Doctors within Borders: Profession, Ethnicity, and Modernity in Colonial Taiwan (review)

Ming-Cheng M. Lo’s historical sociological analysis of Taiwanese physicians under Japanese colonialism offers a useful case study of Japan’s self-defined “scientific colonialism” and of modernization at the local level. Expanding beyond the dominant focus on western colonialisms, Doctors within Borders provides a fascinating examination of a Japanese empire that self-consciously sought to position itself as a “modern” nation while separating itself from European and American imperialism by highlighting “cultural and racial affinities” between colonizer and colonized in such sites as Taiwan. Lo explores how the rhetoric of a shared heritage placed Taiwanese physicians in an ambiguous position. Trained by Japanese professionals and espousing a mission to bring modern medicine to their communities, Taiwanese doctors nevertheless resisted their subordination and demanded the autonomy to shape the medical agenda for a modernizing Taiwan.

Lo’s study moves beyond traditional accounts of Japanese imperialism that have focused on the structure of empire to explore the effects of colonial strategies on one important segment of the population: the new modern medical professionals nurtured by scientific colonialism. This focus on Taiwanese doctors enables Lo to expand the literature on professionalization beyond its European-American focus and to explore how modern professions became embedded within the colonial project. She draws on Chinese and Japanese archival materials, as well as interviews, oral histories, and memoirs of Taiwanese physicians to show how they collectively confronted their ambiguous position. No mere pawns of empire, these doctors “indirectly challenge[d] the colonizers’ monopoly of modernity” (10) by carving a professional sphere for themselves and claiming authority to serve as guardians of national health. Rather than charting a simplistic narrative moving from resistance to co-optation, Lo shows that even as physicians faced pressures to assimilate to imperial practices as modern professionals, they reconfigured their understanding of modernity to implicitly critique Japanese domination.

The heart of Lo’s study focuses on several key periods in the professionalization of Taiwanese physicians. She begins by exploring the formation of a “national physician” identity (1920–1931), in which Taiwanese doctors used their high social status as Taiwan’s first “modern professionals” to challenge colonial politics. Contradictions characterized the “in-betweenness” (52) of their position: while they enjoyed professional autonomy, for example, they faced discrimination due to their ethnicity. The following section explores a period of demobilization (1931–1936), when Japanese imperial officials worked to undermine the nationalist movement and silence Taiwanese doctors through a combination of oppression and regulation. Physicians accordingly abandoned their overtly political agenda and focused instead on their professional duties, which the colonial state mobilized into service for the empire. Some doctors embraced new opportunities to serve as medical missionaries to other Japanese colonial outposts and to transform Taiwan into a center for the study of tropical medicine. As imperial agents, Taiwanese physicians enjoyed substantial economic rewards but consequently found themselves increasingly distanced from their ethnic base. By the Kominka Era (1937–1945), a period of state-led forced assimilation, Taiwanese medical professionals had become transformed into “medical modernists,” committed to the agenda of better living through scientific medicine. As the colonial state dominated the profession, doctors internalized a professional identity to the exclusion of an ethnic identity.

Even as assimilated “medical modernists,” however, Taiwanese physicians challenged the official imperial ideology of subordination by identifying themselves as the most suitable providers of modern medical care in Taiwanese society. In this regard, Lo contributes to postcolonial scholarship that seeks to break down the categories of “colonizers” and “colonized” by examining the role of cultural hybrids. She demonstrates how such “in-between” groups as these Taiwanese medical professionals could embrace the modernity embedded within Japanese imperialism yet also demand the authority to define and shape the modern state. Lo argues that we must recognize that not all colonial hybrids rejected the modernity project. Rather, some “in-between” people and groups sought to redefine modernity in ways they thought could best serve their position and communities.

Lo’s study does leave some questions unresolved...