Transcript

Nadia Rhook

What we can see fairly clearly is also a process where white settlers were taking ownership of medicine and putting themselves in a position to define what counts as medicine and who should be paid, who should get the prestige of being called a doctor.

Jay Ooi

How does race come into play in our history, particularly when it comes to the medical field?

Hello and welcome to Shoes Off, stories about Asian Australian culture. I’m Jay Ooi.

Ever since I dug into the history of racism in Australia, I’ve gone down a few rabbit holes of Asian Australian history, and today? We’re going to focus on some Asian medical practitioners in our history, starting in the mid to late 1800’s. And I know this topic is weirdly specific and is probably something that doesn’t sound that interesting on the surface, but just hear me out, it’s kind of fascinating.

To set the scene for the couple of stories that we're going to talk about, what was the state of medicine in various parts of Australia?

Nadia Rhook

Yeah, so it was really a dynamic, rapidly evolving kind of landscape and medical landscape. I mean, in a formal sense, Victoria and other colonies had strong links to Britain, in terms of medical training, questions of medical prestige. 

Sure. I'm Nadia Rhook. I'm a historian, writer and poet. I've done a lot of research really, during and since my PhD into histories of Asian migrants, Asian migration to Southeast Australia, Victoria in particular. 

Jay Ooi

Okay, let’s set the scene a bit more. Australia hasn’t yet federated into a single entity and country - it’s still operating as separate colonies. They’re British colonies, so the British are in power, and you have British doctors trying to establish themselves and the “right” type of doctor and the “right” way to do medicine.

Nadia Rhook

But the medical landscape was profoundly shaped by migration, and including Asian migrations. So there were Chinese medical practitioners operating in cities and towns across Victoria and beyond, from that gold rush era, really.

So there was kind of this ongoing politics around medicine and medical authority that came from that, who has the right to practice? What kind of medicine, whose medicine is the most effective? There was the practice of quack hunting. This idea that some people's medicine was rubbish or was just a question of faith not of science. But that practice of quack hunting began to kind of dovetail with the politics of migration. So that Asian medical practitioners became particularly susceptible to being placed under scrutiny for their allegedly suspect medical methods, at the same time as there was exchanges of medical knowledge happening globally between Western and Chinese medicine in particular.

Jay Ooi

This took a little bit for me to get my head around so let me try and break it down. When we think about medicine now, we think doctors and hospitals practicing very particular things. We’re talking drugs, surgery, perhaps not eating certain things, drinking water, bed rest, that sort of thing. But when we think about other forms of treatment, say acupuncture, or herbal medicine or reflexology, something very different comes into our head. Perhaps we think, unproven, or skeptical, or not scientific, or unreliable.

This view in and of itself is actually political and it’s how we’ve been brought up to think. After all, before all of this globalisation, Chinese medicine was just medicine in China. It didn’t have to be qualified.

Again, you might be wondering, but our current way of treating people in hospitals is proven, right? It’s more “scientific”. I think we need to think about this from two angles. Firstly, actually no, a lot of modern medicine isn’t necessarily proven in the way we think it is. There’s actually a lot of trial, error and luck to find something that works. You can’t always perform human trials with large enough sample sizes, or the situations where you’d use said medicine doesn’t happen enough to warrant trying various ways of treating it. And on the other side, eastern medicine has been passed down for thousands of years, so that’s a pretty good sample size to iron out a lot of kinks.

But we still have this view that non-hospital or “eastern” medicine is suspicious, and that’s what we’re going to look into today through history. I just want to highlight that western medicine is not necessarily the default medicine. It’s just the medicine we’ve come to accept as the norm and authority today. And especially in the 19th century when this authority doesn’t yet exist in Australia and is in its forming stages, this background really sets the scene for what we’re going to explore today.

Nadia Rhook

it was quite complicated, but it was becoming more formalized through the medical boards, through the passing of legislation, and more professionalized through that process of professionalization in the 19th century. What we can see fairly clearly is also a process where white settlers were taking ownership of medicine and putting themselves in a position to define what counts as medicine and who should be paid, who should get the prestige of being called a doctor. In fact, they changed the Medical Act in 1890 so that it became illegal to advertise as a doctor with a capital D unless you had certain training. They began to charge Asian doctors under the 1890 Medical Act for advertising as doctors. So that's the sketch of the landscape, I guess.

