Depicting Canada’s Children

Pictures of Health: Sick Kids Exposed

T wo types of photographs haunt the history of North American children ’s hospitals. The first, a therapeutic type, depicts the hospital as a place where heroic physicians use technology to heal children, exposing young patients as frail and helpless beneficiaries of healthcare expertise. Passive children displayed unconscious during surgery are particularly good examples of this genre. In these images young doctors and nurses typically loom over still and vulnerable bodies on tables or beds, surrounded by gleaming medical equipment. The second type, images of playfulness, promotes the institution as a place of socializing and fun. These more positive images of hospital life portray sick children actively defying the seriousness of their circumstances, despite the fear and anxiety associated with illness, through friendship and recreation. This type underlines the role of distraction as a coping mechanism in dealing with illness and treatment. Examples include photographs of young tuberculosis patients laughing outside in bed (even during the winter), or gown-clad children playing games together in hospital playrooms and wards.William Notman’s 1893 photograph of the children’s ward in Montreal’s Royal Victoria Hospital —where sick girls play“tea party”as if they are in a grand home or hotel—is an outstanding model of this type (fig. 12.1). Such images present the hospital as a welcoming place for children, and also as an everyday, ordinary institution—like a school—with little indication of the medical technology, illness, or sense of mortality that characterize the therapeutic pictures. This interdisciplinary paper surveys the history of these two parallel trends in depicting sick children, with examples drawn from Montreal and Toronto institutions .1 There are abundant photographs indicative of these two types taken in general hospitals, such as the Royal Victoria tea party, but the archives of paediatric institutions are especially rich, including the Children’s Memorial Hospital (later known as the PICTURES OF HEALTH Sick Kids Exposed ANNMARIE ADAMS DAVID THEODORE PATRICIA MCKEEVER 259 Montreal Children’s Hospital) in Montreal and Toronto’s SickKids (formerly Victoria Hospital and Hospital for Sick Children).2 The significance and uses of photography, however, are changing. The final section of the paper reverses the roles of hospital photographer and patient, positioning children as image-makers in Canada’s largest paediatric facility. Our study of the 1993 Atrium addition at SickKids compares the architects’intentions for the namesake atrium that constitutes the hospital’s lobby, designed by Zeidler Partnership Architects, with the actual ways children think about and use this public space. In 2005–2006 we asked child patients and clinic visitors at SickKids to photograph the monumental atrium. In what follows, we juxtapose themes derived from these six hundred photographs, taken by eighty patients, with those representing the earlier history of children’s healthcare institutions , especially those from the pre–World War II period. Whereas institutional photographs expose sick kids in a healthcare environment, our patient photographs leave SickKids exposed. Understanding the significance of how childhood is depicted in SickKids’ Atrium addition, we claim, means attending to the architect’s representation of childhood, but 260 annmarie adams / david theodore / patricia mckeever FIGURE 12.1 Tea party in a ward at Montreal’s Royal Victoria Hospital, 1894. (Photo by William Notman. McCord Museum, II-105910.2) more importantly, coming to terms with children as agents of architectural knowledge .3 Our argument is that the ambiguous form of the atrium—associated since the 1970s with shopping and consumption—provides an associative arena for sick children . The atrium design, we believe, plays into the same impulses as Notman’s famous photo, prompting observers to imagine sick children transported across time and place, and blurring boundaries of social class that are nearly impossible to transgress outside the institution. In this way, the contemporary hospital construes children not as photographic representations, but as active figures in a remarkably unbounded visual and material landscape. Still, it is important to emphasize that the photographs from these two historical periods had contrasting purposes and content, and were taken by very different kinds of photographers. Taken together and examined side by side, the two types of photographs—and photographers—encourage us to understand the complex cultural positioning and social meaning of childhood embodied in healthcare settings. Type 1: Therapeutic Images / Heroic Healers Children’s hospitals routinely produce images of sick children that document medical techniques, healthcare environments, and hospital life. The charitable and economic missions of these institutions motivate this...