Cracking the case note conundrum...

This week, Archivist Louise looks forward to talking about her favourite things in LHSA’s collections (apart from pictures of cats….)

On Wednesday 19^th October at 12.30pm, I’m going to be giving a free, short public talk in the Centre for Research Collections. The talk’s connected to an exhibition that we’re taking part in inside the 6^th floor display wall in the Main Library. The exhibition looks at the work of an archive from another angle. You’ll often see archive treasures on display, from manuscripts to objects to images, but the hard work that goes into making these collections accessible –so that researchers can physically see them and that they can find what they’re looking for – all goes on behind closed doors….

The Enhance, Access and Understand exhibition aims to put his right, bringing behind-the-scenes conservation, digitisation and description out of the shadows and into the light (but not too much light – we have to be careful about our lux levels! We’re showcasing the work done throughout the Centre for Research Collections (CRC) that has been generously funded by the Wellcome Trust Research Resources scheme – grants to libraries and archives that help to make collections accessible to researchers by funding cataloguing, digitisation and conservation.

Last week, LHSA Manager, Ruth, and Emily Hick (former Project Conservator for LHSA, now CRC Special Collections Conservator) hosted a successful talk and studio tour on the challenges involved in conserving LHSA’s HIV/AIDS collections, which are featured in Enhance Access and Understand. Emily explains some of the issues involved in this work here. On the 19^th October, it’s my turn, and I’ll be focusing on the work that we’ve done in LHSA to catalogue a fascinating but under-used set of resources – 20^th century folder-based case notes.

A typical neurosurgical case note (all identifying details redacted)

If you’re a regular reader of the blog, you’ll know that we currently have two Wellcome Trust-funded cataloguing projects that are ongoing – one is cataloguing Professor Norman Dott’s neurosurgical case notes and the second concentrates on our substantial collection of TB case notes from Southfield Sanatorium, the Royal Victoria Dispensary and two Mass Mobile Radiography campaigns. Since there have been quite a few blogs on the content of casenotes, the methodology of the projects and even the differences between the two, I won’t repeat what’s already been written, but try to give my own angle on why I thing this cataloguing is so important.

To say that I’m attached to case notes is probably an understatement. I started work here at LHSA as Project Archivist, cataloguing Dott’s case notes and now I supervise both projects as Archivist. In fact, I had my firstexperience of case notes as a volunteer for LHSA back in 2010. Looking at case records as a cataloguer both intriguing and intimidating. You gain a privileged view inside someone’s life at a time when they’re probably feeling at their most vulnerable (as we all are as patients), but there’s also a lot of specialist medical language in the cases and, when you’re not a medic, that can take a lot of deciphering! However, this ‘cataloguer’s view’ is unfortunately an all too rare one, since researchers do not use archival clinical cases as much as they might.

Louise as Project Archivist showing off some of her wares!

The first reason is case notes’ physical condition – many are still in their original folders, which can be messy and loose on shelves. Fortunately we’ve solved this problem at LHSA thanks to Wellcome Trust grants that have funded conservation. However, by producing a catalogue to our case note collections, we’re overcoming the two main intellectual barriers to their use as well. First, case notes can be ordered by name, admission number or by ailment – if a researcher wants to find all cases featuring a certain condition, for example, in a set of case notes ordered by admission, it can be a lengthy process scoping hundreds if not thousands of documents. Secondly, since case notes are relatively modern archives, most are classified as confidential under legislation and NHS guidelines that cover health records of living and deceased patients. Even to see what information cases hold, researchers would need to apply for special permission – which can take time.

Our catalogues hope to circumvent these difficulties by providing anonymised descriptions of each case in our neurosurgical and TB case note collections – so potential researchers can see what sort these documents have to offer. Because of the way in which we’re cataloguing the cases, we will also produce a confidential, identifiable catalogue that can be accessed by special permission by legitimate researchers in our reading room. Both catalogues label aspects of descriptions so that they can be searched under specific categories.

Finding a way to describe these glimpses into the recent medical past certainly was a challenge, but has honestly been my career highlight so far! We’ve had a brilliant team working on both case note projects, and we’d love you to come along to learn more about how we went about ‘cracking the case note conundrum’ – there’ll also be a chance for a sneak peek at how entries in the public catalogue will describe cases before the project launch and an opportunity to see some case folders in the flesh. You can book your free places here: http://bit.ly/2dh9NPa.

In case you were disappointed about the lack of cat pictures in this post, by the way, here’s one…

Royal Infirmary resident physician with Darby the cat, 1929 (LHSA photograph collection).