A love story — and harrowing forced resettlement — unfold against the backdrop of the wild north
Christine Fischer Guy’s debut novel, The Umbrella Maker, tells the story of young nurse Hazel MacPherson. Looking for new challenges, Hazel has left the safety and comfort of her home for adventure and found work in Moose Factory in northern Ontario at a tuberculosis sanatorium. There she works with a determined doctor, Lachlan Davies, who, pleased to discover an ambitious ally, willingly puts Hazel and her abilities to use. Hazel is committed and eager to get ahead in her job — until she meets a charismatic stranger who appears in the hospital one day. Enthralled by Gideon — the umbrella mender of the title — Hazel awakens to what lies beyond the boundaries of what she has considered until now her adventurous life.
What particularly fascinated me about this novel is Fischer Guy’s examination of the effects of relocation on the Cree and Inuit people who have tuberculosis — they were often forcibly moved to sanatoriums — as well as her look at how Hazel’s work with Dr. Davies escapes the bounds of social mores.
I asked her questions about these aspects of the book and more.
The Umbrella Mender began with the idea of a woman giving birth in a silo, didn't it?
It did. During a ramble in the country years ago, long before The Umbrella Mender was even a twinkle in my eye, I saw the spray-painted graffiti image of a woman giving birth with the “Caitlin‘s Birthing Centre” on an abandoned silo. I carried that image around for years. She was lost and alone and forced to give birth in a silo. It was probably the work of marauding teens, but…maybe not.
The novel is set in a sanatorium in Northern Ontario. Why that particular place?
The seed for my novel came from a set of memoirs written by my great-uncle, Dr. Barclay McKone, about his tenure in the north. He was a pioneer in tuberculosis treatment in the late 1940s and was asked to open a sanatorium in Moose Factory in 1950 to treat TB in the James Bay communities. It was the adventure of a lifetime for him, and when I finished reading the memoirs I knew it was a stretch of ground big enough for me to pitch my own tent on.
So on a pragmatic level, Northern Ontario was where I found the story. But the uncharted, unknown North, not only as a geographic location but as an ideal and a metaphor for the self, has long been the subject of collective fascination. Without the myriad diversions and insulations of the city, we press up against the final frontier: ourselves. My main character, Hazel, is drawn to the North for that possibility.
Where there other sanatoriums that treated indigenous peoples?
Yes, more than a few across the country. One of the Quebec sanatoriums featured in Benoît Pilon’s film about the Inuit experience of TB, Ce Qu’il Faut Pour Vivre (The Necessities of Life, starring Natar Ungalaaq). Until the sanatorium in Moose Factory was built, Mountain Sanatorium in Hamilton, Ont., was the original destination for patients from the James Bay Communities. There was greater acceptance of treatment by northern community members when the hospital wasn’t 1,000 kilometres away. That was part of the motivation for building it there.
Your great-uncle was the superintendent at the Moose Factory Indian Hospital, as it was known, when it first opened, wasn’t he?
That’s right. He was hired by the federal government to oversee that treatment centre. It was a supervisory position but he was very much on the front lines of patient care, going out in survey boats and treating patients in the hospital. I don’t know how much of that was dictated by the patient load and how much by personal preference, but after he left the north and settled into a family practice in Peterborough, Ont., he made house calls routinely and advocated for the practice. He was that kind of hands-on doctor. He loved his work.
Did he talk about his time in the north with you?
He died in 2006, but in the four years before that, after I’d read his memoir and had begun work on the novel, we had many conversations by mail and in person (I’d take my tap recorder when I visited). He was thrilled that I was taking an interest in that time and place and the work he did there. He’d send packages in the mail with documents he’d dept, film he’d shot at the time, his own notes of various kinds. All of these artifacts were a gift to a writer trying to reconstruct a period she hadn’t lived through.
Is your character Dr. Lachlan Davies modelled on your great-uncle?
