With each participant, individual strategies emerged for generating stories related to their institutionalized family member. Some were driven to gather as much
information as possible – from both family members and public sources – while for others the focus was on other actions they could take to restore the memory of an erased family member or in some way mitigate their erasure. For most, however, part of their response was to seek further information about the relative through public and archival records. The types of public records consulted included online genealogy resources, BC Archives vital statistics (online database), death registrations and certificates (online and library microfiche records), Canadian and US military records, city directories, census records, newspaper articles, photo archives, and in one case even customs records of border-crossing transport vehicles. Participants also had the option of requesting access to the patient file of their relative from BC Archives, if it still existed and if they qualified as closest living next of kin. This involved writing to a contact person (whose name I
provided) at BC Archives, explaining their relationship to the deceased, and usually paying photocopying charges. Four of the seven participants in this study obtained their relative’s patient file, while others (to my knowledge) chose not to.
Patient files varied in content, but at the very least would contain admission forms, medical certification forms – stating reasons for admission and describing symptoms, magistrate’s order for admission, ward notes, and clinical charts; they also might include any of: a patient photograph (head portrait), notification of admission and next of kin to provincial government, a list of patient’s belongings and physical condition upon admission, family history, social worker’s report, diagnostic test requisitions and test results (TB, syphilis), sleep and weight charts, clothing requisition forms,
correspondence between family members and the institution, list of visitors, and forms indicating date and cause of death, and death registration filing record.
As a critic of the medicalization of dis/ability and the ideology of cure, Eli Clare views patient case files with considerable skepticism, as powerful tools of the “medical- industrial complex” that reduce people to diagnoses and “expert opinions” (Clare 2017, 112):
Case files will never provide the answers. Instead they tell stories entirely distorted, filtered through diagnosis, treatment, and cure; stories that flatten body-minds onto paper and computer screens, reduced to fit into vaults and servers. They lay claim to the truth. They lie.
…Let me say again: case files erase so much. (Clare 2017, 115)
There is no doubt that patient files (and indeed, any archival records) are reductive and represent the biases and interests of the systems that produce them. But precisely because they often lay bare those biases, they are instructive. As Iacovetta and Mitchinson
suggest, case files can be mined both “to expose the words and actions of authorities and experts, and to recover the lives of the less powerful” (Iacovetta and Mitchinson 1998, 4) even if the evidence of clients’ voices and actions “may appear in muted forms” (6). They caution the researcher, however, “against the easy assumption that we can merely read off the case file all that is required to know about a given subject” (14). In “Between routine and rupture,” Tristan Platt suggests that archives contain documents and
statements that record both the event of their inscription and references to other events through the signs that compose them (Platt 2012, 22). They suggest “worlds beyond the texts” but also reveal patterns of repetition, linked to the management of everyday social events (22). In my reading of patient files, I oscillated between two attitudes: a critical interpretive perspective on the documents as highly mediated products of the ideological and institutional system they served, and an imaginative curiosity leading me to read “against the grain” for clues of patient agency and resistance – muted as those might be. Despite the efforts of institutional staff to reduce patient lives to sparse “objective facts,” embedded in their reports on deficits or “faulty” behavior were occasional inadvertent referents to patient subjectivity. Both levels of reading involved imaginative thinking and as much attention to what was not there as to what was.
Platt contests the “easy separation” of ethnographic fieldwork and historical archival research into two different methodologies, arguing that their relationship is deeply intertwined. He approaches archival research ethnographically: “I allow archives to present me with the object of my search” (22). I found this perspective useful in understanding the dialogic process of interpreting archival files that emerged with participants. At times, as we pored over maps, patient files, or other documents, objects of interest fairly jumped out at us; at other times, one of us would point out something that had escaped the other’s notice. Or we would each read a document or paragraph and understand them differently, which led to productive questions and dialogue, or
speculation on the attitudes that might be informing recorded comments. All of this took place with the recognition that all such records are subject not just to systemic biases and vested interests, but to significant potential for human error – misspellings, incorrect dates and names, transpositions, omissions, conflicting accounts, and so on. This had become patently evident in my examination of archival burial records for the Woodlands cemetery (three different burial lists, none consistent with the other), and unanswered questions about the cemetery’s multiple plot numbering systems.