In the 5th episode of Research Chat Season 2, Eric Story, a historian of infectious disease in the 20th century and outreach manager of the Laurier Centre for the Study of Canada, is interviewed by Tyler Pacheco, a social psychologist and Research Theme ambassador for Laurier’s research strength area Psychological and Social Determinants of Health and Well-Being. Both Eric and Tyler study respiratory diseases in different contexts and time periods.
The episode features:
Shawna Reibling 00:04
Welcome to the second season of Research Chat. In this season graduate students share the challenges of their research work. In this episode, Tyler Pacheco will interview Eric Story.
Shawna Reibling 00:21
Tyler Pacheco, pronouns he/him, is in his second year of study with Dr. Nancy Kocovski and Dr. Simon Coulombe. He is a Social Psychologist who is working on the research team exploring the effects of the COVID-19 crisis on the mental health of Canadian based workers.
Shawna Reibling 00:36
Eric Story, pronouns he/him, is a First World War historian with a particular focus on memory, colonialism and infectious disease in Canada. His writing has been featured in blogs, magazines, news media, and academic journals. Most recently his article, The Indigenous Casualties of War, on the racist discrimination indigenous veterans and their families faced in the aftermath of World War, while fighting for compensation for their war incurred injuries, appeared in the Canadian Historical Review. Since he arrived at Laurier in 2015, he has been committed to engaging the public with history and historical ideas. In 2017, he became the Outreach Manager of the Laurier Center for Military Strategic and Disarmament Studies, and in this role founded, hosted and produced the podcast On War and Society, a monthly sit down interview with the world's leading historians of war and conflict. Currently, he hosts a speaker series on Canada's past and present.
Shawna Reibling 01:33
The COVID-19 pandemic has greatly shaped his current dissertation project, which explores the history of tuberculosis in the era of the First World War, and the ways in which masculinity shaped the Canadian state's response to the disease in war and its aftermath. Eric is in his fourth year of study with Dr. Mark Humphries at Laurier. Welcome to you both, I can't wait to hear more about your research.
Tyler Pacheco 01:58
So Eric, what did you set out to discover in the research?
Eric Story 02:01
Hi, Tyler, it's good to talk to you again. When I first set out to research the history of tuberculosis in the era of the First World War, I was actually a lot more concerned with pushing the bounds of the existing literature, and much of the existing literature in the history of medicine on tuberculosis looks at the relationship between patients and doctors. And so as a result, I expected much of my research to focus on the doctor patient relationship that tended to exist within the institutions that tuberculous patients inhabited, which are called "sanatoria". And so that was what I was expecting to do. And the sources that I was expecting to look at, were those set within sanatorium. But that's definitely not the track that I'm on right now in terms of my research into the tuberculosis epidemic in Canadian history.
Tyler Pacheco 02:53
And how did you answer your research question? Or how did you go about researching this patient-doctor relationship?
Eric Story 02:59
Yeah, so I started actually focusing on the war itself. So I went to the Library and Archives Canada in Ottawa, which is our National Archives, and I went into record group nine, which records hold all of those pertaining to Canada's experiences during the First World War. And I started to explore some of the ways in which the military managed tuberculosis cases because at this time, tuberculosis was understood as an infectious disease. It was first understood in the scientific literature as an infectious disease in the 1880s so by 1914, it was very much regarded as such, and therefore, was a threat to the Canadian military in their ability to mobilize troops on the battlefield. And so it was very clear even from early on, even in the early stages of screening soldiers when they enlisted, and then of course, on the battlefield, to ensure that tuberculous soldiers were caught early so that they couldn't spread the disease on to other soldiers.
Eric Story 04:00
And so you have the construction of a number of sanatoria, which again, were institutions for tuberculous patients, on the battlefields themselves being constructed ad hoc, and it is within these institutions that you start to see questions about or debates that doctors are having about civil liberties on one hand, the civil liberties of soldiers and the greater public health of not only soldiers in the in the Canadian Corps, but also civilians back home. Because when soldiers became tuberculous, on the battlefields, they essentially became useless to the army, they became no longer a part of the fighting force, they needed to be treated first of all, and once their treatment had got them to a point where they could be moved, they were then sent home. But then those same questions started to emerge, right, of what role does the military have in ensuring that soldiers aren't going back home and infecting their families or infecting their friends or in infecting their communities. And so that's when you start to see the emergence of some of these questions, right? Around personal liberties on one hand, and greater public health on the other.