Only slightly. Dr. Davies shares my great-uncle’s passion for the work, but that’s where the similarities end. Davies is unmarried and otherwise a product of my imagination. I have a great deal of respect for Dr. McKone and it was important to me from very early on that his story and mine weren’t conflated. His memoir is about the campaign against TB in the north. The Umbrella Mender is about the campaign against TB in the north in the same way as Ian McEwan’s Atonement is about WWII: it’s the background conflict for the story of Hazel and the secrets she keeps for 60 years.
What research did you do for the novel?
A friend of mine recently described it as an “insane amount,” but I guess that’s in the eye of the beholder. For this novel, I had to delve deeply into the science of tuberculosis and medicine in general, the time period I wanted to evoke, and the setting, none of which were familiar to me before I started to write. I read social histories of TB, medical articles and books about the disease at that time, and memoirs by northern nurses. I learned the basics of X-ray interpretation and watched video footage of medical surveys in the North. And that was only for the medical side of the novel! It was important to me to create a historically and medically accurate backdrop for the story. I wanted to get the details right.
In healthcare, there is the concept of Primum non nocere, or First, do no harm. How does that play out in your novel?
It’s a maxim I spent a great deal of time thinking about, especially as I read histories of tuberculosis campaigns in the north. It was a war, a necessary one, since the rate of infection in some communities was 9 in 10 and TB was a leading cause of death at the time, but one that involved almost military-style intervention with little cultural sensitivity. In the early days of the campaign, at the time when my novel takes place (1951), translators weren’t part of the equation. Indigenous people found to have the disease were taken away to southern sanatoriums on survey boats, often without a clear understanding of where they were going or how long they would be there because there was no common language. I read hair-raising accounts of what happened to some of them after years in convalescence in the sanatorium. Children were returned to communities that no longer existed in that geographic location, for example, with inadequate clothing for the weather because they had long outgrown their traditional garments.
It seemed only natural that a thoughtful, intelligent medic, as Hazel was, would question the impact the campaign was having on people’s lives. Charlie, a staff physician in my novel, quotes the maxim to Hazel when she feels the first waverings of her conviction..
The drugs that were being used to battle tuberculosis at the time could have serious side effects, couldn’t they?
They could indeed. There were guidelines about the length of treatment because the newly discovered streptomycin could accrue in the system and cause deafness. The problem for doctors and nurses working in the north was the way the disease manifested in the indigenous system: it seemed to have unfettered access to the entire body. The kinds of natural defenses that non-indigenous patients had didn’t exist, and so the disease grew unchecked and also persisted. It became a problem of exceeding maximum dosing periods to eradicate the disease while risking deafness, so doctors needed to be creative. They didn’t have clinical trials to rely on. My great-uncle worried about it long into his retirement. He showed me letters he’d continued to write to find out whether his treatment regimen had caused harm. To his knowledge, it never had. He was also careful to note that in the first two years, they only lost eight patients to the disease.
There were also the effects of forced evacuation on the Cree and Inuit people who tested positive for tuberculosis and were torn from their families and communities.
Yes. If a family’s hunter was taken to hospital, for example, how would that family eat in the years of his absence? Or if a mother and baby were separated, what happened to the child? And yet they couldn’t be left with an illness that was likely to kill them. The streptomycin meant that for the first time in the history of the disease, medics could speak of a cure, but implementing the treatment also raised difficult questions, and it wasn’t always clear which side of the balance sheet the cure fell on.
There was a case recently in which an Ontario judge decided a hospital couldn’t force an 11-year-old indigenous girl to have chemotherapy, but rather that her mother could care for her with traditional aboriginal treatments…
Yes, I saw that. It’s an interesting confluence of medicine and politics. The judge, who is a member of the Six Nations community, based his decision on the definition of aboriginal rights (as described in section 35 of the Constitution) rather than try to weigh or make a judgment on medical efficacy. It was more about identity politics and rights for self-determination than about the cancer treatment itself..
In your book, Lachlan and Charlie clash in their views on patients’ needs and how patients are brought to the hospital, don’t they?
They do. It made sense to me that there would be disagreement among doctors about the tactics in the campaign against tuberculosis: personal philosophies of healing come into play where soft skills are involved. Although Lachlan and Charlie are equally passionate about eradicating the disease, each has his own theories about the therapeutic value of emotional equilibrium. That’s still true among the medical community: the topic of mind-body connection is hotly debated and accorded different value depending who you speak to.
