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Remembering One's Stay in Hospital: A Study in Photography, Recovery and Forgetting

Alan Radley and Diane Taylor Health (London) 2003 7: 129 DOI: 10.1177/1363459303007002872 The online version of this article can be found at: http://hea.sagepub.com/content/7/2/129
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Remembering ones stay in hospital: a study in photography, recovery and forgetting

Alan Radley & Diane Taylor
health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine Copyright 2003 SAGE Publications (London, Thousand Oaks and New Delhi) [13634593 (200304) 7:2] Vol 7(2): 129159; 031872
Loughborough University, UK & De Montfort University, UK
A B S T R AC T This article addresses the question of how people remember their time as a hospital in-patient, and what place this remembering has in the work of recovery. It is based upon a study in which patients took photographs during their time on a hospital ward, using them later on as the basis for an interview in their homes. Using one womans data we discuss how the photo-based interviews made legible the images of her hospital experience and the part these images played in the respondents account of her recovery. The use of photographs is particularly useful in showing how remembering involves an ongoing transfer between different kinds of representation, including the narrative exploration of the movement of objects between hospital and home. K E Y WO R D S
hospital; narrative; photography; recovery; remembering;
representation
A D D R E S S Alan Radley, Department of Social Sciences, Loughborough University, Loughborough, Leics., LE11 3TU, UK. [Tel: +44 (0)1509 223356; fax: +44 (0)1509 223944; e-mail: A.R.Radley@lboro.ac.uk]
Introduction
In a recent article, the medical sociologist David Rier (2000) described his experience of being a patient in intensive care. This description was facilitated by his having retained a notebook that he used to communicate with his family and with staff during his time in an Intensive Care Unit (ICU). Rier was able to make use of this notebook in his work because, he says, a few weeks after discharge, I was prepared to relive my hospitalisation by reading the notebook for the rst time (2000: 85). As a result, he provides a rare and insightful account of what it is like to be a patient in intensive care and, equally important, highlights the lack of research that addresses the situation of the critically ill (see also Backman and Walther, 2001). On the basis of his own unwilling but opportune participation, Rier 129
health: 7(2) suggests that we might learn more about the acute or critical phases of illness by asking patients to keep notebooks of their time in ICU. What such notebooks might reveal, he says, are the layers of memory that such writings can capture and those that they cannot. Specically, he recommends that interviews would take place in two stages: while the patient was still in hospital and then again after discharge, once the former patient and the researcher have had time to review the notebooks. The present article reports such a study of hospital experience, though using photography as the chosen medium rather than notebooks. Patients were asked to take photographs on the ward, and then to talk about these during their hospital stay and then later on at home. In this way, it is possible to address the question of what it is that people remember about their time in hospital. Equally, it becomes possible to ask about the role of forgetting in the work of recovering ones health. In this case recovery refers to a number of things; the overcoming of disease, the working through of illness experience and the transition back from the status of sick person to that of healthy individual. While we endorse Riers criticism of the lack of research relating to the critical phase of illness, this report does not locate that experience in hospital alone. Instead, we ask questions about what it means to have been in hospital, to be recovering from illness or to be someone for whom this is one of several episodes in the course of their treatment. Recovering after a stay in hospital is not an isolated period. This is because it stands as a time that has been eagerly anticipated while patients were on the ward, and even beforehand in the projection of the whole episode prior to admission. In the case of serious illness these weeks are also a time during which the experiences of being an in-patient are worked through, and accounts of medical treatment often reect this when sufferers discuss their recovery of health (Frank, 1991). It then itself becomes a time remembered. While there are important differences between the course of treatment for acute and chronic illness, the idea that the weeks after discharge from hospital are a time of repair sits well with the notion of a biography disrupted (Bury, 1982). While the literature on chronic illness has much to say about how people face the diagnosis of disease and the trials of sickness after treatment, the voice of the patient during their time in hospital is largely accepted as one silenced by medicine. In particular, accounts of chronic illness deal in retellings, in the working over what happened to patients in hospital, but have continuing relevance for the sufferers concerned. It is this retrospective evidence that Rier (2000) complains is insufcient if we are to know more about what happens to people while they are in hospital. Hence we need accounts at both times, so that we can appreciate how this inter-folding of temporal experience occurs and what its signicance for understanding recovery might be.
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Radley & Taylor: Remembering Ones Stay in Hospital
Remembering, images and the use of photography

The decision to use photography in this study originated in our aim to investigate patients experiences of the physical setting of the hospital ward.1 The ward situation, with its particular architecture and array of medical technology, provides the setting in which initial recovery takes place. We wanted to know about this, and to know how individuals make sense of this experience in the days and weeks after discharge. So, asking them to take pictures while they were on the ward provided both a denitive act through which they could communicate signicant experience as well as a visual record that could be reected upon subsequently. In choosing this technique we also recognized that recovery after surgery is very much a physical affair, concerning bodily discomfort, issues of mobility and questions of restriction and control. This means that the setting in which it takes place, and in relation to which it takes place, are things that might usefully be recorded visually as well as verbally. Using photography as a methodology is relatively infrequent in social science but it certainly is not new (John Collier, 1967). Indeed the connection between photographs and memory is one often remarked upon, not only because photographs are material objects that survive for later inspection but also because they are often taken to be a record of a particular moment or occasion (Beloff, 1985; Cronin, 1998). Regarding the rst point, Beloff points out that old photographs owe some of their power (not to mention their fascination) to the unintended detail that they contain. This kind of detail allows photographs to serve as a particular kind of resource for remembering, one that has been exploited by researchers using photoelicitation as a technique (see Harper, 1998; Malcolm Collier, 2001 for overviews). Cronin (1998) quotes Walker and Kimball-Moulton regarding the propensity of photographs to provide evidence of the existence of the moment. She says that, the act of photography anticipates the future by ripping the appearance of a moment out of its time, creating a tangible image for the future of what will be the past (1998: 723). Clearly, then, the meaning of photographs is already caught up by the act of taking the pictures, when, where, by whom and for what reason. What will be remembered cannot be separated from this intentional context that projected, often implicitly, its future appearance within the act itself. What kind of remembering does this view of photography invite? While photographs can certainly act as triggers for memory (Cronin and Gale, 1996), this triggering will likely be different depending upon whether the photographs were taken by the person being interviewed or were taken by others. In both cases, the achievement of some reconstruction of meaning is vital to understanding what the picture is about, and is often provided in the narration surrounding the image concerned. Remembering on the basis of any photograph is rarely just the recall of what happened or what is portrayed, but nearly always why this image was selected and what was 131
health: 7(2) attempted in the way it was framed. This emphasizes the role of this medium in the fabrication of the world as we would like it to be, or to have been when seen from some time in the future. We often do not distil out the picture content from the technology, because in its assimilation to cultural life we do not realize photography as the extension of the senses that it is, a prosthetic engagement with the world that it is helping to make (Lury, 1998). This view of memory as reconstructive rather than replicative is consistent with the rejection of a realist view of photography. It is also in line with the argument that its use be premised upon an expressive deployment, to facilitate its potential to question, arouse curiosity, tell in different voices or see through different eyes from beyond (Edwards, 1997: 54). In the context of the hospital this call was anticipated in the work of Jo Spence (1995). She not only contested the power of medicine in her treatment for breast cancer but challenged the conventionality and artice of photographic styles often used to portray women (Dykstra, 1995; Bell, 2002). The act of photography and the inspection of photographs are together bound up within the making and remaking of the past. Photographs are resources for remembering so that, along with other material artefacts and people, they can be used later on as aids to remember by. For example, when family members view photographs together they attend to these pictures in a special way, encouraging interest and attitudes that are revived through the elaboration of conversation (Edwards and Middleton, 1988). From this perspective, remembering is not a phenomenon circumscribed by cognitive activity but rather a product of a social, collective act in which people draw upon cultural resources to say what the past might have, or must have been (Middleton and Edwards, 1990: Garro, 2000). Not only is the (social) act of photography constitutive of remembering, but so is the act of presenting people with photographs and asking them to talk about them and why they were taken. There is a necessity here to see photographs as being more than a trigger for eliciting memories. The act of talking about them is integral to the act of remembering so that this meaning-making gives sense to the image. In saying this, however, it is important not to suggest that photographs, as material artefacts, are dead matter enlivened by talk. As we shall show, people make sense with photographs not just make sense of them so that we are dealing here with a continuum of representation involving a transfer between kinds of action and media of representation (Streek, 1996). In particular, the use of photography allows for an examination of the ongoing transfer between kinds of representation, where language, the body and material things are all involved together.
The study described

