“The Best Way to Explain it is to Do It”: Ida Cannon and the Professionalization of Medical Social Work During the Progressive Era江南雪
and the 1920s
Anette Bickmeyer (Hannover)
“What I was going to say,” said the Dodo in an offended tone, “was, that the best thing to get us dry would be a Caucus-race.”趣味数学读后感
“What is a Caucus-race” said Alice; not that she much wanted to know, but the Dodo had paud as if it thought that somebody ought to speak, and no one el emed inclined to say anything."
“Why,” said the Dodo, “the best way to explain it is to do it.” (And, as you might like to try that thing yourlf, some winter-day, I will tell you how the Dodo managed it.)
(Dialogue between Alice and Dodo Bird; from Alice in Wonderland)
This quote, “The best way to explain it is to do it,” was Ida Cannon’s motto for her work at the social rvice department at MGH, short for Massachutts General Hospital. Ida Cannon’s contribution as
梅里雪山简介pioneer of medical social work in American hospitals and her leading role in developing and professionalizing this medical social rvice is usually ignored in the historiography. Cannon, who put a life’s work into this project, promoted medical social work nationally as well as internationally. Already in the 1920s more than 400 social rvice departments had been introduced to hospitals all over the United States. Ida Cannon, born in 1877, was Chief of the social rvice department at MGH from 1914 until 1945. She died in 1960.
Cannon and the professionalization of medical social work is the focus of my disrtation project. I look at Cannon as a ca study of the cond generation of social reformers in the years from 1900 to 1930. The larger part of the time frame that I concentrate on was later called the Progressive Era. Women in tho years of social change and reform were especially prominent in the role of reformers. Reformers of the first generation—for example Jane Addams or Francis Kellog—caught a lot of attention in historiography. Ida Cannon also belongs to this group of “exceptional women” of the Progressive Era.
英国旅游I consider medical social work an excellent example to show the realities under which a particular women’s work culture within the health-care industry developed. The eds limiting the development of medical social work were planted already at its beginning. Altruistic ideals, reform spirit, gender co
ncepts, and the promotion of professionalization eventually clashed and, ultimately, in the 1920s led to the fragmentation of medical social work.
In this paper I want to focus on the gender concept on which Ida Cannon bad her argument for the professionalization of social work: I claim that Cannon’s conception of social work as a profession was bad on the nineteenth century gender concept of “parate spheres.” Elaborating on this thesis I also claim that Cannon expanded this gender concept for medical social workers in the early twentieth century by interpreting the “parate spheres” according to her needs, but she never went beyond this application. Before discussing gender concepts and women’s spheres, however, a brief introduction to medical social work is necessary.
Medical Social Work or “A Mad Tea-Party”
The first annual report of the social rvice department at MGH for the year 1905 began with a quote from Alice in Wonderland from the chapter “A Mad Tea-Party”:
“Have some wine,” said the March Hare. “I don’t e any wine,” said Alice. “There isn’t any,” said the March Hare.
This episode from Alice in Wonderland is a metaphor for the situation of out-patient departments in American hospitals. Many physicians, interested in a progressive medicine, considered the medical care for out-patients inadequate. Like the “Mad Tea-Party,” patients were often given advice that the patient was not able to follow: to say to an overworked, tuberculosis-ridden mother of four children, who lived in a rat-infested tenement hou, that she needed a vacation in Florida, lots of milk and meat, was uless as she was not able to afford it.
Often doctor and patient spoke to each other but not with each other; language barriers blocked the mutual understanding of immigrants and doctors, the latter often ignoring the social environment and personal concerns of the patient. Communication problems also aro when the doctor’s advice went simply beyond the comprehension of the patient. Especially questions of hygiene or rules of conduct were for many patients difficult to perceive. The individual life situation, social circumstances and the combination of mental and physical constitution of the patient were usually not taken into consideration by most doctors. As a conquence, symptoms and the dias themlves would constantly reappear.
Medical social workers in the early years were suppod to bridge all of the gaps between doctor and patient. They were to interpret the situation of individual patients through ca studies. By analy
zing their life-situations and by looking for possible caus of their illness in their social, mental or other circumstances, social workers developed a social analysis of each ca. The medical social worker thus became the interpreter of the doctor’s advice, standards of hygiene and conduct towards the patient.
