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«The Reward of Courage (1921) A rediscovered cancer film of the Silent Era David Cantor, PhD Office of History, National Institutes of Health ...»

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The Reward of Courage (1921)

A rediscovered cancer film of the Silent Era

David Cantor, PhD

Office of History, National Institutes of Health

Bethesda: National Library of Medicine, 2013

The Reward of Courage (1921)

Produced by the Eastern Film Corporation

Prepared by the American Society for the Control of Cancer

2 film reels (2708 ft.), silent, black & white with tint, 35mm answer print.

NLM copy made from 35mm nitrate print in the collection of the Library of

Congress on Oct. 26, 27, 2006.

NLM Unique ID: 101570969 (silent) & 101593096 (with music sound track) It was in the fall of 1921 that the American Society for the Control of Cancer (ASCC) released its first public education film. The Reward of Courage sought to transform public ideas about cancer by encouraging people to seek help from a recognized physician at the first sign of the disease or its possibility: early detection and treatment being the ASCC’s main approach to cancer control. The ASCC embedded this message in a melodrama that warned against a nefarious “quack,” invited audiences to sympathize with a vulnerable woman endangered and a young couple thwarted in love, and told of the story of a hard-headed businessman converted to the idea that an industrial clinic could improve worker health and productivity, reduce company costs, and detect cancers.

The movie was the first of the many thousands of public education films about cancer produced since 1921. But until recently it was impossible to view. No copies seemed to have survived in any major film collection. Even the American Cancer Society — as the ASCC was renamed in 1944 — had not kept a copy. The movie was considered lost until 2006 when a print was discovered in a partially catalogued collection at the Library of Congress and preserved by the National Library of Medicine. A digitized copy of this print accompanies this essay. This article follows the life of the movie from its beginnings to its rediscovery. It explains why the film was made, how it sought to promote the ASCC’s educational message, how it was received and distributed, why it was lost, and how it was rediscovered and preserved.

The Origins of The Reward of Courage The Reward of Courage began life amid a growing sense of urgency among the founders of the ASCC that more (and more accurate) public education about cancer was needed. The disease, the organization noted, began as a local entity that later spread to affect other parts of the body. It was most easily treated when it was still in its local circumscribed condition, generally by surgically removing the tumor or a precursor, and sometimes by the use of x-rays or radium. The longer the tumor or a precancerous condition was left untreated, the more likely it was to grow and spread, and the more difficult and uncertain became the treatment. Eventually, the disease would spread so far, the ASCC claimed, that it would be impossible to treat successfully. Consequently, the cancer campaign urged people to seek treatment the moment the disease or its possibility was discovered, before it became “hopeless” or incurable.

The problem, the ASCC claimed, was that people often arrived in the doctor’s office long after anything could be done for them. Part of the reason was that the disease often began insidiously. In its early stages, there was no pain, disablement, or disfigurement to drive patients to their physicians, and the disease only gave the subtlest of signs as to its presence. All too often people failed to notice these early warning signs, were unaware of their significance, or were paralyzed into inaction by fear of the disease or its treatments. The ASCC argued that, to complicate matters further, “quacks” and patent medicine vendors routinely tempted patients away from competent physicians, and too many physicians misinformed their patients about cancer, out of ignorance or incompetence. All these factors stymied ASCC efforts to combat the disease, since, it claimed, even the best treatments for cancer would fail unless patients got to a competent physician in time. As an ASCC pamphlet put it: “No matter how great his skill or how modern his knowledge the doctor cannot help a patient who does not come to him.”1 A key to changing this situation, the organization argued, was public education.

Table 1

Frank J. Osborne’s Appointments 1911–1924 1911 Graduates from the University of Rochester with the B.S. degree 1911–1912 Trains in biology and public health at the Massachusetts Institute of Technology under William T. Sedgwick 1912–1913 Assistant Health Officer, Montclair, New Jersey, under Chester H. Wells.