The data for analysis are drawn from a study of nine patients who were in hospital for at least one week, either for surgery or for medical 132
Radley & Taylor: Remembering Ones Stay in Hospital investigations. This article deals with remembering the hospital stay, and focuses upon the home (and to a lesser extent the hospital) interviews given by one woman who was admitted for surgery. We choose to discuss the interview with just one person to allow cross-reference between comments on the several photographs taken. This womans data are selected because of the range of photographs she took and because of the richness of her home interview, each of which exemplies some key issues about recovery and recall. The format for the study was as follows. Once patients had given consent to be approached we explained to them that the research was about their experience of the ward and that we wished them to photograph up to 12 things that they thought signicant about their stay. The respondents were told that the pictures could be of anything on the ward that was signicant to them, with one proviso. They could select spaces or things that were part of the hospital, as well as objects that they had brought in with them. However, no photographs of people were allowed (this was due to a restriction on the part of the hospital). This did not preclude patients talking about other people (staff or patients) when reviewing the photographs during interview. This meant that other people were discussed in the study through patients inserting them into the pictures, not through being photographed directly. Written guidelines about the photography exercise were left with the patients, as well as a sheet on which they could plan their shots in advance. The researcher stayed with the patients while they selected and took their photographs. We used a simple xed-focus autoash 35mm camera, containing 24 frames allowing two shots of each space or object selected. This was supplemented with a Polaroid camera to enable production of prints that could be used in the hospital interview conducted immediately afterwards. (Further details of the procedure and the hospital interview are given in Radley and Taylor (2003).) The hospital interview was open-ended and limited to the explication of the photographs obtained. The reason for not conducting a wider-ranging interview was to maintain focus upon the act of photography and its potential. In this research we acknowledge photography as both procedure and event (an episode within the hospital experience): it was not merely a bridge to obtaining illness narratives. The interview was tape-recorded with the patients permission, each interview lasting approximately one hour. Patients were asked about the pictures in the order in which they were listed (shots were not always taken in the selected order for practical reasons). Each photograph was presented to the patient who was asked to say what the picture showed, what in particular was being photographed and to give their response to the places or objects pictured. Then all the photographs were spread out and the patient asked to choose which one was most important in capturing their experience of being in hospital and why. This selection procedure was continued until all the photographs had been discussed. Each patient was then asked to comment upon their choice 133
health: 7(2) of shots, whether they had been able to photograph things they wanted to select, to comment upon the limitations of the exercise for showing something of their time in hospital and to say something about the act of photography itself. We used a slightly different format in the follow-up interview, conducted four weeks later in the patients homes.2 After asking general questions about their recovery and memories of being in hospital, we laid out all of the photographs and asked respondents to choose the one that best captured their experience of being in hospital. They were asked to describe the picture (what is this picture about?), to explain their reason for taking it, to say what memories it brought back and to explain what feelings it gave them. This procedure was repeated for the whole set. Finally, they were asked to comment again on their photographic activity in hospital, to say what they would have taken if they had had the opportunity and to express their feelings about the photographs as presently displayed in front of them.
Analysing photographs and interviews

