Who holds the authority?  

Not all patient voices are equally represented across historic records. While some middle- and upper-class patients left personal accounts, the experiences of poorer and more marginalised people are harder to find. Tracing their experiences often requires a closer look at institutional records. 

One example comes from the eighteenth-century London Lock Hospital Asylum. The Asylum was established to treat and “‘reform” women with sexually transmitted infections, such as syphilis. The institution recorded biographies of its patients, written by doctors and administrators rather than the women themselves. The Asylum enforced strict behavioural rules. Yet the records also show resistance, as many women chose to run away rather than submit to the Asylum’s regime. 

A century later, another set of patient voices emerged from the letters of Indian soldiers treated in military hospitals in Brighton during the First World War. While these letters were written, or dictated, by the patients themselves, their correspondence was heavily censored. Glowing testimonies, such as being “‘tended like flowers” ’ passed unchecked, whereas critical comments about maltreatment were redacted. 

Together, these cases demonstrate how surviving evidence was filtered and shaped by the institutions that recorded and controlled it.  They raise important questions about who was able to speak and whose experiences were preserved.