Jay Ooi

When it came to Asian doctors, there were a wide variety of them, with various techniques, and some who even studied the british system of medicine. But Dr Rhook says that in general, there was more use of herbal treatments compared to Western doctors.

Nadia Rhook

So in fact, many Chinese and South Asian doctors advertised their non invasive methods as an alternative. Those methods were particularly attractive to women, and evidently to white women, because they were less invasive. Yeah, less risky in terms of surgery, but also, yeah, less invasive as well. So yeah, there was definitely some differences.

Jay Ooi

Alright, a lot of scene setting, but on with the stories. So the first is of Assaf and Ranja. In 1898, a 19 year old boy named William Bailey had tuberculosis. He was in a terminal state and his current doctor said there wasn’t anything more he could do for him. So what does his father do?

Nadia Rhook

So they then employed Assaf and Ranja who took care of Bailey using a non-stimulant diet, massage, and herbs, in contrast to the previous treatment of milk and whiskey, that was perhaps a less gentle approach at a time too when there were emerging links being discovered between milk and tuberculosis. 

So yeah, so in that case, and similarly in other cases too, those Indian doctors weren't the first choice of the European customer. But they became really desirable when it became clear that these other methods weren't going to ... Western methods weren't going to cure or even comfort Bailey the son.

It was testified in court that these methods, the diet, and the massage really comforted him, and that he did feel better during those weeks where ultimately his disease was terminal and he passed away, sadly. So it was after he passed away, then, that his father who had previously employed Assaf and Ranja then decided to blame them for their quote unquote, "ignorant medical methods" and laid charges of manslaughter against them.

Jay Ooi

Yeah, and it feels a bit almost like a catch 22. He's going to these doctors that he, I guess, in the first instance, wouldn't have trusted but it's because they had no other option. It's for a terminal illness. So when he does die, it seems almost, I don't know, unjust or unfair that he would then go sue for malpractice essentially.

Nadia Rhook

Yep, yep, definitely. I mean, there's no doubt it was his choice to employ them, that he had placed, he had entrusted them with his son's life. He'd made that decision. Then it seems fairly clear that in his state of grief, he turns that emotion into blame or anger, and directs it against the Indian doctors for what he sees is a failure to save his son. But yes, so I read that case. Then I began to find through newspaper reports, similar instances of this first trusting and then blaming Asian doctors. So trusting when it seemed there was hope and then blaming their alleged ignorant medical methods when it didn't grow as desired. Yeah.

Jay Ooi

Yeah. How do you think race and politics comes into this?

Nadia Rhook

Yeah, I think it's that question of trust and the trust of medical authority then, it was really racialized. So European doctors weren't subjected to those same sorts of behaviors. It wasn't a crisis of, “is surgery a valid medical method?” if someone died in surgery. It wasn't seen as a question of all European doctors are quacks. Whereas for Asian doctors, it became this this racializing question of therefore, all Asian doctors are quacks. Not only that, therefore, they don't belong here. There was that narrative as well.

Jay Ooi

I think this is important to reiterate. The scrutiny that the Indian doctors were under is completely different to what the western doctors were under. If someone were to die in the care of a western doctor, whether in a hospital or not, there isn’t an immediate finger pointing that it was because of them and their bad medicine that the person died. In fact, the general assumption is that they’ve done what they can. This was not the case for Asian doctors. And particularly in this case with Assaf and Ranja where Bailey was already terminal, to then point the finger at them shows how race can play a part in who we trust and who we want to blame. Even though their care actually helped Bailey feel better, the white doctor claimed his care of milk and whiskey was professional, whilst these two were not. He damned their practices, despite them actually doing a bit of good, compared to his own.

The result? Assaf and Ranja were actually found innocent, but their reputation was tarnished for good. Tens of articles were published damning their practices and portraying them as incompetent. Assaf and Ranja stopped advertising their business in the Guardian. And in contrast, the white doctor had his reputation restored, being celebrated for attaining the high opinion of the public at his death.

Okay, not the happiest of endings, but I think it highlights how race really does play a part in medicine and who was allowed to be called a doctor. 

But our next story is one of a doctor who managed to gain some respect and credibility in his town. Meet James Lamsey, a Chinese doctor who lived in Bendigo.