Eric Story 05:09
And it was right around this time, actually, that I started to see these documents that the COVID-19 pandemic hit in March 2020 - hit here in North America anyways. And I can say with certainty that the COVI- 19 pandemic has fundamentally reshaped my project, I became less interested in this idea of the doctor-patient relationship, and a lot more interested in the negotiation that the State, the military, and then also the Civilian State played in alleviating soldiers ills and their disease, but also their role in ensuring public health while also balancing civil liberties, which are similar questions that we're talking about today when imposing restrictions, when imposing things like vaccine passports, and also imposing mask mandates. So that's how my research has shifted from the beginning, from one that was much more focused on the academic literature of the doctor-patient relationship, to one that is a lot more public and outside of the institution's walls, though, not necessarily completely outside of them.
Tyler Pacheco 06:18
So, I have a couple of follow up questions. I think in the beginning, you're discussing this screening process on the field was sanatoria, used specifically for testing? Or was it specifically for treatment? And are these the first time that we begin to see sanatoria being used in the world?
Eric Story 06:38
Hmm, those are good questions. So the screening process was actually not done in sanatoria, it was actually done by doctors who were at recruitment stations for soldiers, right, they weren't able to do X-rays on mass scale yet, and they didn't have the ability to actually test, like we would do PCR tests for people today to see if they have COVID, right? So it was much more based on the skeletal musculature of the soldiers, they would often test to see the breathing of the soldier to see if they could hear the "grail lungs", which was a classic sign of tuberculosis, and just kind of generally weak dispositions.
Eric Story 07:17
They're very highly gendered, and can get into some murky waters around eugenics as well at the time period. But these are sort of the things that medical officers were screening for at the time, it wasn't so much based on a more clinical test like the PCR. As to your question, though, about sanatoria, Tyler, sanatoria indeed, were meant for treatment, they were essentially hospitals. The problem being however, that at the time, before kind of the late 1940s and early 1950s, there was no actual proven treatment for tuberculosis, it was essentially a combination of rest, diet, and exposure to the outdoors. Essentially, it was much more therapeutic right than it actually was based on any sort of curative measures. And you actually do start to see after the First World War, the introduction of what's called artificial pneumothorax, which is literally the collapsing of a lung. So essentially, a doctor would go in and make an incision in the lung and literally compress it down with the idea of being able to get rid of the tuberculous bacterium. That was ultimately not effective, extremely painful, and might actually lead to the removal of a rib or several ribs of patients. But just at this time, there's no cure to tuberculosis. There's lots of theories on how but it's much more based on management and therapy than anything.
Tyler Pacheco 08:44
This idea that individuals negotiate with the State in terms of what I take to be their civil freedoms or liberties. Do you see any similarities or differences between that time period and what we're seeing today, like you're talking about these mask mandates and so on?
Eric Story 09:00
Mm hmm. Definitely, in the sense that there is a lot of reluctance amongst politicians to enact these more restrictive and imposing measures. So for example, in the late 19th century, there is a big push amongst anti tuberculosis campaigners for the disclosure of tuberculous status or tuberculosis status by doctors if they were to find a patient positive for tuberculosis. And there were a number of premiers that essentially had to pass bills that would mandate this behavior by the doctors or this disclosure of the doctors. And it was extremely, extremely unpopular, the Premier of Ontario at the time, Oliver Mowat, stood up at Queen's Park and it was just not at all happy that he had to do it, but also understood that he needed to do it. So I think that's definitely somewhere when we're talking about this balancing act of civil liberties on one hand, and ensuring public health on the other, the difficult decisions that politicians have to make, and decisions that they make, perhaps against what they ideally would like to happen.
