Who Cares? The ethics and emotions of historical medical photography

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The next installment of our Emotions and Ethics series is written by Beatriz Pichel, who is Senior Lecturer in Photographic History at De Montfort University. Her co-edited volume, Emotional Bodies, appeared last year with University of Illinois Press and her monograph, Picturing the Western Front: Photography, Practices and Experiences in First World War France, will be out in 2021 with Manchester University Press. She’s currently working on the manuscript “Photography and the Making of Modern Medicine in France”


Who Cares? The ethics and emotions of historical medical photography[*]


In the winter of 2008, as I was starting my PhD, I found myself in the basement of Val de Grâce’s Musée des Services de Santé de l’Armée (Paris), by myself, surrounded by photographs and wax models of soldiers who had endured surgical reconstruction of the face during the First World War. It was not my first time in an archive, neither was it the first time I saw these medical images. But sitting there, alone, a whole afternoon, looking at photograph after photograph, was a bit overwhelming. I turned on my iPod and started listening to music to keep me company.

More than ten years later, in the Autumn of 2019, I had a similar experience. I was in Paris on a research trip focusing on medical photographs produced between 1860 and 1914. As the days passed, the excitement of discovering new material and even having some new ideas turned into an overwhelming sense of sadness. I was in the most beautiful place on earth doing what I love, but spending day after day scrutinising medical images and reading about patients was taking a toll on me. It peaked one day when I was looking at a particularly disturbing set of photographs (the dermatological collection at Saint Louis Hospital) and I saw a photo of a man I thought I recognised. I was sure I had seen him before. The back of the picture had a newspaper clipping attached to it -that’s quite rare so I was excited to read and find out more about him. What I found out is that the man had died by suicide. He had a rare disease (he was called ‘the mummy man’ because he was very skinny) and, according to his suicide note, killed himself because he couldn’t bear living like this anymore. He ‘like(d) all the beautiful things in nature’ while he was not beautiful at all, but wished to donate his body to science, in the hope that it was helpful. It was heart-breaking. I had to take a break, I called my partner, I listened to music. I was overwhelmed.

And that’s when it hit me. The trip was being difficult not just because the images were very disturbing, but also because I was trying to deny the feelings I was having in the archive. I think the reason of this denial was not so much the ideal of the detached, disembodied scientist (I’ve read enough feminist scholarship to reject that), but rather the effects that confronting and acknowledging my own feelings would have on my writing, my thinking and my general approach to medical photographs. Since that first visit to Val de Grâce I had learnt to detach myself from my sources. I could write about medical photography and death and war suicide with respect but always in a very academic manner (in the third person, with lots of “therefore”). During my last trip to Paris, I questioned whether I should continue writing like that. The alternative was scary because it meant finding a new way of writing, a way to use these emotions to write about historical actors, as well as challenging some of the research questions I had about the material.

My “Paris epiphany” also made me realise that acknowledging the ethical issues of historical medical photography had to be at the core of my writing. But that opened up new sets of questions. What were the ethical foundations that were guiding my decisions? Which ethical code was the most appropriate to deal with the specific issues arising from historical medical photographs? Before becoming a photographic historian, my training was in philosophy. I spent four years learning about different ethical systems, so it struck me that most of the discussion on the ethics of photography revolved around questions such as “should we look at these images?” and not so much about the principles that will guide the answers to these questions. Thinking about these principles would mean articulating our responsibility as historians towards our historical subjects and our sources in a more explicit way. The ethics of historical medical photography is one piece of the ethics of history.

Looking for those ethical principles, I read Maria Puig de la Bellacasa’s excellent book Matters of Care (2017). In it, she explores the complexity of care and asks questions not only about the ethics but also the ontology of care. Her work is highly theoretical, but it brought to light a key point for me: the inherent tensions underpinning care. Like touch, where by touching something you are also touched, care is relational, but that does not mean that is unproblematic. Thinking about this tension in the context of historical medical photography opened up new avenues to me. When I ask ‘who cares?’ in relation to historical medical photographs, the answer might be us as historians, past and present viewers, the museums and archives that preserve these sources, and the doctors and photographers who took care of these patients. Writing about the ethics of historical medical photography is writing about the people who care(d). If I include doctors and photographers in the narrative, why not also contemporary viewers or even me, as a historian?

In this short text I am not arguing for solipsistic accounts. Personally, I am not relevant to my sources -I do not even have any personal connections to the people I study or the medical conditions I examine. But that does not make me a neutral observer. What I am trying to say is that acknowledging that we care and that others before us cared about these photographs and these patients is a good starting point. In her wonderful book The Vulnerable Observer. Anthropology that Breaks your Heart (1996), Ruth Behar cites Kafka, who wrote that ‘a book must be an ice-axe to break the sea frozen inside us’. What would happen if we defrost the sea frozen inside us, and use it to write?


Beatriz Pichel, DMU.

[*] This post is a version of talks presented at two workshops: ‘Supporting Researchers Working on Sensitive Histories”, Birkbeck College, 9 January 2020, and AboutFace webinar “Ethics and Emotions: The Use and Abuse of Historical Images”, 17 June 2020.


A great blog series on the 'ethics and emotions' of working with photography 👇 https://twitter.com/AboutFaceYork/status/1291315469891309568

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