1913–1916 Health Officer, Orange, New Jersey 1916–1917 Executive Secretary, the New York Social Hygiene Society;

1917 Field Secretary, the American Social Hygiene Association 1917–1919 First Lieutenant in the U.S. Army’s Sanitary Corps, attached to the Section of Venereal Disease Control of the Surgeon General’s Office and the Commission on Training Activities for extra cantonment duty at Camp Merritt and the Port of Embarkation, Hoboken 1919 Dual appointment:

a) Field Representative, Interdepartmental Social Hygiene Board of the Federal Government.

b) Special organizer of the New York State Department of Health 1919–1924 Executive Secretary, ASCC Sources: “Appointment of a New Executive Secretary,” Campaign Notes. American Society for the Control of Cancer 1, 19 (November 1919): [2]. “Health Coordination Committees,” Campaign Notes. American Society for the Control of Cancer 1, 19 (November 1919): [2–3]. “Frank J. Osborne, East Orange,” State of New Jersey, Manual of the Legislature of New Jersey. One Hundred and Sixty-Eighth Session (Trenton: State of New Jersey, 1944), 370–71.

The organization began in a small way in 1913, but its public education efforts expanded substantially after the First World War, led by its dynamic new executive secretary, Frank J Osborne.2 Appointed November 5, 1919, Osborne had come to the ASCC with a long background in organizing health education campaigns, especially against the venereal diseases (Table 1), and the cancer organization hoped to build on this experience.3 Not only did Osborne have extensive experience of the nuts and bolts of organizing such campaigns, he had also helped to create local health coordination committees in New York which, as the name suggests, sought to bring together public health activities within a particular community. The ASCC hoped that the coordination committees’ involvement in various activities — such as local health centers and educational campaigns to prevent diseases of adult life — might be used for the cancer campaign.4 The ASCC’s public education efforts were in part inspired by what it saw as the success of the much wealthier National Association for the Study and Prevention of Tuberculosis (NASPT) founded in 1904 and renamed the National Tuberculosis Association (NTA) in 1918.5 Like the NASPT/NTA, the ASCC hoped to develop publicity and education programs to direct people to recognized physicians, steer them away from “quacks” and incompetent physicians, and encourage them to seek treatment as soon as the disease or a warning sign was identified.6 In the ASCC’s view, the NASPT/NTA campaign had “resulted in a very great diminution in the number of deaths from this disease [tuberculosis], largely because people have been taught not to delay in consulting a physician,”7 and it hoped to emulate such success. As C-E.A. Winslow, Professor of Public Health at Yale University and a director of the ASCC, put it in 1920: “If it is sound economy to provide for the early diagnosis and sanatorium treatment of tuberculosis, it is just as sound to provide for the early diagnosis and surgical treatment of cancer.”8 Encouraging people not to delay seeking help from a competent physician was to be a central tenet of the anti-cancer campaign.

But the NASPT was not the only model for the ASCC. Osborne’s appointment also highlights parallels between the ASCC’s campaign and the social hygiene campaigns.9 Just as Osborne’s public education efforts against venereal disease sought to dissuade people from turning to the “medical fakir and lying charlatan,”10 so the ASCC wanted to dissuade people from seeking quack cancer treatments. Just as Osborne worried that his anti-venereal disease efforts were undermined by public ignorance and confusion, and that reputable medical advice was constantly competing with a deluge of disreputable literature, so too did the ASCC in its efforts against cancer. Just as Osborne worried about “the past ‘conspiracy of silence’ and taboo”11 around venereal disease, so the ASCC worried about the current silence and taboos around cancer. Just as Osborne worried that “many girls do not know they are infected until the disease has developed to such a point that they have infected many persons,”12 so the ASCC worried that many people did not know they had cancer until it was too late to do anything about it. Both campaigns sought to direct people to reputable physicians and treatment centers, to mistrust the advice of friends, family and even at times their physicians, and both saw the establishment of free diagnostic and consultation clinics as key means of getting the public to seek help. Thus, Osborne was to face many familiar problems when he joined the ASCC.