Before analysing some excerpts from one of the interviews it is important to say something about the relative status of the photographs as compared with the material recorded on the audiotapes. Crucial to this is the fact that choosing the objects and taking the pictures were things done by the patients themselves. The act of photography arose out of the research process but also within the experience of the patients who took up the camera. This was made evident in the way that they spoke about the activity. These comments were available to us as eldworkers prior to any analysis of the interviews. It was through hearing, at the time of photography, the comments made about the objects being pictured, and about the way of looking itself, that we realized the following. The analysis had to include what the patients did to make the pictures as well as what they said in answer to our questions. Rather than being static frames that enclosed pictures of things, the photographs continued to be interrogated and justied by the respondents from selection through to the end of the home interview. This too was part of the study procedure, in which the investigators encouraged respondents to reect upon how they had undertaken the photographic exercise, and to express their feelings about the pictures in the home situation. In this report we focus upon the home interview, though material from both interviews is relevant to talk about the hospital experience. We had also made eld notes at the time of photography, though these notes form only a subsidiary part of the present report. They formed a background to the interview made later in the home setting. These notes were useful in helping sensitize us to matters that might be raised in the course of the second interview. With regard to the selection of material for analysis, for 134
Radley & Taylor: Remembering Ones Stay in Hospital each respondent we set out their photographs and made notes while listening to the two taped interviews. This means that what was recorded on the tape was only part of the data for analysis. Because the photographs are considered a resource for remembering, we set them out when listening to the interviews and making notes from the tapes. The photographs are both material objects and representations of the spaces and artefacts that were pictured. Finally, the home interview itself was an episode in the course of the respondents recovery, so that their manner of appearance and what they said was evidence about their current state of health. In that sense, what the investigator takes from the meeting is more than a record of memories of a stay in hospital. Each interview (every interaction with another) is a challenge to the person to demonstrate her recovered health, and we saw remembering as being fashioned in the context of that challenge (Radley and Billig, 1996). For these reasons, we re-present not only the way that this respondent remembered, but also those experiences that made her remembering signicant in the interviews. This is not an essentialist position. However, we insist that no understanding of how remembering takes place can be grasped without an acknowledgement of the affective nature of that act. So, while excerpts of talk are set out below as a way of structuring the record, we do not privilege the words spoken in the interview. No negrained analysis of text is offered here. The issues with which we are concerned were made articulate by means of the interview conversation, but not by virtue of it alone. The settings for the interviews (hospital, home) and the pictorial representations of spaces and objects made possible other planes and other ways of signication. How the photographs were used as resources and how the home setting itself was pertinent to the act of remembering will be explored in the presentation to follow. In choosing to focus upon one respondent we are privileging one set of pictures and stories over those taken by the other patients. We acknowledge that the range of photographs taken was wider than those shown here, and that the respondents differed both in what they photographed and in how they commented upon it (see Radley and Taylor (2003) for a detailed report of this variation). What we seek to show in this article, by means of a single case, are the ways in which such data might be further analysed so as to place questions of recovery in a new light.
Expecting to remember
Ann (a pseudonym) was in her thirties, married and employed as a hospital nurse. She had been admitted for surgery relating to a diagnosis of cancer for which she had received treatment prior to this hospital stay. The outcome of surgery would have signicant bearing upon the progression of her disease and what this would mean for her life in future. Her experience 135
health: 7(2) of being in hospital, and her later reection upon it, was set in the context of an ongoing illness. This involved past and undoubtedly future treatment, and unknowns that inevitably would arise from these interventions. This meant that when we asked her to take photographs in the hospital we invited her to turn upon her environment, to punctuate this passage of experience by this extraordinary act of taking pictures. This happened not just in the freezing of moments in the photographs. It also occurred in the implicit undertaking that she would be able to justify, later on, those things that she had chosen to picture while in hospital. In the home interview we asked Ann to focus upon the photographs, rather than just tell us about her time in hospital. In this way we not only shaped her remembering, but also made explicit the justication of the exercise in terms of what we had talked about one month previously. These instructions directed her to the photographs as a resource, with the implicit assumption that she would draw upon them in the way that people are used to doing, using photography as a cultural medium in order to capture the past. By laying out the photographs and asking her to choose, successively, which one was most signicant in capturing her experience of being in hospital we set up a task that opened up a number of possibilities about how she might use the pictures in the course of recall. In a direct sense, these memories became material for her to present herself as a kind of patient, now recovered from her hospital stay. The act of choosing a photograph and speaking about it, handling it or passing on quickly to another are disclosures of a kind as well. They refer to and sometimes exemplify ways of dealing with experiences and material in the course of establishing a sense of time and place. In that sense, they are fragments of recovery that were being enacted in front of us, so that their delineation depended upon the interviewers response and the inclusion of this within the analysis. This response is not apparent in the talk of the interview, but requires uncovering in the course of the analysis to follow. A list of Anns photographs is set out below. The order in hospital was determined by her listing the photographs she wanted to take, something done before she took the pictures. The interview conducted on the ward was addressed to each of the photographs in that order, each picture being presented to her one at a time. At the home interview the presentation of the photographs as a set meant that we could compare what was said about each one with reference to the order in which they were picked out. The two orderings are shown below, using the titles given by Ann when she listed them: In hospital 1. Photograph of niece 2. Toy gorilla* 3. Cuddly toys 136 At home Hospital bed* Bathroom* Stairs to ward
Radley & Taylor: Remembering Ones Stay in Hospital 4. 5. 6. 7. 8. 9. 10. 11. Bunch of roses Books CD player Advent calendar Christmas tree Hospital bed Bathroom* Stairs to ward Photograph of niece Christmas tree Advent calendar Bunch of roses Toy gorilla Books Books Cuddly toys
In the hospital interview, the two starred photographs are the ones she designated as being most signicant in representing her stay on the ward. At that time the toy gorilla was identied as something that her husband had brought in, a possession that had accompanied her on previous visits to hospital. It was seen a positive thing. In the home interview, the rst two items were explicitly judged to be most signicant. At that time, the photograph of the bathroom was seen as capturing a negative experience, about which more is said below. Because of lack of space, we cannot discuss all of Anns photographs and commentaries but will restrict ourselves to those that make key points with regard to remembering and recovery.
The past in the present: having to remember what you are trying to forget
Inspection of the photographs shown here reveals their ordinariness to the casual viewer, in the sense that they depict objects and spaces that many of us would expect to nd in a hospital situation. However, this ordinariness was put in question when Ann discussed how and why certain pictures had strong memories for her. One reason for this is that they are indexical of the contexts in which they were taken. They portray certain features of the act of looking at, on to and out towards. And nally they are material objects that, at the time of the hospital interview, were produced, handled and discussed sometimes within a few feet of the objects they depicted. (One can say that, in their physical form, they were also mementoes.) Therefore, we need to avoid the assumption that the photographs are representations of objects that lay in the past, so that when Ann saw them these depictions acted as triggers for memories that somehow she carried within her. Nor do we assume that the depictions in the photographs are images in the sense of having captured something that has a parallel with some mental images she had of her time in hospital. Rather, we shall argue, the images discussed are produced in the course of talking about the photographs, so that they are part of a re-presentation of her time in hospital. We want to keep in question the concept of image, and return to this later on in our discussion of what the analysis shows. The two photographs chosen by Ann as being most representative of her time in hospital were her bed and the bathroom, the latter being off the 137
health: 7(2) private room that she occupied. Photographs (Figures 15) with interview commentaries are given below.
Figure 1 Hospital bed (No. 9).
Interviewer: Which one would you say is most important I would like you to choose one in capturing your experience of being in hospital? Ann: Retrospectively? Talking about retrospectively, are you?
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Interviewer: Yes, if we now talk about that stay in hospital. Which picture would you say best captures your experience? I would like you to choose the one you want to talk about most. Ann: (Chooses) I think the bed. Interviewer: The bed. Ann: Sort of in a negative way, its the way again going back to what I was saying before about the whole experience of being in hospital. (Pause) Interviewer: Look at that picture. What things do you want to draw attention to? What do you want to tell me thats in there in relation to what you have just said? Ann: (Pause) I think, all the equipment above the bed. Considering its a bedroom, a place for you to be able to sleep, I mean its cluttered with equipment that, actually, would more hinder your sleep than anything. Its certainly not comfortable. I mean again its a single bed. Im not used to sleeping in a single bed. Its very functional, doesnt look very comfy at all. Got the charts at the end. Which remind you that (pause) youre ill, or that somebody needs to watch over you. Interviewer: But its when you drew attention to the whole picture, you said the bed area, its not any particular thing you mean? Ann: No, no. I think that just conjures it up because thats where I spent most of the two weeks. Interviewer: So, what does it mean to you when you look at that? How do you remember the feeling there, what feelings does it bring back to you? Ann: Frustration. Frustration, particularly. And Im feeling I mean its quite frightening as well because of all the things that happened. When I rst went into that room, Id got pipes and tubes coming out of me all over the place. And so there were various restrictions lack of food and where you can walk, and when you walk you drag all these things with you. And I just look at that now and I can remember every single pipe and tube. And the experience of having them taken out, something that quite . . . (pause) . . . well, it really hurt when they came out. And that, thinking of having to go through that, how anyone can go through that as well and yet you do. And having people pop in all very very nice nurses but, bar one but people (unclear) say, Ill be back again, um, to take your dressing off, and then not turning up for another number of hours, because a nurse takes priority. Which again is ne, but it tends to go, I cant do anything now because Ive got to wait for the barium. Having to constantly be on their (unclear) now I want to go and have a bath or I have got visitors coming in, or things like that. Just having no freedom at all. Interviewer: OK. Would you like to choose the next picture, the next one that youd say brings back the hospital time, that expresses your experience? Ann: (Chooses the photograph of the bathroom.)
