Changing times, changing addresses, and changing priorities

In July 1956 I was the 18th doctor who entered medical practice on the North Shore of Vancouver. My office was located on Lonsdale Avenue, close to 14th street. I was the junior partner of Dr C.G. McNeil, one of the North Shore’s medical pioneers. We were centrally located and many of our patients could walk to our office; parking a car was also not an issue. I could walk to the North Vancouver General Hospital, built in 1922, with its 120 beds and the head nurse still living in the hospital. I could even walk to the office from our house, if I needed to.

What brought these memories to mind was an article in the Vancouver Sun that reported the purchase by UBC Library’s Rare Books and Special Collections of the only copy left of the Vancouver Weekly Herald and North Pacific News, which had been printed on 15 January 1886, months before the city was officially incorporated and before much of it burned to the ground in the Great Fire of 13 June 1886.

Around that time there were only five or six doctors in Vancouver, including Dr W.J. McGuigan, who became Vancouver’s mayor a few years later. The doctors were employed either by the Canadian Pacific Railway, which was about to put down tracks from Port Moody to Vancouver, or the mill industries around Burrard Inlet. In 1886 the only hospital accommodation in town was in a wooden building with six beds, located on today’s Powell Street. A married couple, but no trained nursing staff, looked after the railway’s surgical or medical cases. In 1887 St. Luke’s Home was opened on Cordova Street, and it offered more hospital accommodations and carried out a small training school for nurses. By 1888 the City Hospital was opened in a two-story wooden building on Beatty Street, and it was later expanded to Cambie Street to become the precursor to Vancouver General Hospital. 

By the late 1890s there were close to 30 doctors in Vancouver—several of them were also active in the public and business life of the city. Nearly half of all doctors’ offices were in the 700 block of Granville Street, with the remaining offices sprinkled among Hastings Street, Main Street, Davie Street, and Robson Street. At first most doctors’ offices were connected to their living quarters. Patients would often encounter their doctor in the neighborhood because they lived or worked close to their doctor’s home and office. 

By the early 1900s, doctors, along with other well-to-do citizens, preferred to live in the Shaughnessy area, Point Grey, or the less-congested West End. As the city grew, and doctors’ offices and homes were separated, the doctor-patient relationship became more impersonal. I remember that even in the early 1960s, when our family moved from near my office in North Vancouver to West Vancouver, I was concerned that my patients would feel distanced from me—especially because my home phone number also changed. 

Today we are likely to travel at least across the city to see our doctor. And with the near complete cessation of house calls, doctors have no opportunities to see firsthand their patients’ living situations or work environments. 

It is with some yearning for the past that I mentioned this to some of my colleagues—location, location, location initiated the growing distance between us and our patients. Now, the brevity of office visits, the tendency to listen to one complaint per visit, and the increased use of highly technical investigation methods make our relationships more impersonal still.

My colleagues shut me up very fast by reminding me that, yes, all that is true and sad, but we can now give a patient a new heart if that is needed. And that is certainly worth something. 
—George Szasz, CM, MD

Suggested reading
Andrews MW. Medical attendance in Vancouver, 1886-1920. BC Studies 1978;40:32-56.
Monro AS. The medical history of British Columbia. CMAJ 1932;26:225-230.

This posting has not been peer reviewed by the BCMJ Editorial Board.

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