Nadia Rhook

So he gained a lot of respectability through his wealth, through the architecture of his houses, and also through philanthropy. So he raised a lot of money for hospitals which, of course, had predominantly European patients. So yeah, he gained a lot of respect. 

So he employed Bendigo's most prominent, well-known architect to design his houses. They were seen to really add an aesthetic value to the city landscape. He also participated in the Bendigo Easter Fair, which still goes on today and is quite famous.

Jay Ooi

So Lamsey gained respect by participating in his community, using white cultural capital, and also by donating to the hospital. He was seen as helping the community, and his prime location and architecture of his practice also bought him that cultural capital. He used white upper class currency to gain a place among them. And he was recognised as such.

Nadia Rhook

He was the only Asian person or non white person at all to have an entry in a book called Australian Representative Men, which was like a federation book of anyone important. 

He was also a political leader. I mean, he was the first group, the Chinese Imperial commissioners when they came in 1888 to check up how their subjects were doing in Australia. So he really mediated between the white and Chinese communities as well. 

Jay Ooi

So this visit from the Chinese Imperial commissioners was essentially to check how their subjects were being treated over here. Lamsey obviously had some prestige being chosen to greet these visitors, but things took a tense turn when they visited Bendigo Hospital.

Nadia Rhook

But when they got to the Bendigo hospital, the group were refused entrance by Dr. Colquhan. So because, explicitly because Lamsey who was Chinese and claimed to be a Chinese doctor was there. He could not admit Lamsey an entrance. So this was actually quite controversial because it wasn't good PR really the Chinese Imperial commissioners were here and they didn't necessarily want to offend them.

But this really became a moment when those sorts of walls, the bounds, the spatial boundaries of the hospital came to signify really much more than just walls. They were really the boundaries of white medical power. Colquhan talked about he couldn't let that Lamsey in because if we let Lamsey call himself a Chinese doctor, anyone might call themselves a Chinese doctor. Someone has to keep their standards.

He almost gained fullness or belonging but this moment showed that especially at that building, that hospital, that was where these borders were erected again.

Jay Ooi

The walls of the hospital. That’s where Lamsey’s influence ended. And this decision by Colquhan was controversial - it was written about in the papers and seen as objectionable, so Lamsey had a bit of support, but nevertheless, the decision was defended, and because of his Chineseness, his influence could not extend into the greater medical field.

Nadia Rhook

that moment to me kind of exposed what was at stake for European doctors.

Jay Ooi

And this idea of what we think is medicine continues today.

Nadia Rhook

Now when I walk around the streets and I see Chinese massage or acupuncture, I think well, we could have had ... Those rooms need to be separate. They could have more rooms for that literally inside hospitals rather than ... So it makes me see that differently. I'm like, why is this form of healing not in the hospital? Why is it separate?

Jay Ooi

So because medicine became politicised and racilalised, it meant that medical training that wasn’t British was seen as suspect. It became political to try and incorporate it into the official medical system. 

But there is one Asian practitioner who had big impact on Australia.

Nadia Rhook

I mean, the exception to that might be Teepoo Hall, who's an Indian doctor, I've written about who was a masseur and who trained white doctors in the art of massage in the early years of the White Australia Policy. He's recognized as one of the founders of physiotherapy in Australia.

Jay Ooi

Yes, even the Australian Physiotherapy Association wrote that he “arguably played the most significant role in founding the Australian physiotherapy profession.” He arrived in Australia in 1888 during a time when Victoria started seeing substantial numbers of migrants from South Asia arriving, since the local policies at the time were more aimed at Chinese, and like other Indian doctors, he provoked complaints of quackery.

But by the mid 1890’s he had flourished in Melbourne, being known as a practitioner and teacher. His practice grew and grew, and soon he was lecturing medical students on therapeutics and hygiene. He helped form medical associations and was recognised for ensuring Australia’s education was more comprehensive than any in the world.

Nadia Rhook

So his legacy and his knowledge clearly has influenced the center of what was for so long a white dominated medical field. But I think massage was different because it wasn't seen as in competition to surgery, whereas herbs was seen potentially as a competition to surgery. If you could be healed through alternative medicines, you may not need the surgeon.

Jay Ooi

What do you think we should learn from these stories?

