An old book lies open, its pages curled to make a heart

“Discharged Well”: or, How I Learned to Feel in the Archive

This story begins in the fall of 2007. I was on my first research trip to look through various records at the Countway Library of Medicine at Harvard. I was a baby researcher, fresh from defending my prospectus and high with the achievement of receiving a research fellowship. But I was also severely insecure. As a fresh ABD student (an acronym referring to graduate students who have completed “all but the dissertation”) I was convinced that someone would finally pay enough attention and say “wait, you’re not a historian, you don’t know what you are doing.” To prove myself, I vowed to be as professional as I had been taught: look in every crack, write everything down, and look at each and every source with a cold, detached, and objective eye.

One set of sources I set out to examine were the maternity records for the New England Hospital (NEH) for Women and Children. The NEH was a charity hospital established in 1862 by Dr. Maria Zakrzewska who hoped to provide a training ground for women physicians and a refuge for working-class women who had neither the funds for a doctor nor the social support to help with reproductive events. My project at the time was investigating miscarriage in nineteenth-century America. I was combing through the NEH maternity records, hoping to find cases of miscarriage. I had no idea if I would find any. I had written my dissertation prospectus based on medical teaching texts and journal articles, and the diary of one woman that included one entry about a miscarriage. I had no idea where else I would find more material.

I spent two weeks, flipping through every page of every book of the maternity patient records from the NEH from 1872 to 1910 looking for reproductive experiences that had gone wrong. The intake records of the NEH consisted of a long page full of data points for the administrative or nursing staff to fill out on behalf of the incoming patient, followed by pages of prose, written most likely by nurses, detailing what happened to the case after the woman was admitted to the hospital. I scanned the records looking for a sign of a miscarriage case. I scanned and I copied. I set out only to record cases of miscarriage and premature birth; however, I was drawn in by other records that piqued my interest–but not in a way that seemed professionally sound.

One type of these outlier records caught my eye because of the hand-drawn large black cross, drawn at the top of the records, perhaps by the nurse in charge of recording the case. These were cases where the child did not survive: either they were stillborn or died within hours or days after being born. I mechanically copied down the words “black cross” in my transcriptions of the records, but did nothing about those crosses beyond that.

Another niggling question was sparked by records whose pages of prose sometimes described weeks of pain and suffering and ended with the phrases: “patient discharged in good condition” or “discharged well.” These words appeared in cases in which the patient left the hospital with a child and in which the patient left alone. I wrote these down, not sure what to do with them because they did not fit my research framework.

As I sat in my private room at the Countway Library, I furiously copied everything that I could from these records paying almost no attention to how these stories, these lives, and these deaths made me feel. Yes, some of my inattention resulted from “archive fever,” cognizant that my time in the archive had a definite end point and that my project’s success could rest on finding just the right source, but only if I looked at everything possible. I needed to focus on efficiency. I would take the time to think and analyze later. But I was also driven by that imposter syndrome, by believing that I could only prove myself as a real historian by not letting my own emotions cloud my judgment or shade what I was seeing. If I could be a robot, with clear unaffected eyes, merely transferring information, then I was on my way to becoming a true professional.

“As I sat in my private room at the Countway Library, I furiously copied everything that I could from these records paying almost no attention to how these stories, these lives, and these deaths made me feel.” (Courtesy Pexels from Pixabay)

Fifteen years later, I laugh in embarrassment at my naiveté, but also recognize a professional failing. Now, when I read the case from 1877 of a 20-year-old Boston woman, mother of four, who came to the hospital at the end of what she described as a “very good” pregnancy, and I see the black cross, I spend more time with it. This was an object that someone spent considerable time drawing and coloring in and I imagine a staff person bent over the painstaking task, seeking to mourn or memorialize the life lost in the midst of a medical routine.

When I see “discharged well,” I see the presence and the erasure of emotion. While I’m sure there were some NEH patients who lost their children and might have appeared well to the nurses upon their departure, I cannot believe that all of them did. In February of 1900, a 32-year-old Boston native arrived at the NEH at, in her estimation, seven or eight months pregnant. She told nurses that she had been feeling quite well throughout, but now had felt labor pains for the past 24 hours. Three of the lines on the intake form ask: “Whether former children, and how many?” “Whether former miscarriages, and how many?” and “Course of former labors.” From these lines we learn that this woman gave birth to eight children, had two miscarriages, and “no child lived over 10 days.” Within a few hours of arriving at the hospital, the woman delivered a girl, born dead. Due to bleeding complications, the woman remained in the care of the hospital for about two weeks, and when she left, staff wrote: “Patient discharged in good condition.” I cannot help but ask today, “Really?” Regardless of her physical condition, these five words hide a wealth of information, erasing her emotional agency and leading a young researcher to shy away from empathy.

Why do I see it differently now? Why do I allow emotions to cloud my judgment? Much has changed about me since 2007. I have been pregnant five times, I have had two miscarriages, one abortion, and now have two children. I have spent years in therapy talking about the importance of acknowledging emotion. I like to believe that I experience less imposter syndrome in my work. I also have a clearer understanding of why I want to acknowledge the emotion in the archive, both my own emotion as a researcher, and the emotions hiding on and in the forefront of the page.

Because that is what I did not see fifteen years ago: the black cross and the “discharged well” were clues to emotion, both presence and absence, of patients and hospital staff. Acknowledging the presence of emotion is vitally important to my understanding of the interaction, the hospital, and the process of maternity in the late nineteenth century. But by shutting down my own emotional response to these stories, I could not be open to their emotions. It is only when I allow myself to think about the sadness of losing a child, the mental pain of failed procedures, the feelings of hope and disappointment that I can be present for my subjects. Only then can I look for, notice, acknowledge, and process the grief, pain, relief, and myriad emotions available to my historical actors.

I now push myself to be open and vulnerable in the archive; to acknowledge my emotional reactions to lines on a page, and to wonder about the emotions contained within those scrawls. Does this make research harder? Hell yes it does! That is a lot of emotion and that is draining. In my current work on infant mortality studies and the development of prenatal care in the early twentieth century, there is a lot of pain, death, purposeful harm and violence, and neglect. For my next archive trip, my suitcase will not only carry the necessities of archival research that seem professional (laptop, pencils, and camera), but it will also contain the tools that will help me to be open to emotion and help me take breaks from it: a meditation app, a yoga mat, a journal, romance novels, and lots of m&ms.

This emotional investment is a new journey for me but one in which I find great value and one I believe honors my historical subjects in ways that feel more respectful and more caring. My question now is: how do I teach this? How do I equip my graduate students with the ability to acknowledge and process multiple layers of emotion without burning out on their first archival trip? This is my next challenge, and one I do not take lightly. Teaching about ethics and emotions as part of research methods is essential to graduate training. I want to see a future with more researchers taking care of their subjects and themselves, with scholars doing the hard work of opening themselves up to take more in.

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