Friday, 20 January 2017

Smaller stories and the bigger picture


In her final blog post for LHSA, our project cataloguing archivist Rebecca looks back on her time with us and shares some stories from the case notes.

Well, I can’t believe it’s been eighteen months since I started work on the RVH v TB project, it’s just flown by! If you’ve been following the blog during that time you’ll see I’ve learnt a lot from cataloguing the case notes about the detection,  prevention, and treatment of pulmonary and non-pulmonary tuberculosis,  about Robert Philip and the Edinburgh Scheme, and about the city and people of Edinburgh.

It’s been a great privilege, though not one without challenges, to get such a detailed look at the case notes, as these sorts of records are not usually catalogued individually. It means that as well as seeing broader trends in TB care, including the development of BCG vaccine and antibiotic treatments, and getting a sense of how the hospitals functioned (in the case of Southfield Sanatorium, apparently not very well!), I’ve been able to see the stories of individual patients.

Correspondence from the Southfield Sanatorium series, bemoaning the poor state of the hospital prior to 1946.
(LHB41 CC/1 PR1.610)


Some of these stories have been very sad, such as the cat with TB, the child who was kept in school (despite the usual recommendation for bed rest) so as not to be “made a drudge at home”, or the husband who forced his sick wife out of the house she had been allocated to as a result of her illness. Others have been happier, including the many cases of patients making a recovery.
Correspondence relating to some of the sadder stories revealed by the case notes
(LBH41 CC/2 PR2.1042, 3322, 4179  - click to enlarge)
 
One thing that comes clear is the stigma surrounding tuberculosis, such as the patient from England who went to Southfield in order to avoid it being known in their locality that they had TB. I’ve even seen a patient threatening to sue the hospital for giving them such an outrageous diagnosis!
Correspondence revealing some of the stigma surrounding TB
(LHB41 CC/2 PR.2 17565, LBH41 CC/1 PR1.356)
 
Some records tell us about the eagerness of the patients and their families to get cured of the disease, and the anxiety faced by those who wished to avoid it, while others show signs of refusal to comply with treatment. Over the past eighteen months I’ve been able to see literally thousands of these stories, and they are still throwing up surprises!
Case notes and correspondence from cases where patients demonstrated anxiety regarding TB
(LHB41 CC/2 PR2.1863, 2631)
Extracts from case notes of patients who refused treatment or who wished to try other means of treatment
(LHB41 CC/2 PR2.1997, 2595, 6298)
 
As well as the catalogue, hopefully another great tool will come out of the work we’ve done on this project, which will reveal the larger stories which the case notes can tell. Last year, I made a successful bid for someone to work on creating a data visualisation tool using data which can be extracted from our case note catalogues. We’ve been tagging and indexing information such as the patient’s gender, age, occupation, medical conditions and treatments throughout the project, and the plan is that this will be put to use to create fancy interactive graphs and charts which can tell the story of the case notes in a visual form. Work on this project hasn’t started yet, but I’m really excited to see what will come out of it!

Some generic examples of data visualisations, from https://github.com/d3/d3/wiki/gallery

While my work here has mostly been focused on the case notes, I’ve also been lucky enough to learn more about some of the other records and objects held by LHSA. It’s also been a  great privilege to take part in other LHSA activities, including assisting Louise at outreach events, attending conferences, delivering a presentation to students on my old course, and even getting crafty and making some ‘zines last month! I’ve really enjoyed working with such a wonderful team over the last 18 months, and I’ll definitely be reading the blog to keep up with what they are getting up to!

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