From Anthony Henday to big box superstores: trends in Canadian trauma care.

When looking forward, it is often useful to explore the past. I would like to begin this address by revisiting recent history, attempting to learn lessons which may help us understand future trends. In 1754, Anthony Henday was dispatched by the Hudson’s Bay Company to seek out new territories and trading partners for the lucrative fur trade. He paddled down the Hayes River and crossed overland to the site of present day Red Deer, Alberta. He encountered the vast herds of buffalo and established contact with the Blackfoot Nation. He is often credited as being the first European to visit the Canadian western plains. On closer inspection, however, his mission for the Bay was in response to the activities of the adventurous son of the Governor of Trois Riviere, Quebec, Monsieur Verendrye. Verendrye had already established a chain of trading posts that extended to the Rocky Mountains. The Blackfoot were well supplied with French trading goods. The horse, too, had arrived, preceding Henday by 30 years. “He visited a Blackfoot camp just south of present day Red Deer, Alberta. The camp consisted of 322 teepees and 2500 people [Fig. 1]. He noted that they rode horses complete with stirrups and pad saddles stuffed with buffalo hair. He experienced the thrill of a mounted buffalo hunt. It was all he could do to control his horse, he reported, while the Indians galloped with both hands free, and felled buffalo with as few as two arrows.” In 1759, Quebec fell to the British; the French competition was quickly replaced by small groups of Scottish and American colonial traders. Effective competition emerged with the formation of the Northwest Company in 1774. The Hudson’s Bay Company awoke from its sleep by the frozen sea and unleashed several extraordinary explorers. In 1771, Samuel Hearne reached the Arctic Ocean. In 1793, Alexander Mackenzie crossed the Rocky Mountains and left his famous mark by the Pacific, “. . .from Canada by land. The 22nd of July, one thousand seven hundred and ninety-three.” The Northwest Company responded by luring David Thompson from the Bay. By 1811, David Thompson mapped the Upper Columbia River and, eventually, reached the Pacific. The frontiers of Canada were now established. Within 100 years, the buffalo and the free-roaming Blackfoot confederacy were gone, the cities and towns of Canada were established, and the population was growing rapidly. The 20th century saw the establishment of the general store and the general hospital. As a child growing up in the 1960s, these institutions possessed an aura of grandeur Submitted for publication November 20, 2002. Accepted for publication November 25, 2002. Copyright © 2003 by Lippincott Williams & Wilkins, Inc. From the Canadian Institute for Health Information, Toronto, Ontario, Canada. Presidential address presented at the Annual Scientific Meeting of the Trauma Association of Canada, April 18–20, 2002, Whistler, British Columbia, Canada. Address for reprints: John Korbeek, MD, FRCSC, FACS, Trauma Services, Foothills Medical Centre, 1403 29th Street N.W., Calgary, Alberta T2N 2T9, Canada; email: [email protected].