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health: 7(2)
Figure 2 Bathroom (No. 10).
Interviewer: Tell me about the bathroom. Or that picture. What it shows and what it brings back. Ann: Again, the rst thing that ashed into my mind is trying to shower in there. And trying to manoeuvre around all the pipes and the, um, machines, the drip stand and things that I was carrying around. And the drainage bags. Thats very vivid, just looking at that. I can just see myself trying to and the very rst time I actually showered there as well, cos [husband] was literally there having to
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hold things and help me wash my hair, and again, I like to I like to have a bath in the mornings and I like to (unclear) but that for the rst few days I had to wait till [husband] came in, because I didnt want anybody else to help me, and I mean its very spartan and functional. Its got none of my comforts in, that I normally have in the bathroom, smelly bubble bath and things like that, its got nothing of mine in there, apart from a towel and a bodywash. Interviewer: So what do you think these places are for you if they dont have these personal things? What do they feel like? Ann: Well, quite alien really. Very alien, uncomfortable places.
Later on, when elaborating upon the problems of timing her use of the bathroom in relation to the hospital routine, she spontaneously recalled an incident that she had recounted to us at length during the hospital interview.
Ann: . . . and another thing is, that unpleasant incident in the shower room. On day two or something, when the nurse told me not to lock the door in a very unfriendly manner, and that was quite unpleasant. Interviewer: And that stayed with you that memory, associated with that place? Ann: But I think the main thing is about being helpless, and that its a very sort of hos . . . I dont want to call it hostile . . .
These two photographs were the rst to be chosen in the context of the injunction implicit in the question asking her to choose a most representative picture. She declared them both as negative in respect of the feelings that she had about them. Memories arising from the rst, the bed area, are qualied with respect to what I was saying before about the whole experience of being in hospital. This was a reference to her opening comment in the interview that she did not have a clear memory of the time at all: I think what stands out most tend to be the more the impression of it all, really, the more negative memories, of being in there. This was said prior to the photographs being laid out, so that it can be taken to refer to what she understood as her spontaneous memories of the hospital stay. Once instructed to look at the pictures and to describe them, her commentary becomes quite specic with regard to the objects identied, which are referred to in the present tense. The photographs denote these objects (the equipment, the charts) which are then discussed in relation to the negative feelings that she says characterize her memory of her stay. The hostility of the setting (its clutter, its spartan nature) is used to dene its alien character that remains as an ongoing feature of the hospital, a place that was and remains unlike home. Viewing these photographs disrupts the separation of then and now, of the hospital and the home. Talking about them is both a commentary on what is there in front of her (what is shown now) and on what she recollects about them. The feelings she has about the pictures are felt there and then in the interview (And Im feeling I mean its quite frightening as 141
health: 7(2) well because of all the things that happened). However, these emotions are made present through being related within accounts of what happened in the past (When I rst went into that room, Id got pipes and tubes coming out of me all over the place. And I just look at that now and I can remember every single pipe and tube). Her reference to the act of looking at the photograph positions the feeling of fright as a now reaction to what is portrayed. We do not take literally the idea that she can remember every single pipe and tube, but see this as a claim to the way in which looking at the pictures provides material to facilitate the justication of the overall feeling about the hospital experience. Speaking about the photographs involves not only talking about what they depict, but making reference to how she is remembering. It is the effect on her in the interview that justies a photographs relevance to the past. So she says that the rst thing that ashed into my mind and thats very vivid, just looking at that. I can just see myself trying to . . .. These references to seeing oneself in that situation, as if the past were there in the present, are related to the strength of feeling that looking at the picture provokes. Note, however, that this is not simply a rhetorical device intended to persuade the interviewer of the relevance of the picture content. While it is certainly this too, in that Ann has been asked to justify her choice of photograph (this is the most signicant one because . . .), the presence of the past in the interview is exemplied in her use of the present tense to talk about her reaction to what she is looking at. It is interesting to note that these two photographs were taken to depict particular spaces. These spaces are lled with objects that allow multiple reference to treatment and care. But they are also the spaces that Ann occupied over time and in relation to which her bodily efforts and discomforts were experienced. While pictures of specic objects can trigger unwanted memories (we had several examples of this in the study) picturing of a space can also position the viewer by means of its composition of distances, angles and arrangements. This re-representation of what it felt like to be dependent or constrained makes possible an apparent coalescence of signier and signied, so that the photograph is of the situation and not merely about it. However, this coalescence is not a sufcient description of what Ann is doing in her commentary. There is a change of direction of movement in this reference, in that the depiction by discursive referent over object no longer holds dominance. Instead, what can be termed the reactivation of the affective setting describes the power of the signied to threaten to overcome the signier. It is as if the object stares back, because the pictures of the bed and of the bathroom exemplify or show forth characteristics that they possess (Goodman, 1968). This kind of signication has been described often in relation to pictures of pain or suffering, where the portrayal of these states signies not just through their being denoted, but through showing or exemplifying them as well. Photographs of technology related to pain and suffering can also have this effect, 142
Radley & Taylor: Remembering Ones Stay in Hospital as with the display of instruments of torture (Scarry, 1985). Therefore, it is not surprising that pictures of spaces in which one had to bear suffering and uncertainty about ones survival should also signify in this way. The importance of drawing out this point is that one can begin to relate the different ways in which Ann made the photographs signify, to the kinds of remembering that she makes evident. She makes clear that these two photographs are strongly negative pictures for her, and goes on to identify (in response to questions from the interviewer) which features of the picture might be focally involved. She gives two important examples in the earlier excerpts. One relates to the chart shown at the end of the bed, which reminds you that (pause) youre ill, or that somebody needs to watch over you. Earlier on, in the hospital interview, she told us that the chart was something from which she actively tried to divorce herself. She spoke at that time of sitting so that she could not see the equipment above the bed, in order to escape from the indignity of being ill. The chart, and the bed itself, were not merely physical objects caught in the photograph but were already signiers of her attempts at forgetting during her time in hospital. The chart evokes an affective setting that does more than remind her of the hospital as a physical location. It reminds her of why she was in hospital something that she was trying at the time (albeit vainly) to forget. One might go further and say that it reminds her of the act of trying to forget. In that sense, what is frightening is not merely the revivication of being in a hostile environment, but the threat of being once more engulfed by feelings that the viewing of the photographs makes possible. The photograph of the bathroom was one of the two Ann designated as most representative of her stay during the interview on the hospital ward. The bathroom picture was clearly negative, both for reasons of its power to signify her dependence and illness condition, and also because of it having been a site of a dispute with a nurse. In the rst instance, she explained in the hospital that while she was lucky to have a private bathroom,
Its very much adapted for the frail, elderly and very unwell, but its a reminder that Ive needed all these bars and things. Someone of my age shouldnt need them. Its a horrible feeling to have been in that position, needing all those trappings.
This excerpt shows that the mere sight of these things reminds her of more than a specic time and a place, of more than a spatio-temporal context. It brings back in a vivid way a state of being of making an effort to avoid, put aside or look away from things that were frightening at that time. What these two pictures denote are physical spaces in the hospital, but what they project or exemplify are affective settings (feelings) relating to being subject to the medical regime. It is not just pictures of spaces that can do this. Equally powerful, we 143
health: 7(2) presume, would be photographs that patients were not allowed to take, in this case those of people who were involved with Anns hospital stay. When in hospital she had told the interviewer the story of the nurse who scolded her for locking the bathroom door, and how this had upset her. At home the mere mention of this story, having been shared earlier with the interviewer, was used to justify again her antipathy to the picture, her feelings of dislike for the depiction of that place. At the end of the interview Ann returned to this episode as a way of explaining that people, rather than photographs of objects, were more important in triggering unwanted memories of her hospital stay. She said about that nurse, I would only have to see her and immediately I would feel that humiliation I felt at rst, and then anger. This quotation shows in the mention of the humiliation I felt at rst her need to rid herself of unwanted memories in order to distance herself actively from the hospital stay. This initial analysis of Anns comments suggests that the interview (the questions and the photographs) set up a tension around her having to remember what she was trying to forget. This tension is manifested in her acknowledgement that the photographs engaged her again in a world of anxiety and potential chaos, while at the same time they were a resource for creating a narrative distance from the hospital. The strength of feeling that she describes indicates an involuntary undoing of the temporal separations on which recovery is premised, the fabrication of a now that is distant from then. That is why the objects depicted are no more in the past than they are in the photographs. It is not a real world from the past that threatens to break in so much as her being repositioned into a state where narrative reconstruction is made difcult and the establishment of present truths (about recovery) are left fragile (Williams, 1984). What these two negative photographs raise is not just an anxiety set in the past, but something, a-temporal, embracing as it were her present and future too. It is this anxiety that retelling counters. By re-presenting features of the hospital using the photographic depictions, remembering gures Ann as the narrator who has these feelings, and potentially can distance herself from them. However, for Ann the memories of what hospital was like could never be mere memories so long as her future prognosis and her state of health were in doubt (which they were at the time of interview).3
Re-presentation, the movement of objects and temporal distance