The out-patient department was especially frequented by tho people who could not afford a visit to an expensive private practice. Poor immigrants, workers and all tho who for financial reasons had no other choice to receive medical treatment other than from the out-patient department came to the hospital. For the patients the physician Dr. Richard Cabot founded the social rvice department at MGH. He was inspired by the idea of supporting and developing a progressive medicine that took into account the whole person, the individual life situation, the intellectual, psychological and physical constitution. He wanted to overcome the traditional approach that looked at dia parately from the patient. Richard Cabot was the lf-assured offspring of a very old distinguished Boston family that belonged to the group of so called “Boston Brahmins.” He faced resistance to his project but his family background certainly helped to
overcome obstacles. The social rvice department started in 1905, and already in 1906 Ida Cannon worked as a volunteer in the department.
“A Caucus-Race” or Ida Cannon’s Image of Medical Social Work, Problems and Resistance100个脑筋急转弯
Neither the hospital administrator nor the doctors, and certainly not most nurs, welcomed social work with arms wide open. It took nine long years until the social rvice department was officially accepted as part of the hospital. Under the conditions, Ida Cannon tried to establish and to legitimize medical social work at MGH against all odds. Tho odds found expression not only in the organizational problems of the hospital but also in the personal policies of the hospital director, Dr. Washburn. This is best illustrated by his attitude toward the social workers: “You’ll have to watch the social workers, or there won't be any room for the people who belong here” (MGH papers). Medical social workers were outsiders and had to find their position in the hospital’s hierarchy.
For my analysis I heuristically refer to Pierre Bourdieu’s term of the “field” in order to explain the problems of social workers (1997: 59-78). They had to position themlves in the “field” hospital and had to negotiate their position with other groups in that field. The leading force in the hospital was male. The doctors were at the top of the hierarchy; the nurs worked below them, following their orders. In 1904 nursing as a women’s occupation was officially granted through the “Nur Practice Act” valid in not all states, and was still in its infancy. For the nurs medical social workers were a threat. Even more so when Cannon publicly defined the position of medical social workers in the hos
pital.
In her book Social Work in Hospitals. A Contribution to Progressive Medicine, published in 1913, Cannon claimed that social workers’ place was not below the physician in the hospital hierarchy, following his orders, but next to the doctor (2). According to Cannon the position of the social worker was that of an网店货源怎么找
expert in social matters, who advid the expert in physical matters, the doctor. For women at that time this unusual professional status claim, was explained by Cannon in terms of gender. Her argument relied on the nineteenth century gender conception of the “parate spheres.” In championing the social worker’s position in the hospital she fit the Victorian gender concept to the changed social reality of early twentieth century America, expanded it to the professional field as far as possible, but did not transcend it.
中衍期货官方网站Cannon wrote in her book that the training of social workers and that of nurs was fundamentally focud on very different positions in the hospital. She criticized the nurs’ training in that they were not challenged to be independent thinkers nor were their leadership skills developed–and Cannon wanted “leaders” in social work (190). The social worker should draw her conclusions about her pati
联想手提电脑ents or clients, as she called them, parately from the doctor’s. The results from her social analysis together with the diagnosis of the doctor would help them to mutually decide on how best to help a patient.
Cannon’s lf-assured claim that social workers belonged on the same hierarchical stratum with the doctors, and her definition of medical social work as a profession caud resistance from the nurs. Cannon was certain about her own professional position next to the doctor. In Social Work in Hospitals she writes: “As the problems of many hospital patients are social as well as medical, two expert professions, not one alone, are needed.” Medical social work was, according to her definition, an “expert profession,” as much as that of the doctor. She points to the social worker’s power of judgment and writes about her quality: “Rather it is one of lf-reliant judgment and planning in her own sphere” (2). This sphere was coded feminine, which Cannon not only emphasized but ud for her own strategic intention.
The historian Eileen Janes Yeo analyzed the Victorian gender concept of the “parate spheres” and confirms that women’s activities in the social realm were explained according to this gender concept. Tho activities were en as
