My semester-long sabbatical ended abruptly with the start of summer session at my college so it’s the perfect time to reflect on five months of research. The goal of this project at the outset was to study the care of women categorized as mentally ill (today’s terminology) in the period 1870 to 1920 in Massachusetts and Rhode Island. As with any project, I’ve met with some success and some failure while being introduced to questions that I did not know I needed to answer.
My research at the Rhode Island State Archives, for example, has proved more fruitful than I expected. Not only have I been able to learn a lot about the state’s efforts to care for mentally ill women, I’ve also been introduced to the challenges of basic health care for poor women in a way I had not anticipated. Looking specifically at conditions and challenges in our nation’s smallest state has been alarming. Sick women often arrived at the RI State Almshouse with children-in-tow. Sometimes those children were healthy and other times they were even sicker than their mothers. In all cases, however, the Almshouse -- one of the only safety nets for poor women in this era -- was the last resort as care at private hospitals was financially out of reach.
Learning more about the history of the US healthcare system has been a goal of this project from the start. In an earlier blog, “Making Connections: History & Medicine” I mentioned my interest in helping students at the community college where I teach develop an understanding of healthcare historically. In a future semester I’m hopeful that I can offer a course designed specifically for our nursing and health-care focused students. Secondary readings toward that end are my focus for the remainder of the summer.
Finally, the greatest challenge I have faced during this sabbatical is access to sources. Access to patients’ records and/or doctors’ notes that could shed light on illnesses and treatments has been inconsistent. Historians have published several narrative histories utilizing 19th-century patients’ records in states such as New York and Virginia -- sometimes changing patients’ names and other times publishing doctors’ notes verbatim. In New England, however, I have been challenged by the inconsistency of repositories’ policies on access. While some libraries allow review of patients’ records after a waiting period of 70 years (from the document’s creation), others have closed patients’ records entirely by citing modern-day state laws regarding patient privacy. I continue to engage in discussions with these libraries about the importance of medical records as historical sources. While I certainly understand concerns about privacy I also believe that being one-hundred years removed from the time period is a significant buffer, especially when coupled with the promise of patient anonymity.
I’m excited to continue this research. Taking a few months away from the classroom to focus on a project that is entirely my own has reinvigorated my academic interests and my desire to find new topics to share with students. I’m inspired to better manage my teaching/preparation time so that all of this amazing research I’ve done does not collect dust. Suggestions welcome.