Madeleine Mant // If you went looking for the Pilley’s Island hospital today, as I did one windswept July afternoon, all you would find is a private driveway at the top of a sharp incline, partially overgrown with the tall grasses and stout greenery typical of the Newfoundland and Labrador landscape. Down the hill, past the silently oxidizing remains of the pyrite mine that encouraged settlement in the area from 1887, you would observe a collection of tidy houses set close to the water.

Problematizing and analyzing the concepts of region and place in the Canadian landscape of social histories of medicine should be an area of key concern for medical history and contemporary public health. Understanding the “minutiae of locality and smaller influences that mark the wider sweep of time, geography, and human experience” (Davies, 89) is necessary to contextualize the issues of isolation and want that still trouble the Canadian province of Newfoundland and Labrador today. According to the Newfoundland and Labrador Medical Association, today as many as 1 in 5 citizens of the province do not have a family doctor (CBC, “1 in 5 people”).
Thirty-eight years before Newfoundland and Labrador joined Canada as its tenth province, the Pilley’s Island hospital formed part of Dr. (later Sir) Wilfred Grenfell’s network of hospitals and nursing outposts in northern Newfoundland and Labrador, under the purview of the United Kingdom’s Royal Mission to Deep Sea Fishermen. Grenfell entrusted the practise to two newly graduated and enthusiastic young Americans, Dr. Hugh Greeley and surgeon Dr. Harrison Briggs Webster. Before it was a hospital, the simple white-washed structure was a hotel, making its transition an appropriate architectural palimpsest. Dr. Hugh Greeley and his wife Floretta wrote copious correspondence to friends and relatives in 1911 and 1912 as they navigated the founding and operation of the fledgling hospital. These letters were published in 1920 as Work and Play in the Grenfell Mission.
Work and Play is an important source for those seeking a ‘history from below’ for historical rural Newfoundland. Gone are any shades of the ‘great man’ narratives that often colour depictions of the Grenfell mission work (see Connor for a discussion of the “Grenfell effect”); instead, the work contains long passages describing the quotidian and the pedestrian happenings of life with no self-conscious ethnographic distance. Here is a medical memoir in which Christmas decorations – “[w]e cut up the red paper wrappings of cakes of soap into strips and hung them on the branches” (Greeley and Greeley, 89) – and Scout troops – “[w]e organized a Boy Scouts Club…to give the boys some occupation other than spitting and throwing stones at birds” (Greeley and Greeley, 40) – receive equal billing with cases of typhoid, tuberculosis, and the occasional acute appendicitis. The hard rhoticity and H-insertions of the local dialect leap off the page as Floretta quotes directly from her companions, describing sudden deaths in the community – “in six hours she was a carpse” (Greeley and Greeley, 25) – while the Doctor “hurge[s]” (Greeley and Greeley, 72) those suffering from typhoid to take a drink of water. The slippery diphthongs that still characterize contemporary Newfoundland English are recorded with care by the Greeleys, imbuing the document with a vibrant local pulse.
The Greeleys write with a lack of restraint that emphasizes the essential humanity of the doctor-patient relationship. Mixed and sometimes judgemental impressions of the locals are recorded, with one Mrs. Penny described as “a neighbor as friendly as she is toothless” (Greeley and Greeley, 19). Floretta notes that the lives of many inhabitants appear “pitifully poor and barren” (Greeley and Greeley, 42); one woman is described as “so hungry that she actually looks pinched” (Greeley and Greeley, 23). Whilst waiting impatiently for news from home, Floretta describes a disappointing mail yield of only “odious little Newfoundland envelopes holding requests for pills” (Greeley and Greeley, 142). Concomitantly, the inhabitants of Pilley’s Island are described as “all ‘hearts’ of gold’” (Greeley and Greeley, 20), and endless examples of generosity are recounted. Ultimately, Floretta opines that “no other single experience will ever teach us more of the depth and the sweetness of life” (Greeley and Greeley, 178).
The landscape of Newfoundland and Labrador itself is presented as an equally important protagonist as its people. Dr. Webster personifies the coastline as defiant and proud, declaring that he likes the coast, “for it always seems to say to a newcomer, ‘Well, it’s up to you. If you settle here, I shan’t make things easy for you. What are you worth?’” (Greeley and Greeley, 16-17). Days dawn “clear and cold, with a furious gale of wind” (Greeley and Greeley, 155)” and the doctors are described “performing an operation and rowing twenty miles in the rain” (Greeley and Greeley, 21). Greeley and Webster make effortful treks by snowshoe to far flung houses: “we walked about twenty-five more seeing sick people at our stopping places. The last three days of uninterrupted travel in which the mere putting of one foot in front of the other, became a more irksome and monotonous necessity, totalling about sixty miles of snowshoe work, was far from pure enjoyment” (Greeley and Greeley, 153-154). Despite the physical labour, the winter landscape around the Island is described as “a fairyland of beauty…ponds, hills, woods, glades, bleak marshes, rocky cliffs, the open sea and the frozen bay in the pale and clouded moonlight, made the trip one of mystic and marvelous beauty, the experience of a lifetime” (Greeley and Greeley, 137).
The Pilley’s Island hospital operated from 1911 to 1924. Low retention of physicians, the inability to secure permanent sources of funding, and the founding of a larger hospital in a nearby town made its continued existence untenable. As the province continues to struggle with family physician retention, medical tales from a century ago may help to answer key questions: what would attract doctors to this harsh and beautiful place? And what might make them stay?

References
CBC News. “1 in 5 People Without a Family Doctor in N.L., Says Medical Association.” CBC, 17 Sept. 2019, https://www.cbc.ca/news/canada/newfoundland-labrador/nlma-family-doctors-1.5286410. Accessed 1 Oct. 2019.
Connor, Jim T.H., “Putting the ‘Grenfell Effect’ in its Place: Medical Tales and Autobiographical Narratives in Twentieth-Century Newfoundland and Labrador.” Papers of the Bibliographical Society of Canada, vol. 48, no. 1, 2010, pp. 77-118.
Davies, Megan J., “Mapping ‘Region’ in Canadian Medical History: The Case of British Columbia.” Canadian Bulletin of Medical History, vol. 17, 2000, pp. 73-92.
Greeley, Hugh Payne and Floretta Elmore Greeley. Work and Play in the Grenfell Mission. Fleming H. Revell Company, 1920.