking permission. Furthermore, it is collective medical power, not the ordinary family doctor who “means well,” which is relevant here.

Body Failure is at its most powerful when, with painstaking detail, Mitchinson uses the physicians’ words and actions to demonstrate the consequences of unchecked medical power. The book’s cut-off date of 1950 has a wider significance; it coincides with the conclusion of the Nuremberg War Crimes Trials and the adoption of the Nuremberg Code, delineating the principle of informed consent, although it would take at least another forty years before informed consent became more than just an ideal in Western nations. This is a story that unfortunately continues to have relevance to every succeeding generation and society. Mitchinson cites multiple examples of the harm, indeed mutilation, of women, particularly by gynecological surgeons. She uses some of the physicians’ own words to indict them, such as the Crossens’s surgical treatment for cancer of the cervix: “Let’s see what we can remove and still have the woman survive” (225).

These bon mots, Mitchinson’s dry commentary following them, and the sprinkling of comments from the patients she interviewed are lost in the University of Toronto Press’s crammed, standard layout, which...