The Patient’s Pain in Her Own Words: Margaret Mathewson’s ‘Sketch of Eight Months a Patient, in the Royal Infirmary of Edinburgh, A.D. 1877’

It has been commonly assumed that nineteenth-century hospital patients were objectified, silenced, treated as the 'accident' of their disease, to use Michel Foucault's term, and also that as charity patients they were largely illiterate paupers, and consequently did not write accounts of their hospital experience. One such account has been known, however, since the 1970s, when W. B. Howie and S. A. B. Black published two articles in medical journals on Margaret Mathewson's 'Sketch of Eight Months a Patient, in the Royal Infirmary of Edinburgh, A.D. 1877'. Martin Goldman subsequently published excerpts from the 'Sketch' in <em>Lister Ward</em> (1987). But Mathewson's account of her experience as a surgical patient of Joseph Lister has never been published in its entirety, nor has it been known that the two existing copies of the manuscript differ extensively, as Mathewson decided to leave out 'some insignificant items and put in others more interesting' in the later version. Admitted because Lister thought he could save her arm from amputation by excision of her tuberculous shoulder joint, her narrative vividly details what it was like to be a surgical patient in Scotland in 1877. Her revisions to that narrative provide clues as to what she thought prudent to exclude from her account, after friends had asked her to publish it. As a charity patient, she was subordinated to the hospital staff, expected to wait uncomplainingly and to accept whatever treatment was given. But her 'Sketch' reveals such unexpected and surprising information as the willingness of the staff, including Lister himself, to teach her and other patients about the nature of their disease and also how to care for themselves, especially how to change their own dressings. Even more startling, Mathewson's narrative documents her confrontation of a 'cruel dresser', a medical student whom she believed to be deliberately causing her pain when he changed her dressing and manipulated her arm, and Lister's corroboration that the patient had the right to report such maltreatment. Mathewson's 'Sketch' narrates her progress from identification as an 'interesting' case to 'successful' and even 'favourite' case; and her movement from one subordinated to medical authority to one who speaks - and acts - on her own behalf. <br />

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