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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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Also interwoven in this film is a progressivist tale of a hard-headed businessman converted to the idea that an industrial clinic could improve worker health and productivity, increase company profits, and detect cancers.45 The movie opens with Gene reporting to Marshall that a newly installed company clinic has paid for itself by preventing time lost on account of sickness, and has saved the workers money as well. Marshall is impressed, converted by Gene’s statistics to accept the business case for a clinic he had previously ignored. The clinic is one of the few film locations that can be identified: It is the industrial clinic of the Jencks Spinning Company of Pawtucket, Rhode Island.46 In the movie, the clinic is supposed to promote better productivity, reduce the loss of worker’s hours due to sickness, and serve as a demonstration of the value to industrialists of providing preventive health services, something that will also improve worker/owner relations — a progressivist message about the value of science and medicine to social and industrial reform. It is something of an irony that the Jencks Spinning Company was in several major disputes with its workers in the early 1920s, shortly after the movie was released.47 In the film, Dr. Dale grumbles that Marshall shows no interest in his work, unaware that Marshall, newly enthused about the clinic’s business potential, has come with Gene to visit and overhears his comment. Despite the embarrassment, Marshall and Gene listen as Dale explains the rationale of his operation: “Regular physical examinations and hygienic instruction are the secrets. We discover the ailments before they become serious.” It will be recalled that Osborne noted that hygienic instruction was not useful in anticancer campaigns, but the ASCC did recommend regular physical examinations as a means of detecting cancers.48 The clinic is not a specialist cancer clinic, but an industrial clinic that is also equipped to identify the possibility of cancer, and so provides an opportunity to route patients to a competent physician.

The point is revealed by the case of “Simpkins,” a worker at the factory whom Dale has diagnosed with cancer. Simpkins’ case provides the filmmakers with an opportunity not only to demonstrate the value of the clinic in cancer prevention, but also to reinforce the point about the dangers of mistaken popular beliefs about the disease and quackery. First, Flint demonstrates the mistaken belief that cancer is an infectious disease when he asks how Simpkins “caught” the disease. The key word here is “caught”, for Dale explains that cancer is not contagious (it cannot be caught, a point noted by Osborne above, and echoed in the ASCC pamphlets that were circulated with the film49), but that early treatment can lead to a cure. “And so in Simpkin’s [sic] case, where the growth is still restricted, he may yet be cured by immediate and expert treatment.” Second, Simpkins anticipates the problems that Anna will later face in that he too has been tricked by Maxwell. Miss Keene enters and informs Marshall, Dale, and Gene that she has just come from Simpkins’ home, and that the “husband refuses to follow the advice of the hospital doctors and says he can cure the cancer with a paste” — the Radiumized Paste that we later find out is produced by Maxwell. In a dramatic scene later in the movie, Marshall, Dale, Gene, and a postal inspector rush to Marshall’s house and rescue Anna who has just handed over a check for $200 to Maxwell.50 Maxwell is arrested by the postal inspector (the Post Office Department could prosecute individuals and businesses that used its services to promote schemes defined as fraudulent),51 and Anna is saved by Dr. Clinton who (off-screen) cuts out the cancer and cures her of the disease.52 We learn nothing about the fate of Simpkins, who never appears onscreen. But the implication is that just as Anna has been saved by the action of her husband and physicians, so Simpkins or workers like him could also be rescued by the action of their employers and physicians.53 This paternalistic message is emphasized in a closing garden scene which shows Anna and Marshall, together with Gene and Dorothy (now happily married) and their healthy new baby six years after Anna’s treatment. Marshall turns to his wife and says: “Dearest, it is just six years since Dr. Clinton performed your operation – and how simple it was after all.” To which Anna responds: “Yes, but I might have been misled and waited too long except for you. Dr. Clinton says it was only successful because it was taken in time.” Audiences may be left wondering what happened to Simpkins, and what sort of operation Clinton performed on Anna that allowed her husband to describe it as “simple”—a standard treatment for breast cancer at the time would have been a radical mastectomy. Nevertheless, the film’s message is that medical knowledge and skills saved both Anna and her family. Where the poster “If Daddy had only known this!” (Figure 1) portrayed a family abandoned by the death of an ignorant husband and father, The Reward of Courage portrayed a family saved by a knowledgeable and brave husband and father. One ASCC official welcomed the film as “a touching, yet fascinating story, depicting ignorance of the laity, the shrewdness of quackery and the rescue by intelligence in a case of cancer.”54 A final word might be said about the title — The Reward of Courage. The title is something of a puzzle, since the main beneficiaries of medical treatment — Anna, Dorothy and possibly Simpkins — display no courage until confronted by their husband, employer, or physician. It may be that that Anna’s surgery demonstrates last-minute courage, or that Dorothy demonstrates courage when she overcomes her false fear of the hereditary taint of cancer. But, the overall message is that the women in the film are saved by their menfolk: Anna because she endangers herself though her fearfulness and gullibility, and is rescued by her husband; Dorothy because she endangers her marriage through ignorance of the (non)hereditary nature of cancer, and eventually comes to accept Gene’s advice to seek the advice of someone who knows.