It also seemed reasonable that some medics would be more bothered by the military-style campaign than others. Charlie and Lachlan embody two possible responses to that situation.
Lachlan makes efforts to accommodate his patients while they‘re under his care, providing craft rooms, etc. How historically accurate is that?
Actually, that’s one of the few biographical details I shamelessly stole from Dr. McKone’s own story. He published on the subject of patient rehabilitation in a 1948 issue of Canadian Nurse, which I found reference to in Pat Sandiford Grygier’s A Long Way Home: The Tuberculosis Epidemic among the Inuit. He was very concerned about the emotional/mental well-being of the patients under his care. Life in the sanatorium could be mentally devastating for someone who had always live on the land, and Dr. McKone had an acute understanding that mental health was at least as important as physical health. He wasn’t the only one who recognised that, though he may have been among the first. Mountain Sanatorium in Hamilton eventually had, among other initiatives along these lines, an all-Inuktitut radio station specifically for Inuit patients convalescing there.
Hazel dares to do more than a nurse normally would and is encouraged in that to some extent by Lachlan. They’re both fascinated by the science behind tuberculosis and are so excited by the idea of finding a cure for this disease that they overlook social norms, don’t they?
I don’t think Lachlan though as much about social norms as Hazel did, to be honest. As the male doctor in charge, he had less to lose than she did. It’s clear that he’s drawn to Hazel’s intelligence and skill and mental toughness, and it worked in his favour, in terms of what he wanted to accomplish medically, to have someone as dedicated as she was at his side. Hazel was willing to work long hours with little recognition except that implied by added responsibility — which could be misinterpreted by anyone looking on as favouritism for less noble reasons. The bigger risk for stepping outside accepted norms, both gender-based and role-based, was hers.
Hazel also takes a step toward the idea of doing no harm herself, and further away from rules she’s abided by, doesn’t she, with the scene in the woods?
Hazel does come up against a situation that demands she make a difficult decision while she’s on the survey boat trip to Rupert’s House (now known as Waskaganish). When they learn that a family of Cree patients has fled when they saw the survey boat coming, Lachlan orders search parties, and Hazel’s team finds the missing group. What she decides to do (trying to avoid spoilers here) becomes one of the secrets she keeps for 60 years.
And Hazel endangers her career almost without thought for a charismatic stranger…
In some ways, Gideon is the embodiment of the wild that surrounds them all in the North: he is as uncontrollable and unknowable. She wasn’t powerless to the magnetic pull of that enigma, she sought it. She left the predictable, stifling haven of the south for that reason. She wanted to press up against the final frontier: herself. It’s not so surprising that she’d toss her work to the side when presented with that possibility, is it? Of course, she’s also young and prone to the kind of risk-taking that youth demands and allows.
Can you talk about the idea of flight and freedom embodied by Gideon (the umbrella mender) and his connection with birds?
Gideon is an early Jack Kerouac and a more extreme version of Hazel herself. He has also headed north for the possibility it offers. The birds he’s enchanted with are, in turn, a more extreme version of himself.
This is your debut novel. How did it feel to move from writing short stories to writing a novel?
The forms are entirely different. Short stories are closer to poetry than they are to novels in my opinion. They investigate a moment or an idea and demand economy of language: every word must count. Novels have more space for diversion and side trips. They’re like symphonic music with recurring themes. I think in some ways, I’m more suited to the novel form. I don’t write quickly and I like to have the luxury of space and time to let the story unfold and the ideas develop. Some short story writers might disagree with me, but a short story is more of a sprint and a novel is a marathon. They demand different skills and strengths. I’m not sure that a novel is more difficult, but it needs to engage you over the years not weeks or months, it takes to write. I continue to write short stories — one is coming out shortly in The Austin Review — but I seem to prefer the long run.
What surprises did you find in the transition?
I don’t think I would have described myself as a marathoner prior to this, and there were several points during the process that I wasn’t sure I had it in me to make it to the final mile!