[cdn-nucl-l] " Radium institute was a lesson in how not to do things "

["Jaro Franta" <jaro-10kbq@sympatico.ca>]

http://www.montrealgazette.com/news/todays-paper/Radium+institute+lesson+thi
ngs/3453694/story.html 
Radium institute was a lesson in how not to do things
  By JOHN KALBFLEISCH, The Gazette August 28, 2010   

Final arrangements regarding the operation of a radium institute ... were
completed this afternoon at the close of a meeting of the provincial
cabinet. 

-Gazette, Friday, Aug. 25, 1922 

Quebec's Institut du Radium was meant to be a research centre, discovering
new ways of exploiting the wonders of the radioactive element. But along the
way, it was also meant to be a hospital, caring for people suffering not
only from cancer but from other ailments including tuberculosis and even
haemorrhoids. 

Student and professional exchanges were meant to strengthen bonds between
Quebec and France, where radium had been discovered by the Curies in 1898.
The institute would be a standard-bearer for Quebec, showing it off as a
world leader in technology and health care. 

And therein lay the institute's problem. As Charles Hayter, a Toronto
radiation oncologist and historian, has demonstrated, it suffered from a
fatal lack of focus. In trying to do too many things, it failed to do any of
them especially well. 

The Montreal-based institute was the brainchild of Dr. Joseph-Ernest
Gendreau, director of the Universite de Montreal's medical school. Gendreau
had studied under Marie Curie in Paris. His appeals to Premier
Louis-Alexandre Taschereau and his colleagues fitted well with their
modernizing instincts, and eventually the cabinet authorized a grant of
$100,000. It would be used almost entirely to purchase a single gram of
radium, which would produce the radon gas used in various therapies. 

The institute opened its doors at the university, then on St. Denis St.,
early in 1923. The Gazette's reporter was impressed with the seeming magic
of it all: "With the lights turned out and the room darkened, the gas from
the radium was seen filling the maze of glass tubes and bulbs. ... The
radium gas shines with a mysterious blue light, and its progress through the
machine was observed as it was forced and compressed by the powerful
electric pumps and the mercury seals." 

From the beginning there were jealous mutterings. Why wasn't the institute
set up at McGill University, already famous for the radiation research of
Nobelists Ernest Rutherford and Frederick Soddy? Was logic to be sacrificed
so that the reputation of a French-speaking university could be puffed up? 

More substantively, the institute quickly began to stumble over the conflict
between what was originally its prime mandate, scientific research, and its
clinical work. 

In its first five years it treated more than 1,500 patients, and despite
some notable successes it soon began creating distrust, even enmity, among
many local doctors. Surgeons were dubious about the value of radiation
therapy, as well as the threat to the fees they earned from operations.
Physicians were just as resentful after noting that nearly a quarter of
those first patients were treated for non-cancerous conditions they commonly
dealt with like Parkinson's, angina, and something called "chronic
inflammations." 

Indeed, the institute became a victim of its early success. Its finances
were in disarray because of the rising flood of desperate people searching
for a miracle cure, many of them too poor to pay. Its dank and crowded
basement quarters were highly unsuitable for treating such numbers anyway.
Something had to give. 

In 1927, the institute moved to the abandoned Maisonneuve city hall, where a
small but better-appointed hospital was set up. With the link to the
university severed, the institute's role as a research centre increasingly
was abandoned. 

Yet the onset of the Great Depression two years later seriously undermined
its vocation as a hospital. There were even more patients, yet fewer
government grants to support them. 

Gendreau himself didn't help. As Dr. Hayter points out, his megalomaniac
style and promotion of radium as a cure for just about anything alienated
fellow professionals. He was a poor administrator, indifferent to his
staff's working conditions and frequently absent. 

The institute continued to treat an impressive number of patients, even
after Gendreau's resignation in 1946 and death the following year. But in
addition to the institute's always-shaky finances, its administrators lacked
the knack of co-operating effectively with other doctors and hospitals. Its
stature continued to decline as more up-to-date cancer centres opened
elsewhere, and it finally closed in 1967. 

Hayter credits the institute with bringing relief to thousands of patients.
But its most important contribution to Canadian medicine might have been
something negative: that is, showing how things should not be done. 

Later and more successful Canadian radium projects ... integrated radium as
one element into a larger program of cancer control and care," he writes,
"which required careful planning and ongoing support." 

lisnaskea@xplornet.com

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http://www.125.umontreal.ca/histoire/1919-c.html 
1922  : Du radium pour traiter le cancer 
      
En 1921, le gouvernement du Québec fait l’achat, au coût de 100 000 $, d’un
gramme et quart de radium, qu’il confie au docteur Ernest Gendreau,
professeur à la Faculté des sciences. Médecin et radiologiste formé à
l’Institut du radium de Paris, le docteur Gendreau fonde l’année suivante
l’Institut du radium de l’Université de Montréal, un centre voué à la
recherche clinique sur le cancer. Installé au sous-sol de l’édifice de la
rue Saint-Denis, l’Institut sera le premier en Amérique à utiliser un
appareil à rayons X de 200 000 volts pour le traitement du cancer. 
-----------------


http://www.ncbi.nlm.nih.gov/pubmed/14725309?dopt=Abstract 
Tarnished adornment: The troubled history of Québec's institut du radium.


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