The photographs constituting the materials of this study were, like some of the objects they represented, resituated in the homes of the patients. This does not mean that the meanings they had in the hospital were simply replaced by those that the patients gave them later on (Pink, 2000). In this section we show that talk about recovery involves, as its aim, the distancing of the hospital experience from the interview situation. The establishment 144
Radley & Taylor: Remembering Ones Stay in Hospital of this distance involves both a remaking of the past as well as a fashioning of the present, each hinging upon the practical requirement to establish oneself as a credible and worthy individual (Williams, 1993). As part of this, the movement of objects from home to hospital and vice versa played an important role. To give an example of where respondents saw this as done successfully, we discuss the photograph that Ann chose as second most important in the hospital, though only eighth in rank order at the home interview. This was a picture of a toy gorilla, something she said in hospital had been brought in by her husband. They shared jokes about this gorilla; it had accompanied her on previous stays in hospital. It helped her, she said, to retain a sense of humour and it brings back your relationship. The toy gorilla stood for a relationship with a signicant other, and established a presence in the clinical emptiness of the hospital room that could provide her with support and comfort. By the time of the home interview, the supportive work that the toy gorilla made possible was completed and seen as over.
Interviewer: Which would be the next photograph best representing your stay in hospital? Ann: That gorilla (laughs). No association with the hospital at all. Its strange because it was with me in hospital three and a half years ago, and again this time. Its now upstairs at the end of my bed. And when I am making my bed in the morning I do not think of anything to do with hospital at all. Interviewer: What job did it do in hospital, being with you? Ann: Part of bringing some of my home comforts, personal objects, just to . . . more comforting. One or two things that were yours from the home surroundings, your home environment . . . Having it in hospital, it was quite comforting, home wasnt too far away. A bit of reassurance really . . . A kind of substitute for that constant comfort and reassurance that you get when your partners there. Quite a comfort really and it reminds me of our relationship as well. Interviewer: So when you look at it (the photograph), it is not associated with hospital? Ann: No, I think I just think of him at the end of my bed. Nothing to do with hospital.
In this exchange, Ann separates out two representations of the toy gorilla depicted in the photograph. One refers to the gorilla in the hospital, sitting in the chair. The other is the (same) gorilla that sits on her bed at home. It is, one suspects, to the latter that she points, laughingly (That gorilla), when identifying the object of the photograph. It is this object, in the present, that she elaborates upon to distinguish it from the hospital surroundings and of herself from that time. She does not think of anything to do with hospital (she is not reminded) when she sees and handles the gorilla, and so its appearance in the picture is responded to in a similar way. In being nothing to do with the hospital the toy gorilla symbolizes the 145
health: 7(2) establishment of a healthier present, one that is distant from the hospital, both spatially and temporally.
Figure 3 Toy gorilla (No. 2).
It should be noted that the hospital is mentioned here almost by its absence. It is something she is not reminded of, though aspects of it are clearly depicted in the photograph. As we shall see later, this is partly a consequence of the exchange between interviewer and respondent, but it 146
Radley & Taylor: Remembering Ones Stay in Hospital highlights the fact that all that is represented is not discussed. In this case, the double representation of the toy gorilla, made possible by its physical relocation, enables the separation of time and place so that her time in hospital is backgrounded. This demonstrates that letting go of difcult memories is facilitated, or made possible even, by a process of transposition revealed through Anns inspection of her photographs. The importance of spatial transformation as a background to the viewing of the photographs needs to be emphasized. This is another way of saying that the re-viewing of the pictures took place not from some abstract viewing position but in the context of an ongoing practice in which Ann endeavoured to recover her healthy life. In the hospital setting these possessions are marked out as exceptional to the clinical environment. Looking at the picture that Ann took, it shows the toy gorilla sitting on a pillow, on a chair, with its arms outstretched. It attains a kind of presence so that she said visitors would remark upon it. In that setting it is marked out by its singularity, contrasting with the coldness of the clinical setting. It signies, in its presence, by exemplifying properties of warmth and cuddliness. (It does not merely denote these properties, but also owns and displays them.) Ann said that visitors would stroke it, or that she would touch it while she spoke to them. However, once back at the end of her bed, its singularity is compromised by the setting of which it is a part, where (we presume) it blends with the background of bedding and home comforts. The reporting of its physical passage into and out of the hospital setting facilitates a mobile narrative that takes Ann into and out of the hospital time and delivers her back home, now at the time of the interview, with the gorilla on the bed, upstairs. These reports suggest that objects are moved and reected upon in the course of people seeking to forget their time in hospital. As we shall show, people often cannot avoid remembering what happened when they were in hospital and why they were in there. The question arises, what actions do people take to fashion the course and the form of that recall? We might note the case of one respondent who chose to keep part of the hospital technology specically as a sign that his period of illness was not yet over. He was a medical patient who had spent some weeks in the hospital for tests, and had retained one of his photographed objects since his discharge. It was his plastic identity bracelet, something kept in a drawer at home. He said that it would only be destroyed when his disease was nally diagnosed and cured. In Anns case she had not kept an item of hospital equipment, but dried some roses from a bunch that had been sent by friends while she was on the ward. The picture she took of the owers also included, inadvertently, the clinical waste bin in her room. In hospital she said that she had photographed the roses because they showed peoples feelings for her. At the time she also remarked briey upon the clinical waste bin, and how it was incongruous having owers near clinical things. 147
health: 7(2)
Figure 4 Bunch of roses (No. 4).
Interviewer: What do they (the owers) bring back to you about the hospital experience? Ann: How kind everybody was really. It feels quite a nice warm feeling. This bunch here were my favourite, but also reminded me of all the other owers I got. But Ive actually dried these owers since. And even though I remember that they were brought into hospital, because I like them so much, I dont
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necessarily associate them with anything negative. A nice warm feeling. They are from friends, Ive got a lot of support. Interviewer: Anything else in that picture you want to remark upon? Ann: Well, you can also see the clinical waste bag on the litter bin, and just above there is the sharps bin, as well. Which is absolutely huge. That sharps bin is huge. The ones I have in my clinical practice are . . . that one is absolutely huge. Interviewer: Maybe they dont need to empty it so often? Ann: Well, thats the other thing. You know that that will still be in that room now, and, I bet that several people have been in that room since Ive left, and the same things have been in there which has just been topped up by sharps that have been used on other people. I just wonder why they have such a huge . . . why they cant put a smaller one. Thats very strange actually that sharps bin, because there would have already been remnants of other people in the room when I got in there, even though they had changed the bed linen and given the sink a wash round and probably swept the oor and given the shower room a wash out. But that (points) its still a reminder that there was somebody else there and their stuff was in there, and my stuff will still be in there, because I know for sure it wont be emptied. Theres no point in having such a big bin to discard it whether its full . . . Thats going to be there for many months to come.
The exchange reported in this excerpt shows how remembering is directed by the interviewer and by the respondents understanding of what the task requires. This explains the initial focus upon the owers the subject of the photograph that are centrally placed in the frame, though sandwiched between the two items for collecting clinical waste. The fact that, during the hospital interview, the interviewer had noted Anns remark about the clinical waste bin prompts him to ask whether there is more in the picture to comment upon. This gives rise to her pointing up the size of the bin used to collect used needles (sharps) and then to go on to speculate about the consequences of this for marking the presence of patients who, each in their turn, occupy the room. (She says this because she is also a nurse.) This is an interesting comment because it arises only when she has left that occupancy, to become one of the many patients who have stayed there. It is no longer her bin but in containing the remnants of her clinical waste retains something of her time in the room. This seemed to the interviewer a spontaneous reection, made possible only by her re-viewing the detail of a photograph that actually focused upon something else entirely. The words Thats very strange actually suggest a realization on her part about the implications of the size of the bin, and hence the contemplation of an aspect of herself remaining (forever) in that hospital context. From the comments she makes it would seem that this is an intriguing rather than an anxietyprovoking image. Rather than drawing her back into the hospital setting, the objectication of her clinical waste as that which is left behind (with that of all the other patients) allows a distancing of herself now from then. But this distancing comes not just from the contrasting of then and 149