Eric Story 10:14
And I think you also see, if we turn our attention to this idea of disability, I think there's a lot of comparisons between these symptoms of long COVID and also this the suffering and affliction of tuberculosis patients, because tuberculosis, once it's in your system, it doesn't go away, people can actually live their entire lives without manifesting any symptoms, but still actually have a clinical diagnosis of tuberculosis, or have the bacteria in their in their bodies. And so it's a lifelong disease. And we don't know how long long COVID is going to last. Were're coming up on two years now so it might be a five to 10 year long journey. But it also might be a lifelong journey. And so I think that some of those experiences that tuberculous veterans after the war experienced, can serve as a number of indicators, I guess, are indications of what we could expect for those suffering from long COVID as well.
Tyler Pacheco 11:12
While you were talking, I was kind of reflecting on my own research and one thing that's characteristic of what I do is that I survey workers, and a lot of the stuff that I use is either data from these online sources, which also include empirical findings that are also posted online. It's evident that the actual information that you use is tied to a geographical location and has that impacted the way that you've conducted research? Or is there any ways that you've overcome these limitations of the geographical location of these presumed pieces of literature that you use in your research?
Eric Story 11:48
Yeah, it's a really good question. Because as we know, the COVID-19 pandemic is constantly evolving. It's a super fast moving pandemic and, as we're talking today, the Omicron variant is detected at the end of November in South Africa, and is now very quickly begun to replace Delta [variant] around the world. And so throughout this pandemic, it's been a constant source of frustration and a challenge for myself as a historical researcher to do my research, because historians, not all historians, but I would say a good sizable majority of us do our research in archives, which are kind of physical locations, often government institutions, that hold all of the records from the past, all of the official records from the past, and some unofficial ones, too, but mostly official for these kind of government institutions.
Eric Story 12:36
And since March 2020, these institutions have been closed for the majority of the time. And it's meant a lot of us having to re-envision what our projects are going to look like having to basically just say no to certain sets of sources, because we know we're just not going to get there unless, you know, we want to wait for years and years and years. And as graduate students, that's just not a realistic possibility for us. So I established this summer/early fall, what I call the number of satellite researchers, a satellite researcher, I guess, a satellite photographer to take pictures of documents for me, that I could then use in my research. And so I have one in British Columbia, I have one in Nova Scotia, and then I actually have one in Hamilton. And the problem is, is that with this incoming very transmissible variant is you're seeing again, archives around Canada, starting to make the decision to close access to researchers. And so even though I have hired a number of satellite researchers or satellite photographers to do this work for me, they too are being barred from access to these archives. And so yes, it's been a constant source of stress and frustration for me.
Tyler Pacheco 13:57
So, Eric, what key messages have emerged from your research?
Eric Story 14:01
Yeah, so I think the that first one that we've talked about quite a lot, that balancing act between civil liberties and public health is certainly one of those key themes that emerged. But my early tuberculosis research before the First World War, the contextual chapters, I argue that there is a culture of tuberculosis that proliferates right at the start of the 20th century, all the way up until the First World War and even beyond. And basically what I mean by a tuberculosis culture is that, right at the turn of the 20th century, there is a massive growth of anti-tuberculosis campaigners who believe that it is their civic duty to stamp out tuberculosis. And so they engage in a number of public health lectures, you also see a big push towards cleaning up slums and cities by introducing sanitation measures, providing sewage systems, clean drinking water, then it evolves into what's called in Canadian history, the Social Reform Movement. And so from that movement with tuberculosis at the center of it, there is a number of different activities surrounding tuberculosis that you see crop up, even outside of this official anti -tuberculosis campaign movement.
Eric Story 15:18
So, for example, in the early 20th century, you start to see the observation of what's called Tuberculosis Sunday. And so what that basically means is that leaders of churches and other religious institutions begin to preach the "worthiness" of public health and the necessity of being responsible, publicly aware individuals in terms of their general health. It's kind of an interesting parallel, actually, to the ways in which public health officials during the COVID-19 pandemic have tried to make use of church leaders and other religious leaders to encourage the uptake of vaccines.
Eric Story 15:58
So, that's kind of a second theme that I've that has emerged as this culture of tuberculosis. And again, to draw it back again to the COVID-19 pandemic, obviously, we can see a COVID-19 culture emerge with masks and social distancing, and the ways in which it's baked into our everyday lives. Certainly not as in your face, the tuberculosis culture, but a culture nonetheless.