If the women are gullible, fearful, and ignorant, the men — especially Gene and Marshall — are courageous. Both men exhibit courage when they confront Maxwell, and also by deciding to support the clinic. Gene is courageous because he incurs the suspicion of his boss who initially doubts the value of the clinic, and Marshall is courageous perhaps because he incurs the financial risk of a clinic he is initially unconvinced about. Their rewards are Anna’s life, Dorothy’s happiness, the birth of a baby, the saving of their families, and Gene and Dorothy’s marriage. By accepting the advice of their husband, fiancé, and physician, Anna and Dorothy not only save themselves but also the happiness of those they love. As the closing scene suggests, the reward of courage is not only life, but also a happy, harmonious family.

It may also be that the title was also important to the filmmakers because of its value as a marketing tool. It likely served to encourage the public to (courageously) overcome their fears of cancer, and seek proper help. It did this by promising potential viewers an uplifting story about cancer, and a series of inspiring role models including Gene, Marshall, Dale, and the off-screen Clinton.

It may also have served to evoke an earlier successful commercial film also called Reward of Courage (1913) in which the hero, hobbled by a sprained ankle, thwarted a married man who made advances to his sweetheart.55 In the 1913 film the heroine gave herself to the hero as a reward for his courage; in the 1921 film, one heroine (Dorothy) gave herself to a hero following his dash to save her mother from his rival in love; another (Anna) gave herself to the surgeon’s knife perhaps as reward for her husband’s courage.

Qualified enthusiasm

If the ASCC commissioned The Reward of Courage amid a growing enthusiasm about the value of film as a tool of education, it also came to worry that the film or its subject matter might undermine its message of early detection and treatment.56 Part of the concern was that the medium of film was so powerful that it could exacerbate existing public fears and concerns about the disease or its treatment, and so prompt people to delay seeking help. With such concerns in mind the ASCC sought to remove or tone down scenes or subjects that it worried might harm the message it hoped to get out. In correspondence, Osborne suggested that an early version of the film or its script included some operative or hospital scenes, but that they were eliminated from the final version because the organization worried that any hint of radical surgery—the recommended treatment of the time—had the potential to undermine educational efforts by frightening people away from their physicians. People were as scared of the treatment as the disease. “I believe,” Osborne noted,57 “the public will respond much more readily to the suggestion of immediate attention to anything suggesting cancer, if the arrangements for radical treatment are kept in the background and left to the physician after the patient has applied for advice.”

Figure 9

Part of the animated section of the film showing the spread of cancer and its consequences, highlighted by arrows. The line drawing of the human figure and dark blotches of the tumors also serve to counter the prospect of any paralyzing fear or disgust that might be evoked by a live action image of tumors.

Thus for all their enthusiasm about this new wondrous cinematic technology, the ASCC kept very close eyes on the production of the film, hoping to ensure that it did the work the organization wanted it to do.58 In addition to removing treatment and hospital scenes, it also ensured that no live-action shots of tumors were screened: The breast examination is done discreetly, so that Anna’s cancer is not shown. (Fig. 5) The only tumors that the audience sees are in an animated section of the film, which shows the growth and development of cancer.59 As Kirsten Ostherr has noted, early twentieth-century theories of visual pedagogy often emphasized the appeal of animation to “‘simple-minded’ audiences”60 because animation minimized the amount of visual information that an image portrayed, and so made comprehension easier, and sometimes more entertaining. But animation served not only to simplify but also to sanitize a film by removing visually disturbing elements. For the ASCC, the line drawings of tumors and bodies in the animated sequence of The Reward of Courage helped to avoid the paralyzing fear or disgust that they feared a live image of a tumor might promote in a viewer. (Fig. 9) The ASCC reassured potential exhibitors and audiences that the film avoided any of cancer’s “more distressing aspects. There is absolutely nothing repulsive or objectionable in the picture.”61

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ASCC Activities during the 1921 National Cancer Week, by State Sources: “Gleanings for Cancer Week” Campaign Notes. American Society for the Control of Cancer 3, 12 (December 1921): [1–4], p.[2]. “Further Reports on Cancer Week,” Campaign Notes. American Society for the Control of Cancer 4, 1 (January 1922): [2–4] p.[2]. “Further Reports on Cancer Week,” Campaign Notes. American Society for the Control of Cancer 4, 4 (April 1922): [1–4] p.[1].

Even after its release the ASCC tried to keep close control over its message. It remained worried that audiences might react in the wrong way, despite its efforts to control the film’s production. So it tried to ensure that it was only screened when a trusted delegate of the ASCC, usually a physician, was present to correct any misconceptions, answer any questions, and calm any fears the film, the disease, or its treatment might generate in the public. Films were often accompanied by a lecture which, as noted above, the ASCC scripted for local speakers. They were also part of a broader educational program that included newspaper and magazine reports, showings of slides and posters, free cancer clinics, and educational pamphlets. All of these could be used to counter any unwanted reactions in a movie-going audience.

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