Figure 1

A poster used during the 1921 Cancer Week, unusual for the time, since most other surviving cancer posters from the early 1920s used little visual imagery, beyond the use of particular fonts and layouts for the text. The poster in this case highlights the impact of male ignorance of cancer on family members, including children. Source: Campaign Notes. American Society for the Control of Cancer 3, 4 (April 1921): [4].

During his time with the social hygiene campaigns, Osborne had sought to develop a diverse range of educational and publicity strategies. “[I]t should be remembered,” he wrote referring to anti-venereal disease campaigns,13 “that ‘the public’ in this country is a complex entity. Different races, tongues, customs, ideals, moral standards, hopes, and fears, are represented. All sorely need social hygiene instruction, but each effort must be planned to fit the peculiar characteristics among the people it is designed to reach.” At first sight the ASCC might seem to have targeted a much narrower audience. Historians have argued that its main focus was white women, but this should not be read to suggest that it saw its public as homogenous or limited to women.14 Its educational campaigns in the late 1910s and early 1920s sought to target Jews and Christians (both Catholic and Protestant), rural and urban populations, business owners and labor unions, cinema and theater goers, and members of fraternal orders and lodges. Women were targeted as mothers, daughters and wives, and men as fathers, sons and husbands; the latter’s ignorance of cancer a danger not only to themselves, but also a tragedy for their families (Fig. 1).

Special efforts were developed to target all these particular groups and many others within that “complex entity” that Osborne saw as the public. Some people were reached by lectures, sermons, and lanternslides, some in the doctor’s office, the clinic, the church or temple, the motion picture theatre, women’s club or fraternal order, and others through newspapers or magazines.

There were myriad ways to reach the public, and to address the interests and concerns of particular groups and individuals within it.

Osborne himself argued that the cancer campaign was different from earlier ones against infectious diseases. As he pointed out, cancer was not preventable in the way that contagious diseases were.15 There was no point in avoiding exposure to an infectious agent — cancer was not contagious. Nor could it be prevented by any system of hygienic living, exercises, diet, or injections of serum or vaccines. Contrary to most contagious diseases, he noted, the beginnings of cancer did not involve plain signs: no terrific fever, loss of sleep, intense pain, or poor appetite. Instead it tended to begin slowly and without obvious warning. Its early signs were subtle and easily misinterpreted, and one of the tasks of an education program was to educate the public as to these “danger signs” and to encourage them to go to a physician the moment one of them was spotted. All these themes would be incorporated into ASCC public education campaigns, including The Reward of Courage.

National Cancer Week, 1921

The Reward of Courage was to be part of a broader effort to re-launch the ASCC after the war led by Osborne and the energetic President of the ASCC, Denver physician Charles A. Powers.16 (Fig. 2) Central to this effort was the creation in 1921 of the first National Cancer Week, held October 30 to November 5, 1921, and blessed by President Warren G. Harding.17 This was an intensive week of public education events, much of which would have been familiar to organizers and audiences of campaigns against tuberculosis and the venereal diseases18 — lectures for physicians, nurses, and the general public (the Society provided lecture outlines for the last of these);19 free diagnostic clinics;20 the distribution of thousands of educational pamphlets and posters;21 the publication of numerous articles in newspapers and other periodicals;22 theater slides;23 an exhibit;24 an educational lecture by radio (apparently the first time that radio had been used for public health education);25 a telephone S.O.S. system to alert people to upcoming events;26 and airplanes that delivered speakers to their destinations.27 The Cancer Society — and Powers in particular — were enthusiasts for new communication technologies like radio, telephone, airplanes, and movies. However, movies got special attention. Of all these new technological marvels, The Reward of Courage was to be a centerpiece of the 1921 campaign.

–  –  –

Studio portrait of Charles A. Powers, created 1886–1901 by the studio Rose & Hopkins.

Source: Denver Public Library’s Western History and Genealogy Digital Collections.

Reproduced with permission.

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