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The 1920s brought the emergence of systematic medical research. Research was now increasingly undertaken in government-funded laboratories and soon yielded spectacular breakthroughs. Banting and Best learned to alleviate diabetes with insulin. Alexander Fleming attacked infection with penicillin. In this world of systematic medicine, Jason Hannah graduated from the Queen’s medical school in 1928.

Dr. Hannah’s field of medicine was neuropathology — the study of disease in the tissue of the nervous system. After Queen’s, he undertook research in labs in Edinburgh and Madrid before becoming a research fellow at the Banting Institute in Toronto and joining the Ontario government as neuropathologist in 1930. Dr. Hannah’s career began just as Canada sank into the worst economic depression since Confederation.

Giving healthcare to those who couldn’t afford it

Dr. Hannah’s daily contact with patients quickly led him to recognize “a distressing modern problem.” On the one hand, medicine was “well advanced in scientific knowledge.” The insulin perfected at the Banting Institute was, for instance, allowing diabetes sufferers to enjoy a normal life. On the other hand, many Canadians lacked the money to gain access to a “full application of medical knowledge.” The Depression had widened this gap into a chasm and Dr. Hannah wanted to bridge it.

In 1937, Dr. Hannah quit his government job and incorporated Associated Medical Services Inc (AMS Inc.). AMS Inc. was a non-profit service that sold pre-paid medical care on a subscription basis. It was not group insurance, but instead catered to small, independent retailers, farmers and members of the economically squeezed middle class. Subscribers paid monthly premiums (averaging $2), picked their own doctor and were covered in the event of illness. AMS Inc. opened offices in Toronto and across the province, and by 1938 had 1,000 subscribers and 600 participating doctors. The Queen’s Review hailed it as a “new medical movement.”

In an era when doctors expected up-front payment for their services, Dr. Hannah’s AMS Inc. was revolutionary. While it was still driven by a subscriber’s ability to pay a premium, it radically reduced the vulnerability to medical emergencies for those who could pay the premiums. In the 1960s, Canada as a whole caught up to Dr. Hannah’s philosophy of assured medical care. The introduction of universal healthcare under the Canada Health Act put AMS Inc. out of business in 1969. With that change, AMS Inc. now had a substantial cash reserve but no ongoing purpose.

Reaching into medicine’s past

Having spent decades looking forward into the future of medicine, Dr. Hannah now redirected his gaze to its past. He had long fretted that doctors lived too much in the present and were oblivious to the roots of their culture.

“Doctors,” he reflected, “could make their lives more productive and interesting if they were brought into closer contact with their predecessors.”

Doctors had long recorded their patients’ history, so why should they not pay greater attention to that of their own profession? The history of medicine, he believed, would instruct medical students on how medical discovery had unfolded through the ages.

In 1971, Dr. Hannah donated a rich collection of antiquarian medical books to the Queen’s rare book library. Two years later, he unveiled plans for what is often called the “Hannah System,” the assignment of five medical historians to Ontario medical schools where they could cultivate an appreciation of the profession’s origins into would-be doctors. In 1973, he funded the Jason A. Hannah Chair in the History of Medical and Related Sciences at Queen’s with $250,000 drawn from a foundation he had established out of his AMS Inc. reserves. Similar chairs were established at the universities of Ottawa, Toronto, McMaster and Western.

The chairs were dedicated to integrating medical history into the curriculum, to advancing research into medical history, to acquiring objects of interest to medical history and to assisting the development of ancillary centres (such as, eventually, the Kingston Museum of Health Care).

Jacalyn Duffin, a hematologist and trained historian, was the Queen’s Hannah Chair. For many years. Her lively and accessible History of Medicine: A Scandalously Short Introduction was adopted as a standard text by many medical and nursing schools. Her passionate teaching has had a formative influence on many young doctors.