health: 7(2) now. It arises from the projection of a timelessness about the bin and its contents, a qualitatively different temporal experience from that evoked by the revivication of what it was like to be there at the time, living through those particular moments. It is not a memory of an actual event or even (as far as we knew) a remembering of something thought about during Anns time in the room. What is going on here when Ann looks at these photographs? If it is an act of remembering, it is one that is also situated within the interview that is taking place. She tells about what might provoke negative memories and what no longer reminds her of the hospital. These commentaries upon how and when she remembers are indicative of an emotional separation from the context of their fabrication. This is shown in the manner of how she said them, in one case with a laugh and in the other with a quizzical comment. What is said in these cases is not just a matter of depicting a past but reects an effort to establish distance between then and now. The past that (hardly) comes into view in these comments is there because Ann is able to detach the depictions of the toy gorilla and the owers from the objects that were there in the hospital setting. By doing this she establishes for the toy gorilla and for the owers a virtual hospital existence, which in their turn signify a different time, a different place. In her commentary upon the sharps bin she describes a kind of reverse movement of objects, so that instead of bringing something home from hospital she leaves something of herself behind in the bin, the clinical waste associated with her treatment. What this photograph cannot show but by implication can refer to are her sharps that are left behind, separated now from her and her present situation. This construction of what she calls a strange (by which we can read intriguing) idea of patients clinical waste accumulating in the bin produces an impersonal world of objects removed from her act of taking the picture. The photograph shows where people have been, prior to and since her stay in the room. The narration of the photograph as depicting a place existing prior to and subsequent to her treatment makes it strange in relation to her episode of illness and thence to her situation now, some weeks after discharge. In sum, Anns interpretation of these photographs as not reminding her of hospital (or of her hospital stay) refers to a distinction between worlds, a difference reproduced by the movement of objects to and from hospital. This allows a double depiction, in which the original photographobject relationship from hospital is displaced by reference to the object in the home context. It is this that is used by her to project this sense of a separation of then from now. With that separation comes the possibility of emphasizing positive aspects of her hospital stay, something that also projected into the interview an image of her as a person making a good recovery.
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Territories of anticipation
At the end of the home interview Ann made clear that the photographs, though taken by her, were not the only (or even the most) evocative of the hospital experience. She said that other people talking to her about her time in hospital and asking about her state of health were more likely to trigger unwanted memories. It was people and their talk not things that apparently threatened her work of recovery. The storied distancing of self from hospital, the narrative form itself, though it locates the past as separate in relation to the present, also opens up the opportunity for others to spoil this in their questioning. She said that those close to her, such as relatives and friends who visited in hospital, sometimes did this inadvertently. It was when these people invited her to remember incidents that had occurred when they had visited her on the ward that such memories returned. This unwanted prompting underlines the point that remembering is a collective act, and that in such cases the propensity for others to provoke images is obviously increased. However, stories told and shared by people who were there with the person are not free narratives but embodied acts. Towards the end of the interview Ann told of meeting again one of the nurses who was to take out one of her drainage bags:
When I saw her, I could just see myself sitting back on the bed and hanging around waiting she had to go off for 10 minutes just sitting there and feeling quite apprehensive about the procedure, will it hurt, what have I got to do, etc.? And there were various people coming, as I was always quite conscious of people visiting. So that made me feel quite apprehensive and anxious. So its denitely people.
As Ann says (When I saw her), at the rst sight of this nurse these memories came back (I could just see myself), so that the effective contrast is not of people as compared with objects, but the way in which events are signied. In this respect the nurse-as-seen is part of the hospital setting though as a potential co-rememberer her potential to raise unwanted memories is extended and deepened. The threat to locating the past in the present lies both with the reappearance of parts of the physical setting (including people who were there), and with its representation through discourse or other forms of portrayal, such as photographs. We now wish to show how the use of these photographs illustrates the disassembly and mobility of the setting in relation to spoiling recovery. To do this we consider a photograph that Ann took of a framed photograph. This picture portrayed her niece, and was designated as the most important photograph at that time because, Its good to have a picture that reminds me of a good relationship. Its helpful to see a smiling face. This picture was positioned on her bedside table in her hospital room and she said that she looked at it a lot. This object along with the toy gorilla had been brought into hospital to sustain her during a difcult time. In this 151
health: 7(2) she was similar to some other patients who spoke about objects they had brought as being resources used to establish continuity throughout their hospital stay. During the home interview, Ann chose this photograph of her niece as the fourth one that best signied her time in hospital.
Figure 5 Photograph of niece (No. 1).
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Ann: And again for slightly different reasons than before. On the rst day that my brother had brought the picture in for me, that night, two different nurses came in because you know the way the rooms set out knocked the cupboard where the picture was, and knocked it off. And it was quite I didnt pay for it an expensive picture frame. And apart from anything else (my brother) had only just got these pictures done. It happened twice with two different nurses, and it ruined the frame a little bit, because there are notches on the frame. And now when I see that picture because I go to my brothers quite often every time I look at that picture now I feel quite upset because the picture frame is ruined. Well, its not ruined exactly, but they gave it to me to help me through the hospital stay. Interviewer: So when you see it? Ann: I feel really upset, because I feel responsible for what happened to it . . . I feel Ive let them down. I feel very upset and sad about that. Yes it does remind me of being in hospital but its still a nice picture and I can divorce the two, but its just looking at the frame . . . . . . it immediately puts you back and that was very early on when it was only my second day. So I was still quite ill and again there were people having to come in to you during the night. They were coming in very frequently to do certain observations . . . again a time whether . . . I couldnt see . . . you know it was very difcult at that particular time to know when I would be well and on my feet again.
This explanation of the photograph is interesting because the story of the damage to the frame (it was damaged at the time of the hospital interview) is introduced here for the rst time. It is also interesting because, with its shift from hospital back to Anns brothers house, the object depicted is different. Where, in hospital, it was the representation of the niece that signied, by the time of the home interview it was the notches on the frame that were given primary meaning. In this case the notches acquired through the actions of the nurses spoil not only the frame for her brother, the owner of the picture, but threaten to spoil her wish to remember the work that the picture did in being a support during her time in hospital. It is signicant that Ann speaks of being able to divorce the two, indicating that this framed picture exists now in two universes of meanings. This derives from the fact that the notches, being indexical of events, leave the picture suspended, as it were, between the worlds of hospital and home. This also draws on the fact that she said that she often saw the damaged picture frame at her brothers house, so that the photograph represents an object that is resituated in another setting. Her remembering is a reworking and a rejustifying of her feelings to the picture now back in her brothers care. This framed picture is interesting as it highlights that recovery as a form of signication is extensive and distributed across places and, we would add, across actions in time. Not only is the movement of objects (and people) crucially involved in this redistribution, but it also involves a remaking and revisiting of times in the course of recovery. In the case of 153