Eric Story 16:23
The third theme that I think has come up is this, similar to this balancing act of civil liberties on one hand and public health on the other, is this push amongst tuberculous veterans, but also wider society, for the government to take a more active role in providing a social safety net for individuals. This is the time where you actually begin to see the early beginnings of a social welfare state in Canada. And so you have the introduction of disability pensions, dependence pensions for veterans, allowances for unemployed veterans in the 1930s, massive infusions of money into the construction or completion of sanatoria.
Eric Story 17:08
And so you really do begin to see the early foundations of the social welfare state, but it's very much driven by veterans, like those suffering with tuberculosis, that are saying, "Hey, we provided a service to you, as soldiers, we sacrificed our bodies, we sacrificed our family's welfare. And we came back home with a disability, right, and we are not able to participate in the economy, we are not able to live our lives in the same ways that we were before 1914. And as a result of our sacrifices that we made on the battlefields, you the state have a role to play in alleviating my suffering, whether it be financial or otherwise." And these really powerful messages really started to resonate, because you actually do start to see the movement of government aligning with some of the demands of veterans. And from there, it kind of takes off, right, once you get into the 1930s, you see veterans again, pushing for greater unemployment benefits and support for families, which the government does slowly start to implement. And then once you get into the Second World War in the 1940s, that's when you really start to see the real strong foundations of the social welfare state being instituted. But you cannot forget that that seed was planted during and after the First World War by tuberculosis, veterans and other veterans who are suffering.
Tyler Pacheco 18:36
So what aspects of your research resonates with you personally?
Eric Story 18:39
Yeah, that's a good question. And I like that question because I have always been interested in individuals. When I do history, I always find that the stories, the personal stories of individuals that come through and you know, in the primary sources that I read, but also in the secondary sources, written by some historians, professional historians, it's those of the individual that I find most attractive and most interesting. And so for me, it can be very depressing going through the records of tuberculous veterans, because in many cases, you see examples of, you know, job discrimination, employers saying, I don't want to hire this guy, because he might infect me and then I might infect my family, right? Or saying, I don't want to introduce this guy into my workforce, because he might infect some of my other workers and I might lose them or they might lose faith in me as their employer, right? And so you see a lot of job discrimination going on for these veterans.
Eric Story 19:41
A lot of these veterans are feeling ashamed, because they're not able to participate in the economy like they were before and men at this time, and I think this is still the case today, men's lives are intimately intertwined with their jobs and that's a source of pride and it's a source of masculinity and not being able to participate in the economy and work in job that you had before 1914 was a source of shame for them. And so as much as it's depressing to go through these stories, and hear how their lives are playing out, I think it builds my capacity for empathy, which I have always said is one of the most important, if not the most important skills that students can have, or can develop at university.
Eric Story 20:26
So yeah, it's it's the personal stories, just, you know, at an intellectual level, I find it interesting, but also just at a personal level, allowing me to relate and empathize with experiences that are not my own.
Tyler Pacheco 20:39
I think while you're talking this idea of work, providing a sense of function, I think it really draws on some perspectives of like Durkheim in the 1800s, talking about the function of work and meaningful contribution to society. So that's definitely very interesting and, what are your next steps in your work?
Eric Story 20:57
And it kind of goes back to that, those disruptions caused by the pandemic, right? I just need my satellite photographers to be able to get back into the archives, so that they can continue to mine the rest of the material that I need. Right now, I'm particularly interested in patient magazines that were published within sanatoria and were actually typically published by tuberculous veterans interestingly, I still haven't quite worked out why it tends to be tuberculosis veterans in particular, that are the driving force behind the publication and founding of these patient magazines. But that is the next set of sources that I am super keen on getting access to. Those are the next sets of records that I really need in order to continue my writing of my dissertation, looking at the activism of tuberculous soldiers looking at their general experiences in and outside of the sanatoria.
Tyler Pacheco 21:55
I think you're discussing the reason as to why veterans are the ones that publish these magazines more. And this isn't to say that doctors don't have a emotional connection to the events but, could it be the fact that veterans had this specific emotional response to these events, and maybe they hold on to items from this past more than you would expect a health care professional to?
