Over the course of the summer, I worked as a research assistant at the Laurier Centre for the Study of Canada on a project that traces the history of the National Sanitarium Association from 1896 to 1921. Established by the National Sanitarium Association, the Muskoka Cottage Sanatorium was Canada’s first in-patient facility for tuberculosis treatment, which opened in 1897 in Gravenhurst, Ontario. My experience was enlightening: I was expecting to learn solely about tuberculosis prevention and treatments but the experience provided much more than that. In digitizing thousands of tuberculosis patient records, I added names and faces to some of those taking sanatorium treatment in Canada. What stood out to me as I uncovered these records, though, was the underlying story of colonialism, inequality, and how the healthcare system itself became a tool through which Indigenous peoples experienced discrimination.

Canada’s healthcare system was never truly equal.[1] While hospitals and healthcare services for non-Indigenous Canadians were expanded, the federal government created a separate system of “Indian Hospitals,” which isolated First Nations tuberculosis patients rather than integrating them into provincial healthcare systems.[2] These hospitals were overcrowded, understaffed, and lacked funding.[3] Differential access to healthcare meant that First Nations patients often experienced late diagnoses and limited treatment, which led to less favourable outcomes or a lower recovery rate. These hospitals were initially established to house sick First Nations people because of a general fear that they posed a threat to public health and safety of settler communities.[4]

Much scholarship has been produced on the subject of First Nations healthcare, but historians tend to focus primarily on these segregated “Indian hospitals” and the federal government’s relationship with status Indians. What I discovered in the records of the National Sanitarium Association, however, was that despite receiving care in an integrated medical institution, Indigenous patients were still subject to a similar strain of anti-Indigenous racism that Indian Hospital patients faced. For example, archival records from the Muskoka Free Hospital for Consumptives illustrate how racial assumptions affected the staff’s view of Indigenous patients. In 1916, a staff member described a patient, Frank C., as “a bad half breed Indian,” accusing him of flouting the rules and breaking into a locker to retrieve his clothing that had been taken from him.[5] His clothes were removed from his possession to prevent the spread of diseases, but it was not recorded if he was given any replacement clothing because a laundry bill was not a part of his record.

What is striking is Frank’s drive to retrieve his clothes. He likely wanted to retain something of his self-identity or to keep his dignity. His actions were not just an act of disobedience but also an attempt to retain some sense of autonomy. Soon after, Frank was sent away to Ottawa for being “difficult” and “defiant.”[6] Rather than attempting to understand the patient’s perspective or circumstance, the staff portray him as inherently disobedient. The note demonstrates the paternalistic and racialized attitudes engrained in the healthcare system. Yet it also shows a patient’s determination to assert their humanity.

Before beginning this job, my knowledge of sanatoria was limited. I viewed them as institutions that worked towards healing or helping patients suffering from ailments to recover or manage their symptoms. While that angle of history certainly exists, it is incomplete. After diving into these records, institutions like the Muskoka Cottage Sanatorium were also connected to much larger systems of inequality and discrimination. When Indigenous patients were admitted to medical facilities, their experiences were shaped, in part, by racism, surveillance, and preconceived notions about their identities.

Utilizing the archives was another aspect of my summer of research that changed and deepened my understanding of sanatoria. One of the most significant things I learned was that archival research is not just for learning about certain events in the past; it is also about understanding the people who lived in the past and their experiences. Medical institutions like the Muskoka Cottage Sanatorium are products of their time, reflecting the values of their contemporary host societies. Reading remarks from medical professionals that start with “a bad half breed Indian” demonstrated to me how racialized attitudes shaped the sort of treatment Indigenous patients received.

The job of a historian is to put the fragmented pieces of the past together into an understandable narrative while simultaneously meeting historical individuals where they are in the archive. Frank C. did not write any letters, one reason being that he did not know how to write, and so his own experiences have largely been lost. But the remarks of sanatorium staff as well as his act of defiance give us some clues of his experience. These institutions were oppressive and at times racist, but patients refused to fully surrender themselves to these powerful social and cultural forces. Patients like Frank C. tried in whatever way they could to reclaim their identity in the face of an institution that tried to control all aspects of patient life. By researching this side of history allows us to get a closer look at the racial prejudices that contributed to long-term inequalities in healthcare but also to the way that Indigenous peoples refused to surrender to these pre-conceived narratives of themselves and their communities.

Notes

[1] Maureen K. Lux, Separate Beds: A History of Indian Hospitals in Canada, 1920s-1980s (University of Toronto Press, 2016), 11.

[2] Lux, Separate Beds, 8, 13.

[3] Lux, Separate Beds, 2.

[4] Lux, Separate Beds, 19.

[5] Patient file of Frank C., 3607, Box 654, Series 9, F-1369, Archives of Ontario.

[6] Patient file of Frank C., 3607, Box 654, Series 9, F-1369, Archives of Ontario.