health: 7(2) the picture frame, Anns need to justify and to explain her innocence in regard to the damage is the directional line that enables her to construct (to remember) the seriousness of her condition and the (then) uncertainty of her future after surgery. The location of the past as a separate, singular episode is a desirable aim at best: it is not easily achieved, if only because it must sometimes be undone by the person in order to re-establish herself in a particular way in the present. As with the photograph of the toy gorilla, this picture signies in two ways, one concerning the picture within of her niece and one concerning the frame with its markings. However, unlike the toy gorilla picture, these two depictions are of different objects, so that she has to make explicit the work she must do to divorce the two. One reason for this narrative work is that one object the frame is signied with respect to both hospital and to her home life. It is not because the separation of past and present is incomplete that this is made a signicant occurrence. Instead, this happens because the territory that is opened up by this separation is subject to intrusions of the kind referred to above. For example, because it is open to inspection by others, they might well remark upon the frame, making remarks that could threaten to introduce actions and events from her time in hospital that Ann would probably not wish to re-examine. We suggest the use of the word territory to refer to the separation of past from present, and of present from future. It is the narrative construction of distance from the (negative) affective setting that opens up this space to being crossed by events. Because remembering is social, a retelling for others, this territory is also subject to their interpolations, to being traversed by them, with all the risks that this entails. The work that Ann does to justify her inability to prevent the damage to the picture frame shows her recognition of one such risk, her potential culpability even in the context of her being on the hospital ward. Her rationale for why the picture frame was damaged is testimony to how the past is not just displaced in recovery, but is given parallel forms in the consideration of what might, but did not happen. At any time, we might need to justify the present (e.g. the notched picture belonging to ones brother). To do this requires more than just a separation from a previous setting, as if the hospital experience was a detachable past. Instead, the territory opened up by recall needs to be reoccupied whenever called for (e.g. by others) in order that Ann can articulate what might have been, what ought to have but could not be. Such spoiled time must always be accounted for.
Discussion
While this study conrms that remembering, using photographs, is a collaborative undertaking (as is all photography for remembering), and, while we have shown the importance of affective imagery in recall, the way that Ann remembered only certain things, and in a certain way, is clearly 154
Radley & Taylor: Remembering Ones Stay in Hospital signicant. As with some (but not all) of the interviews, hers were marked by a tension between the interviewers aim of encouraging memories and that of the respondent to contain them. The latter arose from the strong negative feelings evoked by remembering being on the ward and the reasons for the patients admission to hospital. Several respondents made it clear that their recovery necessarily involved the forgetting of certain experiences, and the sealing off of the hospital time from their present life. All of the responses to the photographs can be seen as a potential disruption to this aim. While this is a particular occurrence, it is not unique to the use of photography as a research technique. There are other interventions (e.g. talk) and reections upon what has and is happening in hospital, and what is planned after discharge. Any of these interventions contribute to the hospital experience not being a sealed-off episode. It can later be made to seem so, and that, we contend, is part of the work of recovery. Inevitably, therefore, remembering ones time in hospital involves a sort of forgetting. However, some patients might wish to recall, or rather to learn anew about what happened to them, especially if, as in David Riers (2000) case, they have a professional framework in which to cast their experience. This study underlines the importance of the role of remembering in the reconstruction of ones biography following treatment for serious disease (Williams, 1984). If it is correct that one of the key avenues to an understanding of the person is through memory, then this topic is particularly important for grasping what it means to recover health in the modern world. This suggestion nds echoes in the excerpts that we have offered of Anns memories of her stay in hospital. It sets up the question of how to relate this issue of the need to forget with the kinds of remembering she showed in response to looking at the photographs. We have suggested that remembering in the cause of establishing a healthy recovery (a biographical repair) involves the establishment of present from past in a distance separating narrator from setting. Added to this, we have proposed that remembering and forgetting are facilitated by the movement of material objects and the re-representation of both objects and people. In summary terms, the idea of achieving distance from the hospital experience was seen as an important aim of Anns narrative, while still enabling her to re-enter this territory safely, to explain and to justify what occurred there. This safety relates to the danger of being overcome by the feelings that looking at certain pictures provoked. We have said that this overcoming can be understood as a reversal of denotation, in which the photograph projects the powers it possesses, threatening to ll the viewer/patient with its gaze. This conclusion reaches the margins of what we can infer on the basis of the material we have presented in this article. However, we do need to take up the question of what this conclusion implies for the affective setting that has been referred to in different terms during this analysis (Anns impression of it all). In his seminal analysis of 155
health: 7(2) the role of images during remembering, the social psychologist Frederick Bartlett proposed the following. He said that an image allows one to
take out of its setting something that happened a year ago, reinstate it with much if not all of its individuality unimpaired, combine it with something that happened yesterday, and use them both to help him to solve a problem with which he is confronted today. (1932: 219)
What, then, in this study is the image to which meaning is given? Do we mean here the perceived content of the picture? Commonly the word image is used to mean what the picture shows. The photograph as metaphor is employed in the description of (mental) images that appear during autobiographical remembering. It has been said that images act like snapshots, and that this imagery is common to all protocols of everyday remembering (Conway, 1990: 127). However, for Bartlett the image described a stage in the act of remembering, a feeling about the material characterised by doubt, hesitation, surprise, astonishment, condence, dislike, repulsion and so on (1932: 207). These terms are worth repeating in full in order to show their implications for what can be described: what can be remembered about, and what can be remembered for. The inclination to remember is affect laden not only because of the recognition of what was in the past, but also because of the need to full the demands of the present. These demands relate to what we have described as the excursions (with associated risks and opportunities) that must be made into the territory opened up to others by their narrative construction of past and present. Whatever the photographs in this study depicted, it was not images in Bartletts sense. For that reason we have not used the word image in talking about the pictures content. Rather than using a visual metaphor of memory images as pictures, what needs to be emphasized is the uncertainty and potential that lies in respondents having to reach out simultaneously to past and present. This conception of images owes more to Walter Benjamins proposals than to theories from psychology or from art history (Weigel, 1996). For Benjamin an image was not a visual or pictorial thing but that in which the has-been comes together in a ash with the Now to form a constellation (Benjamin, cited in Weigel, 1996: 50). In their propensity to congure experience, images have a fabricating, potentially communicative and ultimately political role, especially at times of social change. From this perspective, they are no longer taken to give a full and unbiased representation of events (as with a realist treatment of memory) but rather re-present a displacement of experience (Abbas, 1989). It is not just that images are historical but that, for Benjamin, history is imagistic: the past is to be grasped through images: Here we nd a double point: an historical moment can be understood in terms of the images that become legible at that moment; at the same time, images become legible only at a critical moment (Abbas, 1989: 59, emphasis in original). Surgery, with its journey into and out of unconsciousness, involving intrusions of the body that are known of but 156