Nadia Rhook

I guess that there's really a lot at stake in this because ... For a few reasons, and one is that there's been a lot of lost opportunities clearly for the transfer and exchange of medical knowledge and the integration of Asian medical knowledges into mainstream medical knowledge. Because of these drawings of boundaries of authority very early on, as well as to me, there's a kind of question of you could almost think of it as a historical debt if you like, because Asian doctors work so hard for all of the community really, white and non white health and healing their lives.

Jay Ooi

Yes, because non western medicine was seen as quack, that deep well of knowledge never transferred across. There could be many treatments for many illnesses we have today that could be treated by other types of medicine, but because we see them as inferior forms of medicine, that transfer of knowledge doesn’t really happen. “White” medicine is still today seen as the “right” medicine.

Before I looked into this topic, I definitely had this view - that Chinese medicine is a bit quack. But after reading more and speaking to Dr Rhook, I realised just how ingrained and normalised white medicine is. That’s not to say I’m not going to go to a hospital if I have a major illness, but it is a shame that eastern medicine hasn’t been more integrated into mainstream medicine. 

Nadia Rhook

I think there's still that hierarchy of authority that goes on today that still, when we see a treatment that doesn't go well for someone in a hospital, in a mainstream hospital, we don't have a crisis of the whole medical institution. Whereas there's still questions of herbal treatments and subject to scrutiny. With private health cover, for instance, what's covered and what's not.

Yeah, it's a shame because perhaps some of these forms of medicine don't claim to be able to do everything, but because it's separate from other modern and surgical forms of medicine, there's that question of combining them still hasn't been realized as much as it might have if it wasn't for actually history of racism. Yeah.

On top of that, did a lot of philanthropy and fundraising work at a time when they were subjected to discriminatory laws moreover. So there's kind of an extra dignity in that to me, because not only doing so much for medicine, but also while being subjected to these really harmful laws. So yeah, so it's just made me think about more through the generations, what has afforded the lives of me and my ancestors. It's quite likely that a lot of us had ancestors who benefit either directly from the healing of Asian doctors or indirectly from their philanthropic support of hospitals and etc. I even found that James Lamsey, who I'd written about, had donated in 1908, to the hospital that would become the Queen Victoria Women's Hospital where I was born. So it's just made me realize how on that very basic, even biological level, our lives have been so intertwined for so long.

Jay Ooi

That’s one part of these doctors’ legacy - so many Australians would have benefited from their work, and in fact maybe many of us wouldn’t be here today if it weren’t for them.

Nadia Rhook

I think it's important that these forms of power and authority that could be gained through medical practice fared so closely into the question of migration politics. So in the early years of the White Australia policy, James Lamsey and to Teepoo Hall, masseur, they were advocates for their communities. So they used their medical capital to advocate for Asian belonging in those early years of the White Australia Policy. Teepoo Hall even was very active in creating international networks of resistance that did result in lessening the restrictions of the Immigration Restriction Act so that merchants and students and certain people were able to migrate more freely.

There's honor in being a doctor and healing people, and all that sort of work, let alone having to negotiate the politics and migration as well, and doing so on an international scale. So that is something that is really impressed me too, in terms of the legacy was also to lessen some of the restrictions brought by that legislation.

Jay Ooi

That’s Asian doctors in Australian history.

This episode of Shoes Off was written, produced and edited by Jay Ooi.

Special thanks to Dr Nadia Rhook for her research and work in this area. You can find her writing and other resources in the show notes at shoesoff.net

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Thanks, and catch you next episode.

Nadia Rhook

As we think about who is losing their lives and who is putting their lives at risk, yeah, I think it's just really worth keeping in mind there are histories of race, that that mean that we're in this place already where certain people are more vulnerable. That is already an injustice. I hope that we don't see that injustice become more amplified, but rather that we realize that all lives are important. That there is this history already of racism shaping who's in the medical system, and on the frontline, and more vulnerable. 

 

Guests

Dr Nadia Rhook: https://research-repository.uwa.edu.au/en/persons/nadia-rhook

 

Resources

Read Dr Rhook’s writing: https://research-repository.uwa.edu.au/en/persons/nadia-rhook/publications/

Teepoo Hall: https://mdhs.unimelb.edu.au/news-and-events/news-archive/recognising-a-founder-of-physiotherapy-in-australia,-frederick-teepoo-hall

Western medicine myth: https://www.washingtonpost.com/news/wonk/wp/2015/07/23/one-big-myth-about-medicine-we-know-how-drugs-work/

Art vs science of medicine: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3190445/