A little over four years ago social historian Linda Bryder suggested that the infamous investigation into the so called 'unfortunate experiment' at National Women's hospital, the Cartwright Report held over 1987 -88 somehow got it all wrong. Her book 'A History of the Unfortunate Experiment at National Women's Hospital' opened the academic levy, although for her she'd been heavily investigating the treatment of women in our medical system ever since her ground-breaking history of the Plunket Society, 'A Voice for Mothers'.
Early in her introduction she revisits the 30-year-old scandal but this time it's really just a reminder of why the place featured so prominently in our papers back then, and even now.
"The publication of Professor Linda Bryder’s revisionist volumes denying the occurrence of the Unfortunate Experiment, or harm to patients aroused controversy in the New Zealand Medical Journal in 2010.
Professor Ron Jones, a gynaecologist at National Women’s Hospital who had been a consistent critic of the ‘unfortunate experiment’, asked why, if there was no experiment, there were marked increases in the development of invasive cancer during the period of the research, especially among the women with minimal or no initial curative treatment.
Professor Bryder responded in the same edition of the Journal. Jones and Bryder are here divided by two key issues; the ability to distinguish clearly adequate from inadequate treatment and the implications of the fraudulent nature of Green’s methodology." http://www.cartwrightinquiry.com/?page_id=35
Auckland University Press, and Bryder herself were dragged over the coals and challenged at every turn. Bryder was not quite ridiculed in the streets, but the experience, in an academic peer sense must have come pretty close. But was she right? I believe so. The enquiry was very political then as now, and the battle for control over women's bodies steamrollered over the good intentions and genuine concerns to solve serious medical problems for the benefit of all, But if so, was the deaths and mutilations of so many worth it? History can only provide facts, not empathy, in this case.
A Baby on the Way (1971)
Just over 50 years ago National Women's hospital was a flagship for medical care and innovation. It pioneered many new procedures and there are plenty of children, now adults, who have the staff and doctors of this fine institution to thank for their very lives. It was a centre of excellence, compared teaching hospitals in Europe and America, It was even a household name in England.
Bryder's new work attempts to complete what she actually started out to achieve in her first book, before it veered off down the blind alley of the Cartwright investigation.
"When I put a proposal in [for funding] a decade ago,' she told the NZ Herald (A headline-making hospital by Andrew Stone Feb 18 2014) "I pretty much said I didn't want the story to focus on Cartwright because I was interested in reproductive health....I thought I would simply summarise the inquiry findings and draw on Sandra Coney's [co-author of a Metro article which blew the scandal wide open] work. I didn't realise I was entering a minefield."
Indeed the incendiary devices can be found most deeply in the lush fields of the chapter "Feminists, Midwives and National Women's Hospital", which recounts the tireless push by activists to criticise the stalwart reproductive practices and the very core of the established medical order not only in NWH but all over the country. Specialists with the tile of "Mr" could no longer hide in the bubbles of arrogance or command blind respect without proving their credentials to the wards every day, from now on.
Staring gently, almost like flipping through the Architect's digest or Popular Mechanics, Bryder paints the scene - a primary coloured, glossy dream - a jewel in the crown of the State's vaguely socialistic fantasy of medical care and nutrition for all, post war and into the future. Her history details the life and times of the purpose-built hospital, and we're reminded that although the final years were blackened, during the golden years National Women's was a world-leader for research that produced breakthroughs which altered the way science came to understand the miracle of childbirth and foetal growth.
In 1965 the Hospital gained media rock-star status when Shirley Lawson gave birth to quintuplets. Remember this was just the fifth set of surviving quintuplets in the world. The photo of Shirley Lawson with her four girls and a boy sitting up in bed two hours after giving birth has become a national icon. And the 26-year-old miracle mum was only one of tens of thousands of New Zealanders whose lives were touched in some way by NWH over the second half of the 20th century. My own wife included. And, we learn, The author, who in 1992, had first child there, despite the initially planned homebirth. And Bryder' second child was also born at National Women's, in 1997. So, if you were searching for conflicts of interest, then perhaps they lay here. Perhaps. Perhaps not.
The hospital was a catalyst for the work of medical stars such as Bill Liley, who pioneered antenatal blood transfusions in the early '60's, and Graham "Mont" Liggins and Ross Howie who saved many, many premature babies from respiratory failure by applying steroids prior to delivery. A few cheap injections saves thousands of dollars in intensive neonatal care and ongoing care for handicapped infants, Liggins argued. He advocated for the practice to be widely adopted throughout the country and it finally was accepted in the 1990s. Bryder argues the reason for the delay was discussed at two big London conferences - "territorial jealousies" between rival disciplines existed and were fiercely defended by arrogant parties. And the core evidence and research, and sheer disbelief that this incredible finding could emerge from a "primitive backwater" was a definite slap to the pride of world health professionals. "It was a tight international community, of which New Zealand was a part despite the tyranny of distance, but at the same time it seems that national and personal rivalries abounded."
Surprisingly, at least to me was Bryder's revelation that it was Liggins, in the 1970's who found the trigger for the onset of labour in sheep, leading to solving the initiation of labour in humans. But how exactly he discovered it remains a mystery. And it remained so when Liggins died, in 2010, the mystery remained.
And this is only one case study ...
Professor Bryder likes to look at the interplay of social forces on science and medicine. She argues that the hospital folded in the end because it lost the hearts and minds and trust of the public.
She argues further that the Cartwright and the chest-tapping investigation under Helen Cull, QC were, at the core, about distrust in the medical profession. Beyond the wards the hospital came under such pressure from the feminists, turf wars between doctors and midwives, political funding and pie carving and a blood thirsty medial, gnawing on the fleshy bones of scandal.
All in, this is a fascinating journey and in some ways a miracle that it is written. Thorough, opinionated, at times personal but fair this is a good book, weighing up facts and evidence against the need to tell clear and concise stories to a public dumbed by twitteratti and 30 second sound bite. In a world of OIAs and veiled information it's good to know someone is willing to risk hay fever to delve into the dust files of National Archives and uncover truths the internet cannot provides us, especially something so close to our loins.
Thanks to Auckland University Press: http://www.press.auckland.ac.nz/en.html