Radley & Taylor: Remembering Ones Stay in Hospital will not be experienced by the anaesthetized patient, is just such a critical moment (Radley, 1996). Recovery is a time during which such images might well become legible, especially so if one can keep a trace of that experience. This crisis of experience/image is precisely the point on which the issues of recovery from surgery, remembering and photography can be brought together in a potentially useful way. To what extent, then, was Anns remembering imagistic in Benjamins sense? What is clear from her comments is that the photographs do not show, directly, the images to which Benjamin referred and to which Ann alluded in her comments. Even in the terms used by Bartlett (1932) the memory image that arises is an extensive scheme, referring to an affective relationship in a setting. It sets up a propensity to move away from or towards something. In the case of memories of the hospital stay these are frequently (but not always) negative. However, they are often elusive to explication. What the photographs depicted were scenes that occasionally triggered such affective responses, in relation to which the demands of the interview led to Anns greater or lesser articulation of her need to distance herself from the feelings provoked. At the back of this, however, is the idea of the critical moment as a time that makes certain images legible. It is possible that this also underlay other patients choices of what to photograph in the rst place, although they often said that the photographs could not capture their true experience. At best the photographs became visual cues to the setting out of which they were sampled. As a result, the constructive justication of the images that the photographs made possible became the context that gave these images their meaning. In that sense, it is a mistake to speak of Ann reading her photographs, or even placing an interpretation upon them. She made use of her photographs in different ways, but always as bridges to and from an imagined projection of recovery from illness. Finally, it is important to avoid the conclusion that the aim of recovery is forgetting, pure and simple. This is not the case. Regarding some of her hospital experiences, Ann was willing to tell about moments of anxiety and fear. The aim of remembering (in this case at least) was the re-presentation of displaced experience that Ann wanted to speak about, so that we might understand. This re-presentation was not driven merely by a neutralizing of a traumatic experience, but should be understood as a communicative act, wherein one shows to another person what one went through, how it mattered and why (Frank, 1995). This last point conrms that remembering in this context is part of a wider project of recovery in which the patient involves others to a greater or lesser degree.
Notes
1. Lack of space forbids any detailed discussion of photography as social practice in this article. Useful sources include those by Sontag (1979), Berger and Mohr (1982) and Wells (2000).
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2. The decision to interview patients four weeks after discharge was based upon the belief that this would present an optimum time for them to feel removed from the hospital experience and yet able to make rich responses to their photographs. We do not claim that this period represents the best (or only) time from which to study the process of recovery in detail. 3. Ann died, from cancer, 18 months later.
References
Abbas, A. (1989). On fascination: Walter Benjamins images. New German Critique, 48, 4362. Backman, C.G. and Walther, S.M. (2001). Use of a personal diary written on the ICU during critical illness. Intensive Care Medicine, 27, 4269. Bartlett, F.C. (1932). Remembering: A study in experimental and social psychology. Cambridge: Cambridge University Press. Bell, S. (2002). Photo images: Jo Spences narratives of living with illness. health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine, 6, 530. Beloff, H. (1985). Camera culture. Oxford: Blackwell. Berger, J. and Mohr, J. (1982). Another way of telling. New York: Pantheon. Bury, M. (1982). Chronic illness as biographical disruption. Sociology of Health and Illness, 4, 16782. Collier, J. (1967). Visual anthropology: Photography as a research method. New York: Holt, Rinehart & Winston. Collier, M. (2001). Approaches to analysis in visual anthropology. In T. van Leeuwen and C. Jewitt (Eds.), Handbook of visual analysis, pp. 3559. London: Sage. Conway, M.A. (1990). Autobiographical memory: An introduction. Milton Keynes: Open University Press. Cronin, O. (1998). Psychology and photographic theory. In J. Prosser (Ed.), Imagebased research: A sourcebook for qualitative researchers, pp. 6983. London: Falmer Press. Cronin, O. and Gale, A. (1996). Photographs and the therapeutic process. Clinical Psychology Forum, 89, 248. Dykstra, J. (1995). Putting herself in the picture: Autobiographical images of illness and the body. Afterimage, 23, 1620. Edwards, D. and Middleton, D. (1988). Conversational remembering and family relationships: How children learn to remember. Journal of Social and Personal Relationships, 5, 325. Edwards, E. (1997). Beyond the boundary: A consideration of the expressive in photography and anthropology. In M. Banks and H. Morphy (Eds.), Rethinking visual anthropology, pp. 5380. New Haven, CT: Yale University Press. Frank. A.W. (1991). At the will of the body: Reections on illness. Boston, MA: Houghton Mifin. Frank, A.W. (1995). The wounded storyteller: Body, illness and ethics. Chicago, IL: University of Chicago Press. Garro, L. (2000). Remembering what one knows and the construction of the past: A comparison of cultural consensus theory and cultural schema theory. Ethos, 28, 275319.
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Goodman, N. (1968). Languages of art: An approach to a theory of symbols. Indianapolis: Bobbs-Merrill. Harper, D. (1998). On the authority of the image: Visual methods at the crossroads. In Y.K. Denzin and Y.S. Lincoln (Eds.), Collecting and interpreting qualitative materials, pp. 13049. London: Sage. Lury, C. (1998). Prosthetic culture: Photography, memory and identity. London: Routledge. Middleton, D. and Edwards, D. (1990). Conversational remembering: A social psychological approach. In D. Middleton and D. Edwards (Eds.), Collective remembering, pp. 2345. London: Sage. Pink, S. (2000). Doing visual ethnography. London: Sage. Radley, A. (1996). The critical moment: Time, information and medical expertise in the experience of patients receiving coronary bypass surgery. In S.J. Williams and M. Calnan (Eds.), Modern medicine: Lay perspectives and experiences, pp. 11838. London: UCL Press. Radley, A. and Billig, M. (1996). Accounts of health and illness: Dilemmas and representations. Sociology of Health and Illness, 18, 22040. Radley, A. and Taylor, D. (2003). Images of recovery: A photo-elicitation study on the hospital ward. Qualitative Health Research, 13, 7799. Rier, D.A. (2000). The missing voice of the critically ill: A medical sociologists rst-person account. Sociology of Health and Illness, 22, 6893. Scarry, E. (1985). The body in pain: The making and unmaking of the world. New York: Oxford University Press. Sontag, S. (1979). On photography. Harmondsworth: Penguin. Spence, J. (1995). Cultural sniping: The art of transgression. London: Routledge Streek, J. (1996). How to do things with things. Human Studies, 19, 36584. Weigel, S. (1996). Body- and image- space: Re-reading Walter Benjamin. London: Routledge. Wells, L., Ed. (2000). Photography: A critical introduction, 2nd edn. London: Routledge. Williams, G.H. (1984). The genesis of chronic illness: Narrative reconstruction. Sociology of Health and Illness, 6, 174200. Williams, G.H. (1993). Chronic illness and the pursuit of virtue in everyday life. In A. Radley (Ed.), Worlds of illness: Biographical and cultural perspectives on health and disease, pp. 92108. London: Routledge.
Author biographies
ALAN RADLEY is Professor of Social Psychology in the Department of Social Sciences at Loughborough University, UK. He is the Editor of health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine. His research interests include the relationship of the healthy to the sick, questions of embodiment and the visual representation of illness. DIANE TAYLOR is Senior Lecturer in Media and Cultural Production at De Montfort University, UK. Her expertise is in photographic studies with a special focus upon representations of the sick, disabled, the aged and children. She is currently completing a PhD on the work of Keith Murray, modernist designer.
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Remembering One's Stay in Hospital: A Study in Photography, Recovery and Forgetting

>> Version of Record - Apr 1, 2003 What is This?

Remembering ones stay in hospital: a study in photography, recovery and forgetting

Loughborough University, UK & De Montfort University, UK

hospital; narrative; photography; recovery; remembering;

Radley & Taylor: Remembering Ones Stay in Hospital

Remembering, images and the use of photography

The study described

Analysing photographs and interviews

Figure 1 Hospital bed (No. 9).

Radley & Taylor: Remembering Ones Stay in Hospital

Figure 2 Bathroom (No. 10).

Radley & Taylor: Remembering Ones Stay in Hospital

Re-presentation, the movement of objects and temporal distance

Figure 3 Toy gorilla (No. 2).

Figure 4 Bunch of roses (No. 4).

Radley & Taylor: Remembering Ones Stay in Hospital

Radley & Taylor: Remembering Ones Stay in Hospital

Figure 5 Photograph of niece (No. 1).

Radley & Taylor: Remembering Ones Stay in Hospital

Radley & Taylor: Remembering Ones Stay in Hospital

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