Eric Story 22:20
I think you're definitely on to something Tyler, something that I've thought of too. If these veterans are publishing, or feeling the need to publish a magazine that speaks to their experiences, they have to feel that their identities are somewhat intertwined with either being tuberculous, being a veteran or probably both, right? And so I think that there's something to do with identity in there. And I haven't quite figured out yet if, again, it's that tuberculosis angle, if it's the wartime experience angle, because in the trenches, soldiers actually published trench newspapers that were very popular. And so I don't know if it's a continuation of these trench newspapers, or if it's a newfound identity being a tuberculous veteran living within a sanatoria. So it's a good question, but not one that I'm totally confident answering quite yet.
Tyler Pacheco 23:20
No, definitely. That's totally fair and I think a lot of your work your you discuss this transition from being a veteran and living through this tuberculosis pandemic or epidemic? How does society transition to a new normal post COVID-19, so within the current pandemic?
Eric Story 23:38
Yeah, and I think, I'm not sure that my research on the tuberculosis epidemic is a super great comparison between the COVID-19 pandemic in the sense of how it ends, because tuberculosis is caused by a bacterium, whereas COVID is caused by a respiratory virus, right? And so that the parallels in terms of epidemiology are not exactly there.
Eric Story 24:02
But if we think about the history of epidemics and pandemics throughout history, at least over the past, you know, 700 years is that in order for pandemics to end or for people to transition into what is called a post pandemic, life, people have to stop giving meaning to the pandemic. Basically, there has to be a critical mass of people that say, "This no longer matters anymore. There are other more important things that I need to worry about", and essentially move on with their lives.
Eric Story 24:35
Because I think as what's being increasingly apparent with this new Omicron variant is that's what's likely is that there is just always going to be COVID, there's always going to be a COVID-19 disease. Doesn't necessarily mean it's going to be constantly a pandemic, what's going to happen is eventually it's going to become endemic. I wish I could say that there is that exact time when the pandemic is going to end and that people can effectively transition into post pandemic world. But the reality is, is there is not really an on/off switch, it's going to take time before, going back to this idea of a COVID culture or a tuberculosis culture, those things slowly fade away over time, as they become less and less relevant. And as the threat recedes, the culture at the same time is going to recede. And I wish I could, you know, again, pinpoint when that's going to be, but I don't have an answer to that question either.
Tyler Pacheco 25:35
No, definitely, I think when it comes to the COVID-19 pandemic, it's definitely hard to look into the looking glass, so to speak, and see into the future to see when exactly is, quote unquote, gonna end and, steming from that, do you believe that there is a role that the government has in helping people recover from their normal lives?
Eric Story 25:55
I think they do and I think that if the first world war experience is any indication, it's that the most vulnerable are the ones that tend to fall through the cracks and it's those that need the most support. And we've seen that throughout the COVID-19 pandemic, those that are gig employees, minimum wage workers, a frontline workers, those are the people that bear the brunt of this pandemic. And they're the ones that require the most support, I can remember the calls back last fall for the implementation of paid sick leave so that those that are working on the frontlines, not just healthcare, but the figurative frontline, are able to isolate and able to recover without fearing the loss of their wages.
Eric Story 26:43
And so I think, similarily, the government has to consider who are those most vulnerable, transitioning into a post pandemic world? And I'm not going to prescribe anything in particular, because I'm not a government advisor and I don't think too much specifically about government policy. But I think that if the history of pandemics and epidemics is evident, it's that those that bear the greatest burden are those that are going to require the greatest amount of support. And so if the government is going to allocate any resources to any specific part of the population, it should be those that have borne the greatest burden.
Tyler Pacheco 27:27
It was really great talking about the interconnectedness between World War One and tuberculosis and how the current COVID-19 pandemic has impacted Canadian workers and workers, more generally speaking. Thank you for coming.
Eric Story 27:41
Thanks for being an engaged questioner, Tyler. It's good to chat with you.
Tyler Pacheco 27:46
You as well.
Shawna Reibling 27:47
Thank you to you both for sharing your research. The next series of episodes will feature a different pair of graduate students sharing their research findings and experiences through their graduate work at Laurier.
Shawna Reibling 27:57
Shawna Reibling 28:06
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Shawna Reibling 28:37